[Focal features of idiopathic generalized epilepsy].

Idiopathic generalized epilepsies (IGE), in some cases, have focal features in the kinematic of seizures and in the EEG. The aim of the paper was to study these clinical phenomena using video-EEG monitoring. We studied 180 patients (80 men and 100 women) with different forms of IGE with epileptic seizures recorded with this method. The effect of the "superposition" of focal electro-clinical features on the kinematic matrix and EEG pattern of the generalized myo- (clonic)-tonic-clonic seizures was noted. The authors suggest to discuss the definition of the "phenomenon of secondary focalization". This is the clinical/electroencephalographic phenomenon developed in IGE and presented by the appearance of secondary focal features (clinical and electroencephalographic) in the structure of the generalized epileptic seizure. The evidence for the secondary generalization of the seizure with the presence of the regional cortical ictogenic source as well as the diagnosis of focal epilepsy are the exclusion criteria for the phenomenon of secondary focalization.

[Side-effects of antiepileptic treatment: the current state of the problem].

The current treatment of epilepsy is directed not only at the control of seizures and comorbid states but at the improvement of quality of life and destigmatization that is the key strategic direction. The basis of treatment of epilepsy is a long-term regular taking of antiepileptic drugs (AED). However, it has been shown that quality of life of patients depends not only on clinical presentations of the disease, including seizures and higher mental functions, but on the tolerability of AED. The safety of these drugs becomes the most important component of the treatment even compared to the control of seizures. Therefore, tolerability and compliance (a patient's adherence to a recommended course of treatment, common understanding between a doctor and a patient as well as his/her relatives) receive special attention. The timed detection and correction of side-effects is an integral component of treatment of epilepsy. In some cases, the presence of rare seizures with minimal clinical presentations and even more frequent seizures that are not danger for a patient seems to be more appropriate than the increase in the number and doses of AED reducing quality of life. The balance between therapeutic and toxic effects of AED is a key issue of treatment of epilepsy.

[Modern principles of epilepsy therapy].

Long regular use of antiepileptic drugs (AED) aimed at reducing frequency of seizures or stopping them completely without any significant side-effects is a main principle of epilepsy treatment. The main attention is drawn to the issues of tolerability of antiepileptic therapy and compliancy, mutual understanding between a physician and a patient as well as relatives and other significant persons. The timely detection and correction of side-effects is integral part of epilepsy treatment. Currently, the attention is focused on quality of life of patients with epilepsy including physical and mental health, education, social and psychological functioning. In some cases, the occurrence of rare seizures with minimal clinical presentation or even more frequent seizures which are not dangerous to a patient is less harmful than decreasing of quality of life due to the effect of larger AED number or dose. The balance between AED therapeutic and toxic effects is a main question in epilepsy therapy. Pharmacotherapy of epilepsy requires deep knowledge of AED: spectrum of therapeutic efficacy and extent of drug effect; safety, tolerability and side-effects, in particular severe and life-threatening ones, specifics of pharmacokinetics, pharmacodynamics, between-drug interactions and mechanisms of action; titration rate, necessity in laboratory tests during treatment, peculiarities of application of pharmacoeconomics. The present review addresses modern aspects of epilepsy therapy.

[Disorders of cardiac rhythm and the changes in Q-T interval in mitral valve prolapse syndrome]. / Narusheniia serdechnogo ritma i izmeneniia intervala Q-T pri sindrome prolabirovaniia mitral'nogo klapana.

To study the incidence and nature of cardiac arrhythmias and the changes in the corrected Q-T interval, 60 patients with the prolapsed mitral valve syndrome were examined. All the patients underwent resting ECG and leg isometric exercise. 24-hour ECG monitoring was performed in 48 patients. The latter technique was found to be the most informative tool for detecting cardiac arrhythmias (66.8%). Prolonged corrected Q-T interval (more than 440 msec) was more frequently revealed in leg isometric exercise (41.6%) than in resting ECG (26.6%) and 24-hour monitoring (29.2%). Its degree was directly related to the severity of cardiac arrhythmias in patients with the prolapsed mitral valve syndrome.