Some boys and girls affective ...

For some boys and girls affective disorders by type of alternation gipotimii and hyperintimate scenes reminiscent of the bipolar clinic phase tsiklotimnogo circle. Given the observable atypia in adolescents and analysis of clinical disease, previous therapy, through which achieved only partial control of seizures and could not prevent the negative trends of the disease, with the transformation of generalized forms of attacks in partial seizures and the growth of polymorphism, we have selected a group of adolescents with refractory course epilepsy (34). For the first time in these patients was started Lamiktalom therapy as first-line choice in epilepsy with polymorphic seizures. In addition, several features of clinical disease with a large proportion of affective and other behavioral and cognitive dysfunction - consistent with the spectrum of action of these drugs, with normotimicheskim effect. Thus, the strategy of treatment includes the transfer of patients not only had not previously used preparations, despite the duration of the disease with resistance to therapy, but also to target comorbid mental disorders. Since one of the criteria for selection of patients in study group had no history of hepato-pathology, dermatologic disorders, and tendency to allergic reactions, the remaining 20 patients were not included in the therapy of lamotrigine, and data on the dynamics of their condition during therapy with other anticonvulsants are used for comparison . Predominance among patients those with a large prescription of the disease not only reflects the overall lack of effectiveness of previously used drugs, but apparently not always adequate to their selection. For example, among adolescents with epilepsy absansnoy drew the attention of the application without sufficient effect etosuksemidom monotherapy for six months or more, despite the absence of cupping, in particular, in patients aged 11 to 14 years. An initial polytherapy with two or more anticonvulsants for epilepsy, juvenile myoclonic, without adherence to the therapeutic scheme of valproate, also led some patients to positive results. Among the surveyed group of patients, only 17% (mainly with generalized convulsive seizures awakening) were receiving adequate doses of valproate in the form of monotherapy. Often used a combination of carbamazepine, and barbiturates difenina, with less involvement of valproate in the therapeutic scheme. This allows us to take proper therapeutic factors a role not only in shaping pharmacoresistant with polymorphism of seizures, but also in the development of mental (behavioral) abnormalities. According to this study, prolonged use of barbiturates could have an adverse effect on cognitive function with a decrease in attention and intellectual productivity, as well as the delayed reaction. With the influence of prolonged and ineffective therapy with carbamazepine in combination with benzodiazepines in patients with polymorphic seizures, including myoclonic seizures can be attributed not only to poor results of treatment of infection, but development on this background adynamia, gipotimii, dysthymia, and anxiety-depressive disorders .