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-ВЕСТНИК КАЗНМУ #4-2021 -(¡Щ)-
МЕЖДУНАРОДНАЯ НАУЧНО-ПРАКТИЧЕСКАЯ КОНФЕРЕНЦИЯ «АКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ЭКСПЕРИМЕНТАЛЬНОЙ НЕВРОЛОГИИ, НЕЙРОХИРУРГИИ, НЕЙРОФИЗИОЛОГИИ»
УДК 616.8-009.24-053.2-08
D.T. Xodjiyeva, V.F. Gafforova
Department of Neurology, Ali Abu ibn Sino Bukhara State Medical Institute, Bukhara, Uzbekistan
EEG CORRELATION SOMATOGENOUS OF CONDITIONED FEBRILE SEIZURES IN CHILDREN
Resume: Resume: the article presents the results of a comparative study of children with febrile and afebrile seizures. It is established that febrile seizures develop in hyperthermia due to somatic disease and are accompanied by micro-organic diffuse symptoms that do not affect the cognitive development of the child. Key words: children, seizure, febrile convulsions, afebrile seizures, epilepsy.
Д. Т. Ходжиева, В. Ф. Гаффарова
Эли Абу ибн Сина атындагы Бухара мемлекеттжмедицина институты,
Бухара, взбекстан
БАЛАЛАР^Ы СОМАТОГЕНД1К ФЕБРИЛЬД1 КртЫСУЛАРДЫН, ЭЭГ КОРРЕЛЯЦИЯСЫ
Т^н: мазмуны: мацалада фебрильдi жэне афебрильдi конвульсиялары бар балаларды салыстырмалы зерттеу нэтижелерi келтiрiлген. Фебрильдi конвульсиялар гипертермияда соматикалыц ауруга байланысты дамиды жэне баланыц танымдыц дамуына эсер етпейтт диффузды микроорганикалыц белгыермен бiрге журетш аныцталды. ТYйiндi свздер: балалар, устамалар, фебрильдi устамалар, фебрильдi устамалар эпилепсия.
Д.Т. Ходжиева, В.Ф.Гаффарова
Бухарский государственный медицинский институт имени Али Абу ибн Сины,
Бухара, Узбекистан
ЭЭГ КОРРЕЛЯЦИЯ СОМАТОГЕННО ОБУСЛОВЛЕННЫХ ФЕБРИЛЬНЫХ СУДОРОГ У ДЕТЕЙ
Резюме: в статье представлены результаты сравнительного исследования детей с фебрильными и афебрильными судорогами. Установлено, что фебрильные судороги развиваются при гипертермии вследствие соматического заболевания и сопровождаются диффузными микроорганическими симптомами, не влияющими на когнитивное развитие ребенка.
Ключевые слова: дети, приступ, фебрильные судороги, афебрильные судороги эпилепсия.
Relevance: Febrile seizures (FS), being the most common paroxysmal conditions among children from the age of 6 month, up to 5-7 years, belong to the group of diseases that do not require a mandatory diagnosis of epilepsy . According to the draft classification of 2001, the term febrile seizures was replaced by febrile seizures, since in the clinical picture of this condition not only convulsive, but also convulsive paroxysms can be observed. Thus, FS is defined as an episode of epileptic seizures that occur in preschool children with hyperthermia that is not associated with neuroinfection, and refers to benign, age-dependent, genetically determined conditions in which the brain is susceptible to epileptic seizures that occur in response to high temperature.
In 10-30% of cases, AF is noted in the debut of many epileptic syndromes and epilepsies [1, 7], so they have a history of 10-45% of patients with idiopathic focal epilepsy, and in 7% of children with Roland epilepsy, relatives are identified having a history of AF [1,7,10]. C.P. Panayiotopoulos (2005) notes that a maximum AF frequency of up to 30% of cases is observed in the debut of benign occipital epilepsy [9]. In recent years, AF has been described that occurs in the framework of idiopathic focal
epilepsy of infancy . The frequency of AF in patients with benign myoclonic epilepsy of infancy reaches 27%, is less common in the history of patients with the following forms of idiopathic generalized epilepsy: Doose syndrome - 11%, juvenile abscess epilepsy - 12%, Tassinari syndrome -15%, epilepsy with isolated generalized convulsive 15%, juvenile myoclonic epilepsy - in isolated cases [7]. It has been noted that an early predictor of the transformation of AF into idiopathic focal epilepsy may be the appearance on the EEG more often when recording benign childhood epileptiform patterns in sleep, with these forms of epilepsy there are exclusively typical AFs that are often associated with sleep [7]. At present, genetic, social, exo, and endogenous factors of febrile seizures have been studied [6-9].
