Health care of Kyrgyzstan
Zdravoohraneniye Kyrgyzstana

ISSN 1694-8068 (Print)

ISSN 1694-805X (Online)

Evaluation of the results of surgical treatment of pharmacoresistant epilepsy in adults

Evaluation of the results of surgical treatment of pharmacoresistant epilepsy in adults
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Abstract

Introduction. Drug treatment with antiepileptic drugs (AEDs) is the mainstay of treatment for epilepsy. However, in some patients, despite the use by neurologists of drugs with different mechanisms of action, in some patients with epilepsy, the disease is resistant to drug treatment or pharmacoresistant. In drug-resistant forms of epilepsy, surgery gives the patient a chance for a complete cure or a significant reduction in the frequency of seizures. Purpose of the work was to analyze and evaluate the outcomes of treatment in patients with drug-resistant epilepsy with various methods of their surgical treatment. Material and methods. A prospective analysis of the results of surgical treatment was carried out. The study included 138 patients with drug-resistant epilepsy who were hospitalized at the neurosurgery clinic of the National Hospital under the Ministry of Health of the Kyrgyz Republic from 2004 to 2013. We studied the data of neurological, neurophysiological and neuroimaging examinations, as well as the data of surgical treatment in the near and long term. Results. The overall level of complications caused by surgeries for epilepsy was quite low (only 2 patients developed split-brain syndrome after resection surgeries (callosotomy). A more effective and safe operation for the treatment of drug-resistant epilepsy, according to our observation, was multiple subpial transsection, complete cessation of epileptic seizures occurred in 20 patients (62.5%). Conclusions. The effectiveness of the applied methods of surgical treatment in various forms of epilepsy is shown. Surgical treatment of patients with drug-resistant epilepsy allows to achieve regression of the pathological process or stabilization of the condition in most cases.

About the authors

Мамытов Миталип Мамытович, д.м.н., профессор, заведующий кафедрой нейрохирургии додипломного и последипломного образования КГМА им. И.К. Ахунбаева, Бишкек, Кыргызская Республика
Кадыров Руслан Маннафович, д.м.н., профессор РАЕ РФ, директор хирургического центра “Кортекс”, Бишкек, Кыргызская Республика
Мамытова Элмира Миталиповна, д.м.н., доцент, заведующая кафедрой неврологии и клинической генетики им. акад. А. Мурзалиева Кыргызской государственной медицинской академии им. И.К. Ахунбаева, Бишкек, Кыргызская Республика

Mamytov Mitalip Mamytovich, MD, Professor, Head of the Department of Neurosurgery of Undergraduate and Postgraduate Education, KSMA named after I.K. Akhunbaeva, Bishkek, Kyrgyz Republic
Kadyrov Ruslan Mannafovich, Doctor of Medical Sciences, Professor RAN RF, Director of the Cortex Surgical Center, Bishkek, Kyrgyz Republic
Mamytova Elmira Mitalipovna, MD, Associate Professor, Head of the Department of Neurology and Clinical Genetics named after Academician A. Murzaliev of the Kyrgyz State Medical Academy named after I.K. Akhunbaeva, Bishkek, Kyrgyz Republic

Мамытов Миталип Мамытович, медицина илимдеринин доктору, профессор, И.К. Ахунбаев атындагы КММАнын Дипломго чейинки жана дипломдон кийинки билим берүүнүн нейрохирургиясы кафедрасынын башчысы, Бишкек, Кыргыз Республикасы
Кадыров Руслан Маннафович, медицина илимдеринин доктору, Россиянын Табигый илимдер академиясынын профессору, Кортекс хирургиялык борборунун директору, Бишкек, Кыргыз Республикасы
Мамытова Эльмира Миталиповна, медицина илимдеринин доктору, доцент, акад. А.Мурзалиев атындагы неврология жана клиникалык генетика кафедрасынын башчысы, И.К. Ахунбаев атындагы Кыргыз мамлекеттик медициналык академиясы, Бишкек, Кыргыз Республикасы

