FACTORS PROVOKING EPILEPTIC SEIZURES

2021 ◽  
pp. 52-59
Author(s):  
Tokareva N.G. ◽  
Ignatieva O.I.
Keyword(s):  
Antiepileptic Drugs ◽  
Anticonvulsant Drug ◽  
Epileptic Seizures ◽  
Epileptic Activity ◽  
International Standards ◽  
Lower Percentage ◽  
Drug Resistant ◽  
Therapy Regimen ◽  
First Choice ◽  
Drug Resistant Epilepsy

Currently, the most significant problems of adherence to modern pharmacotherapy have been identified. The urgency of the treatment of epilepsy is confirmed by its frequency of spread. In Russian neurology, epilepsy is treated in accordance with international standards and recommendations. For a number of years, the drugs of the first stage of choice have proven their effectiveness. Monotherapy is preferred; with the development of drug-resistant epilepsy, the possibilities of using a combination of antiepileptic drugs are considered. Epileptic activity in the form of increased seizure frequency can be triggered by alcohol consumption, sleep disturbance - wakefulness, stressful situations, eye strain, somatic diseases and other factors. The aim of this study was to determine the main factors of provocation leading to an increase in the frequency of seizures in epilepsy. Materials and methods: we carried out a retrospective analysis of 43 case histories of patients with increased seizure rates who were hospitalized in the neurological department of one of the central clinical hospitals in Saransk. The initiation of anticonvulsant drug therapy in all patients coincided with the justification of the diagnosis. Seizure remission was achieved in the first year of treatment in most patients, which indicates a good level of compliance and coincides with clinical guidelines. Most patients in the sample received monotherapy with antiepileptic drugs of the first choice. An increase in seizures in patients taking antiepileptic drugs was noted at 3 years of treatment. Results: the most frequent factor provoking seizures was non-adherence to the therapy regimen, which was often mistakenly interpreted by outpatient doctors as the development of drug-resistant epilepsy; patients were referred to inpatient treatment for alternative monotherapy or combination therapy. Non-compliance with the therapy regimen was noted in the form of a decrease in the dose of the drug, irregularity of administration, and forgetfulness of the patient. Other factors provoking an increase in the frequency of epileptic seizures accounted for a significantly lower percentage and did not have a relevant significance

scholarly journals Evaluation of the effectiveness of electroconvulsive therapy in the treatment of psychosis in a patient with epilepsy. Clinical case

2021 ◽  
Vol 13 (1S) ◽  
pp. 79-87
Author(s):  
T. V. Dokukina ◽  
F. P. Khlebokazov ◽  
I. I. Khvostova ◽  
N. N. Misyuk ◽  
K. A. Bondar ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Antiepileptic Drugs ◽  
Electroconvulsive Therapy ◽  
Successful Treatment ◽  
Clinical Condition ◽  
Clinical Case ◽  
Epileptic Seizures ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Progressive Course

The results of successful treatment of schizophrenic psychosis with persistent catatonic symptoms, refusal to eat in a patient with epilepsy are presented. In view of the progressive course of the disease, the lack of dynamics from the ongoing drug treatment, the method of electroconvulsive therapy was applied. Epileptic seizures and visual signs of brain epileptization were absent with the development of psychosis. As a result of the course of electroconvulsive therapy (9 procedures), the patient's clinical condition improved significantly. This observation illustrates the possibility of using electroconvulsive therapy in combination with antipsychotics and antiepileptic drugs as an alternative method for treating drug-resistant epilepsy.

scholarly journals Heart rate variability analysis for the identification of the preictal interval in patients with drug-resistant epilepsy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adriana Leal ◽  
Mauro F. Pinto ◽  
Fábio Lopes ◽  
Anna M. Bianchi ◽  
Jorge Henriques ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Linear Time ◽  
Epileptic Seizures ◽  
Heart Rate Variability Analysis ◽  
Drug Resistant ◽  
Clustering Methods ◽  
Temporal Lobe Seizures ◽  
New Perspective ◽  
Drug Resistant Epilepsy

