Neurological Practice in the Time of War: Perspectives and Experiences from Ukraine.

The full-scale Russian invasion of Ukraine has significantly impacted the country's healthcare system. Insufficient infrastructure, destruction of medical facilities, and barriers to prevention and treatment efforts hinder the provision of timely, high-quality care to our patients. We aim to describe the impact of the war on neurological care across Ukraine. In this article, leading national experts in stroke, epilepsy, multiple sclerosis, and movement disorders describe their personal experience and efforts in organizing and providing care since the war started in February 2022. A neurologist who cared for patients in Mariupol recounts the first weeks of the war when the city was under constant attacks. An international stroke expert describes the role of Task Force for Ukraine, a European Stroke Organization initiative to support the Ukrainian stroke community. We discuss a series of critical challenges facing Ukraine's neurologists, patients, and healthcare delivery system, including shortages of personnel and medical supplies, disrupted logistics, and lack of funding. In addition, we highlight various interventions and strategies aimed at counteracting these challenges, including international support, collaborations within Ukraine, and initiatives enhancing the resilience of the Ukrainian neurology community. As the war is ongoing, this article emphasizes the pressing need for continuous support and investment in the Ukrainian healthcare system to preserve guaranteed access to high-quality healthcare for the Ukrainian people during the war and in its aftermath. Insights from the essays can inform the development and implementation of effective strategies and interventions tailored to such extraordinary circumstances.

A global survey on the attitudes of neurologists and psychiatrists about functional/psychogenic/dissociative/nonepileptic-seizures/attacks, in the search of its name.

PURPOSE: We conducted an observational study to investigate the opinions of neurologists and psychiatrists all around the world who are taking care of patients with seizures [epilepsy and functional seizures (FS)]. METHODS: Practicing neurologists and psychiatrists from around the world were invited to participate in an online survey. On 29th September 2022, an e-mail including a questionnaire was sent to the members of the International Research in Epilepsy (IR-Epil) Consortium. The study was closed on 1st March 2023. The survey, conducted in English, included questions about physicians' opinions about FS and anonymously collected data. RESULTS: In total, 1003 physicians from different regions of the world participated in the study. Both neurologists and psychiatrists identified "seizures" as their preferred term. Overall, the most preferred modifiers for "seizures" were "psychogenic" followed by "functional" by both groups. Most participants (57.9%) considered FS more difficult to treat compared to epilepsy. Both psychological and biological problems were considered as the underlying cause of FS by 61% of the respondents. Psychotherapy was considered the first treatment option for patients with FS (79.9%). CONCLUSION: Our study represents the first large-scale attempt of investigating physicians attitudes and opinions about a condition that is both frequent and clinically important. It shows that there is a broad spectrum of terms used by physicians to refer to FS. It also suggests that the biopsychosocial model has gained its status as a widely used framework to interpret and inform clinical practice on the management of patients.

Dynamics of epidemiological indications of epilepsy prevalence, morbidity and disability among children in kharkiv region, Ukraine.

OBJECTIVE: Introduction: According to the World Health Organization, epilepsy is one of the most common diseases of the central nervous system, which affects 0.5 to 2% of the entire population The aim is comparison of prevalence, incidence and disability from nervous diseases and epilepsy among children of the Kharkiv region of Ukraine and the results are compared with global figures. PATIENTS AND METHODS: Materials and methods: Epidemiological indicators, namely the prevalence and incidence. For the comparative analysis, the statistical data of the last 5 years are used. RESULTS: Review: The prevalence of epilepsy in Ukraine amounts to 25 695 children (3.21%), higher than the prevalence of cerebral palsy or neuroinfections, the average value for 5 years is 24 667 children (3.144%). In the Kharkiv region the number is 1 451 children (3.43%), 5-year average is 1 340 children (3.21%). The incidence of epilepsy in children in Ukraine is 3 306 children (0.43%), the average value for 5 years is 3 569 children (0.454%). In Kharkiv region the incidence is 252 persons (0.53%), an average is 201.2 children (0.468%). CONCLUSION: Conclusions: Reliable epidemiological indicators will make it possible to improve the system of rendering specialized medical care to children with epilepsy, carry out a pharmaco-economic analysis, calculation and estimation of the costs for patients' treatment, which is especially important in the framework of the health care system reformation. Thus, the compilation of patients' registers with epilepsy is one of the urgent tasks to optimize the medical care.