Aim. to assess long-term results of primary angiosurgical prevention of ischemic stroke (is) in patients with multifocal atherosclerosis. Material and methods. this paper analyzes the long-term results of primary angiosurgical prevention of ischemic stroke in 105 patients with multifocal atherosclerosis to create an algorithm of survey and follow-up of these patients. Conclusion. Carotid endarterectomy (CeA) is highly effective method for primary prevention of is if it is performed with strict indications and in certain patients. important follow-up clinical criteria are severity of non-specific complaints of headache, dizziness, auscultatory systolic murmur in the projection of carotid arteries (CA), carotid stenosis severity and the types of atherosclerotic plaques according to duplex scanning, as well as quantitative measures of total cholesterol (tC), very low density lipoproteins (VLdL), atherogenic index.

Background: valproic acid (VA) is a classic, well-proven medication for the epilepsy treatment, but there have not been enough studies to evaluate its effecacy and tolerability in correlation with the epileptiform activity index (EAI) during initial monotherapy. Aim: to evaluate the efficacy and tolerability of monotherapy with VA medications in patients with newly diagnosed epilepsy. Patients and Methods: 63 patients (including 37 (58.7%) men) with focal epilepsy (FE; 24 (38.1%)) and idiopathic (genetic) generalized epilepsy (IGE; 39) over the age of 18 years (average age — 31.49±12.29 years) were included in the single-arm study (61.9%)). All patients at each visit (initially, after 1, 3, 6 and 12 months of therapy) had EEG-video monitoring with an evaluation of EAI (total; before sleep; during sleep; during fragmented awakenings; after sleep). Therapy efficacy was evaluated considering the frequency of seizures: no seizures (medically induced remission); reduced frequency by more than 50% (responders) / less than 50% (lack of effect); therapy retention; increased frequency of seizures relative to the basic level; emergence of a new seizure type (aggravation). Total duration of the study was 12 months. Results: total EAI in patients with IGE before treatment was 2.7 times higher than in patients with FE (37.41 and 13.69, respectively). 1 month after the treatment initiation, it decreased to 4.08 and 2.56 in IGE and FE, respectively (p<0.001), and continued to decrease during the entire follow-up period. Monotherapy retention was achieved in 51 (81%) patients, including 15 (62.5%) with FE and 36 (92.3%) with IGE. Intolerable adverse events developed in only 6 (9.8%) patients. Conclusion: VA is an effective medicine for the initial treatment of FE and IGE in monotherapy. KEYWORDS: idiopathic epilepsy, genetic generalized epilepsy, focal epilepsy, epileptiform activity index, valproic acid, monotherapy, adverse events. FOR CITATION: Kozhokaru A.B., Orlova A.S., Shmyrev V.I. et al. Monotherapy with valproic acid for newly diagnosed epilepsy in adults. Russian Medical Inquiry. 2020;4(9):552–559. DOI: 10.32364/2587-6821-2020-4-9-552-559.

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