AbstractElectrocardiogram (ECG) recordings, lasting hours before epileptic seizures, have been studied in the search for evidence of the existence of a preictal interval that follows a normal ECG trace and precedes the seizure’s clinical manifestation. The preictal interval has not yet been clinically parametrized. Furthermore, the duration of this interval varies for seizures both among patients and from the same patient. In this study, we performed a heart rate variability (HRV) analysis to investigate the discriminative power of the features of HRV in the identification of the preictal interval. HRV information extracted from the linear time and frequency domains as well as from nonlinear dynamics were analysed. We inspected data from 238 temporal lobe seizures recorded from 41 patients with drug-resistant epilepsy from the EPILEPSIAE database. Unsupervised methods were applied to the HRV feature dataset, thus leading to a new perspective in preictal interval characterization. Distinguishable preictal behaviour was exhibited by 41% of the seizures and 90% of the patients. Half of the preictal intervals were identified in the 40 min before seizure onset. The results demonstrate the potential of applying clustering methods to HRV features to deepen the current understanding of the preictal state.

scholarly journals Effect and Safety of Shihogyejitang for Drug Resistant Childhood Epilepsy

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Jinsoo Lee ◽  
Kwanghyun Son ◽  
Gwiseo Hwang ◽  
Moonju Kim
Keyword(s):  
Adverse Events ◽  
Antiepileptic Drugs ◽  
Retention Rate ◽  
Seizure Type ◽  
Drug Resistant ◽  
Exact Test ◽  
Alternative Treatment Option ◽  
Drug Resistant Epilepsy ◽  
Intent To Treat ◽  
Patients With Epilepsy

Objective. Herbal medicine has been widely used to treat drug resistant epilepsy. Shihogyejitang (SGT) has been commonly used to treat epilepsy. We investigated the effect and safety of SGT in children with drug resistant epilepsy.Design. We reviewed medical records of 54 patients with epilepsy, who failed to respond to at least two antiepileptic drugs and have been treated with SGT between April 2006 and June 2014 at the Department of Pediatric Neurology, I-Tomato Hospital, Korea. Effect was measured by the response rate, seizure-free rate, and retention rate at six months. We also checked adverse events, change in antiepileptic drugs use, and the variables related to the outcome.Results. Intent-to-treat analysis showed that, after six months, 44.4% showed a >50% seizure reduction, 24.1% including seizure-free, respectively, and 53.7% remained on SGT. Two adverse events were reported, mild skin rash and fever. Focal seizure type presented significantly more positive responses when compared with other seizure types at six months (p=0.0284, Fisher’s exact test).Conclusion. SGT is an effective treatment with excellent tolerability for drug resistant epilepsy patients. Our data provide evidence that SGT may be used as alternative treatment option when antiepileptic drug does not work in epilepsy children.

Drug-resistant epilepsy and topiramate: Plasma concentration and frequency of epileptic seizures

2018 ◽  
Vol 45 (7) ◽  
pp. 652-658
Author(s):  
Fabiana Angelo Marques ◽  
Nayara Cristina Perez de Albuquerque ◽  
Marília Silveira de Almeida Campos ◽  
Priscila Freitas-Lima ◽  
André Oliveira Baldoni ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Epileptic Seizures ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

scholarly journals Network meta-analysis of antiepileptic drugs in focal drug-resistant epilepsy

2020 ◽  
Vol 167 ◽  
pp. 106433
Author(s):  
Tong Yao Hu ◽  
Hai-Qiang Wang ◽  
Wen Ping Zhang ◽  
Ruo Fei Tian ◽  
Ge Sheng Lei ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Meta Analysis ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

scholarly journals Potentially Pathological Alpha-Pattern as a Variant of Vigilance EEG in Drug-Resistant Epilepsy

2017 ◽  
Vol 8 (4) ◽  
pp. 48-56
Author(s):  
Aleksandr A. Chukhlovin ◽  
Mikhail V. Aleksandrov ◽  
Sergey A. Lytaev ◽  
Vugar R. Kasumov ◽  
Marina E. Pavlovskaya ◽  
...  
Keyword(s):  
Alpha Rhythm ◽  
Refractory Epilepsy ◽  
Functional Decline ◽  
Clinical Signs ◽  
Epileptic Seizures ◽  
Alpha Activity ◽  
Drug Resistant ◽  
Scalp Eeg ◽  
Russian Scientific Research Institute ◽  
Drug Resistant Epilepsy

