Pub Date : 2022-04-17DOI: 10.17749/2077-8333/epi.par.con.2022.065
A. Shershever, S. A. Lavrova, D. Bentsion, V. V. Makhnev, A. Kulakova, M. A. Zafirova, E. V. Sorokova
Objective: to study the effect of perampanel on the dynamics of epileptic seizures and anxiety in patients with brain metastases and epileptic seizures during chemotherapy (CT), radiotherapy (RT), and radiochemotherapy (RCT).Material and methods. The prospective clinical study included 48 patients with lung cancer and 39 women with breast cancer who underwent removal of primary focus. After CT, RT or RCT epileptic seizures were registered. Brain metastases were revealed at brain magnetic resonance imaging data. All patients underwent general and neurological examination as well as electroencephalography. The level of anxiety was assessed by the Beck Anxiety Inventory. Рatients were prescribed perampanel by the concilium decision.Results. It was shown that administered perampanel was effective in any primary tumor location. The quantity of repeated epileptic seizures in all patients with lung and breast metastatic cancer was significantly decreased on Day 6–7 after adding perampanel to either earlier received antiepileptic drugs or as a monotherapy (p=0.0431). In the follow-up period with the median survival rate of 8–13 months, the frequency of epileptic seizures was decreased and then remained stable. Perampanel as mono- or multitherapy positively influenced on controlling anxiety disorders in 25–75% patients with brain metastases.The level of anxiety was decreased due to lowered epileptic activity.Conclusion. Based on the study results, we could recommend administration of perampanel for the treatment of metastatic brain cancers in patients with diverse primary tumors as well as both partial and generalized epileptic seizures while applying CT, RT, RCT or palliative care.
{"title":"Antiepileptic drugs in treating structural epilepsy of patients with metastatic brain cancer: a combination approach","authors":"A. Shershever, S. A. Lavrova, D. Bentsion, V. V. Makhnev, A. Kulakova, M. A. Zafirova, E. V. Sorokova","doi":"10.17749/2077-8333/epi.par.con.2022.065","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2022.065","url":null,"abstract":"Objective: to study the effect of perampanel on the dynamics of epileptic seizures and anxiety in patients with brain metastases and epileptic seizures during chemotherapy (CT), radiotherapy (RT), and radiochemotherapy (RCT).Material and methods. The prospective clinical study included 48 patients with lung cancer and 39 women with breast cancer who underwent removal of primary focus. After CT, RT or RCT epileptic seizures were registered. Brain metastases were revealed at brain magnetic resonance imaging data. All patients underwent general and neurological examination as well as electroencephalography. The level of anxiety was assessed by the Beck Anxiety Inventory. Рatients were prescribed perampanel by the concilium decision.Results. It was shown that administered perampanel was effective in any primary tumor location. The quantity of repeated epileptic seizures in all patients with lung and breast metastatic cancer was significantly decreased on Day 6–7 after adding perampanel to either earlier received antiepileptic drugs or as a monotherapy (p=0.0431). In the follow-up period with the median survival rate of 8–13 months, the frequency of epileptic seizures was decreased and then remained stable. Perampanel as mono- or multitherapy positively influenced on controlling anxiety disorders in 25–75% patients with brain metastases.The level of anxiety was decreased due to lowered epileptic activity.Conclusion. Based on the study results, we could recommend administration of perampanel for the treatment of metastatic brain cancers in patients with diverse primary tumors as well as both partial and generalized epileptic seizures while applying CT, RT, RCT or palliative care.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91021353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-17DOI: 10.17749/2077-8333/epi.par.con.2022.111
Z. G. Tadtaeva, A. Galustyan, М. Y. Krivdina, V. Rusanovsky, E. Efet, A. Е. Krivoshein, N. A. Kuritsyna, О. Gromova
