Background. Comparative study of antiepileptic drugs allows to make the optimal choice in therapy.The aim of the study: a comparative analysis of the administration of two similar by chemical structure antiepileptic drugs (zonisamide and topiramate) in the outpatient practice in epilepsy in children, taking into account the efficacy and tolerability.Materials and methods. A retrospective analysis of outpatient charts of equal in number (n = 18) groups of patients with different forms of epilepsy treated with zonisamide and topiramate in monotherapy and in combined therapy was carried out.Results. In general, no statistically significant difference in the efficacy of zonisamide and topiramate was obtained (p = 0.692). Efficacy in structural focal epilepsy was also comparable (absence of seizures 54.6 % and 45.5 %, respectively). With comparable efficacy, zonisamide was administered to patients much later in the antiepileptic drugs (Me = 5) than topiramate (Me = 3). Side effects on zonisamide were registered in 27.8 %, side effects on topiramate – in 38.9 % (p = 0.480). The difference in the effect of these drugs on cognitive functions was noted.Conclusions. Zonisamide shows its effectiveness in different forms of epilepsy in children, despite the later appointment in practice. The drug is well tolerated and probably has less negative effect on children’s cognitive functions than topiramate.
Актуальность организации помощи пациентам с эпи-лепсией. Эпилепсия является распространенным заболева-нием нервной системы. Как все хронические заболевания, она накладывает отпечаток на образ жизни [1], требует дли-тельного (многолетнего или пожизненного) приема проти-воэпилептических препаратов (ПЭП) и постоянного на-блюдения за пациентами. В целом при эпилепсии сложно говорить об излечении, поскольку предрасположенность к
Purpose. To study the structure of comorbid disorders in children with tycotic hyperkinesis of the city of Tyumen. Materials and methods. We examined 103 children aged 5 to 14 years. Patients were divided into 2 groups: group 1 – local tics (n = 43), group 2 – common tics (n = 60). All patients received anticitotic therapy. Using various scales and questionnaires, an assessment of tic hyperkinesis, the level of anxiety, a study of the rational, emotional and behavioral components of the relationship between parents and a child, an investigation of the emotional sphere, and neuropsychological testing were carried out. Results. Manifestations of ticks contribute to various stressful situations, school adaptation stress. The tics are intensified by emotional overstrain, mental overwork, eye strain. A risk factor for the formation of tic hyperkinesis is family education by the type of symbiosis and hypersocialization. Comorbid disorders in patients with ticose hyperkinesis in most cases are represented by ADHD, anxiety, the prevalence of a combination of stress with pathological compensation, and the presence of a headache. The neuropsychological plan revealed impaired attention, auditory-speech and visual memory, and writing. Conclusion. Identified comorbid disorders in children with tic hyperkinesis significantly reduce the quality of life of patients, disrupts their social adaptation and require timely correction.
The article describes the peculiarities of a rare disease – hemiplegic migraine in 3 patients (two boy aged 7 and 15 years old and a girls of 12 years). The family history of migraine was not burdened. Attack symptoms were almost identical: hemiparesis, dysphasia, headache The electroencephalograms, magnetic resonance imaging in all patients not presented signs brain dysfunction. The considered description increases the awareness of doctors on the issue, which is very rare in the practice of pediatrician and neurologist.
Background: Given the significant share of gene mutations in the etiology of epilepsy, it is important for the practitioners to evaluate progress in this area. Objective: To describe the spectrum of being detected gene mutations in patients with epilepsy or epileptic encephalopathy in clinical practice of neurologists specializing in epilepsy with an analysis of diagnosed epileptic syndromes, the characteristics of seizures, the timing of a genetic diagnosis, options and treatment efficacy. Methods: The study included 100 patients (40 boys, 60 girls) with epilepsy/epileptic encephalopathy and a gene mutation identified. The average age was 6.9±5.1 years. Through remote access, epilepsy specialists filled out a specially designed unified table containing information from outpatient case history. Results: In the outpatient practice of epilepsy specialists, there are patients with a wide range of gene mutations, the leading of which is a mutation in the SCN1A gene (15%). Nowadays, the main method (85%) of detection remains the next generation sequencing in the "Hereditary Epilepsy" panel. Years pass from the onset of the disease to the genetic diagnosis (Me-3 years). In most cases, patients with severe (52% have epileptic encephalopathy, 88% have developmental disorders) and pharmacoresistant (mean amount of anti-epileptic drugs-3,8±2,2, multitherapy-70%) syndromes have undergone genetic testing. In the treatment of these patients epileptologists are increasingly (52%) use alternative methods: steroids, ketogenic diet and others. The absence of seizures was observed only in 46% of patients. Conclusion: Thus, in the outpatient practice of epileptologists of Russia, patients with a wide range of gene mutations are found. As a rule, these are patients with severe, therapy-resistant epileptic syndromes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.