Insomnia is the most common form of sleep disturbance in childhood. Sleep disorders and a decrease in its duration and quality lead to the development of cognitive disorders, change emotional and behavioral functions of the developing organism, and negatively affect medical and psychological aspects that require medical correction. The article provides an overview of current literature data on pharmacological approaches to insomnia therapy in childhood. The general principles of treatment and the use of various pharmacological groups of drugs are discussed. It is shown that pharmacotherapy of childhood insomnia should be carried out based on knowledge about the age characteristics of patients, efficacy, safety, analysis of pharmacodynamic and pharmacokinetic parameters of the drugs used. Drug therapy should be combined with cognitive behavioral techniques, including adherence to sleep patterns and hygiene.
The review considers pharmacological characteristics of new antiepileptic drugs (AEDs) of the third generation such as eslicarbazepine, lacosamide, retigabine, perampanel, everolimus, brivaracetam, zonisamide. The data on the mechanisms of action, pharmacokinetics, drug interactions, indications for use and side effects are presented. The drugs are recognized as superior in safety and efficacy to previously known AEDs of the first and second generations. The majority of new AEDs is used to control focal seizures, as well as in specific epileptic syndromes (Lennox–Gastaut syndrome, Dravet syndrome), and tuberous sclerosis. The drugs differ in the mechanism of action, pharmacokinetic properties, effectiveness and profile of side effects, which account for an opportunity to apply a personalized approach to patient treatment. Properly selected therapy allows to achieve good control over epileptic seizures as well as lower a risk of disease-related complications. While prescribing AEDs, it is necessary to take into account their pharmacokinetic and pharmacodynamic features.
The article presents a brief review of the literature and clinical observation of glutaric aciduria type 1 (GA1) in a child, manifested by encephalitis-like crisis and subdural hematomas, which were initially regarded as the consequences of traumatic brain injury. Based on the analysis of clinical and neuroimaging data, the diagnosis of GA1 was assumed, which was later confirmed by molecular genetic research. After therapy with the inclusion of a specialized diet with protein restriction, some improvement in motor activity was noted. The presence of bilateral subdural hematomas dictates the need for differential diagnosis with GA1. A highly informative method of diagnosing GA1 is brain MRI.
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