Myoclonic epilepsy with ragged red fibers (MERRF) is a maternally inherited disease characterized by myoclonic epilepsy, cerebellar ataxia and progressive muscle weakness. Development of the disease is associated with the most common (90% of cases) point mutation at position 8344 in the mitochondrial lysine transport RNA gene – MTTLys. The disease diagnostics causes certain difficulties due to the insufficient awareness of this pathology and polymorphism of clinical manifestations. The article presents a brief review of the literature data on current views on the disease pathogenesis, diagnostic methods and opportunities for drug treatment, and describes a clinical observation of a 7-year-old child with MERRF syndrome caused by a point mutation at position 8344 in the MTTLys gene. The girl was under dynamic supervision at the neuropsychiatric department. A comprehensive clinical, laboratory and instrumental examination was carried out that also included molecular genetic testing. The progredient progression and multiple symptoms of the disease, slightly increased lactate acidosis in the absence of typical neuroimaging and electromyographic changes are of interest in the observation, thereby confirming they might not necessarily be observed in MERRF. Intrafamily clinical diversity was noted in the absence of signs of the disease in paired mother. A highly informative method of MERRF diagnostics is provided by molecular genetic testing. Establishing a genetic diagnosis underlies a need for conducting medical and genetic counseling for family planning to prevent the re-birth of other sick siblings inheriting this pathology.
{"title":"Myoclonic epilepsy with ragged red fibers in childhood","authors":"Z. G. Tadtaeva, A. Galustyan, М. Y. Krivdina, V. Rusanovsky, E. Efet, A. Е. Krivoshein, N. A. Kuritsyna, О. Gromova","doi":"10.17749/2077-8333/epi.par.con.2022.111","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2022.111","url":null,"abstract":"Myoclonic epilepsy with ragged red fibers (MERRF) is a maternally inherited disease characterized by myoclonic epilepsy, cerebellar ataxia and progressive muscle weakness. Development of the disease is associated with the most common (90% of cases) point mutation at position 8344 in the mitochondrial lysine transport RNA gene – MTTLys. The disease diagnostics causes certain difficulties due to the insufficient awareness of this pathology and polymorphism of clinical manifestations. The article presents a brief review of the literature data on current views on the disease pathogenesis, diagnostic methods and opportunities for drug treatment, and describes a clinical observation of a 7-year-old child with MERRF syndrome caused by a point mutation at position 8344 in the MTTLys gene. The girl was under dynamic supervision at the neuropsychiatric department. A comprehensive clinical, laboratory and instrumental examination was carried out that also included molecular genetic testing. The progredient progression and multiple symptoms of the disease, slightly increased lactate acidosis in the absence of typical neuroimaging and electromyographic changes are of interest in the observation, thereby confirming they might not necessarily be observed in MERRF. Intrafamily clinical diversity was noted in the absence of signs of the disease in paired mother. A highly informative method of MERRF diagnostics is provided by molecular genetic testing. Establishing a genetic diagnosis underlies a need for conducting medical and genetic counseling for family planning to prevent the re-birth of other sick siblings inheriting this pathology.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91166369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-17DOI: 10.17749/2077-8333/epi.par.con.2022.109
E. Morozova, M. Belousova, D. Morozov, M. A. Utkuzova
The article presents a case report, and a literature review on benign epileptiform discharges of childhood (BEDC) as well as effect of this type of epileptiform activity on speech, behavior and communication skills are analyzed. The incidence of BEDC comprises 5% in pediatric population. Examining children with autistic spectrum disorder, BEDC is revealed in 20% cases, whereas in those with attention deficit and hyperactivity disorder (ADHD) or speech disorder – in 25% and 18% cases, respectively. Many studies considering BEDC as a genetic marker of brain immaturity highlighted by different level of expressiveness and penetrance are discussed. It is highly probable that cognitive and speech disorders as well as ADHD in children with BEDC may be genetically determined. However, pediatric BEDC may be asymptomatic or become manifested by diverse psychoneurological symptoms accounted for by developed epileptic encephalopathy and continuous spike and waves during slow wave sleep (CSWS) requiring specialized long-term treatment. Markedly elevated CSWS with morphological BEDC affects interneuron connections, which, in turn, alters memory consolidation in mesial temporal regions. The literature analysis revealed that children with BEDC-like epileptic activity require obligatory periodic sleep electroencephalographic control and dynamic neuropsychological evaluation due to high incidence of speech, mnestic and behavioral disorders. Seizure-free BEDC-like epileptic activity should be corrected pharmaceutically only in case of established causative link with progressive cognitive impairments.
