Epileptoloist should be constantly professionally developed.
This principle is followed by the doctors of research Laboratory of the problems of epilepsy, headache, convulsive states and the family monitoring SVS by Savinov V.M (www.svs.kz). Practically continuously laboratory personnel is in the state of professional development.
In addition to symposiums, congresses, courses conducted within the clinic, doctors try not to miss any of the educational program, both in Kazakhstan and abroad.
Systematically carried out schools of epileptology have become the great event in the world of neuroscience organized by Sanofi Sintelabo firm and AGIUV.
Three years ago, Public Association SVS Nevro (www.svsnevro.kz) conducted a research, which goal was the assessment of knowledge of neurologists and neurophysiologists.
There were surveyed 400 neurologists and 120 neurophysiologists. It was found out that only 27 neurologists can read electroencephalograms, and also 70 know exactly the functional opportunities of the method of brain’s biopotensials registration!
Among neurophysiologists the picture is as follows: 40 doctors did not respond badly to the main issues. And only 23 were able to describe the pattern of gipsaritmy and atypical absence accurately !
Considering all these Public association members have addresses to different medical organizations and to the firms’ representatives - anti epileptical medicines producers, - with the request to support the struggle for doctors literacy.
We can’t help mentioning these firms authority who constantly organize international conferences and sessions inviting the best medical brains in this area.
In 2008, with Alija Khamitova’s arrival in the ranks of the staff of the company Sanofi Sintelabo,
the work tactics have been changed fundamentally. Trivial, thoughtless lectures were ceased where it was only heard that depakin is the best medicine and it should be prescribed. But the nuances and the different individual points were not worked at.
As a result, the medicine was prescribed taking into considerations all the rules, and effectiveness was so poor that devalued its value!
Aliya Khamitova put into practice the expansion of educational programs with those world-class professionals, who know not only the product, but the main problem of epileptology!
1. Professor Marzhan Mahmutovna Lepesova, the Head of the Department of Child Neurology AGIUVa, MD, President of the Association of Children Neurologists of Kazakhstan
2. For the first time in Kazakhstan, a specialist in neurophysiology of the highest world level, Doctor of Medical Sciences, Professor of the Department of Neurophysiology, of Neurocenter of the University Hospital, Uppsala Karin Edebol EEG-Olofsson (Sweden)
3. Professor Elena Belousova, MD, director of psychoneurology and epileptology of the Moscow Research Institute of Pediatrics and Pediatric Surgery of Rosmedtechnology.
4. Senior Research Fellow of the Department of psycho neurology and epileptology of Moscow Research Institute of Pediatrics and Pediatric Surgery of Rosmedtechnology, Candidate of Medical Sciences, Alexander Yurievich Ermakov
Uppsala Karin Edebol EEG-Olofsson’ lectures have opened the session
First of all, she familiarized the participants with the international standards and the recording equipment used in the brains’ biopotentsial research. (EEG)
All the workers of the Laboratory of epilepsy problems research by V.M. Savinov were very proud to hear (www.svs.kz), that all the investigations conducted abroad are carrying into effect at SVS Laboratory. And the main thing is that methods and level coincide with the world standards.
Special attention was given to the correctness of distance calculation between electrodes. As Pr. Karin Edebol EEG-Olofsson pointed out arbitrary suture of electrodes is inadmissible! Only exact and accurate calculation!
The second main question is who must put on electrodes?
It was said clear and well – defined: during EEG recording electrodes should be put on by a doctor or a special educated technician – neurophysiologic
It goes without saying that general medical practitioners and hospital orderly do not have the right to work there. Such forms of epilepsy was studied as syndromes of Vest, Otohara, Duze, etc.
At the photo Doctor of Medical Sciences, Professor of Department of Neurophysiology of the University Hospital Neurocentre, Uppsala Karin Edebol EEG-Olofsson (Sweden) shows the EEG of a boy of 7.5 months, with severe brain elektrogenez delays
Professor Karin Olofsson showed in details a typical pattern in these forms of epilepsy: gipsaritmy, the flash-suppression, atypical abсence . Neurologists have received exhaustive information about the correlation of elektroentsefalograficheskih changes and clinical symptoms!
Professor Elena Dmitrievna Belousova noticed the importance of the early termination of the symptoms at an early epileptic encephalopathy! But what is most important, the need for a fast readjustment of electroencephalogram!
At the photo - Professor Elena Belousova, MD, director of psycho neurology and epileptology of Moscow Research Institute of Pediatrics and Pediatric Surgery of Rosmedtechnology.
