NEUROPSYCHOLOGICAL STATUS OF PATIENTS WITH EPILEPSY AND CLINICAL MANIFESTATIONS OF CRANIOCEREBRAL DISPROPORATION ON THE BACKGROUND OF MODIFIED THERAPY

V. Larkin, N. Stelmakh
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Abstract

In the course of the study, 124 case records of patients with epileptic seizures (cryptogenic epilepsy) were analyzed. Diagnosis was established based on a typical clinical presentation, anamnesis, electroencephalogram (EEG) dynamics, and/or video EEG monitoring in the 10-hour format. Group I comprised 36 patients with normal liquor-cranial indexes ranging from 1.6 to 3.6 with an average value of 2.1±0.2; these patients received standard multicomponent therapy during the hospitalization and at the outpatient-polyclinic stage. Group II comprised 42 patients who had liquor-cranial indexes below the lower limit of normal ranging from 0.8 to 1.2 with an average value of 1.0±0.1; these patients also received therapy for primary diagnosis according to standard therapy scheme, which was identical to that in group I. Patients of group III (main group, n=46) had liquor-cranial indexes below physiological norm (from 0.8 to 1.2 with an average value of 0.9±0.1) and received modified therapy. Two-year follow up study showed that more severe cognitive deficit developed in patients with low cerebrovascular indexes receiving standard therapy compared to patients with low cerebrovascular indexes who received modified therapy. The absence of significant differences between patients of group I and III suggest that timely correction of increased intracranial pressure allowed to prevent significant aggravation of pathopsychological characteristics, loss of short-term and long-term memory, and overall cognitive function decline.
改良治疗背景下癫痫患者的神经心理状态及颅脑比例失调的临床表现
在研究过程中,分析了124例癫痫发作(隐源性癫痫)患者的记录。根据典型的临床表现、记忆、脑电图(EEG)动态和/或10小时格式的视频脑电图监测建立诊断。第一组36例,酒颅指数正常,1.6 ~ 3.6,平均值2.1±0.2;这些患者在住院期间和门诊-综合门诊阶段接受标准的多组分治疗。II组42例,酒颅指数低于正常下限0.8 ~ 1.2,平均值1.0±0.1;与ⅰ组相同,均按标准治疗方案进行初诊治疗。ⅲ组(主组,n=46)患者酒颅指标低于生理常模(0.8 ~ 1.2,平均值0.9±0.1),接受改良治疗。为期两年的随访研究表明,接受标准治疗的低脑血管指数患者比接受改良治疗的低脑血管指数患者出现更严重的认知缺陷。I组和III组患者之间无显著差异,提示及时纠正颅内压升高可防止病理心理特征明显加重、短期和长期记忆丧失以及整体认知功能下降。
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