References

1. Fisher R.S. et al. ILAE Official Report: A practical clinical definition of epilepsy // Epilepsia. Blackwell Publishing Inc. - 2014.- Vol. 55, № 4. - P. 475–482.
2. WHO | Epilepsy: a public health imperative // WHO. World Health Organization. - 2019.
3. Beghi E. et al. Global, regional, and national burden of epilepsy, 1990–2016: a
systematic analysis for the Global Burden of Disease Study 2016 // Lancet Neurol. Lancet Publishing Group. - 2019. - Vol. 18, № 4. - P. 357–375.
4. Commission on Epidemiology and Prognosis I.L.A.E. Guidelines for Epidemiologic Studies on Epilepsy // Epilepsia. - 1993.- Vol. 34, № 4. - P. 592–596.
5. Fiest K.M. et al. Prevalence and incidence of epilepsy // Neurology. Lippincott Williams and Wilkins. - 2017. - Vol. 88, № 3. - P. 296–303.
6. Wiebe S., Jette N. Pharmacoresistance and the role of surgery in difficult to treat epilepsy // Nat. Rev. Neurol. Nat Rev Neurol. -2012. - Vol. 8, № 12. - P. 669–677.
7. Engel Jr JVNP. Outcome with respect to epileptic seizures // Surgical treatment of the epilepsies. – 1993. – Р. 609-621.
8. Nilsson L, Ahlbom A, Farahmand B, Tomson T. Mortality in a Population-based Cohort of Epilepsy Surgery Patients // Epilepsia. – 2003. - 44(4). – Р. 575-581.
9. Kwan P, Arzimanoglou A, Berg A et al. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies // Epilepsia.- 2009. - 51(6). – Р.1069-1077.
10. Benbadis S, Heriaud L, Tatum W, Vale F. Epilepsy surgery, delays and referral patterns—are all your epilepsy patients controlled // Seizure. – 2003. 12(3). – Р.167-170.

1. Fisher R.S. et al. ILAE Official Report: A practical clinical definition of epilepsy // Epilepsia. Blackwell Publishing Inc. - 2014.- Vol. 55, № 4. - P. 475–482.
2. WHO | Epilepsy: a public health imperative // WHO. World Health Organization. - 2019.
3. Beghi E. et al. Global, regional, and national burden of epilepsy, 1990–2016: a
systematic analysis for the Global Burden of Disease Study 2016 // Lancet Neurol. Lancet Publishing Group. - 2019. - Vol. 18, № 4. - P. 357–375.
4. Commission on Epidemiology and Prognosis I.L.A.E. Guidelines for Epidemiologic Studies on Epilepsy // Epilepsia. - 1993.- Vol. 34, № 4. - P. 592–596.
5. Fiest K.M. et al. Prevalence and incidence of epilepsy // Neurology. Lippincott Williams and Wilkins. - 2017. - Vol. 88, № 3. - P. 296–303.
6. Wiebe S., Jette N. Pharmacoresistance and the role of surgery in difficult to treat epilepsy // Nat. Rev. Neurol. Nat Rev Neurol. -2012. - Vol. 8, № 12. - P. 669–677.
7. Engel Jr JVNP. Outcome with respect to epileptic seizures // Surgical treatment of the epilepsies. – 1993. – Р. 609-621.
8. Nilsson L, Ahlbom A, Farahmand B, Tomson T. Mortality in a Population-based Cohort of Epilepsy Surgery Patients // Epilepsia. – 2003. - 44(4). – Р. 575-581.
9. Kwan P, Arzimanoglou A, Berg A et al. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies // Epilepsia.- 2009. - 51(6). – Р.1069-1077.
10. Benbadis S, Heriaud L, Tatum W, Vale F. Epilepsy surgery, delays and referral patterns—are all your epilepsy patients controlled // Seizure. – 2003. 12(3). – Р.167-170.

