[Features of maternal behavior in women with epilepsy]. / Osobennosti materinskogo povedeniia bol'nykh épilepsiei zhenshchin.

AIM: To study characteristics of maternal behavior in women with epilepsy. MATERIAL AND METHODS: Twenty-three women with epilepsy, aged 25-35 years, with one or more children, aged 0-10 years, were interviewed. Thirty age-matched women were included in the control group. The following psychological methods were used: the projective test 'Mother and Child', the Scale of the degree of rejection of a child in the family, the Parent Institution Study Test Questionnaire (PARI), the projective methodology 'Unfinished sentences', a method for diagnosing the level of empathic abilities. RESULTS AND CONCLUSION: The style of child upbringing in women with epilepsy is authoritarian, directive. Often there is egocentrism, fixation on one's own behalf, internal coldness. Mothers with epilepsy have a reduced level of empathy and are irritable, anxious, hyperopic, indulgent, emotionally cold, hypochondriac, uncritical, dependent, devout, conceited.

[Pharmacogenetic markers of metabolic disorders in the treatment with valproic acid]. / Farmakogeneticheskie markery metabolicheskikh narushenii pri lechenii val'proevoi kislotoi.

The review includes studies on the association between the use of VA drugs and weight gain in patients with epilepsy as well as other valproate-induced adverse drug reactions, including insulin resistance. Understanding the mechanisms of significant weight gain of patients taking VA drugs will help personalize antiepileptic therapy and minimize the risk of valproate-induced obesity.

[Brivaracetam in the treatment of patients with epilepsy]. / Brivaratsetam v lechenii bol'nykh épilepsiei.

The newest antiepileptic drug (AED) brivaracetam (Briviac, UCB Pharma) (BRV) was approved in the Russian Federation in 2017 as an adjuvant therapy for the treatment of partial seizures with/without secondary generalization in adults and adolescents over 16 years old with epilepsy. This review contains the data of BRV preclinical studies, pharmacokinetic profile and the results of comparative study of BRV and LEV. The results of main studies of efficacy and tolerability with pooled analysis as well as data from meta-analysis are presented. The authors present conclusions of the Russian leading epileptologists on perspectives of using BRV in different populations of epileptic patients. The use of BRV is able to provide long-term efficacy in terms of seizure control, is well tolerated, keeps quality of life and social activity of people with epilepsy.

[Lacosamide (vimpat). Prospects for clinical application]. / Lakosamid (vimpat). Perspektivy klinicheskogo primeneniia.

This article presents the review of the most significant studies of the efficacy and tolerability of lacosamide (LCM) in treatment of patients with focal epilepsy. The review includes the results of the main studies which preceded the official approval of LCM use in mono- and polytherapy. Results on the efficacy of LCM in long-term use and treatment retention in clinical practice, most effective LCM combinations, tolerability, an influence on cognitive and mental functions, advantages in treatment of elderly patients are presented. Characteristics of LCM in comparison with other sodium channel-blocking antiepileptic drugs and selection priorities are shown. The authors assess perspectives of further use of LCM in clinical practice.

[The structure of the non-psychotic mental disorders in patients with epilepsy with and without pharmacoressistance]. / Struktura nepsikhoticheskikh psikhicheskikh rasstroistv u bol'nykh epilepsiei v zavisimosti ot nalichiya ili otsutstviya farmakorezistentnosti.

AIM: Patients with epilepsy (PE) develop persistent mental disorders identified as significant personal and affective disorders, especially of depressive and anxiety spectrum, observed in the interictal period of the disease. To study the frequency of non-psychotic mental disorders in patients with epilepsy, to specify the clinical features of non-psychotic affective disorders and to analyze the association of different variants of affective disorders with symptoms of drug-resistance in epilepsy (DRE). MATERIAL AND METHODS: One hundred and sixty patients with epilepsy, including 80 patients with DRE and 80 patients with controlled epilepsy (CE), were studied using a battery of psychometric scales. RESULTS AND CONCLUSION: The variety of depressive and anxious psychiatric condition was detected in 59.4% of PE, in 86.3% of patients with DRE and in 32.5% with CE. A clinical and psychopathological analysis of non-psychotic mental disorders showed that the frequency of affective disorders as well as great «structural complexity¼ and the depth of depressive and anxiety disorders were significantly higher in the group of patients with DRE compared to patients with CE. Patients with affective symptoms had earlier onset and the longer course of disease.

[Russian experience of lacosamide (vimpat) usage in treatment of uncontrolled focal epilepsy]. / Rossiiskii opyt primeneniya lakosamida (vimpat) pri lechenii patsientov s nekontroliruemoi fokal'noi epilepsiei.

