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De Vivo disease is a rare genetic disorder associated with glucose transporter type 1 (GLUT1) deficiency. We provide a review of publications describing various clinical manifestations of this syndrome, including the combination of epilepsy with choreic hyperkinesis. The seizures related to De Vivo disease are resistant to basic antiepileptic therapy. The ketogenic diet is suggested as the main treatment method. We present our own clinical observation describing an 18-years old male patient, who had myoclonic-astatic seizures and atactic manifestations such as impaired movements coordination and walking instability, which first appeared at the age of 1.5 years. Due to therapy with valproic acid drugs, seizures persisted with a frequency of up to 5 times a month. From the age of 17, involuntary violent irregular movements of trunk and limb muscles emerged, occurring at a fast pace. The patient underwent a comprehensive examination; as a result, the diagnosis of De Vivo disease was verified. By prescribing proper antiepileptic therapy and ketogenic diet, it was possible to stabilize the patient's condition and stop De Vivo disease-related manifestations of epilepsy and hyperkinetic disorder. We pay attention to the differential diagnosis of conditions characterized by epileptic seizures, mental retardation and violent movements, as well as to the diagnosis and management tactics of patients with De Vivo disease. Unfortunately, not all patients with this pathology receive adequate pathogenetic and symptomatic therapy often undergoing numerous hospitalizations, since the major cause underlying such symptoms, namely GLUT1 deficiency, is not diagnosed.

The high prevalence of primary affective disorders in patients with epilepsy is beyond doubt. However, patients in this group are often identified as suffering from mood disorders that do not fulfil the criteria for primary mood disorders, such as recurrent depressive disorder and bipolar affective disorder. The aim of this paper is to analyze the classification and clinical picture of affective disorders in patients with epilepsy and differential diagnostic approaches to identify primary affective disorders and secondary affective disorders in epilepsy. A set of diagnostic signs for the differential assessment of affective disorders in patients with epilepsy is presented. Research of affective pathology in patients with epilepsy and the development of strategies for its successful treatment are still needed.

Background. Drug support provided to the general population and medical institutions represents one of the most important directions in social policy of the Russian Federation.Objective. To determine the awareness epileptologists and epilepsy patients about legal normative and regulatory aspects regarding preferential drug provision (PDP).Material and methods. The study was conducted by using empirical data retrieved from questionnaire survey of epilepsy patients and epileptologists. We used an original questionnaire that consisted of questions about the PDP legal normative and regulatory aspects as well as organization of drug provision for patients with epilepsy.Results. The study data revealed that half of the surveyed patients were unaware of the legal right to have a reduced drug coverage for patients with epilepsy without disability. The normative document designating the categories of diseases including epilepsy as well as the level of appropriate drug coverage for which citizens may qualif, was unknown to either patients or health care workers. Both groups named no the authorized body to which they should apply in case of refusal obtain a preferential vacation leave. The minimum number of correct answers was received to the questions about the maximum term of course prescriptions for reduced-price supply, the term of service for such prescriptions as well as the term for submission of notice on unwanted response to Federal Service for Surveillance in Healthcare (Roszdravnadzor). One-third of patients were unaware of the opportunity for electronic appeal to a state health care authority.Conclusion. There is a need for educational activities among health care professionals and patient outreach to increase awareness of own legal rights and responsibilities of participants of PDP for epilepsy patients.

Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy.Objective: to study clinical and mental changes during NCI in patients with epilepsy.Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) – 25 patients undergone COVID-19 in the period from 2020 to 2022; Group 2 (control) – 25 patients not undergone COVID-19 during the same period. Clinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20).Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group.Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).

Suicidal behavior is characterized by the response of the individual to the conditions of the crisis situation experienced. The unrelenting interest of researchers around the world is aimed at studying the factors that determine the risk of suicidal intentions in patients with epilepsy.Purposal. To determine the main types of attitude to the disease in patients with epilepsy and suicidal thoughts.Materials and methods. 112 patients with epilepsy were examined and divided into 2 groups depending on the presence of suicidal thoughts at the time of the study: 1st group – with suicidal intentions, 2nd group – without it. The method «Type of attitude to the disease» were used.Results. Thus, among the clinical factors of suicidal risk in patients with epilepsy, severe course of the underlying disease is the most significant, which is manifested by frequent seizures, serial course, and drug resistance form. It was revealed that patients with epilepsy with suicidal thoughts are characterized by the presence of «mixed» and «diffuse» types of attitude to the disease, with a predominance of maladaptive forms. The analysis of «pure» types of attitude towards the disease in two groups showed that there are fewer respondents with a «pure» type of attitude towards the disease in the group of patients with suicidal thoughts than in the group of patients without it. Along with the ergopathic and sensitive types, in the 2nd group of patients, the anosognosic type of attitude to the disease is also quite pronounced, and in the 1st group, patients with anosognosic, anxious and hypochondriacal types of attitude to the disease were identified.Conclusion. Consequently, patients with epilepsy are characterized by: vulnerability, vulnerability, concern about possible adverse impressions that they can make on others with information about their illness; the desire, despite the severity of the disease, to continue working; lack of criticality to their own disease, which can lead to destabilization of the underlying disease and the formation of suicidal behavior.

