[Epilepsy pharmacotherapy: basic principles and tenets].
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Biomedical subjects
Publications and source records attributed to D E Dyskin.
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The glutamate receptor autoantibody level was studied in blood of 170 epileptic patients as well as of 114 control donors (64 patients with nonepileptic cerebral pathology and 50 healthy individuals). The elevation of autoantibodies level (higher than 140%) was observed in 63.5% of patients with paroxysmal epileptic disturbances. This elevation was observed more frequently in the initial period of the disease as well as in generalized (convulsive or nonconvulsive) fits irrespective of disease etiology. Combined application of the test with EEG method permitted to confirm the epileptic nature of the disease in 83.5% of cases. The results of repeated analysis of glutamate receptor autoantibody level in blood proved to be a significant criterion of the effectiveness of anticonvulsive therapy. It also allowed to predict the development of posttraumatic epilepsy in individuals with craniocerebral trauma in the past.
To study clinical manifestations and pathogenetic mechanisms of long-term consequences of closed brain injury, 244 patients with a history of cerebral injury of varying severity were examined. For instrumental and laboratory verification of injury use was made of straight craniography, pneumoencephalography, computer-aided tomography, electroencephalography, rheoencephalography, psychophysiological techniques, immunological examination of the blood and CSF biochemistry. Comparative information content of the different research methods was defined. Broad clinical polymorphism and definite specificity of the manifestations of the consequences of closed braid injury of varying severity in decompensation were revealed. The role of immunological disorders (lowering of suppressor influences of T lymphocytes, elevation of the degree of autoneurosensitization) detectable in 87% of cases was established as was the importance of changes in the correlation of the main neuromediators of the CSF in the formation of the pathogenetically multilevel process of the traumatic disease of the brain.
The complex analysis of clinico-instrumental data obtained during the examination of 220 patients with nonpenetrating cerebral trauma made it possible to determine the main neurologic syndromes and variants of clinical course of trauma consequences. The article shows the role of additional methods for objective studying of neurologic disorders, and for closer definition of cerebral pathology and pathogenetic mechanisms of some neurologic syndromes. The authors give a comparative characteristic of clinical, instrumental and psychological methods of study. The research has shown that there were no straight dependency between the gravity of trauma in the acute period and its possible consequences.
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