Many patients with epilepsy receive treatment in polytherapy. Selection of antiepileptic drugs (AEDs) for the combination should be carried out in accordance with the principles of rational polytherapy, taking into account the mechanism of action, pharmacokinetic (PK) and pharmacodynamic (PD) properties of drugs. Along with levetiracetam, gabapentin, vigabatrin and pregabalin, lacosamide (LCM) shows superior PK profile in rating of all AED and can be combined with any of them. The goal of this study was to evaluate efficacy and tolerability of LCM in patients with uncontrolled partial onset seizures (POS) in routine clinical practice. METHODS: 181 patient's charts from 14 sites in Russia have been analyzed in retrospective manner. Patients 16 years old and older with POS with or without secondary generalization were included. Documented observation period of up to 12 months after initiation or until discontinuation of LCM therapy. Primary effectiveness variables was retention at Observational Point 3 (approximately 12 months). Other variables were: percentage change from historical baseline in seizure frequency, 50% and 75% treatment response and seizure-free status at the Observational Points 1, 2 and 3 (approximately 3, 6 and 12 months) and incidence and reason of treatment discontinuation. RESULTS: retention rate was high with 89.5% after 12-month observation. The development of seizure frequency showed a continuous decrease in terms of 50%, 75% treatment respond rates and seizure free status. A total of 5 adverse drug reactions leading to discontinuation of LCM therapy were recorded in 5 of 181 patients (2.8%) during the observation period. The high retention rate observed in this retrospective chart review is assumed to indicate a good tolerability and effectiveness of an adjunctive LCM treatment in patients with uncontrolled partial epilepsy in Russia.

[Preventing cardiovascular risk in miners].

The article presents results concerning usage of intravenous laser radiation of blood in miners with cardiovascular diseases. After cardiovascular state assessment, the miners at high cardiovascular risk were subjected to prophylactic procedures with traditional medical treatment added by intravenous laser therapy. Findings are anti-arrhythmic, antihypertensive, antiatherogenic and anti-aggregation effects of complex treatment with intravenous laser radiation of blood in miners at high cardiovascular risk and its subsequent decrease due to treatment.

[Algorithms of mono- and polytherapy in clinical epileptology. Part 1. General principles of drug choice]. / Algoritmy mono- i politerapii v klinicheskoi épileptologii. Chast' 1. Obshchie printsipy vybora farmakoterapii.

The large number of antiepileptic drugs (AEDs) at the physician's disposal provides not only a broad therapeutic potential in the treatment of epilepsy (EP), but creates difficulties in the adequate choice of AED. The sufficient experience in the management of patients with epilepsy has been gained so far in the world, based on which the International League Against Epilepsy (ILAE), updated classification, adopted the basic definition of efficiency, remission, resistance, evidence of research on the effectiveness of AED therapy, and introduced the concept of "resolved" epilepsy. In this article, a group of Russian experts suggest recommendations on the main steps in the choice of therapy in epilepsy. Possible drug interactions between different AEDs and other drugs as well as main characteristics of mono- and polytherapy of epilepsy are described. Some features of the use of AEDs in the elderly, characteristics of the "female" epilepsy related to the reproductive function and basic requirements for the therapy of epilepsy in children are presented.

[Algorithms of mono- and polytherapy in clinical epileptology]. / Algoritmy mono- i politerapii v klinicheskoi épileptologii. Chast' 2. Osobennosti lecheniia otdel'nykh grupp patsientov.

The large number of antiepileptic drugs (AEDs) at the physician's disposal provides not only a broad therapeutic potential in the treatment of epilepsy (EP), but creates difficulties in the adequate choice of AED. The sufficient experience in the management of patients with epilepsy has been gained so far in the world, based on which the International League Against Epilepsy (ILAE), updated classification, adopted the basic definition of efficiency, remission, resistance, evidence of research on the effectiveness of AED therapy, and introduced the concept of "resolved" epilepsy. In this article, a group of Russian experts suggest recommendations on the main steps in the choice of therapy in epilepsy. Possible drug interactions between different AEDs and other drugs as well as main characteristics of mono- and polytherapy of epilepsy are described. Some features of the use of AEDs in the elderly, characteristics of the "female" epilepsy related to the reproductive function and basic requirements for the therapy of epilepsy in children are presented.

[Acute symptomatic epileptic seizures and status epilepticus].

Acute symptomatic seizures (ASS) are the seizures of different etiology that occur in close temporary relationship to acute damage of the central nervous system arising simultaneously due to metabolic, toxic, infectious and inflammatory factors and structural brain damage. At the time of its origin, ASS is often not distinguished from epileptic seizures in the clinical and electrophysiological parameters, although represent a fundamentally different state from the point of view of pathogenesis, therapy and prognosis. Tactics in the ASS and symptomatic epileptic status of any nature provides for the immediate carrying out differential diagnosis and differential treatment. Treatment of ASS includes two aspects: reduction in ictal activity (seizures) and prevention of future development of seizures through the elimination or correction of physiological trigger of the attacks and the decision to conduct a long-term antiepileptic drug therapy if the risk of seizures is saved.

