Russian Journal of Child NeurologyRussian Journal of Child NeurologyРусский журнал детской неврологии2073-88032412-9178Publishing House ABV Press33110.17650/2073-8803-2020-15-2-12-16ORIGINAL REPORTSОРИГИНАЛЬНЫЕ СТАТЬИManagement of patients with single and rare epileptic seizuresВедение пациентов с единичными и редкими эпилептическими приступамиhttps://orcid.org/0000-0003-2988-5706KotovA. S.КотовА. С.
Russian Federation

61/2 Shchepkina St., Moscow 129110

Алексей Сергеевич Котов

129110 Москва, ул. Щепкина, 61/2

alex-013@yandex.ruM.F. Vladimirsky Moscow Regional Research Clinical InstituteГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»1504202015212162809202028092020Copyright ©; 2020, ABV-PressCopyright ©; 2020, АБВ-пресс2020ABV-PressАБВ-прессhttps://rjdn.abvpress.ru/jour/about/editorialPolicieshttps://rjdn.abvpress.ru/jour/article/view/331

Objective: to study the structure of the disease and develop tactics of treatment of patients with single and rare epileptic seizures. Materials and methods. 1200 patients with epilepsy were examined, 103 patients were identified who had no more than 3 seizures throughout their life. Study included evaluation of anamnesis, clinical and neurological examination, routine electroencephalography and/or videoelectroencephalographic monitoring, magnetic resonance imaging of the brain. Results. Relapse of seizures in individuals with a history of follow-up occurred in 32 % of cases; epileptogenic changes in magnetic resonance image and, especially, anatomical and electro-clinical correlation of the epilepsy focus were associated with the risk of relapse. Conclusions. The decision on drug therapy after the first unprovoked seizure should be based on the ratio of the risk of repeated seizures and the risk of side effects. This solution should be individual and take into account not only medical problems, but also the preferences of the patient and his family members.

Цель исследования – изучение структуры заболевания и разработка тактики лечения пациентов с единичными и редкими эпилептическими приступами. Материалы и методы. Было обследовано 1200 пациентов с эпилепсией, выявлено 103 пациента, перенесших не более 3 приступов в течение всей жизни. Обследование включало изучение анамнеза, клинический и неврологический осмотры, рутинную электроэнцефалографию и/или видеоэлектроэнцефалографический мониторинг, магнитно-резонансную томографию головного мозга. Результаты. Рецидив приступов у пациентов с отслеженным катамнезом произошел в 32 % случаев, с риском рецидива ассоциировались эпилептогенные изменения на томограмме и особенно анатомо-электроклиническая корреляция очага эпилепсии. Выводы. Решение о медикаментозной терапии после первого неспровоцированного приступа (или единичных приступов) должно базироваться на соотношении риска повторных приступов и риска побочных эффектов терапии. Это решение должно быть индивидуальным и учитывать не только медицинские проблемы, но и предпочтения пациента и членов его семьи.

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