[Nootropics and antioxidants in the complex therapy of symptomatic posttraumatic epilepsy].

To study the possibility of application of nootropics and antioxidants in the complex antiepileptic therapy, we examined 75 patients with symptomatic focal posttraumatic epilepsy. A statistically significant reduction in the number of epileptic seizures, improvement of cognitive function and quality of life of the patients as well as a decrease in the severity of depression and epileptic changes in the EEG were identified. The potentiation of antiepileptic activity of basic drugs, normalization of brain's electrical activity and reduction in EEG epileptiform activity, in particular coherent indicators of slow-wave activity, were noted after treatment with the antioxidant mexidol. A trend towards the improvement of neuropsychological performance and quality of life was observed. There was a lack of seizure aggravation typical of many nootropic drugs. Thus, phenotropil and mexidol can be recommended for complex treatment of symptomatic posttraumatic epilepsy.

[Efficacy and safety of the mono- and combined therapy with oxcarbazepine in adult patients].

The trial included 302 patients with focal and generalized forms of epilepsy, aged from 18 to 73 years (mean age 33.23+/-12.73 years). Oxcarbazepine (trileptal) was prescribed in accordance to recommendations and titration schemes (continuous and single-stage) conventional in Russia. Trileptal was prescribed as the start antiepileptic therapy to 46.1% of patients. In other patients, antiepileptic drugs used previously were withdrawn mainly to their low clinical efficacy and poor tolerability. The duration of the study was 12 weeks. The efficacy was assessed by the number of patients with seizures reductions of 50%. The positive therapeutic response was found in 93.2% of patients who completed the trial, and the complete reduction of seizures was achieved in 34.9%. There were also positive changes in the seizure duration, frequency of consciousness change and other post seizure phenomena. The low frequency and intensity of adverse effects during the treatment with trileptal was observed: there were 93 adverse effects in 60 patients included in the trial; 3 (3.2%) of these effects were considered as severe (dizziness in one patient, sleepiness in two patients). The adverse effects disappeared without any additional treatment.

[An association between the FABP2 gene polymorphism and efficacy of valproates].

To search for association between the 163G>A polymorphism of the fatty acid binding protein 2 (FABP2) gene and intracellular transport of the valproic acid in the small intestines, 168 patients with different forms of epilepsy, aged from 1 to 89 years, and different illness duration have been studied. The patients received valproates (127 patients) and topiramate (41 patients) as a monotherapy. It has been shown that the 163G>A (Ala54Thr) polymorphism exerts an influence on effective dose of the valproic acid but not of topiramate.

[Use of a 3-oxypiridine antioxidant in combined therapy of patients with partial epilepsy].

Fifty-four patients with partial epilepsy (age 18-50 years, 26 males and 28 females, illness duration from 6 months to 18 years) have been examined. Idiopathic epilepsy was diagnosed in 7 patients, symptomatic in 36, cryptogenic in 11. The control group comprised 22 sex- and age-matched individuals. All the patients underwent computerized EEG and pharmaco-EEG testing, MRI or CT of the brain. Follow-up duration was from 6 months to 2.5 years. An antioxidant therapeutic course was conducted during 30 days on the background of the basic anticonvulsive therapy with carbamazepine (finlepsin-retard 200) received in individual dosages. Computer EEG analysis was made using "BRAINWIN" soft (Mitrofanov A.A., "Statokin", Moscow). To estimate the effect of the medications on bioelectric brain activity, methods of spectral and coherent EEG analysis, localization of equivalent dipole source of paroxysmal activity were applied. After a 30-day course of combined therapy with carbamazepine (finlepsin-retard 200) and antioxidant Mexicor, inhibition of generator activity of limbic and hypothalamic as well as stem and cerebellum structures and displacement of generator zones into cortical hemisphere structures were observed that may be explained by enhancement of determinant foci of the cortical structures in inhibition of secondary foci. It may be considered as a favorable prognostic factor, which reduces probability of the secondary generalization of partial epileptic seizures.

[Effect of carbamazepine on the structure-function relations in the development of the epileptic structure]. / Vliianie karbamazepina na strukturno-funktsional'nye sviazi v razvitii épilepticheskoi sistemy.

The experiments on white outbred male rats with cobalt-induced epileptogenic focus in the left sensomotor cortical region showed that the anticonvulsant effect of carbamazepine (20 mg/kg) depends on the functional state of the epileptic system (ES). In various stages of the ES development, the drug effect is related to the influence upon the determinant focus generating the epileptic activity. In the initial stage, carbamazepine primarily affects epileptic activity of the cortical foci (ipsi- and contralateral hemisphere). In the second (generalization) stage, the drug decreases the epileptic activity in all structures, but to a greater extent, in the dorsal hippocampus and lateral hypothalamus.