1. Fisher R.S. et al. ILAE Official Report: A practical clinical definition of epilepsy // Epilepsia. Blackwell Publishing Inc. - 2014.- Vol. 55, № 4. - P. 475–482.
2. WHO | Epilepsy: a public health imperative // WHO. World Health Organization. - 2019.
3. Beghi E. et al. Global, regional, and national burden of epilepsy, 1990–2016: a
systematic analysis for the Global Burden of Disease Study 2016 // Lancet Neurol. Lancet Publishing Group. - 2019. - Vol. 18, № 4. - P. 357–375.
4. Commission on Epidemiology and Prognosis I.L.A.E. Guidelines for Epidemiologic Studies on Epilepsy // Epilepsia. - 1993.- Vol. 34, № 4. - P. 592–596.
5. Fiest K.M. et al. Prevalence and incidence of epilepsy // Neurology. Lippincott Williams and Wilkins. - 2017. - Vol. 88, № 3. - P. 296–303.
6. Wiebe S., Jette N. Pharmacoresistance and the role of surgery in difficult to treat epilepsy // Nat. Rev. Neurol. Nat Rev Neurol. -2012. - Vol. 8, № 12. - P. 669–677.
7. Engel Jr JVNP. Outcome with respect to epileptic seizures // Surgical treatment of the epilepsies. – 1993. – Р. 609-621.
8. Nilsson L, Ahlbom A, Farahmand B, Tomson T. Mortality in a Population-based Cohort of Epilepsy Surgery Patients // Epilepsia. – 2003. - 44(4). – Р. 575-581.
9. Kwan P, Arzimanoglou A, Berg A et al. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies // Epilepsia.- 2009. - 51(6). – Р.1069-1077.
10. Benbadis S, Heriaud L, Tatum W, Vale F. Epilepsy surgery, delays and referral patterns—are all your epilepsy patients controlled // Seizure. – 2003. 12(3). – Р.167-170.

Для цитирования

Мамытов М.М., Кадыров Р.М., Мамытова Э.М. Оценка результатов хирургического лечения фармакорезистентной эпилепсии у взрослых. Здравоохранение Кыргызстана 2022, № 3,с. 130-139. https://dx.doi.org/10.51350/zdravkg20229319130

For citation

Mamytov M.M., Kadyrov R.M., Mamytova E.M. Evaluation of the results of surgical treatment of pharmacoresistant
epilepsy in adults.Health care of Kyrgyzstan 2022,No.3, pp.130-139. https://dx.doi.org/10.51350/zdravkg20229319130

Цитата үчүн

Мамытов М.М., Кадыров Р.М., Мамытова Э.М. Чоңдордогу фармакозезистенттүү эпилепсияны хирургиялык дарылоонун натыйжаларын баалоо. Кыргызстандын саламаттык сактоо  2022, № 3,с. 130-139. https://dx.doi.org/10.51350/zdravkg20229319130

Authors Mamytov M.M., Kadyrov R.M., Mamytova E.M.
Link doi.org https://dx.doi.org/10.51350/zdravkg20229319130
Pages 130-139
Keywords pharmacoresistant epilepsy, effectiveness of surgical treatment of epilepsy
Russian
Об авторах

Мамытов Миталип Мамытович, д.м.н., профессор, заведующий кафедрой нейрохирургии додипломного и последипломного образования КГМА им. И.К. Ахунбаева, Бишкек, Кыргызская Республика
Кадыров Руслан Маннафович, д.м.н., профессор РАЕ РФ, директор хирургического центра “Кортекс”, Бишкек, Кыргызская Республика
Мамытова Элмира Миталиповна, д.м.н., доцент, заведующая кафедрой неврологии и клинической генетики им. акад. А. Мурзалиева Кыргызской государственной медицинской академии им. И.К. Ахунбаева, Бишкек, Кыргызская Республика

Полный текст

PDF (RUS)

