This paper analyzes a case with the patient having focal structural epilepsy by processing electroencephalogram (EEG) fragments containing the “sharp wave” pattern of brain activity. EEG signals were recorded using 21 channels. Based on the fact that EEG signals are time series, an approach has been developed for their analysis using nonlinear dynamics tools: calculating the Lyapunov exponent’s spectrum, multiscale entropy, and Lempel–Ziv complexity. The calculation of the first Lyapunov exponent is carried out by three methods: Wolf, Rosenstein, and Sano–Sawada, to obtain reliable results. The seven Lyapunov exponent spectra are calculated by the Sano–Sawada method. For the observed patient, studies showed that with medical treatment, his condition did not improve, and as a result, it was recommended to switch from conservative treatment to surgical. The obtained results of the patient’s EEG study using the indicated nonlinear dynamics methods are in good agreement with the medical report and MRI data. The approach developed for the analysis of EEG signals by nonlinear dynamics methods can be applied for early detection of structural changes.

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Заявление о конфликте интересов/Conflict of Interest StatementСтатья выпущена при финансовой поддержке компании Eisai. Авторы несут полную ответственность за содержание статьи и редакционные решения. Конфликт интересов не повлиял на результаты исследования.The paper has been published with financial support from Eisai. The authors are solely responsible for the content of the article and for editorial decisions. The conflict of interest has not affected the results of the investigation.

Summary Introduction. Perampanel (PER) (Fycompa) 5′-(2-cyanophenyl)-1′-phenyl-2,3′-bipyridinyl-6′(1′H)-on is the newest antiepileptic drug and is the first-in-class selective non-competitive antagonist of ionotropic AMPA glutamate receptors of the postsynaptic neuronal membrane. The aim was to summarize Russian experience in using PER in daily clinical practice, and for this purpose the results of its use as an add-on treatment for focal epilepsy were assessed retrospectively Material and Method. The results of the study of PER efficacy and safety in 52 patients with refractory focal epilepsy are presented. Mean age was 28.9 ± 14.0 years; proportion of male patients was 56%, duration of the disease over 10 years - 69.2%, symptomatic epilepsy - 76.9%, with frontal - 46.2% and temporal - 44.2% localization of epileptic lesion. Majority of patients - 71.2% started PER treatment after 3 preceding lines of therapy Results. The baseline seizure frequency of all types was 127.3 ± 82.3 per month; secondary generalized seizures - 6.7 ± 1.9 per month. After PER was added, a significant decrease in seizure frequency was observed already during the first month, to 52.1 ± 29.3 seizures per month (Sign test, p = 0.00001) for seizures of all types and to 3.7 ± 1.7 (Sign test, p = 0.00001) for secondary generalized seizures. In an overwhelming majority of cases, duration of PER treatment was more than 6 months. In 58% of patients, seizure frequency decreased by more than 50% (responders). Seizure-free status for all seizure types was observed in 9% of cases at 12 month, and absence of secondary generalized seizures only was achieved in 31% of patients. Adverse events were observed in 30.1% of patients: aggression - 11.5% and drowsiness - 9.6%, with all other AEs observed more rarely. PER dose was reduced due to side effects in 7 patients (13.5%), and in 4 patients (7.7%) PER was discontinued. Average PER dose in adult patients was as low as 6 mg. Conclusions. PER was effective in the treatment of refractory forms of focal epilepsy, reducing seizure frequency on average by 76% by the second month of treatment. In addition to a good clinical effect, PER demonstrated a rather acceptable and predictable safety profile.

The paper presents studies of electroencephalogram (EEG) signals of epilepsy patients based on wavelet transform and calculation of the total signal energy. The object of the study was a patient aged 17-22 years diagnosed with focal (structural) epilepsy, mesial sclerosis on the left and focal cortical dysplasia of the left temporal lobe, and a control group. The results were compared in the form of 3D Morle wavelets and topographic images. Topographic images of the head surface are obtained on the basis of the integral energy of brain signals. The study showed that wavelet analysis of EEG signals can be a useful tool in the study of EEG signals both in epilepsy patients and in comparison with the control group. It is assumed that such analysis will be useful for early detection of neurological changes and decision-making by doctors for further treatment.