{"title":"The effect of benign epileptiform discharges of childhood on cognitive function, behavior and speech","authors":"E. Morozova, M. Belousova, D. Morozov, M. A. Utkuzova","doi":"10.17749/2077-8333/epi.par.con.2022.109","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2022.109","url":null,"abstract":"The article presents a case report, and a literature review on benign epileptiform discharges of childhood (BEDC) as well as effect of this type of epileptiform activity on speech, behavior and communication skills are analyzed. The incidence of BEDC comprises 5% in pediatric population. Examining children with autistic spectrum disorder, BEDC is revealed in 20% cases, whereas in those with attention deficit and hyperactivity disorder (ADHD) or speech disorder – in 25% and 18% cases, respectively. Many studies considering BEDC as a genetic marker of brain immaturity highlighted by different level of expressiveness and penetrance are discussed. It is highly probable that cognitive and speech disorders as well as ADHD in children with BEDC may be genetically determined. However, pediatric BEDC may be asymptomatic or become manifested by diverse psychoneurological symptoms accounted for by developed epileptic encephalopathy and continuous spike and waves during slow wave sleep (CSWS) requiring specialized long-term treatment. Markedly elevated CSWS with morphological BEDC affects interneuron connections, which, in turn, alters memory consolidation in mesial temporal regions. The literature analysis revealed that children with BEDC-like epileptic activity require obligatory periodic sleep electroencephalographic control and dynamic neuropsychological evaluation due to high incidence of speech, mnestic and behavioral disorders. Seizure-free BEDC-like epileptic activity should be corrected pharmaceutically only in case of established causative link with progressive cognitive impairments.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74162336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-17DOI: 10.17749/2077-8333/epi.par.con.2022.069
I. Lusnikova
Objective: to demonstrate the mutual influence of the quality of patients’s life during epilepsy, adherence to received anticonvulsant therapy and retention on therapy.Material and methods. We conducted an analytical review of studies published by foreign authors in recent years (published within 2016–2021 were considered of top priority), devoted to the influence of various factors on adherence to therapy in patients with epilepsy. A search for relevant publications was conducted in English-language databases (PubMed/MEDLINE, ClinicalKey) by using key words and phrases: “epilepsy AND quality of life AND adherence to therapy”, “epilepsy AND quality of life AND retention on therapy”, “epilepsy AND adherence to therapy”, “compliance AND epilepsy AND quality of life”, “adherence to therapy AND retention on therapy AND epilepsy”, “nonadherence to therapy AND epilepsy AND quality of life”. After the selection procedure, 22 scientific publications were included in the review.Results. Factors that have a negative impact on adherence to therapy have been identified (comorbid cognitive impairment, the combination of lack of control over seizures and the presence of adverse events after drug administration, depression and anxiety, the need to change the lifestyle for taking the drug, concern about the potential negative consequences of taking the drug, recent uncontrolled seizures, lack of professional implementation, high frequency of taking the drug, problems with doctor-patient relationship, insufficient social support), and factors that have a positive impact (emotional support from the doctor, establishing doctor-patient partnership).Conclusion. There is a relationship between the patient's quality of life and adherence to therapy. Patient adherence to therapy is important for the effectiveness of epilepsy treatment and, along with the severity of epilepsy, is a significant factor affecting the quality of patients’ life during epilepsy. An opportunity for long-term retention on anticonvulsant therapy also has a cross-correlation with quality of life.
