ZHANAIDAROV, ZH. (2013) SURGICAL TREATMENT OF POST-TRAUMATIC EPILEPSY. Научно-практический журнал “Вестник КазНМУ” (3). ISSN 9965-01-300-4
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Abstract
Post-traumatic epilepsy (PTE) is one of the most severe and intractable forms of the effects of traumatic brain injury (TBI) and has the essential features that influence the clinical picture, diagnosis and surgical treatment of this group of patients [2]. Frequency of development, according to the literature, is very variable - 11 - 50% [9, 13, 21, 26], which due to the dependence of this parameter on such factors as the time after undergoing CCT, its nature and severity [10, 13, 18 , 27]. The reason of occurrence PTE is directly traumatic brain injury [1] and (or) different post-traumatic pathologic processes [12], wherein the structural changes in the brain tissue may vary from coarse to subcellular processes scarring disorders [19]. Structural and functional changes that occurred after the head injury, lead to the development of complex pathological process involving endogenous mechanisms of brain damage. One of these mechanisms is the aggregate formation hyperactive neurons - the epileptic focus (EO) which may occur in different brain regions [8, 11, 14, 20, 24]. TBI disrupts the function of limbic-reticular complex and its interaction with the pituitary and hypothalamic structures, which affects the person's emotional sphere and leads to mental disorders, which are one of the leading PTE syndromes [1, 8]. Given these circumstances, probably one of the basic mechanisms of traumatic epilepsy is the degree and nature of the damage to the brain stem structures in the acute phase of injury. The main object of the study were 137 (26.7%) patients with post- traumatic epilepsy, among whom there were 108 men (78.8%) and 29 (21.2%) women aged 12 to 53 years (mean age - 32, 9 ± 2,8 years) who were treated at the Russian Neurosurgical Institute. In the histories severe head injury has prevailed (83 patients - 60.6%). Trauma mild to serve the cause of epilepsy in only 17 (12.4%) and 14 (10.2%) cases, respectively. In 23 (16.7%) cases, the degree of injury has not been established. CONCLUSIONS: 1. Post-traumatic epilepsy is formed in 24.0% of patients in the period up to 4 months after severe traumatic brain injury, and the nature and severity of traumatic lesions of the brain stem are among the main factors of its occurrence. 2. The main feature of traumatic etiology of epilepsy is its combination with other effects of traumatic brain injury. Neuroradiological investigation (CT and MRI) reveals various structural changes of the skull, brain, meninges and likvorosoderzhaschih spaces in 82.5% of patients and 17.5% of cases, such changes are not detected. . Surgical treatment of traumatic epilepsy should be comprehensive and aimed at radical removal of the epileptic focus and the simultaneous correction of related post-traumatic disorders.
| Item Type: | Article |
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| Uncontrolled Keywords: | epilepsy, head injury, electroencefalografy |
| Subjects: | R Medicine > RD Surgery |
| Divisions: | Научно-практический журнал "Вестник КазНМУ" > Выпуск №2 2013 год |
| Depositing User: | Mr Press KazNMU |
| Date Deposited: | 01 Jul 2013 05:29 |
| Last Modified: | 01 Jul 2013 05:29 |
| URI: | http://repository.kaznmu.kz/id/eprint/12089 |
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