Список литературы

1. Fisher R.S. et al. ILAE Official Report: A practical clinical definition of epilepsy // Epilepsia. Blackwell Publishing Inc. - 2014.- Vol. 55, № 4. - P. 475–482.
2. WHO | Epilepsy: a public health imperative // WHO. World Health Organization. - 2019.
3. Beghi E. et al. Global, regional, and national burden of epilepsy, 1990–2016: a
systematic analysis for the Global Burden of Disease Study 2016 // Lancet Neurol. Lancet Publishing Group. - 2019. - Vol. 18, № 4. - P. 357–375.
4. Commission on Epidemiology and Prognosis I.L.A.E. Guidelines for Epidemiologic Studies on Epilepsy // Epilepsia. - 1993.- Vol. 34, № 4. - P. 592–596.
5. Fiest K.M. et al. Prevalence and incidence of epilepsy // Neurology. Lippincott Williams and Wilkins. - 2017. - Vol. 88, № 3. - P. 296–303.
6. Wiebe S., Jette N. Pharmacoresistance and the role of surgery in difficult to treat epilepsy // Nat. Rev. Neurol. Nat Rev Neurol. -2012. - Vol. 8, № 12. - P. 669–677.
7. Engel Jr JVNP. Outcome with respect to epileptic seizures // Surgical treatment of the epilepsies. – 1993. – Р. 609-621.
8. Nilsson L, Ahlbom A, Farahmand B, Tomson T. Mortality in a Population-based Cohort of Epilepsy Surgery Patients // Epilepsia. – 2003. - 44(4). – Р. 575-581.
9. Kwan P, Arzimanoglou A, Berg A et al. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies // Epilepsia.- 2009. - 51(6). – Р.1069-1077.
10. Benbadis S, Heriaud L, Tatum W, Vale F. Epilepsy surgery, delays and referral patterns—are all your epilepsy patients controlled // Seizure. – 2003. 12(3). – Р.167-170.

Для цитирования

Мамытов М.М., Кадыров Р.М., Мамытова Э.М. Оценка результатов хирургического лечения фармакорезистентной эпилепсии у взрослых. Здравоохранение Кыргызстана 2022, № 3,с. 130-139. https://dx.doi.org/10.51350/zdravkg20229319130

English
About authors

Mamytov Mitalip Mamytovich, MD, Professor, Head of the Department of Neurosurgery of Undergraduate and Postgraduate Education, KSMA named after I.K. Akhunbaeva, Bishkek, Kyrgyz Republic
Kadyrov Ruslan Mannafovich, Doctor of Medical Sciences, Professor RAN RF, Director of the Cortex Surgical Center, Bishkek, Kyrgyz Republic
Mamytova Elmira Mitalipovna, MD, Associate Professor, Head of the Department of Neurology and Clinical Genetics named after Academician A. Murzaliev of the Kyrgyz State Medical Academy named after I.K. Akhunbaeva, Bishkek, Kyrgyz Republic

Full text

PDF (RUS)

References

1. Fisher R.S. et al. ILAE Official Report: A practical clinical definition of epilepsy // Epilepsia. Blackwell Publishing Inc. - 2014.- Vol. 55, № 4. - P. 475–482.
2. WHO | Epilepsy: a public health imperative // WHO. World Health Organization. - 2019.
3. Beghi E. et al. Global, regional, and national burden of epilepsy, 1990–2016: a
systematic analysis for the Global Burden of Disease Study 2016 // Lancet Neurol. Lancet Publishing Group. - 2019. - Vol. 18, № 4. - P. 357–375.
4. Commission on Epidemiology and Prognosis I.L.A.E. Guidelines for Epidemiologic Studies on Epilepsy // Epilepsia. - 1993.- Vol. 34, № 4. - P. 592–596.
5. Fiest K.M. et al. Prevalence and incidence of epilepsy // Neurology. Lippincott Williams and Wilkins. - 2017. - Vol. 88, № 3. - P. 296–303.
6. Wiebe S., Jette N. Pharmacoresistance and the role of surgery in difficult to treat epilepsy // Nat. Rev. Neurol. Nat Rev Neurol. -2012. - Vol. 8, № 12. - P. 669–677.
7. Engel Jr JVNP. Outcome with respect to epileptic seizures // Surgical treatment of the epilepsies. – 1993. – Р. 609-621.
8. Nilsson L, Ahlbom A, Farahmand B, Tomson T. Mortality in a Population-based Cohort of Epilepsy Surgery Patients // Epilepsia. – 2003. - 44(4). – Р. 575-581.
9. Kwan P, Arzimanoglou A, Berg A et al. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies // Epilepsia.- 2009. - 51(6). – Р.1069-1077.
10. Benbadis S, Heriaud L, Tatum W, Vale F. Epilepsy surgery, delays and referral patterns—are all your epilepsy patients controlled // Seizure. – 2003. 12(3). – Р.167-170.