As a result of pathomorphosis affecting the mechanisms of electrical activity generation interictal EEG may show reduced epileptiform changes whereas clinically apparent epileptic seizures may be present. In these cases patterns of dominant alpha activity are sometimes recorded on the scalp. In this study variations of alpha activity in patients with refractory epilepsy are classified. A group of 50 refractory epilepsy patients aged between 20 and 55 years who were submitted to Polenov Russian Scientific Research Institute of Neurosurgery in 2014-2017 was included in this study. They underwent scalp EEG as a part of their presurgical assessment. In 12 cases patterns of potentially pathological alpha activity were observed. Three variations of alpha-patterns were described: 1) alpha-rhythm with decreased regional diversity and a marked synchronization in temporal areas; 2) alpha-rhythm with reduced epileptiform complexes integrated into the spindles, 3) decelerated non-rhythmic alpha activity distorted by the higher frequency components. Distinguished varieties of potentially pathological alpha-activity according to their order here represent gradual functional decline of normal thalamo-cortical interaction. Considering clinical manifestation of drug-resistant epilepsy with frequent seizures in these patients, reported varieties of alpha activity can not be interpreted as Landolt’s syndrome (forced normalization of EEG). Invasive electrocorticographic monitoring demonstrated that bursts of sharpened polyphasic waves coinciding with alpha-rhythm on scalp EEG are consistent with epileptic discharges on the brain cortex surface. This allows to think of these components as correlates of epileptic activity. Therefore, on a number of occasions in patients with epilepsy a dissonance between clinical signs and electroencephalographic patterns recorded during restful wakefulness may be observed, when epileptiform components are absent or reduced to nonspecific complexes.

scholarly journals “Ictal” Bradyarrhythmias in Patients with Drug-Resistant Epilepsy: Results of Long-Term Heart Rhythm Monitoring

Kardiologiia ◽  
2021 ◽  
Vol 60 (12) ◽  
pp. 90-96
Author(s):  
S. E. Serdyuk ◽  
K. V. Davtyan ◽  
S. G. Burd ◽  
E. S. Mishina ◽  
O. M. Drapkina ◽  
...  
Keyword(s):  
Heart Rhythm ◽  
Epileptic Seizures ◽  
Channel Blockers ◽  
Drug Resistant ◽  
Disorder Of Consciousness ◽  
Functional Changes ◽  
Long Duration ◽  
Drug Resistant Epilepsy ◽  
Patients With Epilepsy

Aim      To determine the type and incidence of ictal bradyarrhythmias in patients with drug-resistant types of epilepsy by long-term electrocardiogram (ECG) monitoring.Material and methods  Subcutaneous ECG monitors programed for recording pauses >3 sec and episodes of bradycardia ≤45 bpm were implanted in 193 patients with persistent epileptic seizures without organic pathology of the myocardium. Recording was activated by the patient/family at the onset of epileptic seizure. The follow-up period was 36 months with visits to the clinic every three months.Results For 36 months of monitoring, 6494 ECG fragments were recorded. Ictal bradycardia was observed in 6.7 % of patients, including ictal asystole in 2.6 % of patients. Episodes of bradycardia and asystole during epileptic seizures were transient and developed significantly more frequently in men, patients with long duration of the disease, bilateral tonic-clonic or focal seizures with disorder of consciousness, during sleep, on the background of treatment with several antiepileptic agents, mostly from the group of potassium channel blockers.Conclusion      Bradyarrhythmias accompanying epileptic seizures are transient and reproducible from seizure to seizure. They reflect functional changes in the myocardium and do not determine the life prediction for patients with epilepsy without organic pathology of the heart.

scholarly journals Symptomatic Epileptic Seizures in Patients with Brain Gliomas

2021 ◽  
Vol 10 (3) ◽  
pp. 549-557
Author(s):  
D. I. Abzalova ◽  
A. V. Prirodov ◽  
M. V. Sinkin
Keyword(s):  
Antiepileptic Drugs ◽  
Tumor Resection ◽  
Epileptic Seizures ◽  
Low Grade ◽  
Drug Resistant ◽  
Newly Diagnosed ◽  
New Antiepileptic Drugs ◽  
Cerebral Gliomas ◽  
Brain Gliomas

Introduction. Epileptic seizures are an important problem that significantly worsens the quality of patients’ life with both newly diagnosed and recurrent brain gliomas.Review. The analysis of domestic and foreign literature showed that low-grade gliomas, this symptom occurs on average in 76%, with high-grade gliomas – in 21% of patients. Despite the maximum allowable tumor resection, it is likely that epileptic seizures persist in 18-64% of patients, and in 5% of patients they first appear in the postoperative period. From 15 to 50% of epileptic seizures in cerebral gliomas are drug-resistant. In patients undergoing chemotherapy, it is better to use new antiepileptic drugs because their cross-effects are minimal.Conclusion. There is no generally accepted algorithm for prescribing and discontinuing antiepileptic drugs in patients with symptomatic epileptic seizures with cerebral gliomas. Further research is needed to determine the optimal combination and dosage regimen of antiepileptic drugs, especially during chemotherapy.

