Predictors of epilepsy in children after ischemic stroke

Objective. To determine clinical/instrumental predictors of symptomatic epilepsy after ischemic stroke in children. Material and methods. One hundred and thirty-six patients, aged 0-15 years, with the diagnosis of ischemic stroke (ICD-10 I63.0-I63.9) were examined. The duration of the study was 18 months - 12 years. Patients were stratified into post-stroke (n=22) and control (n=114) groups, the latter included patients without epilepsy regardless of the presence of convulsive seizures in the acute stage of stroke. Predictors were determined based on EEG and characteristics of convulsive syndrome in the acute stage of stroke. Results and conclusion. The following prognostic criteria were found: generalized type of seizures, focal type of seizures with secondary generalization, epileptiform (peak and/or peak-wave) activity, focal character of epileptiform activity, generalized type of seizures in the combination with slow wave background activity on EEG, generalized type of seizures in the combination with slow wave activity and disorganized activity on EEG. © 2016, Media Sphera. All Rights Reserved

SOMATIC COMORBID ITY AND DE VELOPIN G EPILEPSY IN CHILDREN AFTER A SINGLE SEI ZURE

Aim – to study chronic somatic comorbidity as a possible predictor of epilepsy in children after a single seizure.Materials and methods. Based on the follow-up results, 279 cases were studied and compared: the study group – epilepsy – included 166 children with two or more seizures developed at least 24 hours after the first seizure; the control group – 113 children with a single seizure that remained isolated for the subsequent three years.Results. We found that at the time of the first (single) attack, the background of chronic ocular morbidity (myopia, hypermetropia, optic nerve atrophy, retinal dystrophy) was significantly more common among children in the control group as compared with the confirmed epilepsy group where cardiovascular disorders prevailed. Other concomitant diseases had no statistically significant correlations with the occurrence of epilepsy after a single seizure.Conclusion. Diagnosis of somatic comorbidity in children with a single seizure may be a prognostic factor of subsequent epilepsy

Formation of the phenotype “epilepsy–autism” in childhood

The combination of autistic spectrum disorders (ASD) with epilepsy is one of the most common neuropsychiatric comorbidities, which occurs with a frequency of up to 46 %. Such a high frequency is explained by the similarity of the pathophysiological mechanisms of each of the nosologies development. The common basis for both epileptogenesis and the development of ASD is the anomalies of neural communication mediated by the inversion of neurotransmission. In the formation of the epilepsy–autism phenotype the most significant is impairment of the departments responsible for the verbal-mediated social functioning. Such disorders are manifested in the lag of mental functions development, as well as in the epileptiform activity forming and epileptic seizures triggering. The epilepsy – autism comorbid phenotype core is represented by forms with an established genetic defect associated with structural pathology of the CNS. However, other ways of forming such a phenotype are also possible. Thus, in the epileptic or epileptiform encephalopathies picture there are often symptoms of ASD called an acquired epileptic neuropsychological syndrome. On the other hand, ASD (or the pervasive developmental disorder semiotics) may develop against the epileptiform changes background. In such cases, autistic epileptiform (in case of clinical seizures–epileptic) regression is diagnosed. Our concept of the epilepsy–autism phenotype forming is based on a detailed comparison of the etiology and pathogenesis of epilepsy and ASD. It is presented in the original cyclic sequence form. The variability of the epilepsy–autism phenotype is also presented in the form of the diagram explaining the perspective of each of the nosologies relationship

THE PARENTS OF CHILDREN WITH EPILEPSY EMOTIONAL STATUS

Purpose – to study mental and emotional status of parents raising children with epilepsy.Materials and methods. The level of mental and emotional state in 23 parents in families where children with epilepsy are raising was studied. Control group consisted 29 parents raising healthy children. The following questionnaires were used in our study:Torontoalexithimia scale (TAS) and the assessment of the quality of life by SF-36 questionnaire.Results. Parents of children with epilepsy have showed a higher score on a scale of alexithimia and a higher chance of having an increased or high score on this test compared with parents of healthy children. Parents of children with epilepsy also have lower rates of almost all scales of SF-36, and a statistically significant lower score on the total mental health component.Conclusion. The parents of children with epilepsy mental and emotional state is exposed to disorders and this fact need to be considered when developing treatment tactics of pediatric patients with epilepsy