Epilepsy and paroxysmal conditions

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Vol 15, No 1 (2023)
5-9 641

The Founder and Publisher became aware of a potential apparent conflict of interest – it is assumed that it is not entirely correct to continue to be the Editor-in-Chief at the “Epilepsy and Paroxysmal Conditions” Journal, being a member of the founders of an organization that has registered another journal with similar name. Therefore, the Founder of the “Epilepsy and Paroxysmal Conditions” Journal was forced to refuse further cooperation with the Editor-in-Chief. Information about a new Editor-in-Chief will be brought in a separate order. Also, informational support of any public organizations by the journal is suspended until the situation is clarified. The entire cycle of editorial processes is now fully controlled by the Irbis LLC. No changes in the operating team occurred. The “Epilepsy and Paroxysmal Conditions” Journal continues to be published as usual.


10-17 295

Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy.

Objective: to study clinical and mental changes during NCI in patients with epilepsy.

Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) – 25 patients undergone COVID-19 in the period from 2020 to 2022; Group 2 (control) – 25 patients not undergone COVID-19 during the same period. Clinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20).

Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group.

Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).

18-25 285

Background. An impact of burdened family history on epilepsy course and disease outcome remains insufficiently studied.

Objective: assessing the rate of achieving remission in epileptic patients with/without burdened family history.

Material and methods. The study included 660 patients with a specified family history of epilepsy divided into three groups: Group 1 (n=192) – patients with genetic forms of epilepsy (56 with and 136 without family history); Group 2 (n=148) – patients with structural forms of epilepsy (16 with and 132 without family history); Group 3 (n=320) – patients with epilepsy of unknown etiology and unspecified epilepsy (48 with and 272 without family history). In Group 1, there were significantly more patients with burdened family history (29.2%) than in Group 2 (10.8%) (p<0.01) and Group 3 (15%) (p<0.01). ><0.01). Anamnesis collection, clinical and neurological examination, routine electroencephalography (EEG) and/or video-EEG monitoring, brain magnetic resonance imaging and analysis of medical records were carried out. Therapy was adjusted.

Results. In all groups, patients with burdened family history tended to have earlier onset of epilepsy. The frequency of seizures at the onset of the disease did not depend on identified burdened family history of epilepsy. In Group 1, the effectiveness of treatment (rate of achieving remission) in both subgroups was almost identical (p>0.05), whereas in Groups 2 and 3 it tended towards a greater effectiveness of therapy in patients without family history.

Conclusion. Epilepsy familial burden depends on the form of the disease and has limited prognostic value regarding disease course and likelihood of achieving remission. It is necessary to increase availability of genetic studies and identify genetic substrate of various epileptic syndromes.


26-35 576

Background. Opsoclonus-myoclonus-ataxia syndrome (OMAS) in adults is an extremely rare condition, often leading to rapidly deteriorated neurological performance. The majority of published cases are considered as being of post-infectious, paraneoplastic or idiopathic origin. However, there have been reported few OMAS cases developed after administration of check-point inhibitors used in various oncological conditions. In the last decade, the widespread use of immunotherapy in oncology has led to rise in immune-related adverse events, including diverse neurological toxicities.

Objective: to evaluate an opportunity of OMAS-triggering PD-1 treatment.

Material and methods. We present the case report of a subacute OMAS onset in an elderly man after continuous administration of pembrolizumab as a first line treatment in bronchial squamous cell carcinoma. The study was conducted in accordance with the Helsinki Declaration. We also review the main OMAS clinical features, pathogenesis and immunological mechanisms in adults along with potential diagnostic and management strategies.

Results. The development of severe OMAS clinical picture during immunotherapy required the withdrawal of targeted treatment, which in combination with glucocorticoids led to a prominent regression of neurological deficit. After a thorough clinical investigation, infectious and organic factors were excluded, allowing for proposal of immunotherapy-triggered OMAS etiology in the patient.

Conclusion. Discontinuation of immunotherapy may be a justified means for OMAS clinical features in adult patients with verified oncological condition undergoing treatment with check-point inhibitors (considering all other etiologies are ruled out).

36-43 249

Background. After-discharge (AD) activity is a pattern that differs from background corticography, represented by rhythmic stereotypical slow waves and/or repetitive spike discharges with ≥1 Hz frequency, recorded after cessation of electrical stimulation and lasting for more than 2 seconds. Despite the accumulated experience in the field of intraoperative neuromonitoring, there is no unified protocol for high-frequency stimulation of cortical functional areas (FAs) upon the AD event.

Objective: to demonstrate a need to change the intraoperative FAs mapping protocol in patients with brain tumor on awakening in cases of AD recording.

Material and methods. Two clinical cases of awake surgical functional mapping followed by resection of the brain tumor are presented. Multimodal monitoring included high-frequency stimulation according to the approved intrahospital protocol with maximum stimulation force of auditory-speech zones of 2.5 mA, electrocorticography, and subcortical dynamic mapping.

Results. In the first case, AD was registered while FAs mapping in a patient with a history of one epileptic seizure, upon reaching the maximum stimulation force of 2.5 mA, that was replaced by recording focal epileptiform activity with the following evolution to ictal generalized event and development of intraoperative convulsive seizure. In the second patient with a history of recurrent epileptic seizures, AD with spatiotemporal evolution of the pattern development of clinical ictal event was registered with stimulation at 2.5 mA. In both cases, the appearance of AD required to change mapping protocol with a stepwise decrease in stimulus strength to obtain cortical FAs data.

Conclusion. Registration of AD is the basis for changing the protocol of high-frequency cortical stimulation in surgical treatment of brain tumor FAs.


44-52 266

The contribution of genetic factors to development of neurological diseases has long been recognized, and the majority of the advances coupled to using molecular genetic technologies resulted in identifying genes associated with the pathology of developing nervous system. The review is aimed at demonstrating opportunities and achievements of using massive parallel sequencing technology in the diagnosis of a disease with damage to nervous system. Currently, next-generation sequencing (NGS) technology in the genetic diagnosis of epilepsy relies on targeted gene panels, whole exome sequencing or whole genome sequencing. Integrating genetic and genomic analysis into clinical practice to establish clear molecular diagnoses for previously undiagnosed patients will avoid further unnecessary diagnosis and therefore lead to greater healthcare cost savings over time. The use of biomarkers will contribute to the prediction of disease outcome and therapy decision-making.


53-69 467

This article is aimed at familiarizing medical specialists involved in the registration and analysis of electroencephalographic (EEG) examinations with the basic principles of work and the capabilities of current computer software for EEG recording and analyzing. Understanding the basics of how the software works should help medical staff use all its functionality correctly and ultimately improve the quality of medical care. The basic and innovative capabilities of computer software in the field of mathematical processing and analysis of EEG signals are discussed, the limitations of using mathematical processing methods are described.


70-84 3418

For a long time, people suffering from epilepsy have been feared, suspected, and misunderstood, socially stigmatized and viewed as outcasts. On the other hand, epilepsy was attributed to many remarkable personalities, among whom are Julius Caesar, Alexander the Great, Socrates, Aristotle, Joan of Arc, Leonardo da Vinci, Michelangelo, Ivan the Terrible, Newton, Peter the Great, Napoleon, Walter Scott, Paganini, Byron, Van Gogh, Dostoevsky, Leo Tolstoy, and many others. The article is aimed to confirm on historical facts or debunk the myths about the essence of epilepsy in some of these individuals.

ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)