AGE-RELATED ASPECTS OF COMORBIDITY AND MEDICAL REHABILITATION IN CHILDREN WITH EPILEPSY

Topicality. Further evidential studies are needed to explore medical rehabilitation of patients with epilepsy, its consequences and comorbid disorders during existing seizures as well as the issues of its comprehensive evaluation. Purpose of the work. To determine the frequency and structure of comorbid disorders in children of different age groups during the onset of epilepsy before prescribing anticonvulsant therapy as well as to estimate effectiveness of medical rehabilitation interventions performed differentially according to the unified evaluation of epilepsy severity. Material and methods. We performed a prospective cohort study of 447 children with epilepsy aged from 0 to 17 years before prescribing them anticonvulsant therapy. The frequency of age-related psychic, neurologic and somatic accompanying disorders was studied. Two groups of children who were matched by the main criteria were formed: those who received complex medical rehabilitation (n=233) – the main group, and those who did not (n=214) – the control group. Results. Psychic disorders at the onset of epilepsy were found in 30.6% of cases with the highest frequency in children less than 1 year of age (50.8%), pFisher<0.001. A complex delay of psychic and preverbal development was verified in 53.4% of children under 1 year. Comorbid neurologic disorders at epilepsy onset were noted in 26.6% of cases, and in the group under 1 year neurologic disorders were present in 66.8% of cases. Chronic somatic pathology in children under 1 year was registered in 74.6% of cases, while in older children it was noted in every second patient, pFisher<0.001. In the main group after medical rehabilitation positive dynamics was noted in 30.0% of cases, stable functioning potential – in 67.8%, negative dynamics – in 2.1%. Medical rehabilitation was not associated with aggravation of epilepsy. Conclusion. The study results showed high frequency of comorbid disorders found in children with epilepsy at the onset of disease and before anticonvulsant therapy, which justifies the necessity of performing medical rehabilitation interventions already at disease onset. These interventions performed according to the unified evaluation of patient's state showed high efficacy.