Background. Given the difficulties in identifying absences and assessing the level of consciousness in epilepsy patients, it is extremely relevant to develop digital programs for automatic registration and testing of this type of epileptic seizures and related electroencephalographic (EEG) patterns, including those based on artificial intelligence.

Objective: development of an algorithm for automatic detection of absence seizures to test real time patient's consciousness level during long-term video-EEG monitoring.

Material and methods. The work on creating an algorithm was carried out during joint doctor/engineer cooperation. Doctors prepared a set of labeled EEG recordings of patients with verified absence epilepsy. Two independent experts in the generated examinations database mapped typical episodes of absence seizures that allowed to develop training and testing samples for a neural network algorithm to detect EEG absence epiactivity. Next, trained neural network was incorporated into Neuron- Spectrum.NET software to compare its accuracy with similar approaches published elsewhere.

Results. A neural network algorithm was developed and trained using a mapped database to detect EEG absence epiactivity. A comparative analysis of the effectiveness for the proposed method vs. other approaches showed that the former is comparable in quality, whereas in some aspects – even superior to the latter. Accuracy was assessed using a publicly available database with mapped epiactivity episodes.

Conclusion. A hardware and software system for automated assessment of patient’s consciousness level during absence seizure in continuous video-EEG monitoring was proposed. Potentially, neural networks may be applied not only to assess patient’s consciousness level, but also to stop stimulation-mediated seizure onset in the future.

Background. According to some authors, neuroinfection agents play a role in the development of several neurological disorders, including epilepsy. For many years, it was believed that acute infectious diseases, such as tick-borne encephalitis virus and meningococcus played a leading role in the emerging epileptic process of postinfectious etiology. Regarding a role for chronically persistent infections, it has not been fully explored.

Objective: to identify clinical, diagnostic, and morphological features of locally induced postinfectious epilepsy, both at disease onset upon emergence of the first epileptic seizures during acute infectious process and during their recurrence in a chronically persistent infection.

Material and methods. The study included observations of 1500 patients with locally induced epilepsy admitted and treated from 2007 to 2017 in various medical inpatient and outpatient institutions. Post-infection locally induced epilepsy with clear causality link between previous neuroinfection and onset of epileptic seizure was found in 127 patients (Group 1). During initial visits, infectious agents in a cohort of patients with recurrent epileptic seizures manifested as chronic persistent infection were suspected in more than 1/3 of the 1373 subjects who sought medical aid comprising 550 people (Group 2). In addition to the clinical evaluation of patients, instrumental studies were performed, including routine electroencephalography (EEG), sleep video-EEG monitoring, magnetic resonance imaging (MRI), and some patients underwent pathomorphological examination using electron microscopy and histological techniques.

Results. Gross and marked diffuse disturbances in brain bioelectrical activity were most often detected (58% and 31%, respectively) during video-EEG monitoring in Group 1, whereas moderate alterations were recorded less frequently (11% of observations). In Group 2, the majority of diffuse disturbances in brain bioelectrical activity were of moderate level (79%) followed by mild and irritative changes recorded less frequently (in 21% of cases). MRI data showed that disorders of the amygdala-hippocampal system were observed in 41 (32%) and 211 (38%) patients in Groups 1 and 2, respectively. Histological and electron microscopic data revealed a number of morphological disorders in patients with locally induced postinfectious epilepsy common with earlier described mitochondrial encephalomyopathies (mitochondrial megaconia and pleioconia) as well as a set of specific manifestations typical to such pathology.

Conclusion. The conducted clinical, neurophysiological, neuroimaging, and pathomorphological studies of postinfectious epilepsy revealed specific features underlying its development at different stages, from its onset in acute infectious process to chronization in persistent infection. It was found that a comprehensive analysis of the presence and impact of infectious agents in patients with epileptic seizures is important for course and prognosis of postinfectious epilepsy, which is relevant for timely diagnosis and development of specific pharmacotherapy.

Background. People living with epilepsy (PLWE) often face psychological comorbidities and social challenges due to low levels of knowledge and awareness about epilepsy, as well as personal experiences with the condition. This can result in a low quality of life for PLWE.

Objective: to investigate the psychosocial impact of epilepsy on patients residing in rural regions of South Africa (Limpopo and Mpumalanga Provinces).

Material and methods. A non-experimental quantitative research was conducted, which involved 162 respondents living with epilepsy. Most were males, and the majority were between 18 and 35 years old in both provinces combined. The participants were offered a questionnaire divided into three sections comprising sociodemographic aspects, questions that assessed knowledge, and questions on the psychosocial impact of epilepsy.