[Possibilities of using intravenous forms of antiepileptic drugs in epileptic seizures]. / Vozmozhnosti primeneniia vnutrivennykh form protivoépilepticheskikh preparatov pri épilepticheskikh pristupakh.

The literature data on using intravenous forms of AEDs that expand treatment possibilities for patients with epilepsy are presented. AEDs can be used in different situations, when patients are not able to take AEDs in per os. These situations can include seizure emergencies (recurrent seizures, clusters, status epilepticus), caused by disease decompensation; acute symptomatic seizures; perioperative preparation in the case of surgery; dysphagia; gastrointestinal problems; psychiatric disorders, and others. This article is based on a review of International and Russian expert consensus practice guidelines for management of clinical situations mentioned above. The authors present data on available Russian parenteral forms of drugs used today (valproats, levetiracetam, lacosamide, diazepam, midazolam, propofol, thiopental potassium). It has been concluded that an ideal intravenous AED should be highly effective, acts fast, has no severe adverse effects, has low drug-drug interactions, does not require frequent plasma concentration monitoring, and should be easily switched to a per os form without any additional titration. The importance of separate treatment approaches on different stages of medical help is emphasized. The choice of drug used can be influenced by a particular clinical situation, indications/contraindications, the recommended infusion speed, side effects, possible drug-drug interactions with other AEDs and other drugs used for the treatment of concomitant diseases, availability of a particular drug at the moment and the level of a physician's knowledge of usage of intravenous forms of AEDs.

[The use of the antiepileptic drug trileptal in the clinical practice].

The data on therapeutical efficacy of the new antiepileptic drug trileptal (oxcarbazepine) and results of the own observations of 38 patients with partial epilepsy who received trileptal as mono- or polytherapy are presented. The high efficacy and good tolerability of the drug has been shown. The seizure control has been obtained in 84% of patients.

[The use of generic valparin xr in the treatment of epilepsy.].

Therapeutic efficacy of valparin xr, a new form of valproic acid (VPA) generic drugs, manufactured by "Torrent Pharmaceuticals Ltd", India, has been studied in 25 patients with epilepsy of different types and frequency of seizures. The therapeutic efficacy similar to that of an original VPA was determined in monotherapy strategy, being lower in polytherapy, but more effective than other antiepileptic treatment. As for original drugs, the best results were obtained for controlling myoclonic and polyclonic seizures. The percentage of side-effects did not exceed the same index for brand drugs. The substantial advantage of valparin xr is a lower price as compared to the original VPA.

[Topamax in the treatment of epilepsy].

To specify efficacy of topamax in different types of epileptic seizures and its influence on patient's quality of life (QL), the drug was assigned to 38 patients, aged 18-69 years, as mono- and polytherapy (in combination with other anticonvulsive medications). Topamax dosages ranged from 25-50 mg at a base-line to 600 mg. Treatment duration was 6-18 months. Positive effect of different extent was achieved in 95.7% patients. A seizures frequency decreased by 25% in 17.4% patients; by 50%--in 8.7%; by 75%--in 43.5%; a complete disappearance of seizures was detected in 30.4%. The results confirmed the earlier data received by the authors that topamax was most effective in generalized convulsive, partial and secondary generalized seizures. It exerts a less pronounced effect in myoclonic seizures and absences. After topamax treatment, a total QL index measured by WHO questionnaire increased by 5.2%. The drug is well tolerated and does not affect cognitive functions of the patients. It is concluded that currently topamax is one of the most effective antiepileptic medications.

[Medico-social aspects of risk factors impairing quality of life in patients with epilepsy]. / Mediko-sotsial'nye aspekty riska razvitiia oslozhnenii zhizni bol'nykh épilepsiei.

The results of 2-year multicenter project "Epilepsy, risk factors and insurance" organized by Epilepsy European Commission, on risk factors deteriorating quality of life of epileptic patients in 9 European countries (Italy, Germany, Spain, Netherlands, England, Portugal, Estonia, Russia and Slovenia), have been used in the study. The "patient-control" pairs were matched for various features characterizing social aspects of epileptic patient's life (educational level, professional level and employment, marital status, driving abilities, sports, medical insurance) as well as medical events (concomitant diseases, medical complications, seizures, frequency of accidents, hospitalization, disablement indices, etc). Patients at low and high risk for quality of life impairment were defined. In Russia, the rate of these risk factors in epileptic patients corresponds in general to that in other European countries.