Long-term follow-up in patients with catastrophic epilepsies

Objective: to investigate the features of the course and long-term outcome of catastrophic epilepsies. Patients and methods. A total of 130 patients (62 (47.7%) men and 68 (52.3%) women) aged 21 to 78 years were examined. The follow-up was 1 year to 14 years. The inclusion criteria for the investiga...

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Main Authors: K. V. Firsov, A. S. Kotov
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2019-12-01
Series:Неврология, нейропсихиатрия, психосоматика
Subjects:
Online Access:https://nnp.ima-press.net/nnp/article/view/1213
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author K. V. Firsov
A. S. Kotov
author_facet K. V. Firsov
A. S. Kotov
author_sort K. V. Firsov
collection DOAJ
description Objective: to investigate the features of the course and long-term outcome of catastrophic epilepsies. Patients and methods. A total of 130 patients (62 (47.7%) men and 68 (52.3%) women) aged 21 to 78 years were examined. The follow-up was 1 year to 14 years. The inclusion criteria for the investigation were above 18 years of age; severe epilepsy with daily seizures considered as catastrophic epilepsy. The exclusion criteria were a history of nonepileptic seizures of any etiology, as well as noncompliance. The examination included history data collection; seizure diary analysis; clinical and neurological examination; routine EEG and/or EEG-video monitoring; brain magnetic resonance imaging; and laboratory tests. Results and discussion. The onset of epilepsy immediately with catastrophic seizures was observed in 28 (21.5%) patients; this onset was most frequently seen in 18 of the 28 children. At the same time, catastrophic seizures did not appear immediately, but it took some time for them to occur after the onset of active epilepsy in 102 (78.5%) patients. Moreover, the onset of catastrophic seizures could not be associated with any external influences or errors in 58 (56.9%) of these patients taking the drugs. Transition to catastrophic epilepsy could occur both abruptly in 11 (10.8%) patients and gradually in 91 (89.2%). After treatment correction, 16.8% of patients achieved remission at the time of study completion; the frequency of seizures decreased by 50% or more in 27.1% of cases; the effect was absent in 56.1%. Conclusion. Based on the findings, it can be concluded that in catastrophic epilepsy, the probability exists for spontaneous occurrence and remission of destructive seizures, frequently regardless of the therapy. The onset of the disease and that of catastrophic seizures can be spread in time. The efficiency of treatment remains low in patients with catastrophic epilepsies.
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spelling doaj.art-09f49dd600a943eab5ee6d5af1ee32a32023-03-13T08:42:19ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422019-12-01114778110.14412/2074-2711-2019-4-77-81925Long-term follow-up in patients with catastrophic epilepsiesK. V. Firsov0A. S. Kotov1M.F. Vladimirsky Moscow Regional Research Clinical InstituteM.F. Vladimirsky Moscow Regional Research Clinical InstituteObjective: to investigate the features of the course and long-term outcome of catastrophic epilepsies. Patients and methods. A total of 130 patients (62 (47.7%) men and 68 (52.3%) women) aged 21 to 78 years were examined. The follow-up was 1 year to 14 years. The inclusion criteria for the investigation were above 18 years of age; severe epilepsy with daily seizures considered as catastrophic epilepsy. The exclusion criteria were a history of nonepileptic seizures of any etiology, as well as noncompliance. The examination included history data collection; seizure diary analysis; clinical and neurological examination; routine EEG and/or EEG-video monitoring; brain magnetic resonance imaging; and laboratory tests. Results and discussion. The onset of epilepsy immediately with catastrophic seizures was observed in 28 (21.5%) patients; this onset was most frequently seen in 18 of the 28 children. At the same time, catastrophic seizures did not appear immediately, but it took some time for them to occur after the onset of active epilepsy in 102 (78.5%) patients. Moreover, the onset of catastrophic seizures could not be associated with any external influences or errors in 58 (56.9%) of these patients taking the drugs. Transition to catastrophic epilepsy could occur both abruptly in 11 (10.8%) patients and gradually in 91 (89.2%). After treatment correction, 16.8% of patients achieved remission at the time of study completion; the frequency of seizures decreased by 50% or more in 27.1% of cases; the effect was absent in 56.1%. Conclusion. Based on the findings, it can be concluded that in catastrophic epilepsy, the probability exists for spontaneous occurrence and remission of destructive seizures, frequently regardless of the therapy. The onset of the disease and that of catastrophic seizures can be spread in time. The efficiency of treatment remains low in patients with catastrophic epilepsies.https://nnp.ima-press.net/nnp/article/view/1213epilepsycatastrophic epilepsyepileptic encephalopathyremissionrecurrencediagnosistreatmentprognosiselectroencephalographymagnetic resonance imaging
spellingShingle K. V. Firsov
A. S. Kotov
Long-term follow-up in patients with catastrophic epilepsies
Неврология, нейропсихиатрия, психосоматика
epilepsy
catastrophic epilepsy
epileptic encephalopathy
remission
recurrence
diagnosis
treatment
prognosis
electroencephalography
magnetic resonance imaging
title Long-term follow-up in patients with catastrophic epilepsies
title_full Long-term follow-up in patients with catastrophic epilepsies
title_fullStr Long-term follow-up in patients with catastrophic epilepsies
title_full_unstemmed Long-term follow-up in patients with catastrophic epilepsies
title_short Long-term follow-up in patients with catastrophic epilepsies
title_sort long term follow up in patients with catastrophic epilepsies
topic epilepsy
catastrophic epilepsy
epileptic encephalopathy
remission
recurrence
diagnosis
treatment
prognosis
electroencephalography
magnetic resonance imaging
url https://nnp.ima-press.net/nnp/article/view/1213
work_keys_str_mv AT kvfirsov longtermfollowupinpatientswithcatastrophicepilepsies
AT askotov longtermfollowupinpatientswithcatastrophicepilepsies