Results of Assessing Clinical and Psychopathological Changes in Patients with Symptomatic "Vascular" Epilepsy in Chronic Cerebrovascular Disorders

The purpose of the work was to identify clinical and dynamic features and assess the severity of cognitive impairment in patients with chronic cerebrovascular circulation disorder accompanied by epileptic attacks. Material and methods. We conducted a retrospective and prospective analysis of 76 chronic cerebrovascular circulation disorder patients' case records, including 38 patients (17 men and 21 women) who had chronic cerebrovascular circulation disorder accompanied with epileptic attacks. The second group included 38 patients (18 men and 20 women) with chronic cerebrovascular circulation disorder, who had no epileptic attacks. All patients were examined in accordance with the local clinical protocol for the treatment of patients with chronic cerebrovascular circulation disorder. Results. As a result of the conducted studies, we detected significant differences in the neurological state of patients in both groups under study in the frequency of occurrence of the following symptoms: anizoreflection was observed in the vast majority of patients in the studied groups of both sexes (83% -95% of cases), indicating that they had an organic brain impression; pseudobulbar syndrome occurred quite rarely (in 1-2 patients of each group), which may be explained by the absence of gross violations of the brain in patients; axial signs were observed significantly more often (in 56% -71% of cases). Analysis of the distribution of patients with scores according to the МоСА scale showed that 85-95% of patients in both groups had severe cognitive impairment. This number comprised a significant majority. The normal state of cognitive function occurred in 5-10% of patients and dementia was detected in 5-6% of patients. The average value of the index of cerebrovascular circulation in patients of the first group was (0.8 ± 0.15), and (0.8 ± 0.18) in the second group, indicating a slight violation. The majority of lipid profiles showed no differences between the groups of DEP patients who had epileptic attacks and those with no attacks, except for a significantly higher level of total cholesterol in women of the second group (χ2 = 11.7; p <0.05). Conclusions. The constructed factor structures of the indicators of men and women in both groups indicate that there are various mechanisms of providing cognitive functions. In men with DEP and epileptic attacks, cognitive function is not related to the lipid metabolism and the quality of cerebrovascular circulation; men without epileptic attacks have deterioration of cognitive function on the background of increasing concentration of very low density lipoprotein. In women of both groups, the increase in the MoCA score is on the background of improving the quality of cerebrovascular circulation, which corresponds to contemporary ideas about its role in preserving cognitive functions. Thus, the obtained results confirm the significant influence of the cerebrovascular circulation quality and lipid profiles on the state of cognitive functions of chronic cerebrovascular circulation disorder patients with and without epileptic attacks.