Rehabilitation potential of patients with epilepsy, its importance in the implementation of an individual rehabilitation program

Authors:

Pomnikov Viktor Grigorievich – Grand PhD in Medical sciences (Dr. Med. Sci.), Professor, Head of the Department of Neurology at the Institute of Additional Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: v.pomnikov@yandex.ru; https://orcid.org/0000-0002-4241-0644.

Kritskaya Larisa Anatolyevna – PhD in Medical sciences (Cand.Med.Sci.), Associate Professor, Department of Neurology, Institute of Additional Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: kritskaya1957@mail.ru; https://orcid.org/ 0000-0001-8377-7859.

Dudkina Olga Vladimirovna – PhD in Medical sciences (Cand.Med.Sci.), Associate Professor of the Department of Neurology at Institute of Additional Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: 79217447243@yandex.ru; https://orcid.org/0000-0003-1501-4838.

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

Annotation:

Introduction. Epilepsy is one of the most common diseases of the central nervous system. There are 65 million people with epilepsy worldwide. The social significance of epilepsy is determined by its prevalence in the population (from 2.7 to 17.6 per 1000 population), insufficient effectiveness of treatment (in 20-25 % of cases) and potentially severe consequences. The relevance of assessing the rehabilitation potential of an epileptic patient in the organization and development of rehabilitation programs is due to the need to compensate for the social insufficiency of a person suffering from epilepsy.

Aim. To substantiate the importance of assessing the rehabilitation potential of patients with epilepsy in the formation of an individual rehabilitation program, which determines the success of the rehabilitation goals at various stages of the rehabilitation process.

Materials and methods. The analysis of more than 400 certificates of examination of patients with epilepsy in the Bureau of medical and social expertise using statistical, clinical and expert methods was carried out in order to clarify the clinical and functional criteria leading to social maladaptation.

Results. An analysis of the certificates of examination of patients at the Bureau of medical and social expertise showed that when making an expert decision in those recognized as disabled for the first time, expert rehabilitation significance in 68 % of cases had verified frequent or moderate frequency generalized epileptic seizures, in 32 % – psycho-organic syndrome and psychopathic symptoms.

Discussion. The rehabilitation potential of patients with epilepsy was assessed, which has some features due to the course of the disease (taking into account the type and severity of epileptic seizures, prognosis, comorbid conditions), prolonged (sometimes lifelong) treatment with antiepileptic drugs, pharmacoresistance, low compliance, and professional opportunities. The success of achieving rehabilitation goals is shown, taking into account the rehabilitation potential of the individual, the specifics of the orientation of his motivational sphere.

Conclusion. Assessment of the rehabilitation potential of patients with epilepsy determines the success of the implementation of rehabilitation goals and objectives at various stages of the rehabilitation process.

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