Complex rehabilitation of patients with epilepsy

Authors:

Viktor G. Pomnikov, M.D., Grand PhD in Medical sciences, Professor; St. Petersburg Postgraduate Institute of Medical Experts, 11А Bolshoy Sampsonievsky Ave., 194044 St. Petersburg, Russian Federation; ORCID: 0000-0002-4241-0644; e-mail: v.pomnikov@yandex.ru

Larisa A. Kritskaya, M.D., PhD in Medical sciences, Associate Professor; St. Petersburg Postgraduate Institute of Medical Experts, 11А Bolshoy Sampsonievsky Ave., 194044 St. Petersburg, Russian Federation; ORCID: 0000-0001-8377-7859; tel. 8-911-922-51-39; е-mail: kritskaya1957@mail.ru

Olga V. Dudkina, PhD in Medical sciences, Associate Professor; St. Petersburg Postgraduate Institute of Medical Experts, 11А Bolshoy Sampsonievsky Ave., 194044 St. Petersburg, Russian Federation; e-mail: 79217447243@yandex.ru

Yulia V. Bakaeva, doctor for medical and social expertise, head of branch No. 47; The Main Bureau of Medical and Social Expertise in the City of St. Petersburg, 58 Liteiny Ave., 191014 St. Petersburg, Russian Federation; e-mail: spbuslugi@mse78.ru

Anatoly V. Petrov, doctor for medical and social expertise; The Main Bureau of Medical and Social Expertise in the City of St. Petersburg, 58 Liteiny Ave., 191014 St. Petersburg, Russian Federation; e-mail: spbuslugi@mse78.ru

Annotation:

Introduction. The social significance of epilepsy is determined by its prevalence (about 70 million people in the world suffer from epilepsy, and 2/3 are ill in childhood), potentially severe consequences and insufficient treatment efficiency in 20-25 % of cases. The relevance of developing rehabilitation programs for patients with epilepsy is due to the need to improve the quality of life of a person suffering from epilepsy.

Aim. To substantiate the importance of a systematic integrative approach to all aspects of rehabilitation for epilepsy, the need to assess the rehabilitation potential in the formation of an individual rehabilitation program.

Materials and methods. The analysis of more than 200 certificates of examination of patients with epilepsy in the bureau of medical and social expertise was carried out using statistical, clinical and expert methods in order to clarify the clinical and functional criteria that lead to social maladaptation.

Results and discussion. The analysis of the certificates of examination of patients in the bureau of medical and social expertise showed that 58 % of patients had verified frequent or moderate generalized epileptic seizures. In 42 % of cases, epileptic seizures were rare or mild, and gradually increasing changes in mental processes and emerging personality disorders (psychopathic-like symptoms) acquired expert and rehabilitation significance.
In our study, all patients received antiepileptic drugs (monotherapy in 62 % of cases, polytherapy in 38 %), neurosurgical treatment and other types of treatment were not used.
The assessment of the professional capabilities of patients with epilepsy was carried out, and the importance of psychological correction was shown in order to use the remaining resources of the individual to achieve the rehabilitation goal.

Conclusion. Integrative implementation of complex rehabilitation of patients with epilepsy, aimed at achieving and maintaining a stable remission of the disease, will successfully address many issues of prevention of disability and social insufficiency of patients with epilepsy.

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