ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 11 / UIF:8.2 / MODERNSCIENCE.UZ
279
STUDYING THE IMPACT OF MODERN ANTIEPILEPTIC DRUGS ON THE
QUALITY OF LIFE OF PATIENTS
Nabijonova Diyora Avazbek qizi
Central Asian Medical University
Student of the Medical Department.
Aliyev Doniyor Soibjon o’g’li
Central Asian Medical University
Assistant of the Department of Anatomy.
https://doi.org/10.5281/zenodo.17565690
Abstract.
Department of Neurology Epilepsy is a chronic brain disease characterized by
recurrent, unprovoked attacks of motor, sensory, or mental dysfunction resulting from excessive
neuronal discharge in the gray matter of the cerebral cortex. From this definition it follows that
no other clinical (mental changes) or electroencephalographic (epileptiform activity) signs alone
can be the basis for a diagnosis of epilepsy. Epilepsy does not include single seizures, regardless
of their clinical manifestations. Only repeated seizures are the basis for a diagnosis of epilepsy.
By definition, febrile convulsions, as well as convulsions that occur during process
damage to the brain (for example, with encephalitis, subdural hematoma, acute cerebrovascular
accident, etc.) are not epilepsy-epilepsy includes spontaneous, unprovoked seizures (with the
exception of reflex forms). Idiopathic forms of epilepsy have characteristic etiological, clinical
and prognostic parameters clearly formulated in the specialized literature, with known or
possible genetic predetermination, in which a complete clinical or paraclinical study does not
reveal structural damage to the brain and the condition of another known disease (2,3).
Cryptogenic-presumably symptomatic forms of epilepsy or syndromes, the cause of which
is notclear. Up to 60-70% fall cases of epilepsy are cryptogenic (ZenkovL.R.). Currently, a
number of forms of epilepsy and epileptic syndromes that are not included in the International
Classification have been described: absence seizures in infants, absence epilepsy in adults,
autosomal dominant frontal epilepsy with nocturnal paroxysms, familial benign temporal lobe
epilepsy, etc. (1). The prevalence of epilepsy in the population ishighand reaches1-2%
(ZenkovL.R.). The treatment strategy for epilepsy has currently undergone significant changes.
The modern approach to the problem of treating epilepsy involves solving a number of
issues related not only to achieving the maximum therapeutic effect, but also to the problems of
adequate functioning of patients in society: education, choice ofprofession, employment, starting
a family (5). Currently, this definition has found its echo in the concept of “Quality of Life”.
According to the WHO definition, QOL is an individual's perception of their position in
life in the context of the culture and value system in which they live, in accordance with their
goals, expectations, standardsand concerns.
Keywords:
epilepsy, antiepileptic drugs, quality of life.
ИЗУЧЕНИЕ ВЛИЯНИЯ СОВРЕМЕННЫХ ПРОТИВОЭПИЛЕПТИЧЕСКИХ
ПРЕПАРАТОВ НА КАЧЕСТВО ЖИЗНИ ПАЦИЕНТОВ
Аннотация.
Кафедра неврологии. Эпилепсия – хроническое заболевание головного
мозга, характеризующееся рецидивирующими, неспровоцированными приступами
двигательной, сенсорной или психической дисфункции, возникающими вследствие
избыточной нейронной активности в сером веществе коры головного мозга.
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2025
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Из данного определения следует, что никакие другие клинические (психические
изменения) или электроэнцефалографические (эпилептиформная активность) признаки
сами по себе не могут служить основанием для диагностики эпилепсии. К эпилепсии не
относятся единичные приступы, независимо от их клинических проявлений. Только
повторные приступы являются основанием для диагностики эпилепсии. Фебрильные
судороги, а также судороги, возникающие при патологических изменениях головного
мозга (например, при энцефалите, субдуральной гематоме, остром нарушении мозгового
кровообращения и т.д.), по определению не являются эпилепсией – эпилепсия включает в
себя спонтанные, неспровоцированные приступы (за исключением рефлекторных форм).
