Vol 13, No 4 (2018)

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Full Issue

AUTHENTIC ARTICLES

Safety and tolerability of antiepileptic drugs in women with epilepsy (literature review and own data)

Mukhin K.Y., Pylaeva O.A., Petrukhin A.S.

Abstract

Women with epilepsy are at particular risk of developing side effects due to antiepileptic drugs (AED). Neuroendocrine disorders in women can be caused by both epilepsy itself and the therapy. This literature review aims to evaluate safety and tolerability of different AED in girls and women of reproductive age, incidence of neuroendocrine disorders associated with AED, and pregnancy outcomes in women with epi­lepsy. We also provide some own research results. We conducted a retrospective analysis of data for 345female patients aged between 15 and 40 years that were followed up at the Svt. Luka’s Institute of Child Neurology and Epilepsy between 2000 and 2018. We also performed a separate analysis of neuroendocrine disorders and pregnancy outcomes in these women. We found that 65 patients (18.8 %) developed pronounced neuroendocrine reproductive and cosmetic disorders (menstrual disorders, including dysmenorrhea, opsomenorrhea, amenorrhea, anovulatory cycles, and infertility; cosmetic neuroendocrine disorders, including obesity, hirsutism, and hair loss; adverse pregnancy outcomes), which significantly reduced the quality of life. Neuroendocrine disorders were observed in 55patients, whereas adverse pregnancy outcomes were registered in 10 (14.2 %) out of 70pregnancies.

Our findings suggest that the majority of women with epilepsy successfully gave birth to healthy children. The outcome of pregnancy depends on many factors, including the use of different AED. Valproic acid has the highest teratogenic potential. In our study, neuroendocrine repro­ductive disorders were primarily reported by women receiving valproic acid. Carbamazepines were the second most common AED associated with teratogenic effects and reproductive disorders. The most favorable results were observed in women receiving new AED, including oxcar- bazepine, topiramate, and levetiracetam.
Russian Journal of Child Neurology. 2018;13(4):7-22
pages 7-22 views
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Particularities in differential diagnostics of epileptogenic brain malformations on the low-field MRI-device

Khalilov V.S., Kholin A.A., Bakaeva B.R., Bobylova M.Y., Gazdieva K.S.

Abstract

Russian Journal of Child Neurology. 2018;13(4):23-39
pages 23-39 views
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REVIEWS AND LECTURES

Comorbidity between epilepsy and autism from the point of view of ontogenesis

Kuzmich G.V., Sinelnikova A.N.

Abstract

Early childhood autism, or autism spectrum disorders, is an extremely heterogeneous group of conditions that share similar symptoms  of dysontogenesis. Epilepsy is the most significant comorbidity in autism. The present article covers various aspects of comorbidity between epilepsy and autism, described in the literature over the last 50 years. This review aims to analyze the development of epilepsy and autism during ontogenesis and to identify causal relationships between these diseases, considering the information on the two age peaks for epilepsy onset in patients with autism.
Russian Journal of Child Neurology. 2018;13(4):40-52
pages 40-52 views
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West syndrome: long-term outcomes depending on etiology and treatment (literature review)

Prygunova T.M.

Abstract

West syndrome is a severe form of childhood epilepsy associated with drug-resistant seizures and intellectual disability. The disease  is characterized by specific seizures called infantile spasms, hypsarrhythmia on the electroencephalogram, and delayed psychomotor development. The identification of the disease etiology may affect the prognosis and the choice of therapy. The following prognostic factors have been described so far: etiology, abnormal neurological signs, presence of other epileptic seizures before and after epileptic spasms, response to therapy regardless of the drug type. Difficulties associated with the diagnosis of West syndrome and long-term examination in outpatient settings lead to persistence of hypsarrhythmia and worsen the prognosis. Lack of universal standards for IS therapy results in significant diffe rences in treatment outcomes observed in different regions. Despite significant efforts made towards studying West syndrome, many aspects are still poorly understood. Further studies are needed to help physicians in choosing an optimal treatment strategy and appropriate duration  of follow-up as well as to improve the disease prognosis.
Russian Journal of Child Neurology. 2018;13(4):53-63
pages 53-63 views
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CLINICAL OBSERVATIONS

Epileptic trances – focal motor epileptic seizures: past, present and a little bit of future

Chadaev V.A., Mukhin K.Y., Selezneva L.G., Nurmukhametova S.R., Alikhanov A.A., Mendelevich O.V., Vasilyev I.G., Glukhova L.Y., Nikitina M.S., Pylaeva O.A.

Abstract

This article provides a detailed description of clinical and electroanatomical characteristics of epilepsy in patients suffering from epileptic trances – a rare type of focal motor seizures with ambulatory automatism manifesting as an unplanned travel. We reviewed the currently available data on the nature of psychical seizures in patients with epilepsy and the role of social and legal expertise for this disease. We developed the criteria for differential diagnosis between epileptic trances and other conditions with similar manifestations (for example, epileptic fugues) and identified a diagnostic minimum. We also proposed a hypothesis of ictal spatial migration. We emphasized the efficiency of surgical treatment in the case of compliance with a proper diagnostic algorithm.
Russian Journal of Child Neurology. 2018;13(4):64-69
pages 64-69 views
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Mental disorders in children with intractable epilepsy as a manifestation of forced normalization of the electroencephalogram (Landolt syndrome)

Gagara D.A., Evtushenko S.K.

Abstract

The forced normalization of the electroencephalogram (Landolt syndrome) is a rapid normalization of the electroencephalogram (decrease in or disappearance of paroxysmal activity) under the influence of anticonvulsant treatment of epilepsy patients, corresponding to a decrease in frequency or complete disappearance of seizures with the appearance of neuropsychiatric disorders (dysphorias, the syndrome of hyperactivity and attention deficit, mysophobia etc). The authors present a review of the literature on the Landolt syndrome, and own data.
Russian Journal of Child Neurology. 2018;13(4):70-74
pages 70-74 views
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