Effectivity and safety of medical rehabilitation in children with epilepsy

Authors:

Shalkevich Leаnid Valentinovich, Grand PhD in Medical sciences, Associate Professor, Head of the Department of Pediatric Neurology of the Belarusian Medical Academy of Postgraduate Education, 3/3 P. Brovka Street, Minsk, 220013 Republic of Belarus, e-mail: shalkevich_@tyt.by

Smychek Vasiliy Borisovich, Grand PhD in Medical sciences, Professor, Honored Scientist of the Republic of Belarus, Director of the National Science and Practice Centre of Medical Assessment and Rehabilitation, district of the village of Yukhnovka, Kolodishchansky village council, Minsk district, 223027 Republic of Belarus, e-mail: rnpc@meir.by

Zhevneronok Irina Vladimirovna, PhD in Medical sciences, Associate Professor of the Department of Pediatric Neurology of the Belarusian Medical Academy of Postgraduate Education, 3/3 P. Brovka Street, Minsk, 220013 Republic of Belarus, e-mail: ira_jevner@tyt.by

Annotation:

Introduction. Epilepsy in children is accompanied by high frequency of concomitant psychic, neurologic and somatic diseases. According to some data, medical rehabilitation in such patients can increase the number of seizure episodes, but other information shows that it does not influence the course of epilepsy. In most cases rehabilitation measures are started only after reaching clinical remission which can cause delay of medical aid and worsen prognosis regarding existing disorders and lead to pathologic developing of functional systems which are not affected but undergo the stage of formation.

Aim. To determine effectivity and safety of medical rehabilitation in children with epilepsy.

Materials and methods. There was held a cohort prospective longitudinal comparative study which included 447 children with epilepsy. Two groups were formed: basic group — 233 patients, who had medical rehabilitation measures according to a programme developed by rehabilitologist, and control group — 214 patients, who did not have medical rehabilitation.

Results and discussion. Evaluation of effectivity of rehabilitation measures was made using the index of function potential. It was calculated twice — the first time three months after start of anticonvulsant treatment (FP1) and after 6 months (FP2), when children from basic group took rehabilitation, and children from control group did not.
Function potential was ranked into high, middle and low. In basic group there was found the increase of number of patients with high function potential by 16.4%, in control group the number of patients with high function potential reduced by 29.9%, р<0.001. The number of patients with low function potential in basic group decreased by 11.6%, in control group it increased by 8.4%, p<0.001. The number of patients with middle function potential in basic group reduced by 4.7%, in control group it increased by 21.5%. Medical rehabilitation measures given to children in basic group did not cause the increase of seizure frequency. Occurrence of epileptiform activity on electroencephalogram in basic group under treatment and with rehabilitation after 6 months decreased by 23.9%, in control group under treatment without medical rehabilitation after 6 months it reduced by 22.2%, p>0.05.

Summary. Medical rehabilitation on children with epilepsy has statistically significant effect upon retention and increase of initial level of function potential, it preserves and improves the activity of organs and systems affected by epilepsy or being at risk by their pathology. In patients with epilepsy who did not have rehabilitation the function potential authentically more often moves to lower level. Medical rehabilitation can be held in children with epilepsy not only under clinical remission in seizures but also with them on condition of rare or middle frequency of seizure episodes. Using the measures of medical rehabilitation does not lead to worsening of clinical course of epilepsy in form of increase of seizures and does not raise the occurrence of epileptiform activity on electroencephalogram.

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