Voitiuk A. Clinical, neurophysiological and hormonal disorders in young men with epilepsy

Українська версія

Thesis for the degree of Doctor of Philosophy (PhD)

State registration number

0824U002713

Thesis Registration Form

0824U002713.pdf

Applicant for

Specialization

  • 222 - Медицина

22-05-2024

Specialized Academic Board

СВР 59_5243

Kharkiv National Medical University

Essay

The study reveals for the first time the peculiarities of the clinical course of epilepsy in young men, the relationship of this disease with the level of steroid hormones (testosterone, prolactin, progesterone, estradiol). The influence of these hormones on reproductive function was also established. Epilepsy and ASMs can have a complex effect on the reproductive system, leading to a decrease in fertility in men, as well as causing various endocrine disorders. The purpose of this study is to determine the role of hormonal disorders in young men in the pathogenesis of epilepsy based on comprehensive clinical, neurophysiological, biochemical and neuropsychological studies and to optimize diagnostic and therapeutic approaches. To achieve the aim and objectives of the dissertation study, 80 male patients with epilepsy aged 18 to 44 years (mean age 29,62±6,71), who were classified as young adults according to the WHO classification, were examined. All patients were divided into 3 groups depending on the age of epilepsy debut. Group 1 - young men who had the age of epilepsy onset up to 13 years, group 2 - male patients with epilepsy onset in puberty (13-17 years) and group 3 - patients with epilepsy onset in the postpubertal period (18 years and older). All patients had a history of epilepsy for at least 1 year. The control group consisted of 20 practically healthy individuals matched for age and sex (mean age 30.31±5.32). All patients and control group members underwent a comprehensive clinical and anamnestic, clinical and neurological, neurophysiological (electroencephalographic), neuroimaging (magnetic resonance imaging), and biochemical (blood hormone spectrum) examination, neuropsychological examination (determination of the quality of life by the SF-36v2 questionnaire /WHO version/, EQ-5D-5L health questionnaire, Columbia University Suicide Severity Rating Scale C-SSRS, Hamilton Depression Rating Scale HADRS, sexual dysfunction scale). This study found that young men with epilepsy had significantly lower quality of life scores compared to the control group, which is associated with the impact of the disease itself on the human body. It was also found that the higher the age of epilepsy debut, the more patients who have suicidal thoughts and suicidal behavior are observed. In most cases, patients with epilepsy have non-psychotic mental disorders. In this study, it was recorded that non-psychotic mental disorders were more common in patients of groups 1 and 2 at the time of the examination than in patients of group 3 (=5,16; р0,01). There was also a correlation between the occurrence of these disorders and the age of debut (r=-0.16; p=0.04) and the duration of epilepsy (r=0.24; p=0.002). Due to the early onset of the disease and its prolonged course, affective symptoms were more common. The present study established the relationship between the level of steroid hormones in young men and the age of epilepsy onset. The relationship between the level of steroid hormones and the form of epilepsy was also considered. It is appropriate to pay attention to the relationship between the level of steroid hormones and the type of epileptic seizures, as well as the frequency of seizures. It is also worth mentioning the effect of ASMs on steroid hormone levels. Since the level of sex hormones varied depending on the active ingredient of the ASMs. On the basis of the data obtained, recommendations for individualized diagnosis and treatment of epilepsy in young men were developed. This study found that young men with epilepsy had significantly lower quality of life scores compared to the control group, which is associated with the impact of the disease itself on the human body. It was also found that the higher the age of epilepsy debut, the more patients with suicidal thoughts and suicidal behavior are observed. In this study, it was recorded that non-psychotic mental disorders were more common in patients of groups 1 and 2 at the time of examination than in patients of group 3 (j=5.16; p<0.01). There was also a correlation between the occurrence of these disorders and the age of debut (r=-0.16; p=0.04) and the duration of epilepsy (r=0.24; p=0.002). Due to the early onset of the disease and its prolonged course, affective symptoms were more common. The present study established the relationship between the level of steroid hormones in young men and the age of epilepsy debut. The relationship between the level of steroid hormones and the form of epilepsy was also considered. It is appropriate to pay attention to the relationship between the level of steroid hormones and the type of epileptic seizures, as well as the frequency of seizures. The level of sex hormones varied depending on the active ingredient of the ASMs. Based on the data obtained, recommendations for individualized diagnosis and treatment of epilepsy in young men were developed.