The hypothesis that a genetically determined predisposition to convulsive states is a consequence of a generalized defect in the metabolism of catecholamines in the central nervous system is widely recognized [3]. In the early eighties of the XX century, the American neurophysiologist J. Zabara hypothesized that stimulation of the vagus nerve can prevent the development of epileptic seizures [5]. Later, in the study of patients with
epilepsy in the interictal period, the following autonomic disorders were revealed: an increase in parasympathetic activity in lesions of the right hemisphere and, accordingly, in sympathetic activity in the left hemisphere focus [6]. In addition, as a result of studies of children with febrile seizures, it was found that increased excretion of amines in children with febrile seizures is a consequence of ergotropic (sympathetic-adrenal) hypertonicity, which is based on genetically caused or resulting as a result of perinatal pathology dysfunction of higher suprasegmental vegetative centers, and above all, the structures of the limbic-reticular complex [6]. As for the identification of changes in EEG in children with AF, they are non-specific. Perhaps a study of the state of the ANS in children with AF and comparing them with the EEG results will help to identify the relationship of these disorders, showing the unidirectional nature of current processes in AF and epilepsy.
The purpose of the study: The aim of our work is a comparative description of the clinical manifestations and results of EEG studies of somatogenically caused febrile seizures.
Materials and methods: 20 patients with febrile seizures were examined, of which 10 children had simple febrile seizures, and 10 children had complex AF, from 6 months to 3 years of age. The examination plan for each child consisted of the collection and analysis of clinical and medical history of the disease and life, and the study of neurological status. The EEG study was carried out in conditions of relative rest, background recording was recorded in a sitting position, for 5 minutes. Registration and assessment of the bioelectric activity of the brain was carried out in a state of wakefulness and physiological daytime sleep. EEG recording was carried out on a 16-channel computer electroencephalograph under the name Neuron-Spectrum-2. To register the EEG, a 10-20 electrode arrangement was used, including 21 cup electrodes with a ground electrode in the center of the anteroposterior region. The alphanumeric and numeric designations of the electrodes were in accordance with the international 1020 layout. Allocation of electric potentials was carried out in a monopolar way with an averaged common. The advantage of this system is the less laborious process of applying electrodes with sufficient info. The average duration of EEG registration in each patient was standard and the possibility of conversion to any bipolar was 40-60 minutes.
Results of the study: in 16 children (80%), a burdened obstetric and pediatric history was revealed, namely, the pregnancy proceeded against the background of iron deficiency anemia (20%; 4 patients) suffered from SARS during pregnancy (25%; 5 patients) , threats of abortion (5%; 1 patient), hypoxic-ischemic encephalopathy (20%; 4 patients) and other pathologies (10%; 2 patients). The typical age period of the onset and development of febrile seizures in children was 10-28 months. The temperature increase at the time of febrile seizures ranged from 37.5 to 41 ° C. The causes of fever that caused febrile seizures were ARVI (60%; 12 people), lacunar angina (25%; 5 people), pneumonia (15%; 3 people). An analysis of the hereditary family background in 2 children revealed the presence of relatives suffering from febrile seizures. Electroencephalograph^ (EEG) changes in AF did not have specific patterns, but, nevertheless, had certain individual characteristics. The percentage of detection of epileptiform discharges in febrile seizures is still not exactly known: according to different authors, from 2 to 80%, depending on the age of the examined children and
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the time elapsed after the attack. It is known that the slowdown of bioelectric activity (diffuse slowdown of wave activity, the presence of multifocal epileptiform discharges) on the EEG can persist up to 7 days after a febrile seizure. With complex convulsions, the EEG has a high predictive value, but so far there are no clear recommendations regarding the need for it. Our experience shows that foci of epileptic activity during EEG recording at the time of an attack are found in approximately 53.4% of cases, while recording in the interictal period, their number is reduced to 26.7%. Localization of these changes is grouped mainly in the temporal leads found in 37.5% of cases, in the frontoparietal leads - 31.25%, and in the frontal leads - only in 18.75% of cases. In the remaining 12.5% of cases, the foci are evenly distributed between other leads (central, parietal and occipital). Pathological activity is usually asynchronous in nature, being presented both on the left and on the right side. Extremely unilateral epileptiform activity is rarely recorded, but secondary bilateral synchronization with the primary focus in one of the temporal hemispheres is quite common. According to the results of our EEG studies: 73.3% of children had no significant changes, 20% of children had convulsive activity and 6.7% had an epileptic focus. It should be noted that convulsive activity and the presence of an epileptic focus were noted in children with repeated febrile seizures, with a weakened somatic status Conclusion: Clinical and paraclinical correlation somatogenically determined F.S. showed the following: 1 F.S. if it occurs once, without hereditary burden on the EEG, epiactivity is not detected.
