Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector28210.17816/psaic282Original articlesОригинальные статьиUnknownPredictors of pharmacoresistance in adults with epilepsyПредикторы фармакорезистентности эпилепсии у взрослыхKotovA. S.КотовАлексей Сергеевич
Russian Federation
alex-013@yandex.ruM.F. Vladimirsky Moscow Regional Research Clinical InstituteМосковский областной научно-исследовательский клинический институт им. М.Ф. Владимирского1003201261253002022017Copyright ©; 2012, Kotov A.S.Copyright ©; 2012, Kotov A.S.2012Kotov A.S.Kotov A.S.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/282

Six hundred ninety-six patients with epilepsy were examined. Clinical and neurological examinations, routine EEG and/or video-EEG monitoring, MRI and/or CT of the brain, and laboratory tests were performed. Antiepileptic pharmacotherapy was either prescribed for the first time or corrected if it was prescribed before. Factors associated with pharmacoresistance were analyzed, such as: onset in infancy or early childhood, high frequency of seizures, failures in the previous pharmacotherapy, diffuse epileptiform activity or abnormal background activity according to EEG, progressive brain lesion etc. According to the obtained data, only non-compliance (r=0.31; p<0.001) and high frequency of seizures (r=0.31; p<0.001) were significant predictors of pharmacoresistance. Routine EEG and MRI are not informative enough for prediction of pharmacoresistance of epilepsy. Accurate patient examination and identification of a certain epileptic syndrome are necessary for correct prognosis of pharmacoresistance.

Обследовано 696 пациентов с эпилепсией. Методы исследования включали клинический и неврологический осмотр, рутинную ЭЭГ и/или ЭЭГ-видеомониторинг, МРТ и/или РКТ головного мозга, лабораторные анализы. Всем пациентам была назначена впервые или подвергнута коррекции текущая терапия антиэпилептическими препаратами (АЭП). Изучены факторы, ассоциирующиеся с фармакорезистентностью: ранний возраст дебюта эпилепсии, высокая частота приступов, неудачи предшествующей терапии, диффузная эпилептиформная активность или аномальная фоновая активность на ЭЭГ, процессуальный характер поражения мозга и др. Согласно полученным данным единственными достоверными предикторами фармакорезистентности были высокая частота приступов (r=0,31; p<0,001) и некомплаентность (r=0,31; p<0,001). Рутинное ЭЭГ и МРТ исследования недостаточно информативны для выявления достоверных предикторов неэффективности терапии. Для адекватного прогноза фармакорезистентности необходимо четкое определение конкретного эпилептического синдрома и детальное изучение каждого отдельного случая заболевания.

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