Regularities in the course of epilepsy during various age periods

Abstract

Objective : to optimize patient management tactics and disease prognosis, by detecting the regularities of the course of epilepsy during various age periods. Patients and methods. The results of following up 1632 patients with epilepsy in the Samara Region were given. Among them, there were 865 (53.0%) men and 767 (47.0%) women. The classification of epilepsy and epileptic syndromes (New Delhi, 1989) was used to establish the diagnosis. Each patient underwent neurological evaluation, electroencephalography (EEG) and video-EEG monitoring, studies of long-latency visual evoked potentials, as well as neuroimaging examinations (brain computed tomography and magnetic resonance imaging (MRI)). Factor and principal component analysis and logistic regression were used to make a mathematical model to predict remission in epilepsy. Results . The specific features of the occurrence and course of epilepsy in various age periods were analyzed. According to the results of mathematical simulation, the age at the onset of late epilepsy can be considered to be 29 years. Remission of epilepsy was more frequently attained and absolute resistance was less frequently observed in the younger age group, except for infants with catastrophic epilepsy and epileptic syndromes. There were fewer remissions and much more patients with relative and absolute resistance and rare seizures in the older age group. Epilepsy in young patients is that of the immature brain and epilepsy of adulthood (late epilepsy) of the involutional brain. Conclusion . Epilepsy runs a benign course in patients who fell ill in adolescence or adulthood and have minimal brain structural changes, as evidenced by MRI. Marked brain morphological changes most frequently determine the drug-resistant course of epilepsy, manifesting in early childhood and at an elderly age.