{"title":"A relation between the quality of life of patients with epilepsy and adherence to treatment as well as retention on therapy","authors":"I. Lusnikova","doi":"10.17749/2077-8333/epi.par.con.2022.069","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2022.069","url":null,"abstract":"Objective: to demonstrate the mutual influence of the quality of patients’s life during epilepsy, adherence to received anticonvulsant therapy and retention on therapy.Material and methods. We conducted an analytical review of studies published by foreign authors in recent years (published within 2016–2021 were considered of top priority), devoted to the influence of various factors on adherence to therapy in patients with epilepsy. A search for relevant publications was conducted in English-language databases (PubMed/MEDLINE, ClinicalKey) by using key words and phrases: “epilepsy AND quality of life AND adherence to therapy”, “epilepsy AND quality of life AND retention on therapy”, “epilepsy AND adherence to therapy”, “compliance AND epilepsy AND quality of life”, “adherence to therapy AND retention on therapy AND epilepsy”, “nonadherence to therapy AND epilepsy AND quality of life”. After the selection procedure, 22 scientific publications were included in the review.Results. Factors that have a negative impact on adherence to therapy have been identified (comorbid cognitive impairment, the combination of lack of control over seizures and the presence of adverse events after drug administration, depression and anxiety, the need to change the lifestyle for taking the drug, concern about the potential negative consequences of taking the drug, recent uncontrolled seizures, lack of professional implementation, high frequency of taking the drug, problems with doctor-patient relationship, insufficient social support), and factors that have a positive impact (emotional support from the doctor, establishing doctor-patient partnership).Conclusion. There is a relationship between the patient's quality of life and adherence to therapy. Patient adherence to therapy is important for the effectiveness of epilepsy treatment and, along with the severity of epilepsy, is a significant factor affecting the quality of patients’ life during epilepsy. An opportunity for long-term retention on anticonvulsant therapy also has a cross-correlation with quality of life.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86996616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-17DOI: 10.17749/2077-8333/epi.par.con.2022.095
V. A. Aysina, О. V. Kozhevnikova, О. V. Osipova, A. V. Lashkova
The insight into the Norrie disease viewed from neurology perspective and clinical case of refractory epilepsy relevant to the disease are considered. Epilepsy rarely accompanies Norrie disease. The dynamics of changes in electroencephalograms (EEG) and types of epileptic seizures during the disease progression as well as depending on the therapy received in the clinical case is analyzed. It is relevant for patients with Norrie disease to regularly undergo video-EEG monitoring to detect epileptiform activity, ictal patterns for timely diagnostics of epilepsy followed by prescribing proper therapy to improve quality of life.
{"title":"Epilepsy in Norrie disease","authors":"V. A. Aysina, О. V. Kozhevnikova, О. V. Osipova, A. V. Lashkova","doi":"10.17749/2077-8333/epi.par.con.2022.095","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2022.095","url":null,"abstract":"The insight into the Norrie disease viewed from neurology perspective and clinical case of refractory epilepsy relevant to the disease are considered. Epilepsy rarely accompanies Norrie disease. The dynamics of changes in electroencephalograms (EEG) and types of epileptic seizures during the disease progression as well as depending on the therapy received in the clinical case is analyzed. It is relevant for patients with Norrie disease to regularly undergo video-EEG monitoring to detect epileptiform activity, ictal patterns for timely diagnostics of epilepsy followed by prescribing proper therapy to improve quality of life.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73772417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-17DOI: 10.17749/2077-8333/epi.par.con.2022.107
A. Malov
According to the new classification of the epilepsies proposed in 2017 by The International League Against Epilepsy, idiopathic epilepsies are recommended to refer to genetic epilepsy, suggesting to consider the term “idiopathic” as outdated. In connection with this, a tendency arose to refer forms of epilepsy previously called “idiopathic” as genetic epilepsy. However, idiopathic epilepsy constitutes just a part among genetic epilepsies. The other groups resulting from this etiology are monogenic epilepsies (e.g., Dravet syndrome) as well as symptomatic epilepsies due to other genetically determined syndromes (e.g., biotinidase deficiency or neuronal ceroid lipofuscinosis). The distinction between the three groups comprising genetic epilepsy is important not only due to difference in related etiology and course, but also because specific treatment in some monogenic forms might be possible. Here, the major criteria for distinguishing between such epilepsy groups are presented.
