[The impact of antiepileptic therapy on sleep disorders in women with epilepsy]. / Vliyanie protivoepilepticheskoi terapii na narusheniya sna u zhenshchin s epilepsiei.

OBJECTIVE: To analyze the frequency of various sleep disorders in patients with epilepsy receiving antiepileptic therapy. MATERIAL AND METHODS: Sixty-four women were selected from the register of patients with epilepsy and other paroxysmal conditions. The group consisted of young and middle-aged women (36.9±13.5 years), all patients received antiepileptic therapy. To diagnose sleep disorders, we used a sequential algorithm for clinical examination supplemented by instrumental methods according to indications (polysomnography, respiratory monitoring). RESULTS: The duration of epilepsy was 15.7±7.6 years, the disease was represented by three forms: structural (n=15, 23.4%), genetic (n=32, 50%) and unspecified (n=17, 26.6%). Sleep disorders were common among female patients with epilepsy (43.7%), they are most frequently combined with genetic epilepsy (18.7%), and represented by: insomnia (43%) mild to moderately severe breathing disorders (32%) and sleep movement disorders (25%). Sleep disorders were combined with symptoms of depression in the majority of patients (71%). A 6-month follow-up evaluation of nighttime sleep parameters after treatment showed a decrease in the frequency of sleep disorders to 25%; scores on the Epworth Sleepiness Scale significantly decreased to 6.7±3.6. A change in antiepileptic therapy in patients with sleep breathing disorders resulted in a marked regression of the Apnea-Hypopnea Index (9.2±2.5 points; p=0.003). However, there were no significant changes in the severity of sleep movement disorders. CONCLUSION: Sleep disorders are common in patients with epilepsy, in most cases they are associated with mood disorders, and may regress after optimization of antiepileptic therapy.

[Diagnosis and treatment of pelvic disorders in patients with multiple sclerosis].

Pelvic dysfunction is a frequent severe manifestation of multiple sclerosis (MS). Basing on the experience in management of 70 MS patients with pelvic affection, we developed an algorithm of outpatient care for such patients which involves neurological, urological and gastroenterological assistence.