Идиопатические формы эпилепсии имеют характерные этиологические,
клинические и прогностические параметры, четко сформулированные в специальной
литературе, с известной или возможной генетической предопределенностью, при
которых полное клиническое или параклиническое исследование не выявляет
структурных повреждений головного мозга и состояния другого известного заболевания
(2,3). Криптогенные – предположительно симптоматические формы эпилепсии или
синдромы, причина которых не ясна. До 60–70% случаев эпилепсии являются
криптогенными (Зенков Л.Р.). В настоящее время описан ряд форм эпилепсии и
эпилептических синдромов, не вошедших в Международную классификацию: абсансы у
младенцев, абсансная эпилепсия у взрослых, аутосомно-доминантная лобная эпилепсия с
ночными пароксизмами, семейная доброкачественная височная эпилепсия и др. (1).
Распространенность эпилепсии в популяции высока и достигает 1–2% (Зенков
Л.Р.). Стратегия лечения эпилепсии в настоящее время претерпела значительные
изменения. Современный подход к проблеме лечения эпилепсии предполагает решение
ряда вопросов, связанных не только с достижением максимального терапевтического
эффекта, но и с проблемами адекватного функционирования пациентов в обществе:
образование, выбор профессии, трудоустройство, создание семьи (5). В настоящее время
это определение нашло свой отклик в концепции «Качество жизни». Согласно
определению ВОЗ, качество жизни – это восприятие человеком своего положения в
жизни в контексте культуры и системы ценностей, в которой он живет, в
соответствии с его целями, ожиданиями, стандартами и заботами.
Ключевые слова:
эпилепсия, противоэпилептические препараты, качество жизни.
Purpose of the study:
Improving the quality of life of patients with epilepsy based on the
rational use of modern antiepileptic drugs.
Materials and methods:
The study was conducted at the ASMI clinics and neurological
departments of the regional hospital from 2022 to 2024. The study included 45 patients aged
from 14 to 65 years (average age 30.66+1.16 years) with disease duration from several months to
48 years (average 8.43+0.76 years), suffering from symptomatic and cryptogenic focal epilepsy.
The diagnosis was established in accordance with the International Classification of
Epilepsy, Epileptic Syndromes and Similar Diseases (New Delhi, 1989).
Results and discussions:
The majority of patients (56.44%) were diagnosed with
cryptogenic (unknown etiology, presumably symptomatic) focal epilepsy, the remaining patients
ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 11 / UIF:8.2 / MODERNSCIENCE.UZ
281
(43.56%) were diagnosed with symptomatic focal epilepsy (with a known etiology). Depending
on the location of the source of epileptogenesis in the cerebral cortex, frontal epilepsy was
diagnosed in 38.22% of patients, temporal epilepsy in 26.67%, occipital in 0.44%, multifocal in
0.89%. In another 33.78% of patients, the localized form of the disease could not be established.
The age of onset of the disease among the examined patients ranged from 4 to 55 years.
The onset of the disease before the age of 10 years was noted in 16% of patients, in the
age intervals of 11-20 years –in 44.44%, 21-30 years -in 14.67%, 31-40years -in12.89%, 41 -50
years -for 8.89%, more than 50 years-for 3.11%. Thus, in 60.44% the disease debuted before the
age of 20 years, with the peak incidence occurring in these conddecade of life(44.4%). Analysis
of previous antiepileptic therapy showed that 59.11% of patients initially received monotherapy
treatment: 38.22% of them with first-line antiepileptic drugs (AED-1), 20.89% with second-line
drugs of choice (AED-2). Duotherapy with AEP-1 and AEP-2 in various combinations was
received by 9.33% of patients, treatment with three or more-3.56% of patients. After the
necessary examination and diagnosis, all patients underwent correction of previously received
treatment or were prescribed therapy for the first time in accordance with ILAE
recommendations. The dose of drugs was increased gradually in order to minimize the risk of
side effects of therapy. Initially, patients were prescribed a minimum therapeutic dose, which
was subsequently increased under the control of effectiveness and tolerability. When gradually
replacing therapy, we ad hered to the tactic of prescribinga second AED until the the rapeutic
dose was reached, followed by discontinuation of the initially used drug. This approach allows
for a more correct interpretation of the clinical effect.