{"title":"Idiopathic and symptomatic forms of genetic epilepsy","authors":"A. Malov","doi":"10.17749/2077-8333/epi.par.con.2022.107","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2022.107","url":null,"abstract":"According to the new classification of the epilepsies proposed in 2017 by The International League Against Epilepsy, idiopathic epilepsies are recommended to refer to genetic epilepsy, suggesting to consider the term “idiopathic” as outdated. In connection with this, a tendency arose to refer forms of epilepsy previously called “idiopathic” as genetic epilepsy. However, idiopathic epilepsy constitutes just a part among genetic epilepsies. The other groups resulting from this etiology are monogenic epilepsies (e.g., Dravet syndrome) as well as symptomatic epilepsies due to other genetically determined syndromes (e.g., biotinidase deficiency or neuronal ceroid lipofuscinosis). The distinction between the three groups comprising genetic epilepsy is important not only due to difference in related etiology and course, but also because specific treatment in some monogenic forms might be possible. Here, the major criteria for distinguishing between such epilepsy groups are presented.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89181700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-17DOI: 10.17749/2077-8333/epi.par.con.2022.098
A. G. Koshchavtsev
Objective: to compare the methods of electroencephalography (EEG) and amplitude-integrated electroencephalography (aEEG), related technical features, their clinical application in newborns at the intensive care unit, as well as a correlation between aEEG and other diagnostic methods (neurological status, neurosonography).Material and methods. Fifty-two newborns were examined who mainly born at full-term or had an initial degree of prematurity. In 29 infants, seizures were recorded, which were noted 1–5 times. An EEG was performed within 107.7±32.7 minutes followed by further software aEEG processing.Results. While analyzing aEEG, significant differences were found among the indices of delta 2 activity denoted as a percentage in premature vs. full-term infants relative to other rhythms. It was shown that prevalence of high-amplitude delta 2 activity throughout entire recording presented as percentage was higher in infants with vs. without seizures.Conclusion. It was demonstrated that aEEG clarifies and supplements the data obtained with routine EEG, and can be used not only for conducting continuous monitoring of neonatal brain functions, but also as an additional program to a standard EEG study. The method has a great potential for specifying diagnosis and further neonatal neurological support at intensive care units.
{"title":"Amplitude-integrated electroencephalography as an additional research method in newborns with seizures","authors":"A. G. Koshchavtsev","doi":"10.17749/2077-8333/epi.par.con.2022.098","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2022.098","url":null,"abstract":"Objective: to compare the methods of electroencephalography (EEG) and amplitude-integrated electroencephalography (aEEG), related technical features, their clinical application in newborns at the intensive care unit, as well as a correlation between aEEG and other diagnostic methods (neurological status, neurosonography).Material and methods. Fifty-two newborns were examined who mainly born at full-term or had an initial degree of prematurity. In 29 infants, seizures were recorded, which were noted 1–5 times. An EEG was performed within 107.7±32.7 minutes followed by further software aEEG processing.Results. While analyzing aEEG, significant differences were found among the indices of delta 2 activity denoted as a percentage in premature vs. full-term infants relative to other rhythms. It was shown that prevalence of high-amplitude delta 2 activity throughout entire recording presented as percentage was higher in infants with vs. without seizures.Conclusion. It was demonstrated that aEEG clarifies and supplements the data obtained with routine EEG, and can be used not only for conducting continuous monitoring of neonatal brain functions, but also as an additional program to a standard EEG study. The method has a great potential for specifying diagnosis and further neonatal neurological support at intensive care units.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78027612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-17DOI: 10.17749/2077-8333/epi.par.con.2022.108
О. S. Shilkina, E. A. Kantimirova, A. A. Usoltseva, Т. I. Prusova, D. V. Dmitrenko
Investigation of autoimmune epilepsy (AIE) has been attracting increasingly more attention due to discovery of neuronal antibodies and improved understanding of the mechanisms related to such immune-mediated syndromes. The review is aimed at autoimmune epilepsy taking into account up-to-date advances in exploring its pathophysiology. Definitions related to this issue are outlined, and pathogenetic mechanisms, features of antineuronal antibodies as well as AIE clinical picture based on type of autoantibodies, are considered. The necessity of regular monitoring patients with AIE is indicated, preferably by an epileptologist together with a neuroimmunologist. With prolonged follow-up, chronic pharmacoresistant epilepsy persists in some patients, despite aggressive immunotherapy and antiepileptic drugs. With a deeper understanding of the mechanisms of antibody-mediated and autoantigen-specific T-cell-mediated AIE syndromes, the use of antiepileptic drugs and immunotherapy can be further optimized.
