medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2023-14-45-50medalphabet-3250Research ArticleСтатьиЭпилепсия у больных с глиобластомой: механизмы возникновения и проблемы лечения (часть 1)Epilepsy in patients with glioblastoma: Mechanisms of occurrence and problems of treatment (part 1)https://orcid.org/0000-0003-0190-3335ВасиленкоА. В.VasilenkoA. V.

Василенко Анна Владимировна - кандидат медицинских наук, заведующий учебной частью, доцент кафедры нейрохирургии ИМО НМИЦ им. В.А. Алмазова Минздрава России; доцент кафедры неврологии им. акад. С.Н. Давиденкова СЗГМУ им. И.И. Мечникова.

Санкт-Петербург

Anna V. Vasilenko - PhD Med, head of teaching unit, associate professor at Neurosurgery Dept, Almazov National Medical Research Centre; associate professor at Neurology Dept n.a. acad. S. V. Davidenkov, North-Western State Medical University n.a. I.I. Mechnikov.

Saint Petersburg

vasilenko_anna@list.ruhttps://orcid.org/0000-0002-8343-4917УлитинА. Ю.UlitinA. Yu.

Улитин Алексей Юрьевич - доктор медицинских наук, профессор, заслуженный врач РФ, заведующий кафедрой нейрохирургии ИМО НМИЦ им. В.А. Алмазова Минздрава России; профессор кафедры нейрохирургии им. проф. А.Л. Поленова СЗГМУ им. И.И. Мечникова.

Санкт-Петербург

Alexey Yu. Ulitin - DM Sci (habil.), professor, honored doctor of the Russian Federation, head of Neurosurgery Dept, Almazov National Medical Research Centre; professor at Neurosurgery Dept n. a. professor A.L. Polenov, North-Western State Medical University n.a. I.I. Mechnikov.

Saint Petersburg

https://orcid.org/0000-0001-5405-7182ЛебедевИ. А.LebedevI. A.

Лебедев Илья Аркадьевич - доктор медицинских наук, профессор кафедры детских болезней и поликлинической педиатрии.

Тюмень

Ilya A. Lebedev - DM Sci (habil.), professor at Dept of Children's Diseases and Polyclinic Pediatrics.

Tyumen

АблаевН. Р.AblaevN. R.

Аблаев Нариман Рустемович - ординатор 2-го года обучения кафедры нейрохирургии ИМО.

Санкт-Петербург

Nariman R. Ablaev - resident of the 2nd year of training at Dept of Neurosurgery.

Saint Petersburg

ДиконенкоМ. В.DikonenkoM. V.

Диконенко Михаил Викторович - ординатор 2-го года обучения кафедры нейрохирургии ИМО.

Санкт-Петербург

Michail V. Dikonenko - resident of the 2nd year of training at Dept of Neurosurgery.

Saint Petersburg

МансуровА. С.MansurovA. S.

Мансуров Ахмед Саипович - ординатор 2-го года обучения кафедры нейрохирургии ИМО.

Санкт-Петербург

Ahmed S. Mansurov - resident of the 2nd year of training at Dept of Neurosurgery.

Saint Petersburg

ШайховМ. М.ShaikhovM. M.

Шайхов Мадани Магомедович - ординатор 2-го года обучения кафедры нейрохирургии ИМО.

Санкт-Петербург

Madani M. Shaihov - resident of the 2nd year of training at Dept of Neurosurgery.

Saint Petersburg

ФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова» Минздрава России; ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава РоссииРоссияAlmazov National Medical Research Centre; North-Western State Medical University n.a. I.I. MechnikovRussian FederationФГБОУ ВО «Тюменский государственный медицинский университет» Минздрава РоссииРоссияTyumen State Medical UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова» Минздрава РоссииРоссияAlmazov National Medical Research CentreRussian Federation202319102023014«Неврология и психиатрия» (2)4550Copyright © Василенко А.В., Улитин А.Ю., Лебедев И.А., Аблаев Н.Р., Диконенко М.В., Мансуров А.С., Шайхов М.М., 20232023Василенко А.В., Улитин А.Ю., Лебедев И.А., Аблаев Н.Р., Диконенко М.В., Мансуров А.С., Шайхов М.М.Vasilenko A.V., Ulitin A.Y., Lebedev I.A., Ablaev N.R., Dikonenko M.V., Mansurov A.S., Shaikhov M.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3250

Эпилепсия, вызванная глиобластомой, требует внимательного изучения комбинации вызывающих ее факторов с комплексным подходом к профилактике и полному купированию при возникновении таких припадков. Основные взаимосвязанные вопросы должны быть рассмотрены при лечении эпилептических припадков у пациентов с глиобластомой. Контроль над судорогами часто требует введения противоэпилептических препаратов одновременно с другими видами лечения, включающими хирургию, лучевую и химиотерапию. Фармакологические взаимодействия между противоэпилептическими препаратами и антинеопластическими агентами могут изменять активность обоих методов лечения, снижая их эффективность и увеличивая вероятность развития комплекса побочных эффектов, связанного с обеими терапиями. Представленный литературный обзор резюмирует новые патофизиологические пути, связанные с глиобластомой и участвующие в эпилептогенезе, а также описывает взаимодействие между противоэпилептическими препаратами и онкологическим лечением. В статье уделяется особое внимание влиянию лечения на выживание, представлены доказательства эффективности противоэпилептического лечения, включая потенциальную полезность новых противоэпилептических препаратов третьего поколения.

Glioblastoma-related epilepsy requires paying careful attention to a combination of factors with an integrated approach. Major interrelated issues must be considered in the seizure care of glioblastoma patients. Seizure control frequently requires the administration of antiepileptic drugs simultaneously with other treatments, including surgery, radiotherapy and chemotherapy, with complete seizure relief often being difficult to achieve. The pharmacological interactions between antiepileptic drugs and antineoplastic agents can modify the activity of both treatments, compromising their efficacy and increasing the probability of developing adverse events related to both therapies. This review summarizes the new pathophysiological pathways involved in the epileptogenesis of glioblastoma-related seizures and the interactions between antiepileptic drugs and oncological treatment, paying special attention to its impact on survival and the current evidence of the antiepileptic treatment efficacy, including the potential usefulness of new third-generation compounds.

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The authors declare that there are no conflicts of interest present.