scholarly journals ABCB1 Polymorphisms and Drug-Resistant Epilepsy in a Tunisian Population

2019 ◽  
Vol 2019 ◽  
pp. 1-16
Author(s):  
Malek Chouchi ◽  
Hedia Klaa ◽  
Ilhem Ben-Youssef Turki ◽  
Lamia Hila
Keyword(s):  
Treatment Response ◽  
Antiepileptic Drugs ◽  
Gene Polymorphisms ◽  
Tunisian Population ◽  
Drug Resistant ◽  
Population Genetic Analysis ◽  
Interindividual Variations ◽  
Treatment Failure Rate ◽  
Epileptic Patients ◽  
Drug Resistant Epilepsy

Background. Epilepsy is one of the most common neurological disorders with about 30% treatment failure rate. An interindividual variations in efficacy of antiepileptic drugs (AEDs) make the treatment of epilepsy challenging, which can be attributed to genetic factors such as ATP-Binding Cassette sub-family B, member1 (ABCB1) gene polymorphisms. Objective. The main objective of the present study is to evaluate the association of ABCB1 C1236T, G2677T, and C3435T polymorphisms with treatment response among Tunisian epileptic patients. Materials and Methods. One hundred epileptic patients, originated from north of Tunisia, were recruited and categorized into 50 drug-resistant and 50 drug-responsive patients treated with antiepileptic drugs (AEDs) as per the International League Against Epilepsy. DNA of patients was extracted and ABCB1 gene polymorphisms studied using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results. The C1236T, G2677T, and C3435T polymorphisms were involved into AED resistance. Significant genotypic (C1236T TT (p≤0.001); G2677T TT (p=0.001); C3435T TT (p≤0.001)) and allelic associations (C1236T T (3.650, p≤0.001); G2677TT (1.801, p=0.044); C3435T T (4.730, p≤0.001)) with drug resistance epilepsy (DRE) were observed. A significant level of linkage disequilibrium (LD) was also noted between ABCB1 polymorphisms. Patients with the haplotypes CT and TT (C1236T-G2677T); GT, TC, and TT (G2677T-C3435T); CT and TT (C1236T-C3435T); CTT, TTC, TGT, and TTT (C1236T-G2677T-C3435T) were also significantly associated to AED resistance. Conclusions. The response to antiepileptics seems to be modulated by TT genotypes, T alleles, and the predicted haplotypes for the tested SNPs in our population. Genetic analysis is a valuable tool for predicting treatment response and thus will contribute to personalized medicine for Tunisian epileptic patients.

scholarly journals The use of perampanel in drug-resistant focal epilepsy: its effect on sleep

2020 ◽  
Vol 12 (6) ◽  
pp. 49-53
Author(s):  
A. A. Filin ◽  
M. V. Tardov ◽  
N. L. Kunelskaya ◽  
P. N. Vlasov
Keyword(s):  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Focal Epilepsy ◽  
Drug Resistant ◽  
Quality Of Sleep ◽  
Night Sleep ◽  
Nocturnal Sleep ◽  
Therapy Regimen ◽  
Drug Resistant Epilepsy

Perampanel (PER) is an antiepileptic drug (AED), the effects of which on sleep have not been studied in Russia.Objective: to assess changes in the quality of sleep, the level of daytime sleepiness, and the polysomnographic (PSG) characteristics of nocturnal sleep in patients with drug-resistant focal epilepsy when PER is incorporated into the therapy regimen as an additional AED.Patients and methods. The investigation enrolled 12 patients (4 men and 8 women) aged 21 to 49 years with drug-resistant epilepsy treated with several AEDs, who had initiated therapy with PER as an additional AED. PSG study and questioning survey were done before and 1 month after initiation of PER therapy.Results and discussion. After one month of PER therapy, there was an increase in the quality of night sleep in 5 cases and a reduction in daytime sleepiness in 6 cases. The PSG pattern was stable in 3 patients, worsened in 1, and improved in 8.Conclusion. The preliminary results suggest that PER therapy improves night sleep quality and reduces daytime sleepiness in about half of the cases, as evidenced by the improved PSG pattern in 67% of patients.

Sign in / Sign up

Export Citation Format

Share Document