DOI: https://doi.org/10.22141/2224-0713.4.106.2019.174048

Evaluation of clinical parameters in patients with symptomatic vascular epilepsy and chronic disorders of cerebral circulation

M.M. Mushegian, T.A. Litovchenko, A.A. Voitiuk

Abstract


Background. Among the mechanisms of epilepsy in older persons, the leading role belongs to chronic cerebral ischemia associated with slowly progressive insufficiency of its blood supply. Significant prevalence of cerebrovascular pathology in the elderly and its consequences in the form of vascular epilepsy determine the relevance of the study of its pathogenesis, clinical course and effectiveness of treatment. We performeda comparative assessment of clinical, functional and hemodynamic features of the course of chronic cerebral ischemia in patients with and without epileptic seizures. Materials and methods. A retrospective and prospective analysis of the case histories of 76 patients with chronic cerebrovascular disorders was carried out; 38 of them had epileptic seizures (the first group), the second group involved patients with no seizures. Results. In both groups of patients, the second stage of dyscirculatory encephalopathy and stage 2 hypertension were significantly more frequently observed. In patients of the first group, complex partial generalized seizures were significantly more often observed in men (8 (47 %) and 2 (9.5 %) women; χ2 = 5.65; p < 0.05); absences accompanied consciousness were registered in one (5.9 %) men and 5 (23.8 %) women; tonic-clonic seizures were significantly more often observed in men (17 (100 %) men and 12 (57 %) women; χ2 = 9.55; p < 0.05), that indicates significant gender differences. Analysis of the distribution of patients by EEG type showed that the frequency of occurrence of all its types did not differ significantly, except for the fifth type, which was significantly more common in patients with epilepsy. Conclusions. It was found that focal changes in the brain significantly (p < 0.05) increase the risk of epilepsy by 4.3 times, the presence of paroxysmal activity by 26.9 times, dysfunction of median structures by 6.4 times.


Keywords


epilepsy; chronic disorders of cerebral circulation; electroencephalography; doppler ultrasound examination in epilepsy

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