Optimization of correction and prevention methods of cognitive impairment in patients with post-traumatic epilepsy

Background. During the study of cognitive functions in patients with post-traumatic epilepsy, in most cases moderate cognitive impairments are noted. With the repetition of epileptic seizures up to 3-5 times a week, more pronounced cognitive decline is determined. Cognitive deficit in such patients increases due to long use of anticonvulsants. In the pathogenesis of cognitive impairment in post-traumatic epilepsy further processes are important: local cerebral vasospasm, metabolic disturbances at the cellular and molecular levels in the brain matter and shifts in the functioning of mediator systems in brain's cortical-subcortical departments. In this regard, important directions of pathogenetic therapy of the indicated contingent of patients are: correction of intracerebral hemodynamics and angioprotection, normalization of neurometabolism, correction of cortical-subcortical interhemispheric interconnections, achievement of a balance of epileptic and antiepileptic systems. Aim. To analyze the effectiveness of the treatment of cognitive and psycho-emotional disorders in post-traumatic epilepsy in patients, who have had a mild traumatic brain injury, while taking anticonvulsants, in particular topamax, by including a drug of cortexin multimodal action in the treatment scheme, based on the results of a neuropsychological examination. Materials and methods. The indicated treatment was carried out to 71 patients of the main group, in combination with traditional therapy (dehydrating, vasoactive, metabolic drugs, vitamin therapy). The control group consisted of 30 patients with the consequences of a mild traumatic brain injury in the form of an epileptic syndrome, who took only traditional therapy, including anticonvulsants. The effectiveness of the recommended therapy was judged on the basis of changes in neuropsychological parameters and sensorimotor functions. Results. When analyzing the state of cognitive functions during treatment with cortexin, a significant improvement in neuropsychological tests execution was revealed. Significant recovery of autonomic disorders has also been observed. In addition, the results obtained indicate a beneficial effect of the drug on motor functions and balance, in particular on postural instability. Conclusions. Thus, the early use of cortexin is an effective direction in the prevention and treatment of cognitive impairment in post-traumatic epilepsy.

post-traumatic epilepsy, cognitive impairment, cortexin