Objective: Study and compare the clinical and electrophysiological and neuroimaging findings in children with symptomatic epilepsy with lissencephaly, assess the effectiveness of antiepileptic therapy and quality of life of sick children. Methods: The study involved 22 children. Submitted neurological examination, brain MRI (magnetic resonance imaging), EEG (electroencephalography). Results: Neuroimaging in the survey equally revealed pachygyria (50%) and agyria (50%). The 9.09% noted a combination of these anomalies. The debut of epileptic seizures significantly more often observed in the age of six months (50%) (p=0.0304). The predominance of epileptic spasms in the debut of epilepsy (50%). Were reported more often by focal seizures with secondary generalization and without secondary generalization (63,64%). Neuroimaging, EEG correlation was observed in 45.45% of children. In the treatment of seizures in patients with lissencephaly often used valproate (90.9%). Less – topiramate (27.27%), vigabatrin (22.73%), hormones, levetiracetam, carboxamide derivatives (18.18%), benzodiazepines (13.64%), phenobarbital (13.64%), benzonal (4 , 55%). Two patients did not receive treatment in the absence seizures (9.09%). In the analysis of results of treatment of children with lissencephaly revealed the following characteristics: remission of seizures was observed in two (9,09%) children, slowing attacks – ten (45.45%), lack of effect of the therapy – eight (36,36%), including transformation convulsing from six (to 27.27%). Positive dynamics of the EEG was recorded in two (9.09%) patients. Deterioration or lack of positive EEG changes – at eighteen (81.81%). The examined children drug resistance was noted in 36,36%, and the absence of positive EEG changes in 81,81% of cases. Conclusion: The results of the study suggest that one of the common causes of severe forms of epilepsy in children are malformations of brain development, particularly lissencephaly, so their early visualization, verification and adequate antiepileptic therapy correlated with the prevention of pharmacoresistant symptomatic epilepsy and social exclusion of children.
Read full abstract