Voronova A. The role of intrathecal immunoglobulin G synthesis and blood-brain barrier permeability state in the genesis of resistant forms of epilepsy in children

The dissertation is an integrated clinical and instrumental examination underwent 64 children with variable resistant forms of epilepsy. Revealed that the average frequency of intractable epilepsy seizures before treatment is higher than in those with controlled seizures. Depth neuropsychiatric deficits correlate with the severity of epilepsy, the severity of non-specific changes in brain bioelectrical activity and the number of epileptic foci in the patient. In children with intractable epilepsy established a violation of immune reactivity in the form of lower levels of lymphocyte subpopulations CD3, CD4, CD8, immunoglobulin G and increasing CD95 + lymphocytes in the blood compared with healthy individuals and children with controlled epilepsy. In 65.6% of children with intractable epilepsy have the increased permeability of the blood-brain barrier, in 40.6% of patients determined by raising intrathecal synthesis of IgG, 42.2% of the patients increased levels of IgG in cerebrospinal fluid. A marked positive correlation between the increase in the permeability of the blood-brain barrier, intrathecal synthesis of IgG and rose-solution of his level in the cerebrospinal fluid, suggesting a pathogenetic relatedness of these phenomena. CSF parameters (albumin index, index of intrathecal synthesis and levels of IgG) show a positive correlation with the level of CD95 + lymphocytes in the blood, suggesting a possible response of the immune system with the development of intrathecal autoimmune process. Children with increased permeability of the blood-brain barrier severity of epilepsy and neuropsychiatric deficit correlates with intrathecal synthesis and IgG levels in the cerebrospinal fluid. In children with normal data liquor severity of epilepsy and neuropsychiatric deficits largely correlated with EEG. It says that when drug-resistant epilepsies inflammatory mechanisms play a role in enhancing the ictal and interictal manifestations.