Abstract
Background. To choose tactics for patients with a single unprovoked generalized convulsive seizure (SUGCS) is a quite a challenge due to the lack of common approaches to interpreting this episode. Objective: to study the clinical, electroencephalographic (EEG), neuroimaging (magnetic resonance imaging (MRI) — positron emission tomography (PET)) and morphocytochemical features of peripheral blood cells (PBC) in patients with SUGCS. Patients and methods. Group 1 included 47 patients with SUGCS. A comparison group comprised 50 patients with different forms of locally induced symptomatic and/or cryptogenic epilepsy (LIE). All the patients underwent complex clinical examination including EEG, MRI, and PBC morphocytochemical study, which could reveal predictors for a high risk of recurrent convulsive seizure. In addition, PET was performed in 34 (72%) patients with SUGCS and 41 (82%) patients with LIE. Results and conclusion. The paper shows the possibilities of complex diagnosis using highly informative studies (PET, PBC cytomorpholog-ical examination) that allows identification of predictors of a high risk for a recurrent convulsive seizure. The findings may be useful in defining the treatment policy in patients with SUGCS and in timely using antiepileptic therapy.
Highlights
To choose tactics for patients with a single unprovoked generalized convulsive seizure (SUGCS) is a quite a challenge due to the lack of common approaches to interpreting this episode
The paper shows the possibilities of complex diagnosis using highly informative studies (PET, peripheral blood cells (PBC) cytomorphological examination) that allows identification of predictors of a high risk for a recurrent convulsive seizure
The findings may be useful in defining the treatment policy in patients with SUGCS and in timely using antiepileptic therapy
Summary
Бехтерева» Минздрава России, 2ГБОУ ВПО «Северо-Западный государственный медицинский университет им. Однократный неспровоцированный генерализованный судорожный эпилептический припадок: результаты обследования и 5-летнего катамнестического наблюдения 47 пациентов. Цель исследования – изучение клинико-электроэнцефалографических (ЭЭГ), нейровизуализационных (магнитно-резонансная – МРТ – и позитронно-эмиссионная – ПЭТ – томография) и морфоцитохимических особенностей клеток периферической крови (ПК) у больных с ОГСЭП. В 1-ю группу было включено 47 пациентов с ОГСЭП. Всем больным проведено комплексное клиническое обследование, включая ЭЭГ, МРТ, а также морфоцитохимическое исследование клеток ПК. 34 (72%) больным с ОГСЭП и 41 (82%) с ЛОЭ выполнена ПЭТ. В статье показаны возможности комплексной диагностики с использованием современных высокоинформативных методов обследования (ПЭТ, цитоморфологическое исследование клеток ПК), позволяющих выявить предикторы высокого риска развития повторного судорожного эпизода. Полученные результаты могут быть полезны для определения лечебной тактики у пациентов с ОГСЭП и своевременного назначения антиэпилептической терапии. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg
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