Epilepsy is a disease of the brain, characterized by a persistent predisposition to the occurrence of epileptic seizures, as well as neurobiological, cognitive, mental and social disorders. The drug Epitomax is an excellent treatment for this disease.
The incidence of epilepsy ranges from 0.28-0.53 per 1,000 population. At the same time, more than 1 million epileptic seizures occur annually in the world is in childhood. In total, epilepsy affects at least 100 million people worldwide, a large proportion of whom do not receive adequate treatment. The risk of death in epilepsy is 2-3 times higher than in the general population, which is largely due to the etiology of the disease (cerebrovascular disease, brain tumor), accidents during seizures, and the phenomenon of sudden unexpected death in epilepsy.
A distinction is made between simple and complex partial, or focal, seizures.
Simple partial seizures, unlike complex seizures, are not accompanied by disorder of consciousness. Their manifestations are manifold and depend on which area of the cerebral cortex has epileptic activity. In simple motor partial seizures, clonic seizures develop in a single body part, such as the arm or face, and may extend to adjacent body regions (Jackson seizures). Tonic seizures are characterized by muscle tension (without clonic movements) or by the formation of a forced posture (e.g. turning the head or eyes). After a motor seizure, there may be temporary weakness of the muscles involved in the seizure (postictal Todd’s palsy).
Complex partial seizures are accompanied by impairment of consciousness. In these seizures, epileptic activity occurs in a limited area of the brain, then spreads to areas that regulate attention and consciousness. In a typical case, the patient suddenly freezes, staring meaninglessly at one point, then automatisms develop (e.g. munching or chewing). In some cases, patients continue to perform complex actions, such as riding a bicycle. During a complex partial seizure, the person is unresponsive to external stimuli and contact is usually disrupted for 30-90 seconds. Confusion and drowsiness often persist after the seizure. Patients do not remember what happened to them during the seizure, but sometimes remember the events preceding it.
Patients with epilepsy may have severe difficulties in social activities and daily life, yet up to 70% of them can live a normal life with timely and appropriate treatment and care.
One widely used antiepileptic drug is Epitomax, which is available in tablets of 25 and 100 mg. The pharmacological properties of the drug are:
- blocking of sodium channels and inhibition of the emergence of repetitive action potentials against the background of prolonged depolarization of the neuron membrane;
- increasing the activity of gamma-aminobutyric acid (GABA) relative to certain subtypes of GABA receptors, modulating their ability to induce the flow of chlorine ions into neurons;
- inhibition of kainat activation of specific receptor sensitivity to glutamate;
- no effect on N-methyl-D-aspartate (NMDA)-receptors.
Epitomax is used as monotherapy in patients with newly diagnosed epilepsy or to switch to monotherapy in patients with epilepsy, and as an additional therapy in adults and children aged >2 years for partial or generalized tonic-clonic seizures and epileptic seizures with Lennox-Gastaud syndrome. The drug is of interest primarily in cases where partial seizures are refractory to therapy. Studies have demonstrated the efficacy of its use at a dose of 200-600 mg/day for this type of seizures. Further increasing the dose did not reduce the number of seizures recorded, but increased the severity of side effects. Thus, the optimal dose that reduced the number of seizures by 50%, according to most scientists, was 400 mg/day.
The results of Epitomax efficacy study in partial seizures in children and adolescents (age 1-16 years) show 35% seizure reduction. The International Child Neurology Association (ICNA) recommends Epitomax as first-line therapy for treatment of generalized tonic-clonic seizures, myoclonic seizures, Dravet syndrome, Lennox-Gastaud syndrome, myoclonic-astatic epilepsy. As a second-line drug, this organization recommends Epitomax for therapy in patients with absences, tonic and atonic seizures, childhood and juvenile absences epilepsy, juvenile myoclonic epilepsy, rolandic and occipital epilepsy, infantile spasms, Landau – Kleffner syndrome, Patry syndrome.