Epilepsy and cerebral palsy (CP) are among the most frequently co-occurring neurological disorders and are characterized by high comorbidity. This article provides a brief overview of the issue and presents clinical cases of patients with CP combined with focal epilepsy of childhood with structural brain changes and benign epileptiform discharges of childhood on electroencephalogram (FECSBC-BEDC) and infantile epileptic spasms syndrome. Vigabatrin is a first-line drug for the treatment of infantile epileptic spasms syndrome and can also be successfully used for focal epilepsy in patients with CP. Due to its GABA-mediated mechanism of action, vigabatrin has demonstrated the ability to reduce symptoms of spasticity in dystonia. Although the FECSBC-BEDC syndrome has been described in patients with CP, it has not yet been assigned a taxonomic position in the International Classification of Epilepsies and Epileptic Syndromes. Sulthiame has demonstrated efficacy and good tolerability in patients with FECSBC-BEDC.
T. R. Tomenko, Zhuzhuna M. Tsotsonava, M. Y. Shchennikova et al.· Russian Journal of Child Neu...· 0 citations
This review elucidates the concept of levels of epileptogenesis, including the effector level of ion channels, the mechanisms that ensure their functionality, and the maintenance of ionic equilibrium, both intracellular, involving specific proteins, and extracellular, encompassing astroglia. Moreover, the discussion extends to the level of mediator systems, including glutamate, gamma-aminobutyric acid (GABA), and acetylcholine, as well as the propagation of excitation to adjacent neurons (plasticity) and the emergence of secondary excited neurons that contribute to the formation of a hyper-excited neural network. Drawing on both the existing literature and original research findings, this article addresses the ion channel dysfunction, the implicated protein systems that support channel function, and the relevance of synaptic and extrasynaptic localizations. The role of neuroinflammation, endocrine factors, and the establishment of aberrant hyperexcitable neural networks are also analyzed. The presented findings underscore that epileptogenesis is a multifaceted process, characterized by numerous pathophysiological factors that interact in complex, overlapping, and interdependent ways. While it is established that ion channels are the definitive effector of epileptogenesis, the significance of ancillary factors must not be overlooked. Such factors include the activities of glial components, synaptic proteins, and neuroinflammatory processes, which serve dual roles as effectors and contributors to the progression of epilepsy as a chronic condition. This integrated approach to understanding epileptogenesis is essential for the efficacy of current treatment methodologies, including pharmacotherapy, dietary interventions, and neurosurgical procedures. Furthermore, this approach can drive the exploration of innovative therapeutic strategies for the management of epilepsy.
P. L. Sokolov, N. V. Chebanenko, A. I. Krapivkin· Zhurnal Nevrologii i Psikhia...· 0 citations
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