{"title":"Autoimmune epilepsy","authors":"О. S. Shilkina, E. A. Kantimirova, A. A. Usoltseva, Т. I. Prusova, D. V. Dmitrenko","doi":"10.17749/2077-8333/epi.par.con.2022.108","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2022.108","url":null,"abstract":"Investigation of autoimmune epilepsy (AIE) has been attracting increasingly more attention due to discovery of neuronal antibodies and improved understanding of the mechanisms related to such immune-mediated syndromes. The review is aimed at autoimmune epilepsy taking into account up-to-date advances in exploring its pathophysiology. Definitions related to this issue are outlined, and pathogenetic mechanisms, features of antineuronal antibodies as well as AIE clinical picture based on type of autoantibodies, are considered. The necessity of regular monitoring patients with AIE is indicated, preferably by an epileptologist together with a neuroimmunologist. With prolonged follow-up, chronic pharmacoresistant epilepsy persists in some patients, despite aggressive immunotherapy and antiepileptic drugs. With a deeper understanding of the mechanisms of antibody-mediated and autoantigen-specific T-cell-mediated AIE syndromes, the use of antiepileptic drugs and immunotherapy can be further optimized.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87289671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.17749/2077-8333/epi.par.con.2021.066
E. Narodova, N. Shnayder, V. Karnaukhov, V. Narodova
Background. Non-pharmacological methods of palliative therapy for structural focal epilepsy (SFE) have been extensively investigated. Development of self-care methods based on behavioral psychotherapy and reference bioadaptation is a promising and economically justified approach.Objective: to present a clinical case of administering EpiTapp application based on the author-proposed wrist tapping method for palliative care in adult SFE.Material and methods. The author-proposed method of wrist tapping (RF patent No. 2606489 of 01.10.2017) for a smartphone Android OS application was used. Wrist tapping was performed during the period of aura and/or focal seizures (FS) in patients with SFE. Patients used the smartphone application as an element of emergency palliative therapy for SFE outpatient settings.Results. Patient L., 33 years old, suffering from SFE with frequent FS and bilateral seizures (BS), received duotherapy in the preoperative period. The woman used the EpiTapp application regularly that allowed to reduce FS rate by 65%, as well as prevent BS development without altering the antiepileptic therapy regimen.Сonclusion. The experience of using the EpiTapp application based on the author-proposed method of wrist tapping has demonstrated that it holds promise for SFE palliative therapy. The proposed technique requires additional research to confirm its effectiveness.
