Особенности эпилептиформной активности у пациентов с диагностированной глиобластомой: от генетических и биохимических механизмов к клиническим аспектам

Введение. Мультиформные глиобластомы (глиомы Iv степени) – часто встречающиеся наиболее агрессивные первичные опухоли головного мозга с крайне неблагоприятным прогнозом. Во всех опубликованных ранее статьях об эпилептиформной активности при глиобластомах содержится недостаточно информации о результатах электроэнцефалограмм.

Цель – разностороннее изучение особенностей эпилептиформной активности у пациентов с глиобластомами и разработка плана дальнейшего исследования таких больных.

Материалы и методы. Представлен анализ статей из баз данных Elsevier, Embase, Scopus, The Cochrane Library, global Health, Российской базы научного цитирования (Russian Science Citation Index, RSCI), поисковых систем Scholar, google, web of Science, pubmed и научной электронной библиотеки CyberLeninka. при отборе материала учитывались системы индексирования журналов и цитируемость, научная новизна исследований, статистическая значимость полученных результатов. публикации, в которых дублировались данные предыдущих работ или использовались эксперименты на животных, исключались из анализа.

Результаты. В ходе исследования были систематизированы сведения о механизмах патогенеза эпилептиформной активности у пациентов с глиобластомами, предрасполагающих факторах (локализация опухоли в височной, лобной и теменной долях, наличие мутаций в генах IDH-1 и / или IDH-2), особенностях лечения таких больных. Кроме того, предложен оригинальный план сбора данных для проведения клинических исследований, учитывающий недостатки предыдущих работ, что способствует повышению качества интерпретации полученных результатов.

Заключение. Эпилептиформная симптоматика при глиобластомах негативно влияет на качество и продолжительность жизни пациентов. В настоящее время ведутся активные поиски эффективного метода лечения эпилептических припадков у больных глиобластомой. Наиболее действенным оказалось комбинирование темозоломида с вальпроатом и леветирацетамом в связи с хорошими показателями контроля над частотой приступов, низкой токсичностью и фармакодинамическим синергизмом данных лекарственных препаратов.

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