Эпилепсия и мигрень


А.С. Котов

МОНИКИ им. М.Ф. Владимирского, Москва
Мигрень и эпилепсия – самые частые из неврологических заболеваний, проявляющихся пароксизмальными расстройствами. Распространенность эпилепсии среди лиц с мигренью варьируется от 1 до 17 % с медианой 5,9 %, что существенно выше, чем среднее значение в популяции (0,5 %), а распространенность мигрени среди пациентов с эпилепсией составляет 8–15 %. Клинические проявления приступов при мигрени и эпилепсии могут быть схожими, что затрудняет их дифференциальную диагностику, для которой наиболее важен инструмент сбора анамнеза. Электроэнцефалография (ЭЭГ) может быть полезной для пациентов с головной болью, у которых также имеются признаки эпилепсии, например атипичная аура или эпизоды потери сознания. Длительный видео-ЭЭГ-мониторинг используется в качестве дифференциальной диагностики мигренозной и эпилептической ауры, а также объективизации параллельно текущих мигрени и эпилепсии или синдрома мигралепсии. При сочетании мигрени и эпилепсии следует отдавать предпочтение препаратам, эффективным в отношении обоих расстройств (вальпроатам и топирамату).

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Об авторах / Для корреспонденции


Котов Алексей Сергеевич – профессор кафедры неврологии ФУВ ГБУЗ МО МОНИКИ им. М.Ф. Владимирского, д.м.н. e-mail: alex-013@yandex.ru


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