Establishing misdiagnosis “epilepsy” is a common event comprising 25% total cases of “pharmacoresistant” forms. Eventually, the majority of cases resulted in diagnosing psychogenic nonepileptic seizures, or functional seizures, conversion seizures, and dissociative seizures. Here we review publications assessing psychogenic non-epileptic seizures. The scientific resources for analysis were selected in Russian (eLibrary) and international (Pubmed/MEDLINE, Google Scholar) databases, as well as in open access resources. We also present a clinical case of a patient diagnosed with epilepsy. In particular, the patient was admitted to the hospital with complains of paroxysmal conditions starting as headache, nausea proceeding with speech arrest and decreased mindfulness of what happens in personal life. He also informed about at least two episodes of disorientation described as “missed public transport stop” and “finding himself in unfamiliar place”. The patient underwent examination (electroencephalography, brain magnetic resonance imaging) and dynamic follow-up to verify origin of such conditions. As a result, he was diagnosed with psychogenic non-epileptic seizures. Administering proper therapy allowed to achieve stabilized condition and arrest seizures. The criteria provided in the review as well as clinical case report may help clinical practitioners to timely conduct differential diagnostics and deliver specialized medical aid.

Background. Over the past decades many Russian and foreign authors have devoted their studies to psychiatric comorbidity and suicidal behaviour in people with epilepsy. It is particularly important to find risk factors to develop suicidal ideation in this group of patients. According to the World Health Organisation, suicide is the second cause of death among patients with epilepsy, especially those under 29 years. Social maladaptation and deviant reactions to isolation within the framework of personality disorder and frustrating elements necessitate strategy development to prevent suicide intentions in this group of patients. Objective: to find risk factors contributing to suicidal behaviour in patients with epilepsy. Material and methods. We examined 102 patients diagnosed with epilepsy and divided them into two groups consistent with the available relevant suicide ideators: Group 1 (reference group) – without suicide ideators (n=73), Group 2 (study group) – with suicide ideators at the time of the study (n=29). We conducted a pathopsychological study using scales and questionnaires. Results. Patients with epilepsy and suicidal ideation are more vulnerable to a wide range of mental health disorders. Behavioural and mood disorders predominate. Risk factors for suicide in this patient cohort relate to a darker outlook on the future and emotional instability. All limits of the antisuicidal behaviour pattern reduced uniformly, except for the Family responsibility. Amidst the severe course of the underlying medical conditions, disharmony is formed in attitude towards the disease. Conclusion. Assessment of the risk factors for the development of suicidal ideation in patients with epilepsy is a challenging multidisciplinary task. Even with relative mental well-being, it is worth focusing on all aspects of quality of life.

The Struge-Weber syndrome is the third most common neurodermal disease after neurofibromatosis and tuberous sclerosis. This disease is not inherited, but occurs exclusively sporadically, both in men and in women, and in all races and ethnic groups. In 90% of cases, this syndrome is diagnosed in pediatric practice. Adult cases of this syndrome are sporadic, since they remain unrecognized due to the polymorphism of this disease. Comorbidity between epilepsy and the Sturge-Weber syndrome was noted.Aim. To conduct a literature analysis and describe the clinical observation of epilepsy with the Sturge-Weber syndrome.Materials and methods. Patient M., 50 years old has been observed for a long time due to complaints on episodes of numbness according to the hematotype with transient paresis. The examination (MRI) revealed changes characteristic for Sturge-Weber syndrome. The presence of specific paroxysmal changes according to the results of electroencephalography helped to verify the genesis of paroxysmal conditions.Results. The patient underwent a comprehensive examination. As a result, the diagnosis of epilepsy was verified. The prescription of adequate antiepileptic therapy allowed for stabilization and jugulation of epileptic seizures.Conclusion. In this clinical observation, we focus on the differential diagnosis between transient ischemic attack and epilepsy. Unfortunately, at the moment, adults with a previously undetectable syndrome undergo multiple hospitalizations and do not receive antiepileptic therapy, since the prior disease (epilepsy) is not verified.

Cerebral strokes in 25-90 % of cases are accompanied by the emergence of various mental disorders. Thus, in 80% of cases of mental disorders manifest mental disorders nonpsychotic level (affective, cognitive, behavioral, personality), which are dominated by depressive disorders. The maximum frequency of depressive episodes recorded in the periods 3-6 months after stroke (70%). The risk of death when combined stroke depression increases 2.6 times, and the treatment of depression can prevent 11% of stroke. National center of psychiatry and neurology im. V.M. Bekhterev has 25 years of experience of use in patients with consequences of sharp violations of cerebral circulation of the drug gliatilin, which not only improves the neuroplasticity of the brain tissue but improves cognitive function and normalization of the emotional sphere of patients. One of the most important symptoms of depression are sleep disturbances. Changes in the structure of sleep in the acute period of stroke prognostic importance. Antidepressant trazodone used in the treatment of depressive disorders accompanied by insomnia. Doctors evaluated the effectiveness of the therapy, trittico in 34% of cases as excellent, 45% as good and 21% of cases as satisfactory. Patients evaluated the effectiveness of the drug in 24% of cases as excellent, 55% as good and 22% as satisfactory. To continue the drug treatment were in agreement 87% of patients.