RISK FACTORS OF EPILEPSY ATTACKS IN PATIENTS WITH CHRONIC BRAIN CIRCULATORY DISORDERS
Authors: Mushehian М. М. 
Published: January 2021

The aim of the research was determination of risk factors for epilepsy on the background of cerebrovascular pathology by comparative assessment of the influence of individual etiological factors on the risk of this pathology developing.

Methods. The research was based on the analysis of medical history of 76 patients with chronic cerebrovascular disorders, 38 of whom had epileptic seizures. Patients were examined according to the local treatment protocol for patients with cerebral circulatory disorders. The examination included collection of life history and disease, determination of the degree of hypertension, the presence of concomitant cardiac (cardiac arrhythmia, coronary heart disease) and endocrine (diabetes mellitus, obesity) pathology, analysis of neuroimaging data to determine the presence of microangiopathy. For this purpose, magnetic resonance imaging was performed in the T2 – VI mode, especially with sequential suppression of the cerebrospinal fluid signal. The Fazekas visual scale is used to quantify the severity of this phenomenon.

Results. In most cases, the onset of epilepsy (76% of cases in men and 71% – in women) is observed in patients with chronic cerebrovascular disorders aged 40–60 years. Significantly more often the first epileptic seizure in both gender groups of patients developed at the age of 50–60 years. According to the results of comparing the frequency of smoking in men and women of the researched groups, it was found that this bad habit was significantly more common in patients with epileptic seizures. According to the results of research, smoking significantly (p<0.05) increases the risk of epileptic seizures among men by 7.5 times, among women – by 7.6 times. Alcohol consumption increases the risk of epileptic seizures in men by 4.8 times (p<0.05). Factors that contribute to the development of epileptic seizures in patients with chronic cerebrovascular disorders include traumatic brain injury and general anesthesia. It was found that the presence of a medical history of trauma significantly increases the risk of epilepsy by 7.6 times (among men – 14.7 times, among women – 7.8 times), and surgery with general anesthesia – 11.7 times (among men – 9.3 times, among women – 14.3 times). It was found that the presence of a patient with chronic cerebral circulatory disorders of type 2 diabetes increases (p<0.05) the risk of epilepsy by 4.2 times and obesity – by 7.6 times. Atrioventricular block was significantly more frequently observed in patients with epilepsy and cerebrovascular pathology (F=0.019030; χ2=6.73) than in patients without epileptic seizures. The risk of epilepsy in the presence of atrioventricular block increases 5.4 times. In the patients with epilepsy Fazekas 1 was observed in 7 (18.4 ± 6.29%) patients against 10 (26.3 ± 7.14%) in the group of patients without epilepsy. Men of the researched groups do not differ in the frequency of the corresponding degree of leukoareosis. Significant differences in the incidence of the corresponding degree of leukoareosis between women were found. The Fazekas criterion demonstrated a steady regular effect in prognostic mathematical models for assessing the risk of epileptic seizures in patients with chronic cerebrovascular disorders, developed by discriminant analysis.

Conclusions. Thus, the research revealed the risk factors for epileptic seizures in patients with chronic cerebral circulatory disorders. It has been proven that the presence of hereditary predisposition, bad habits, concomitant cardiac and endocrine pathology increase the risk of epilepsy in patients with cerebrovascular pathology.