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Epilepsia and paroxysmal conditions

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Vol 6, No 3 (2014)

DISTINCTIVE ARTICLES

6-12 6357
Abstract
Abstract: the inflammation in epilepsy pathogenesis is the subjects of scientific discussion. Extensive evidence in favor of the inflammatory theory of epileptogenesis is obtained, according to which epilepsy is a consequence of specialty inflammation in the CNS connected with both the induction of convulsions and their progression. Special attention is paid to cytokines containing in plasma mostly because they are natural pro-convulsants, the markers of inflammation, increased level of which result in higher risk of seizures. Inflammatory factors and mediators such as IL-1 p и TNF can influence on neuron transmission of mediators and promote development of hyper synchronous in neurons and hyper excitation of the brain. The specific role of cytokines IL-1 p in epilepsy is discerning due to it expression in CNS in astrocytes and microglia as a factor of chronic inflammation in CNS. The aim of our study is to evaluate the dynamics of immunological parameters in patients with epilepsy (PE) during the treatment with rIL-2-medicament (Roncoleukinum®), cytokine drug of Interleukins series containing recombinant human Interleukin-2 (rIL-2), which is a structural and functional analog of the endogenous IL-2. The results of the research of specialties of system inflammation response in epileptic patients reveal the increased level of the inflammation markers in plasma and CNS (increased concentration and violation of balance of cytokines of IL-1 p family defined by decrease of RAIL-1 concentration and RAIL-1/IL-1 coefficient). We obtained the data on decrease of content of pro-inflammatory cytokine IL-8 and increase content of BDNF in PE as a result of rIL-2-medicament treatment. Changes of these immunological parameters correlated with clinical improvement of PE: reduction of seizure frequency and positive EEG changes. These results might be used to optimize treatment of PE due to modulation of inflammatory process and increase of neurotrophic factors production required for the processes of brain neuroplasticity and neurogenesis.
13-19 108
Abstract
Abstract: The article content results of estimation of Blink Reflex and evoked brain potentials (cognitive and visual) parameters changes on epilepsy patients, which treated by anticonvulsants and repetitive transcranial magnetic stimulation course (rTMS). Data of Blink Reflex parameters on dependence from epileptic process activity were given. Received data define some aspects of epilepsy pathogenesis and widen conception about long-lasting processes of brain reaction after short rTMS course.
20-29 177
Abstract
Abstract: gelastic seizures are focal epileptic seizures that involve sudden outbursts of forced laughter. In our study Gelastic seizures were revealed in 25 patients that comprised 1,98% of all epilepsy events with onset under 18 years of age (n=1261). Male patients prevailed in the group: 16 male patients (64.0%) against 9 female patients (36.0%). Symptomatic focal epilepsy was identified most frequently - in 80% of patients. Cryptogenic focal epilepsy (probably symptomatic focal epilepsy) was defined in 20% of cases. Epilepsy onset varied in a broad age interval: from the first day after birth till 16 years, 4.53+4.52 years on average. Most often (82%) onset was observed in the first years of life - from the first days of life till 6 years old. Clinical findings may disclose 12 different types of seizures. Most frequently were observed: focal motor seizures with typical automatisms - 64% of cases, secondarily generalized tonic-clonic seizures - 48% of cases and tonic seizures - in 32% of all cases. MRI changes: hypothalamic hamartoma - 32% of cases, temporal lobe atrophy - 12% of cases, DNET - 8% of cases, focal cortical dysplasia (insular-opercular region) - 4%, local bifrontal atrophy - 8%, Tuberous Sclerosis - 8% of cases, diffuse cerebral atrophy presented in the form of ventriculomegalia was diagnosed in 2 patients - 8% of cases. Remission was achieved only in 24% of cases. Whereas, in 12% of cases seizures were blocked only after surgical intervention. Reduction of seizures frequency >50% was observed in 20% of patients. In 56% of cases AED therapy produced no significant effect.

CLINICAL CASES

30-37 115
Abstract
Abstract: the data about seizures as the clinical manifestation of acute stroke in childhood is generalized. Authors propose the following diagnostic criteria to determine seizures as the symptom of stroke vs epilepsy debut: stable neurological signs (more than 24 hours) during the postictal period; neuroimaging data, confirming the focus of stroke; congenital heart malformations or diseases; procoagulant or hemorrhagic predisposition confirmed due to laboratory data in children or in family history; hyperhomocysteinemia; thrombophilic genes polymorphisms (more than 3) in children or in family. Clinical case of 6 y.o. boy demonstrates the time lag before seizures debut and stroke verification as the reason for those seizures.

SCIENTIFIC SURVEYS

38-44 166
Abstract
Abstract: the article provides a revised definition of epilepsy, according to the recommendations of the International League Against Epilepsy. Epilepsy can be installed after one unprovoked seizure in people who have other factors associated with a high risk of permanent lowering of the threshold of convulsive readiness. Persons with reflex seizures also attributed to epilepsy. It is resolved that epilepsy is no longer for those who had no seizures for at least 10 years without antiepileptic therapy, provided that there are no known risk factors associated with a high risk of recurrence of seizures.

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