[Clinical and functional disturbances in epilepsy patients with schizencephaly]. / Kliniko-funktsional'nye narusheniya u patsientov s epilepsiei pri shizentsefalii.

OBJECTIVE: To study the features of diagnosing and predicting structural epilepsy in children with schizencephaly (SE) based on the analysis of clinical, electrophysiological and neuroimaging results. MATERIAL AND METHODS: Fifteen patients with epilepsy and SE (seven boys and eight girls), aged from 3 months to 14 years, were examined. RESULTS: Unilateral SE was detected in ten patients (closed - in four, open - in six), bilateral open SE was detected in five patients. The predominant localization of the anomaly is in the frontal region. In 100% of cases, cognitive and motor impairments of varying severity were detected. In the study group, 11 patients (73.3%) were diagnosed with epilepsy before the age of 6 years. The clinical presentations of epilepsy in children with SE included focal seizures in ten patients (73.3%), epileptic spasms in three patients (20.0%), focal seizures with secondary generalization in five (33.3%), atonic - in one child (6.7%). Refractory epilepsy was noted in 26.7% children with SE, and the absence of positive electroencephalographic changes in 40% of children. CONCLUSIONS: The extent of structural brain damage in SE in patients with epilepsy correlates with the degree of cognitive and motor deficits. The form of epilepsy, the semiotics of epileptic seizures, and the effectiveness of antiepileptic therapy do not depend on the type of SE, but correlate with the extent of cortical disorders.

[Phenotypic and neuroimaging differentiation of polymicrogiry in children]. / Fenotipicheskaia i neirovizualizatsionnaia differentsiatsiia polimikrogirii u detei.

AIM: To study the results of the examination of children and to assess the degree of correlation of cortical disorders with phenotypic and neuroimaging characteristics of polymicrogyria (PMG). MATERIAL AND METHODS: An analysis of disease history, neurological data, semiotics of epileptic seizures, neuroimaging and electrophysiological results was performed in 27 patients with PMG. RESULTS AND CONCLUSION: Correlations between the prevalence of cortical malformation and the increased frequency of abnormalities in internal organs, stigma of dysembryogenesis, cognitive and motor disorders are shown.

[New opportunities in the optimization of epilepsy treatment in adolescents]. / Novye vozmozhnosti optimizatsii terapii épilepsii u podrostkov.

In the pubertal period, the most severe forms of childhood epilepsy persist and are modified; genetically determined syndromes, atypical for early and late age periods, make their debut. Hereditary predisposition, instability of homeostatic mechanisms, neuroendocrine restructuring at the age of puberty and the influence of factors contributing to the realization of a genetic defect lead to a long-term transformation of mediator systems and formation of epileptic activity in adolescents. The authors present common approaches in the treatment and characterization of the modern antiepileptic drug perampanel, which is highly effective in treatment of patients with resistant forms of epilepsy. The article presents a summarized overview of the clinical forms of adolescent epilepsy observed in a psychoneurological department and an analysis of treatment results. A clinical case of the successful use of the antiepileptic drug perampanel in a female patient with focal seizures with secondary generalization of epilepsy, type I neurofibromatosis is presented.

[Diagnosis and correction of cognitive impairment in preschool age children with epilepsy].

OBJECTIVE: To study cognitive impairment and the efficacy of hopantenic acid (pantogam) in children, aged from 4 to 7 years, with epilepsy and cognitive impairment. MATERIAL AND METHODS: The study included 40 children with epilepsy treated with pantogam (the main group) and 23 children with epilepsy who did not receive pantogam (the comparison group). All children were diagnosed with cryptogenic epilepsy and symptomatic epilepsy. We presented the main results of the clinical examination including routine EEG, video-EEG monitoring and brain MRI. An analysis of cognitive impairment in children of the comparison group and in the main group before and after treatment with pantogam was performed using a set of neurocognitive tests (the Luscher Color Test, «Piano playing test¼, «Three word test¼ and «Four is redundant test¼). RESULTS AND CONCLUSION: There were a significant decrease in cognitive impairment in children of the main group compared to the comparison group as well as age normalization and improvement of EEG after 2 months of treatment in 15% of the patients. The good tolerability of the drug and no increase in the frequency of seizures were observed.