Antonenko S. Clinical and pathogenetic features of autonomic disorders and their correction in a patient with post-traumatic epilepsy

Based on a comprehensive examination of 77 young patients with post-traumatic epilepsy (PTE), certain patterns of the formation and development of symptomatic epilepsy after a traumatic brain injury (TBI) of varying severity with the obligatory participation of the ANS were revealed. The main neurological syndromes accompanying PTE, the average formation time, the relationship of autonomic disorders of various levels with the clinical course of PTE, the severity of its manifestations, the number and form of epiparoxysms, as well as changes in their characteristics in the delayed period were identified. The efficiency of a phased algorithm for diagnosing PTE using the autonomic testing and evoked sympathetic potentials has been developed and studied. The efficiency of a phased algorithm for diagnosing PTE using the autonomic testing and evoked sympathetic potentials has been developed and studied. The coincidence of morphological lesions with zones of symptomatic and irritative electroencephalographic changes was revealed, including correlation with the severity of TBI with the prevalence of temporal localization with the presence of aura (р <0.05), as well as vegetative crises (р <0.05). The leading clinical manifestations and subjective experiences were autonomic, psychoemotional disorders and cognitive deficit. The effectiveness of pathogenetic therapy of PTE was determined based on the use of a new therapy method for the differentiated treatment of PTE and the correction of autonomic dysfunctions taking into account the autonomous status, which made it possible to select the optimal combination of anticonvulsant and additive drugs and to obtain reliable positive clinical diagnostic results of therapy in relation to seizure control. The effectiveness of pathogenetic therapy of PTE was determined based on the use of a new therapy method for the differentiated treatment of PTE and the correction of autonomic dysfunctions taking into account the autonomous status, which made it possible to select the optimal combination of anticonvulsant and additive drugs and to obtain reliable positive clinical diagnostic results of therapy in relation to seizure control. Based on a comprehensive study of the state of the autonomic system, psychoemotional and cognitive spheres, features of clinical and electrophysiological indicators, as well as neuroimaging data, a phased algorithm for diagnosing and differential diagnosis of PTE is created, which in a short time, without additional material costs will allow timely use of adequate treatment methods using separate antiepileptic drugs in combination with vegetotropic depending on the state of tone and other characteristics ANS.