Background. Brain tumor-related epilepsy (BTRE) is an important and insufficiently studied interdisciplinary problem. In a significant part of brain tumor patients, the disease onsets with epileptic seizures. The course of tumor-associated epilepsy is often pharmacoresistant and requires rational polytherapy. To date, there are no uniform recommendations on the choice of an antiepileptic drug (AED) for the initial therapy of BTRE.

Objective: retrospective analysis of the efficacy/tolerability of adjunctive therapy with perampanel in relation to epileptic seizures in patients with epilepsy associated with glial brain tumors and metastases.

Material and methods. The analysis included 51 patients with glial tumors and brain metastases who were prescribed perampanel as part of adjunctive therapy. Its effectiveness against focal seizures (FS) and bilateral tonic-clonic seizures (BTCS) was evaluated at follow-up periods of >1≥3≥6 months. A decrease in the frequency of seizures by 50% or more (responders) or by 100% (seizure freedom) was analyzed. An analysis of the influence of intervening factors in a multifactorial model, an assessment of the effectiveness of perampanel as a whole and a stratified assessment of intervening factors were carried out. The frequency and profile of adverse events (AEs) were also evaluated, including their possible association with the use of other AED.

Results. In the multifactorial model, independent predictors of the clinical effect were the onset of the disease in the form of FS at >1≥3≥6 months follow-up. None of AEDs used in the first line of therapy demonstrated an impact on the clinical effect. There were no predictors of clinical effect in patients with BTCS during the entire follow-up period. Out of 51 patients, 48 (94.1%) were responders, and in 36 of them (70.6%) the seizure freedom was registered. Among patients with FS, the proportion of responders was 83.3–90.9% at different follow-up periods, including 31.2–50.0% who showed seizure freedom. Among patients with BTCS, 86.7–92.3% became responders, including 56.1–88.5% who achieved seizure freedom. AEs were noted in 7 (13.7%) patients, the most common was aggression – 4 patients (7.8%). There were no cases required reduction the dose or discontinuation the treatment with perampanel due to AEs. In most patients at >1≥3≥6 months follow-up, the median was 6 mg/day.

Conclusion. The study performed in real-world practice confirmed the high efficiency and safety of perampanel in the adjunctive therapy of epileptic seizures associated with glial brain tumors and metastases, which together with the low potential of drug interactions allow us recommend the drug to this contingent of patients.

Background. Epilepsy is a frequent neurological condition with complicated effects, and it is characterized by seizures that can last quite a long time. It is important that people around treat epilepsy patients with understanding and be able to help them during seizures.

Objective: to determine the perceptions of teachers regarding epilepsy education being included in life skills education considering that teachers spend a great deal of time with school students.

Material and methods. The study employed an exploratory-descriptive design to explore primary school teachers' perceptions regarding the need to include epilepsy in life skills education. It was conducted in Limpopo and Mpumalanga provinces in South Africa. Data were collected from 20 primary school teachers in Limpopo and Mpumalanga using semi-structured interviews. Only primary school teachers who teach life skills were interviewed to reach data saturation.

Results. The respondents revealed their knowledge that epilepsy is a disease associated with falling, shivering movements/ seizures, releasing saliva in a bubble foam, and being unconscious. However, they showed insufficient understanding regarding some aspects and expressed the opinion that there is a need of including epilepsy in life skills education, because it will assist the learners and teachers in knowing more about epilepsy. The participants consider that since epileptic seizure is an unpredictable condition that can happen to anyone, at any time, they feel it is important that learners and teachers are educated about it. For this purpose, they suggested various teaching methods and the necessary areas of knowledge about epilepsy.

Conclusion. The findings of the study revealed that the inclusion of epilepsy in life skills education will enhance the knowledge and understanding of epilepsy through learning the aspects that have been suggested by the participants.

A clinical case of a patient with pharmacoresistant epilepsy due to focal cortical dysplasia (PCD) directly adjacent to the speech zone in the left temporal region is presented. The diagnostic search and transition from MRI-negative form to structural focal epilepsy progressed for more than 6 years. It was accounted for by the fact that type IIa vs. IIb FCD is visualized much worse, magnetic resonance imaging (MRI) signs of type IIa FCD are not so prominent, so that this type of dysplasia is often omitted. Functional research methods in epileptology, such as video-electroencephalography monitoring, brain positron emission tomography with ¹⁸F-fluorodeoxyglucose, functional MRI of speech zones, allow to more accurately verify the form of epilepsy and determine a scope of surgical treatment. Surgical intervention in carefully selected patients may contribute to favorable outcome of epilepsy (Engel 1, 51-months follow-up), which will lead to improved quality of life.

Cognitive impairment (CI) is a common comorbid pathology in epilepsy patients that exerts profound negative impact on quality of life. The CI causes may be due to various factors related to etiology, clinical manifestations, and treatment of epilepsy. A typical disorder in temporal lobe epilepsy is memory impairment. However, neuropsychological impairments may be more extensive and involve other neuropsychological domains. The risk of CI in patients with temporal lobe epilepsy may increase in structural brain disorders such as hippocampal sclerosis as well as in frequent seizures, early onset and long course of the disease. Surgical treatment of epilepsy may positively or negatively impact the cognitive function. In recent years, due to development of neurosciences as well as advances in the field of medical technologies, particularly neuroimaging, genetics, immunology, and biochemistry, new data emerged regarding potential mechanisms for developing CI in patients with epilepsy. The aim of the review is to assess available ideas about neurophysiological mechanisms of CI development, cues influencing emergence of neuropsychological disorders in patients with temporal lobe epilepsy.

The article is aimed at familiarizing medical specialists involved in registration and analysis of electroencephalographic (EEG) examinations with the basic principles of operation and the design of a modern EEG recorder. Understanding the technical fundamentals behind operation of EEG equipment should help medical personnel to correctly use all its capabilities and ultimately improve quality of medical care. The basic diagram of the electroencephalograph operation, the types and features of EEG electrodes, the opportunities and limitations of digitally processed bioelectric signals are discussed. A review on the main technical characteristics of EEG equipment and their influence on the quality of the recorded signal is presented.

On November 15, 2022, a meeting of the Council of Experts from the working group of neurologists-epileptologists from the Volga Region and epilepsy experts from Moscow was held, dedicated to assessing effectiveness of antiepileptic therapy in the Volga Region, taking into account age, clinical, hormonal, social characteristics, as well as reproductive plans of female patients. Priority provisions have been developed aimed at selecting starting therapy in different age groups, as well as determining management tactics and a need for correction of antiepileptic therapy in women with childbearing potential. The article presents the Resolution of the experts meeting, adopted after discussion.