For citation

Mamytov M.M., Kadyrov R.M., Mamytova E.M. Evaluation of the results of surgical treatment of pharmacoresistant
epilepsy in adults.Health care of Kyrgyzstan 2022,No.3, pp.130-139. https://dx.doi.org/10.51350/zdravkg20229319130

Kyrgyz
Авторлор жөнүндө

Мамытов Миталип Мамытович, медицина илимдеринин доктору, профессор, И.К. Ахунбаев атындагы КММАнын Дипломго чейинки жана дипломдон кийинки билим берүүнүн нейрохирургиясы кафедрасынын башчысы, Бишкек, Кыргыз Республикасы
Кадыров Руслан Маннафович, медицина илимдеринин доктору, Россиянын Табигый илимдер академиясынын профессору, Кортекс хирургиялык борборунун директору, Бишкек, Кыргыз Республикасы
Мамытова Эльмира Миталиповна, медицина илимдеринин доктору, доцент, акад. А.Мурзалиев атындагы неврология жана клиникалык генетика кафедрасынын башчысы, И.К. Ахунбаев атындагы Кыргыз мамлекеттик медициналык академиясы, Бишкек, Кыргыз Республикасы

Толук текст

PDF (RUS)

Шилтемелер

1. Fisher R.S. et al. ILAE Official Report: A practical clinical definition of epilepsy // Epilepsia. Blackwell Publishing Inc. - 2014.- Vol. 55, № 4. - P. 475–482.
2. WHO | Epilepsy: a public health imperative // WHO. World Health Organization. - 2019.
3. Beghi E. et al. Global, regional, and national burden of epilepsy, 1990–2016: a
systematic analysis for the Global Burden of Disease Study 2016 // Lancet Neurol. Lancet Publishing Group. - 2019. - Vol. 18, № 4. - P. 357–375.
4. Commission on Epidemiology and Prognosis I.L.A.E. Guidelines for Epidemiologic Studies on Epilepsy // Epilepsia. - 1993.- Vol. 34, № 4. - P. 592–596.
5. Fiest K.M. et al. Prevalence and incidence of epilepsy // Neurology. Lippincott Williams and Wilkins. - 2017. - Vol. 88, № 3. - P. 296–303.
6. Wiebe S., Jette N. Pharmacoresistance and the role of surgery in difficult to treat epilepsy // Nat. Rev. Neurol. Nat Rev Neurol. -2012. - Vol. 8, № 12. - P. 669–677.
7. Engel Jr JVNP. Outcome with respect to epileptic seizures // Surgical treatment of the epilepsies. – 1993. – Р. 609-621.
8. Nilsson L, Ahlbom A, Farahmand B, Tomson T. Mortality in a Population-based Cohort of Epilepsy Surgery Patients // Epilepsia. – 2003. - 44(4). – Р. 575-581.
9. Kwan P, Arzimanoglou A, Berg A et al. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies // Epilepsia.- 2009. - 51(6). – Р.1069-1077.
10. Benbadis S, Heriaud L, Tatum W, Vale F. Epilepsy surgery, delays and referral patterns—are all your epilepsy patients controlled // Seizure. – 2003. 12(3). – Р.167-170.

Цитата үчүн

Мамытов М.М., Кадыров Р.М., Мамытова Э.М. Чоңдордогу фармакозезистенттүү эпилепсияны хирургиялык дарылоонун натыйжаларын баалоо. Кыргызстандын саламаттык сактоо  2022, № 3,с. 130-139. https://dx.doi.org/10.51350/zdravkg20229319130

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