MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-22
Часть–1_ Март –2025
162
PHARMACORESISTANT FORMS OF EPILEPSY WITH LONG-
TERM USE OF ANTIEPILEPTIC DRUGS IN WOMEN OF FERTILE AGE.
Amonova Zakhro Kakhramon Kizi
Candidate of Medical Sciences, Associate Professor Department of
Neurology and Nervous Diseases Samarkand State Medical University, Uzbekistan
Amonova Zilola Kakhramonovna is a 2st year student of the Faculty of
Dentistry of the European Medical University
ABSTRACT : The gold standard in diagnosing epilepsy as well as predicting
its clinical course is the electroencephalographic (EEG) examination method, which
indicates the functioning of brain neurons and their excitability, which makes it
possible to diagnose an epileptic focus. EEG is performed on patients with suspected
or already diagnosed seizures to identify the type of epilepsy. The sensitivity of EEG
for epilepsy is up to 50%; in 10% of epileptic patients epileptiform activity is not
recorded.
KEYWORDS:
T3,
T4,
TSH,
TRH,
pathological
process,
electroencephalographic features, pathogenetic mechanisms, epilepsy, patients,
hypothalamic-pituitary syndrome, pituitary gland, hormones, treatment, nervous
activity, depolarisation paroxysms, pathomorphosis.
INTRODUCTION
30-75% of focal pharmacoresistant epilepsies have electro-clinical
manifestations of secondary bilateral synchronisation (SBS) on EEG due to
pathomorphosis of bioelectrical activity, which reduces epileptiform bursts and
produces an α-wave dominant pattern.
Depolarisation paroxysms are a characteristic sign of epilepticisation of
cortical neurons, causing the generation of strong pathological neuronal excitation
[5]. Currently, the study of endogenous evoked potentials (EPs), and in particular
cognitive evoked potentials (CEPs), which are characterised by the presence of a P300
component in EEG studies, is attracting increasing attention. The study of this
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-22
Часть–1_ Март –2025
163
technique in patients with epilepsy is recommended by the Association of
Neurophysiologists at the international level [8]. This study makes it possible to
diagnose functional disorders in the cognitive sphere, in particular conscious
perception [7] decision-making, recognition and memory [9]. The development of
disorders in the cognitive sphere of epileptic patients is characterised by the
appearance of a positive specific wave with a latency of 300 ms (P300) during EEG.
P300 is characterised by the presence of amplitude and latency, so the amplitude gives
an idea of the number of neurons involved in stimulus processing, and the level of
latency indicates the speed of stimulus classification [6]. EP P300 performance
depends on age, cognitive ability, memory, personality type, and degree of
wakefulness [1]. The EP P300 is produced by the cortex of temporal, parietal regions
and frontal lobes of the large hemispheres with the involvement of the thalamus [4].
EP P300 in epilepsy stated the effect of epiactivity strength on cognitive abilities [3].
The P300 in epilepsy depends on the location of the epileptic focus, the type of
epileptic seizures, and the type of AEDs taken by the patient and his sensitivity to
them [2].
It is known that in hormonal imbalance, especially GHNS imbalance,
cognitive disorders are noted in patients, and the presence of epilepsy significantly
aggravates them. The study of P300 indices in this cohort of patients will allow us to
establish the degree of cognitive disorders, since a decrease in P300 amplitude will
allow us to characterise the synchronisation of neuronal processes activity when
solving cognitive tasks, and its prolongation will characterise cognitive disorders and
structural disorders of the cortex and white matter of the brain [8].
The fight against epilepsy, as defined by WHO experts, requires special and
priority attention, because in the structure of morbidity, is characterised by severe
consequences. Epilepsy refers to systemic diseases, where the pathological process of
the brain reflects a single functional system of the div[7]. At one time, the state of
the brain, it is the result of the activity of non-specific structures with the
manifestation of neuropsychic, autonomic and neurohormonal systems. Accordingly,
the aspect of studying the nature of the hypothalamic-pituitary system in patients with
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-22
Часть–1_ Март –2025
164
epilepsy, expands the diagnostic field of research, for a deeper evaluation of clinical
signs of the disease, identifying new pathogenetic mechanisms, in order to optimise
treatment tactics[7].
Modern scientific research is mainly focused on the study of hormonal status
in epilepsy and hormonal imbalance, few and contradictory, little studied remain,
interictal period and chronicisation of the process, the mechanism of adaptation in the
gender aspect, depending on metabolic disorders. The modern level of scientific
research requires, not only analyses in the course of the disease, the relationship with
somatoform changes in the structure of the whole organism as a whole, but an
important component of the study is the prognosis[2].
