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CLINICAL DISORDERS OF PHARMACORESISTANT EPILEPSY IN CHILDREN
WITH VARIOUS FORMS OF CEREBRAL PALSY
Gofurov SH., 503-II faculty pediatrics
Scientific director: Abdusattarova G. SH.
TashMPI, Department: Neurology, children’s neurology, medica l genetics
Relevance:
In the treatment of epilepsy, antiepileptic drugs reduce the frequency of seizures and
reduce their intensity. Resistant epilepsy is a type of disease in which the optimal drugs are ineffective.
Well-chosen drug therapy leads to prolonged remission of the disease and a person can live a full life.
Objective:
To study the clinical features of pharmacoresistant epilepsy in children with various
forms of cerebral palsy
Material and methods of the study:
The study is based on data from 90 children aged 4 to 7
years. The first group consisted of 39 children with various forms of cerebral palsy with
pharmacologically resistant epilepsy, the second group consisted of 51 children with various forms of
cerebral palsy with controlled symptomatic epilepsy. All patients underwent neurophysiological
research methods (EEG, EEG monitoring, NSG, brain MRI).
Results and discussion:
The main risk factors in the occurrence of resistance to AED are the
literature submitted: early debut of epilepsy; high frequency of seizures (status-like course); seizure
polymorphism; the presence of complex partial seizures (30% of patients with partial epilepsy are
usually resistant to AED); symptomatic etiology of epilepsy; the presence of structural changes in the
brain (tumors, malformations, etc.); the presence of mental retardation.In most patients (90.6%),
seizures debuted before 3 years. In the process of studying the history of patients with cerebral palsy
with epilepsy, 4 variants of the course of the disease were identified - benign (19%), relatively benign
(34%), stable (11%) and progressive (36%). A specific feature of cerebral palsy is a delay in the
formation of the central functions of the central nervous system. Each form of cerebral palsy differs
from another in its qualitative originality and a specific combination of motor pathological components.
Conclusions:
Factors of an unfavorable prognosis of epilepsy in a child with cerebral palsy include
the following: periventricular leukomalacia and malformations of the cerebral cortex, tetraplegic form
of cerebral palsy, a history of neonatal cramps, the onset of epileptic seizures before the age of 1 year,
infantile cramps and complex partial seizures with secondary generalization.
Factors for a favorable prognosis of epilepsy include: focal and multifocal hypoxic-ischemic brain
damage, hemiplegic cerebral palsy, the onset of epilepsy after one year of age, a simple partial nature
of the attack factor favorable prognosis of epilepsy.
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