{"title":"Experience of using EpiTapp application in structural focal epilepsy","authors":"E. Narodova, N. Shnayder, V. Karnaukhov, V. Narodova","doi":"10.17749/2077-8333/epi.par.con.2021.066","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2021.066","url":null,"abstract":"Background. Non-pharmacological methods of palliative therapy for structural focal epilepsy (SFE) have been extensively investigated. Development of self-care methods based on behavioral psychotherapy and reference bioadaptation is a promising and economically justified approach.Objective: to present a clinical case of administering EpiTapp application based on the author-proposed wrist tapping method for palliative care in adult SFE.Material and methods. The author-proposed method of wrist tapping (RF patent No. 2606489 of 01.10.2017) for a smartphone Android OS application was used. Wrist tapping was performed during the period of aura and/or focal seizures (FS) in patients with SFE. Patients used the smartphone application as an element of emergency palliative therapy for SFE outpatient settings.Results. Patient L., 33 years old, suffering from SFE with frequent FS and bilateral seizures (BS), received duotherapy in the preoperative period. The woman used the EpiTapp application regularly that allowed to reduce FS rate by 65%, as well as prevent BS development without altering the antiepileptic therapy regimen.Сonclusion. The experience of using the EpiTapp application based on the author-proposed method of wrist tapping has demonstrated that it holds promise for SFE palliative therapy. The proposed technique requires additional research to confirm its effectiveness.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79654355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.17749/2077-8333/epi.par.con.2021.100
N. E. Maslov, A. A. Litvinova, P. S. Kovalev, N. Maslova, N. V. Yuryeva, E. I. Khamtsova
According to 2019 statistics records, traumatic brain injuries (TBI) are the most common type of injuries and one of the main causes for disability in Russia. Every year 200 people per 10,000 subjects around the world suffer from serious brain injuries. Severe TBI can result in long-term disability. Posttraumatic epilepsy (PTE) is one of the most dramatic consequences of TBI with an estimated incidence rate ranging from 2% to 50% based on severity of injury. Conducting studies on PTE poses numerous challenges because epilepsy never develops in many patients with TBI or it may occur more than 10 years after TBI.In this review, which includes data from studies conducted by Russian researchers, including us, and foreign colleagues over the last few years (mainly 2017–2022), we analyzed and generalized currently known risk factors, clinical and diagnostic features of PTE in order to increase the awareness about modern methods of laboratory and instrumental diagnostics related to this disease (including electroencephalography and routine/special neuroimaging techniques that allow to identify PTE biomarkers). We also aimed to promote development of preventive strategies for patient management. It has been proved that no clear algorithms for PTE diagnostics and treatment are currently available, which often leads to insufficient patient care.
{"title":"Posttraumatic epilepsy: clinical, diagnostic and therapeutic features","authors":"N. E. Maslov, A. A. Litvinova, P. S. Kovalev, N. Maslova, N. V. Yuryeva, E. I. Khamtsova","doi":"10.17749/2077-8333/epi.par.con.2021.100","DOIUrl":"https://doi.org/10.17749/2077-8333/epi.par.con.2021.100","url":null,"abstract":"According to 2019 statistics records, traumatic brain injuries (TBI) are the most common type of injuries and one of the main causes for disability in Russia. Every year 200 people per 10,000 subjects around the world suffer from serious brain injuries. Severe TBI can result in long-term disability. Posttraumatic epilepsy (PTE) is one of the most dramatic consequences of TBI with an estimated incidence rate ranging from 2% to 50% based on severity of injury. Conducting studies on PTE poses numerous challenges because epilepsy never develops in many patients with TBI or it may occur more than 10 years after TBI.In this review, which includes data from studies conducted by Russian researchers, including us, and foreign colleagues over the last few years (mainly 2017–2022), we analyzed and generalized currently known risk factors, clinical and diagnostic features of PTE in order to increase the awareness about modern methods of laboratory and instrumental diagnostics related to this disease (including electroencephalography and routine/special neuroimaging techniques that allow to identify PTE biomarkers). We also aimed to promote development of preventive strategies for patient management. It has been proved that no clear algorithms for PTE diagnostics and treatment are currently available, which often leads to insufficient patient care.","PeriodicalId":52318,"journal":{"name":"Epilepsy and Paroxysmal Conditions","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73936610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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