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: email@example.com
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: firstname.lastname@example.org
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: email@example.com
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: firstname.lastname@example.org
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: email@example.com
In the heading: Original researches
Year: 2022 Volume: 4 Journal number: 1
Article type: scientific and practical
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.
1. Nevrologiya: natsional’noye rukovodstvo: v 2-kh t. [Neurology: national guidelines: in 2 volumes]. pod red. Guseva EI, Konovalova AN, Skvorcovoi VI 2-e izd., pererab. i dop. [ed. Guseva EI, Konovalova AN, Skvorcovoi VI 2nd ed., revised and complemented]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2019;(1):406-47 (In Russian).
2. Karlov VA Karlov VA. Epilepsiya u detey i vzroslykh zhenshchin i muzhchin: Rukovodstvo dlya vrachey [Epilepsy in children and adult women and men: A guide for physicians]. Moskva: OAO «Meditsina» [Moscow: JSC «Medicine»]; 2010. 720 p. (In Russian).
3. Pomnikov VG, Kritskaya LA, Magomedova NG. Mediko-sotsial’naya ekspertiza pri epilepsii [Medico-social expertise in epilepsy]. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova [The Korsakov’s Journal of Neurology and Psychiatry]. 2017;117(9(2)):95-9. (In Russian).
4. Spravochnik po mediko-sotsial’noy ekspertize i reabilitatsii. V 2-kh t., 5-ye izd. [Handbook of medical and social expertise and rehabilitation. In 2 vols. 5th ed.] Pomnikov VG, red. [Pomnikov VG, ed.]. SPb: Gippokrat [St. Petersburg: Hippocrates]; 2021. 640 p. (In Russian).
5. Gusev YeI, Avakyan GN, Nikiforov AS. Epilepsiya i yeye lecheniye: rukovodstvo dlya vrachey [Epilepsy and its treatment: a guide for physicians]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]; 2014. 160 p. (In Russian).
6. Mukhin KYu, Mironov MB, Petrukhin AS. Epilepticheskiye sindromy. Diagnostika i terapiya. Rukovodstvo dlya vrachey. 3-ye izd. [Epileptic syndromes. Diagnostics and therapy. Guide for doctors. 3rd ed.]. Moskva: OOO «Sistemnyye resheniya» [Moscow: System Solutions LLC]; 2014. 367 p. (In Russian).
7. Zenkov LR. Neparoksizmal’nyye epilepticheskiye rasstroystva: rukovodstvo dlya vrachey [Non-paroxysmal epileptic disorders: a guide for physicians]. Moskva: MEDpress-inform [Moscow: MEDpress-inform]; 2016. 280 p. (In Russian).
8. Kritskaya LA, Pomnikov VG. . Kompleksnaya reabilitatsiya bol’nykh epilepsiyey [Comprehensive rehabilitation of patients with epilepsy]. Uchebno-metodicheskoye posobiye [Educational and methodological manual]. St. Petersburg: SPBIUVEK; 2022. 43 p. (In Russian).
9. Pomnikov VG, Voitenko RM, Kritskaya LA. Nekotoryye aspekty reabilitatsii bol’nykh epilepsiyey [Some aspects of the rehabilitation of patients with epilepsy]. Yubileynyy sbornik NPK «100 let mediko-sotsial’noy ekspertize. Aktual’nyye voprosy MSE i reabilitatsii» 14 dekabrya 2018 g [Anniversary collection of NPK “100 years of medical and social expertise. Topical Issues in ITU and Rehabilitation”, December 14, 2018]. 2018: 226-7. (In Russian).
10. Voitenko RM, Kritskaya LA. Rehabilitology: concept and methodology [Reabilitologiya: kontseptsiya i metodologiya]. St. Petersburg; 2016. 109 p. (In Russian).