2. With repeated F. S. on EEG revealed pathological activity, without epileptic patterns.
3. Repeated F. S. with burdened heredity lead to an epileptic pattern, and these children should be monitored by a neurologist.
Authors' Contributions. All authors participated equally
in the writing of this article.
No conflicts of interest have been declared.
This material has not been previously submitted for
publication in other publications and is not under
consideration by other publishers.
There was no third-party funding or medical
representation in the conduct of this work.
Funding - no funding was provided.
Авторлардьщ улеа. Барлык; авторлар осы мак;аланы
жазуга тен, дэрежеде катысты.
Мудделер цацтьгеысы - мэлiмделген жок;.
Бул материал баск;а басылымдарда жариялау ушш
бурын мэлiмделмеген жэне бас;а басылымдардын,
;арауына усынылмаган.
Осы жумысты журпзу кезшде сырт;ы уйымдар мен медициналык; екшджтердщ каржыландыруы жасалган жок;.
Царжыландыру журпзшмедь
Вклад авторов. Все авторы принимали равносильное участие при написании данной статьи. Конфликт интересов - не заявлен. Данный материал не был заявлен ранее, для публикации в других изданиях и не находится на рассмотрении другими издательствами. При проведении данной работы не было финансирования сторонними организациями и медицинскими представительствами.
Финансирование - не проводилось.
REFERENCES
1 International Classification of Diseases (ICD-10). Short version, mainly at the International Statistical Classification of Diseases. M., 2006; 741.
2 Encyclopedia of basic epilepsy research / Three-volume set (Schwartzkroin P., ed.). Philadelphia Elsevier / Academic Press. 2009; 1-3: 2496.
3 Febrile cramps. In the book: Pediatrics. Ed. Baranova A.A. (Series: "Clinical recommendations"). M .: GEOTAR-MEDIA, 2009; 349-59.
4 Shelkovsky V.I., Studenikin V.M., Maslova O.I., Mazurina E.M. etc. The problem of febrile seizures in children. Questions of modern pediatrics 2005; 4 (4): 50-3.
5 Studenikin V.M., Shelkovsky V.I., Balkanskaya S.V. Febrile seizures. Pediatrician practice 2007; 1: 8-10.
6 Moreno M.A., Furtner F. Advice for parents. Febrile seizures in children. Arch. Pediatr. Adolesc. Med. 2009; 163; 872.
7 Aicardi J. Diseases of the nervous system in children. 3rd ed. London Mac keith Press / Distributed by Wiley-Blackwell. 2009; 966.
8 ILAE. Guidelines for epidemiologic studies on epilepsy. Epilepsia 1993; 34: 592-6.
9 Patrick H.T., Levy D.M. Early convulsions in epileptics and in others. JAMA 1924; 82: 375-81.
10 Lorin M.I. The Febrile Child: Clinical Management of Fever and Other Types of Pyrexia. New York John Wiley & Sons. 1982; 226-7.
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