Read more

Research papers

1. Voitiuk A. Comparative analysis of epidemiological indicators of the prevalence and incidence of epilepsy among young men on the example of Kharkiv and Transcarpathian regions in Ukraine / A. Voitiuk, T. Litovchenko // Archives in Neurology & Neuroscience. — 2019, 3(3). — p. 1–3.

2. Voitiuk A. Epilepsy: age and gender aspects/ A. Voitiuk // Archives in Neurology & Neuroscience. — 2019, 3(4). — P. 1–3.

3. Voitiuk A. The problem of cognitive impairments in young men with epilepsy // A. Voitiuk, T. Litovchenko // Ecronicon Neurology. — 2019, 11(9). — P. 882–889.

4. Voitiuk A. Assessment of the quality of life of young men suffering from epilepsy / A. Voitiuk // Acta Scientific Medical Sciences. — 2019, 3(4). — P. 10–12.

5. Voitiuk A. Sleep disorders in epilepsy / A. Voitiuk // Ecronicon Psychology and Psychiatry. — 2019, 8(2). — P. 101–103.

6. Mushegian M. Evaluation of clinical parameters in patients with symptomatic vascular epilepsy and chronic disorders of cerebral circulation / M. Mushegian, T. Litovchenko, A. Voitiuk // International Neurological Journal. — 2019, 14 (4). — P. 26–32.

7. Grymailo V. et al. The peculiarities of the heart rate variability and electroencephalogram changes in patients with epilepsy and cardiovascular pathology / V. Grymailo, T. Litovchenko, A. Voitiuk et al. // Wiadomości Lekarskie. — 2019, 72(2). — P. 165–168.

8. Voitiuk A. Non-psychotic mental disorders in young men with epilepsy / A. Voitiuk, T. Litovchenko // International Neurological Journal. — 2020. — 16 (6). — P. 44–49.

9. Vostrotin O. Difficulties of neuropsychological diagnosis of unilateral neglect in the management of patients with ischemic stroke / O. Vostrotin, T. Litovchenko, A. Voitiuk // International Neurological Journal. — 2021, 17 (3). — P. 25–28.

10. Voitiuk A. Reproductive dysfunction in young men with epilepsy / A. Voitiuk, T. Litovchenko // Archives in Neurology & Neuroscience. — 2021. — 9 (5). — P. 1–5.

11. Voitiuk A. The role of the epiphysis hormone in the development of epileptic seizures in young men / A. Voitiuk, T. Litovchenko // International scientific journal «Grail of Science». — 2021. — No. 2–3 (April). — P. 539–543.

12. Voitiuk A. Comparative analysis of neurophysiological features in young women and men suffering from epilepsy / A. Voitiuk, T. Litovchenko // International Medical Journal. — 2021, 27 (1). — P. 63–66.

13. Voitiuk A. Non-epileptic paroxysmal states in epilepsy / A. Voitiuk, T. Litovchenko, T. Markova // Journal of Neurology and Neuroscience. — 2021. — 11 (5). — Р. 330.

14. Voitiuk A. Differential diagnosis of paroxysmal states: literature review and analysis of a clinical case on the example of CLOCCs-syndrome in a young man / A. A. Voitiuk, T. A. Litovchenko, O. N. Borodai, N. A. Rudkivska // Wiadomości Lekarskie. — 2022, 75 (4 p1). — 907–913.

15. Voitiuk A. The importance of neuroimaging methods in the diagnosis of epilepsy in young men: literature review and own clinical case / A. Voitiuk // EUREKA: Health Sciences. — 2022. — No. 1 (70). — P. 56–62.

16. Voitiuk A. Hormonal background in young men with epilepsy: the influence of pathology and treatment / A. Voitiuk // ScienceRise: Medical Science. – 2022. - No. 4 (49). — P. 44–49.

17. Voitiuk A. Melatonin: the role in the development of epileptic seizures / A. Voitiuk // The 34th European Neurology Congress: Abstract / June 24–25, 2020.

18. Voitiuk A. EEG peculiarities in young men with posttraumatic epilepsy/ A. Voitiuk // Матеріали конгресу: XXV Міжнародний медичний конгрес студентів і молодих вчених. — Тернопіль, 2021 — С. 68–69.