Results. I t was shown that while PLWE have a solid understanding of epilepsy as a medical condition, they may not fully comprehend its effects on daily life. For example, many respondents felt shameful after having a seizure and difficulties in forming relationships, and a significant proportion stated that they were never married because of epilepsy. The study highlights the significant psychosocial impact of epilepsy on PLWE, including depression, difficulties in forming and maintaining social connections, and a lack of marital experience.

Conclusion. To improve PLWE’s quality of life, the psychological help is recommended through healthcare facilities or local support groups.

In most cases, variants of nucleotide sequence in the SEMA6B gene account for developing the phenotype of progressive myoclonus epilepsy and, to a lesser extent, developmental encephalopathy with or without epilepsy. Loss-of-function variants in nucleotide sequence localized mainly in exon 17 of the SEMA6B gene contribute to production of aberrant proteins with “toxic” functions. A clinical case of status epilepsy in a patient with a variant in the SEMA6B gene (c.2506delС; p.His836ThrfsTer136; NM_032108.4) is described in the article that expands our knowledge regarding the SEMA6B gene variants resulting in progressive myoclonus epilepsy.

In pediatric practice, epilepsy holds one of the leading places among neurological pathologies. Along with seizures, a child's intellectual impairment lowering quality of life plays a crucial role in social disintegration. Cognitive impairments occuring in idiopathic generalized epilepsies (IGE) and self-limited epilepsy with centrotemporal spikes (SeLECTS) considered benign have been widely investigated. However, available data suggest that such disorders result in multiple persistent alterations in the cognitive sphere. In this case, features of the epilepsy etiopathogenesis account for disease early onset and profoundly remodeled structures involved in the implementation of cognitive functions. Current review is aimed to summarizing data regarding developmental mechanisms and range of cognitive impairment in IGE and SeLECTS.

Success of surgically treated epilepsy depends on the accuracy of epileptogenic zone localization. Single-photon emission computed tomography (SPECT) using SISCOM (subtraction ictal SPECT co-registered to MRI) protocol is the only imaging method that allows identification of ictal onset zone by injection and fixation of a special radioactive tracer in the area of increased cerebral blood flow. The review outlines the key stages of SPECT using SISCOM protocol, generalizes and analyzes data for related opportunities and disadvantages as well as its prospects for use in preoperative examination of patients with epilepsy. It was demonstrated that the technique showed high sensitivity (mean 70–75%) to localize epileptogenic zone in patients with pharmacoresistant epilepsy in case if brain structural changes were not detected by magnetic resonance imaging (MRI). However, the organizational features of the procedure in combination with its specific limitations for epilepsy patients do not allow it to be considered as a routine diagnostic method.

Background. Сognitive impairment is one of the major epilepsy-related comorbidities. Upon long-term disease course, a decline in cognitive functions occurs in about 70–80% of cases. Juvenile myoclonic epilepsy (JME) is one of the most common forms of epilepsy (about 9.3%). Compared with other forms of idiopathic generalized epilepsy, JME is featured with high risk of seizures along with lowered patient compliance to treatment as well as a danger of developing drug resistance that may be a cause of cognitive disorder.

Objective: to review research publications on cognitive impairment in JME, discuss its putative causes, describe neuropsychological profile for JME patients.

Material and methods. The search was carried out in eLibrary, PubMed/MEDLINE, and Google Scholar databases using keywords and their combinations: “cognitive impairment”, “cognitive disorder”, “cognitive functions”, “neuropsychology”, “epilepsy”, “juvenile myoclonic epilepsy”, “JME”, “idiopathic generalized epilepsy”, “antiepileptic drugs”. We analyzed the articles published over the past 5 years and some earlier works of significant scientific interest. All articles were published in English or Russian languages.

Results. A total of 895 articles were found in databases. Comprehensive screening, evaluation of full-text articles eligibility in accordance with the criteria for selecting and deleting duplicates allowed to include 3 scientific publications in Russian and 67 scientific publications in English in the literature review. The main causes of cognitive impairment in JME patients were analyzed followed by describing relevant neuropsychological profile. Diagnostic tools and current opportunities for correction of cognitive disfunctions were considered as well.

Conclusion. The underlying causes of cognitive impairment in JME patients are multifactorial in nature and require further research. However, in this patient cohort prominent obstacles remain in identifying and timely correcting such disorders. Approving uniform diagnostic and therapeutic standards, developing rehabilitation methods for cognitive impairment in epilepsy will help improve the quality of life in JME patients.