The final assessment of the effectiveness of therapy was carried out no earlier than 6
months of treatment, preliminary - 2-3 months, depending on the rate of AED titration, based on
an analysis of diaries of seizures, filled out independently by patients. We designated the
complete absence of attacks during treatment throughout the entire observation period as
“remission.” We defined a reduction in seizure frequency by 50% or more as “improvement.” By
no effect we meant maintaining the number of attacks at the same level, as well as reducing their
number by less than 50%. An increase in the frequency of attacks was regarded by us as
“deterioration”. Thus, VPA, CBZ and LEV significantly more often led to complete relief from
SHSP than from partial seizures (p < 0.05). TPM and OKZ were equally highly effective in
different types of seizures (P>0.05). All drugs equally led to a complete reduction of VGSP
(p>0.05). However, arelatively higher frequency of ineffectiveness against VGSP was recorded
when using VPA compared withCBZ(p<0.01),TPM (p<0.001). When analyzing the effectiveness
of drugs against partial seizures, a significantly higher frequency of ineffectiveness of LEV and
VPA was found compared to CBZ and TPM (p <0.05). Complete relief of partial seizures was
observed significantly more often during treatment with TPM compared to VPA, CBZ, LEV
(p<0.05) and in the OKZ group compared to CBZ (0<0.05). No other statistically significant
differences were found. The QOL study was carried out in patients with symptomatic and
cryptogenic (presumably symptomatic) focal epilepsy within a period of 6 to 12 months (average
8+2.5 months) from the start of monotherapy, including patients who stopped taking the drug
within these periods before discontinuation of therapy. QOL was studied using the QOLIE-31
questionnaire (Quality of life in epilepsy, version 1.0).
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VOLUME 4 / ISSUE 11 / UIF:8.2 / MODERNSCIENCE.UZ
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The questionnaire allows you to quantify inpoints seven main ar eas of quality of life of
patients with epilepsy: “fear of seizures”, “general quality of life”, “emotional well-being”,
“energy/fatigue”, “cognitive functions”, “effect of drugs”, “social functioning” and calculate
final QOL score When analyzing the test results using the QOLIE-31 questionnaire, we
conditionally adopted a score according to which a QOL oflessthan 30 points corresponds to a
very low QOL, from30 to 39-low, from 40 to 49-average, from 50 to 59—good, over 60 points-
very good QoL. When comparing the final indicators of the quality of life of patients with
epilepsy receiving treatment with various AEDs, the largest number of patients who rated their
quality of lifeas “good” and “high” was noted in the groups of new AEDs: OKZ - 75%, LEV -
72%, TPM - 61.4 %. In patients receiving monotherapy with CBZ and VPA, the frequency of
“good”and“high”assessments of the final QoL was 52% and 49.25%, respectively. The vector of
increasing frequency of “low” ratings was directed as follows: OKZ - 4.17%, LEV - 8%, TPM -
10.53%, KBZ - 16%, VPA 16.42%.It is worth noting that there were no “new”AEDs is any of
the groups. When comparing the final indicators of QOL in the groups of “new” AEDs, “low”
scores were significantly more often observed in patients receiving TPM and LEV treatment
compared to the OKZ group (p<0.001andp<0.05, respectively). Thus, the results of testing
patients with focal epilepsy receiving monotherapy with various modern AEDs using the
QOLIE-31 questionnaire showed that the majority of them rated their quality of life as “good”
and “high” (from 49% to 75% in different groups of drugs). The data obtained should probably
be considered as an indicator of the high rehabilitation potential of patients with epilepsy,
including in social terms, and indicates that outside of attacks and with good tolerance of
treatment, many of them feel like healthy people. There is no doubt that the key to the success of
therapy is the timely administration of adequate monotherapy, taking into account the individual
potential for effectiveness and side effects.
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