20. Voitiuk A. Disorders of reproduction in young men suffering from epilepsy/ A. Voitiuk // The 34th International Epilepsy Congress (ILAE) // Epilepsia (62): Abstract. — 2021. — P. 44.

21. Voitiuk A. Changes of lipid metabolism in young men with epilepsy / A. Voitiuk // The 34th International Epilepsy Congress (ILAE) // Epilepsia (62): Abstract. — 2021. — P. 44–45.

22. Sasikumar S. International case control study of Sudden Unexpected Death in Epilepsy / Sunayana Sasikumar, Peter Bergin, Anna Voitiuk et al. // The 34th International Epilepsy Congress (ILAE) // Epilepsia (62): Abstract. – 2021. – p.68-68.

23. Voitiuk A. Gender peculiarities of epilepsy course / A. Voitiuk, T. Litovchenko // Збірник матеріалів VII Міжнародної науково-практичної конференції «Гендер. Екологія. Здоров’я». — 2021. — p. 45–46.

24. Voitiuk A. Hormonal changes in young men suffering from epilepsy/ A. Voitiuk, T. Litovchenko, G. Selyukov // The 16th World Congress on Controversies in Neurology (CONy): Abstract / March 24–27, 2022.

25. Voitiuk A. Bone metabolic disorders in young men suffering from epilepsy/ A. Voitiuk // The 2nd North American Epilepsy Congress (ILAE): Abstract / May 5–8, 2022.

26. Voitiuk A. The comorbidity between migraine and epilepsy in young men/ A. Voitiuk // The 17th World Congress on Controversies in Neurology (CONy): Abstract / March 23–25, 2023.

27. Voitiuk A. Gastrointestinal disorders in young men with epilepsy/ A. Voitiuk // AES Annual Meeting 2023: Abstract / December 1-5, 2023.

28. Voitiuk A. Sexual disorders in men with epilepsy – an interdisciplinary problem! / A. Voitiuk, T. Litovchenko // Збірник наукових праць ΛΌГOΣ: «Education and Science Of Today: Intersectoral Issues and Development of Sciences», volume 4. — 2021. — P. 27–29.

29. Voitiuk A. The problem of sleep disorders in young men with epilepsy / A. Voitiuk, T. Litovchenko // Збірник наукових праць SCIENTIA: I International Scientific and Theoretical Conference «Theoretical and Practical Scientific Achievements: Research and Results of Their Implementation», volume 4. — 2021. — P. 40–42.

30. Voitiuk A. The importance of neuroimaging methods in the diagnosis of epilepsy in young men: literature review and own clinical case / A. Voitiuk, T. Litovchenko// Збірник наукових праць SCIENTIA: II International Scientific and Theoretical Conference «Formation of Innovative Potential of World Science» 2021. Vol. 2. — P. 91–96.

31. Voitiuk A. The problem of SUDEP in young men suffering from epilepsy/ A. Voitiuk // Збірник наукових праць ΛΌГOΣ: «DÉBATS SCIENTIFIQUES ET ORIENTATIONS PROSPECTIVES DU DÉVELOPPEMENT SCIENTIFIQUE», 2023. — P. 168–171.

Read more

Files

autoreferat-Анотація Войтюк А-О-.pdf

evolution-Рішення спеціалізованої вченої ради про присудження ступеня доктора філософії Войтюк А-О-.pdf

Дисертація Войтюк А-О-.pdf

Similar theses

0824U002708

Denys S. Yaroshenko

Development and functioning of testes in conditions of long-term action of bisphenol A in the experiment

0824U002715

Yelyzaveta S. Katsalap

Complex surgical treatment of congenital pseudoarthrosis of the tibia in children. (experimental and clinical research)

0824U002717

Anastasiia O. Chekhunova

Pathogenetic Substantiation of Optimisation of Diagnosis and Treatment of Adenomyosis

0824U002723

Anastasiia S. Marchenko

Pathogenetic and clinical significance of serum blood morphogenetic proteins in the development of secondary osteoporosis in patients with type 2 diabetes mellitus and obesity

0824U002726

Mykhailo O. Kalinichenko

Individual anatomical variability of the superficial vascular bed of the human cerebellum