详细
Background. The article presents the results of a study of the effectiveness of antiepileptic drugs (AEDs) in the treatment of epileptic syndromes associated with generalized tonic-clonic seizures (GTCS). Significant differences in therapeutic approaches to the treatment of various epileptic syndromes associated with GTCS, in the course of epilepsy and in further prognosis are relevant for the study of a group of patients with generalized seizures. Objective. Evaluation of the effectiveness of antiepileptic therapy of epileptic syndromes associated with GTCS. Methods. 190 patients with GTCS were followed-up. The observed GTCS were included in the structure of 14 different epileptic syndromes. Results. In most (75.8%) patients with epilepsy associated with GTCS, remission is possible. The best result was obtained in the treatment of generalized genetic epilepsy: 87.8% of cases of reliable relief of seizures. Remission of seizures in structural/probably structural epilepsy with the phenomenon of secondary bilateral synchronization was achieved only in 27.3% of cases. In epileptic encephalopathies, seizure blocking was registered in only 8.3% of patients. Conclusion. A possible prognosis of the course of the disease and the effectiveness of the AED in a patient with GTCS are possible only with the exact establishment of a specific form of epileptic syndrome. At the same time, the importance of additional examination methods, such as long-term video-EEG monitoring with the inclusion of sleep, neuroimaging methods with the predominant role of magnetic resonance imaging, including high-resolution technologies, and genetic counseling, is increasing.
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