In the Republic of great importance is a comprehensive programme to
improve early diagnosis and reduce complications of somatic pathologies. In this
regard, the study in patients with epilepsy, clinical and paraclinical manifestations of
disorders in the hypothalamic-pituitary system, as well as characteristic features.
neurophysiological disorders in order to develop an integral assessment of risk factors
for the development of adverse outcomes of epilepsy and predicting its severity in
hypothalamic-pituitary-adrenal system dysfunction is an urgent problem. The
development of complex treatment of patients with epilepsy using the results of the
study of identified disorders in the hypothalamic-pituitary-adrenal system will
contribute to improving the provision of medical care to patients with epilepsy at a
higher level[4].
The problem of epilepsy is one of the most urgent in modern neurology [3].
Lack of epidemiological data on epilepsy, as WHO believes, in part of countries leads
to poor level of medical care for such patients (World Health Organization; 2019).
Antiepileptic drug (AED)-resistant forms of epilepsy and some epileptic
syndromes force researchers to search for alternative therapies that sometimes provide
comparable clinical efficacy to AED therapy [7]. Modern epileptology is developing
an active search for early predictors of pharmacoresistance to AEDs in epileptic
patients for better therapy of the disease and prevention of direct and indirect
manifestations of pathology. The effect of hormone therapy (HT) on epileptogenesis
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-22
Часть–1_ Март –2025
165
of brain cells is based on the activity of the hypothalamic-pituitary-adrenal system
(HHAS), as epileptic activity of brain neurons stresses the CNS and the whole
organism, and HHAS activation is a normal neurophysiological response [10]. GHNS
hormones influence epileptogenesis, so adrenocorticotropic hormone (ACTH)
stimulates the adrenal cortex, increasing the secretion of GCS, aldosterone and sex
hormones, affecting melanocortin receptors in the hypothalamus reduces the
production of CRH, reducing epileptogenic activity and negative effects on immature
neurons of the large hemispheres of multiple epileptic impulses.
Understanding the influence of the hypothalamic-pituitary system in
epileptoid patients, provides an opportunity to expand the assessment of the clinical
diagnostic picture of the disease and the ability to optimise treatment tactics.
Regulation of the cerebral function of the hypothalamus, which ultimately constitutes
the hypothalamic-pituitary system (HPS), by the hormonal background modulates
epileptic activity; study in this direction creates a prerequisite for new promising
approaches to the treatment of epilepsy, taking into account the lack of efficacy of
antiepileptic drugs. Conclusions: In the scientific literature for the last 10 years, we
have not found studies on EEG and EP P300 indices among epilepsy patients on the
background of GHNS disorders. However, their evaluation can serve as an aid in
studying the functionality of the cerebral hemispheres, clarification of clinical
symptomatology, predetermination of critical states and convulsive activity of CNS
neurons, and thus enable specialists to predict the patient's condition and adjust the
prescription of AEDs in terms of preventive treatment.
REFERENCES
1.
Epilepsy on the background of hypothalamic-pituitary system dysfunction from
the position of gender differences. Z.K. Amonova, A.T. Jurabekova, F.S. Khamedova
- Modern state of world science development …, 2021.
2.
Neuro-Endocrinological Aspects In Patients With Epilepsy. Z.K. Amonova,
A.T. Djurabekova - International Conference on Studies in Humanity. 2022.
3.
HARMFUL ASPECTS OF EPILEPSY.
Amonova Z.K. Amonova Z.K.
International research journal. “PEDAGOGS”. 2024.
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-22
Часть–1_ Март –2025
166
4.
Neurophysiological changes in epilepsy with disorders of hormonal status.
Amonova Z.K. The American Journal. 2024.
5.
Peculiarities of the Effect of Epilepsy on the Hypothalamic-Pituitary System.
Djurabekova A.T. Amonova Z.K. 2023/7.CENTRAL ASIAN JOURNAL OF
MEDICAL AND NATURAL SCIENCES. Published by “ CENTRAL ASIAN
http://www.centralasianstudies.org
6.
Djurabekova Aziza Taxirovna, Amonova Zakhro Kahramon Kizi. Clinic,
Diagnostics and Optimization of the Treatment of Epilepsy with Dysfunction of the
Hypothalamic-Pituitary System. Central Asian Journal of Medical and Natural
Science, 2022.