As Professor Belousova E.D said: «You can not treat the EEG! But in the case of gipsarihtmy, this rule makes an exception! »
The faster on EEG and in clinical manifestations will be completed remission, the more likely the patient will maintain the intellect.
It was suggested several options of the basic therapy. It was investigated the application of the scheme of depakin, lamiktal and topamaks in the treatment of severe forms of epilepsy.
Professor Elena Belousova and associate professor Alexander Yermakov shared personal experiences and practices in the use of sinakten - depot and corticosteroids in the treatment of syndromes of early epileptic encephalopathy.
A question about the application of the drug Vigabatrin (Sabril) caused a very heated debate. The point is that there is a great experience in the treatment of a drug produced by Sanofi Aventis (which produces anticonvulsant depakin).
This is the drug of the first choice in treating infantile spasms, gipsaritmy remediation and treatment of other severe epileptic encephalopathy. But in Kazakhstan it is not registered! Not registered because of the small market.
The representatives of the Public Association SVS Nevro (www.svsnevro.kz) decided to conduct statistical research and to determine the prevalence of potential consumers of vigabatrin. And then – to call to the government to help to put the drug in Kazakhstan.
After all, even if there are only hundred patients whose syndrome of Vest, Otahary and other encephalopathy convulsions will not be ceased., the economic damage to the country will be expressed in millions of dollars! Instead of developing the economy, the money will be spent for disability, nurses, multi-therapy, special gardens, schools and so on! And also, the parents of the child will be deprived of the full work!
Statistical data, the approach to the treatment of many forms of epilepsy and convulsions were discovered in an excellent lecture of the founder of child neurology in Kazakhstan pr. Marzhan Mahmutovna Lepesova
Practically all child neurologists of Kazakhstan are students of Marzhan Mahmutovna! Her heroism of a professional and her patriotism are invaluable! In a vague nineties of the last century, when almost the entire Medicine was collapsed, Professor M.M Lepesova created and maintained the first department of child neurology in Kazakhstan!
And so, neurologists and neurophysiologists of the «Laboratory of epilepsy, convulsions, headache problems research and family monitoring by V.M Savinov SVS.» perceived proudly the appreciation of the professional growth given by Marzhan Mahmutovna!
The seminar was not just the presentation of lecture material. Cooperative patients discussion was of great help. To listen to people’s opinions, whose lectures and articles are taught all over UIS. was very useful and inspired assurance in future therapy success, medical histories.
Neurologists and epyleptologists of V. M. Savinov Laboratory SVS got the opportunity to discuss a lot of professional questions, to consult EEG recordings, to compare with data of clinical manifestations and to get knowledge from the specialists with rich experience.
Even during the breaks leading neurologists and epyleptologists of the Public Associations SVS Nevro didn’t let Pr Karen Edebol EEG-Olofsson take a rest.. But it is not only triggered condemnation from the eminent specialist, but on the contrary the desire to know the depth of the profession received a great approval!
From the left to the right: Sergey Victorovich Savinov – the Director of the Laboratory of epilepsy, convulsions, headache problems research and family monitoring named after V.M. Savinov.
splendid interpreter from English into Russian Timur Nurpeisov Doctor of medical science, Pr of the Department of neurophysiology , neurocentre of University Hospital Upsala Karen Edebol EEG-Olofsson (Sweden)
a leading neurophysiologist – neurophysiologic of Laboratory SVS Yana Evgenievna Akchurina,
Tatiana Nikolayevna Sinicina a leading neurologist- neurophysiologist of the Laboratory of epilepsy, convulsions, headache problems research and family monitoring by V.M. Savinov.
Doctor of Medical Sciences, Professor of Department of Neurocentre Neurophysiology of the University Hospital Uppsala Karen Edebol EEG-Olofsson (Sweden) and a leading neurologist- neurophysiologist of the Laboratory of epilepsy, convulsions, headache problems research and family monitoring named after V.M. Savinov Yana Evgenievna Akchurina are having discussed EEG.
Epileptology, as all medicine in whole, is constantly moving forward.
Compared with 1989, when doctors in our country can prescribe only Phenobarbital and carbamazepine, the chance of a patient not to get epileptically degradation was very small.
In addition, when it is not possible to achieve control over the attacks conservatively, there are methods of surgical correction.
At this period, in Kazakhstan such kind of operations are not conducted. However, video EEG monitoring was first brought to our country only in 2004 (see the first site in Kazakhstan V.M. Savinov Laboratory video EEG monitoring SVS www.svs.kz).
Nevertheless, a lecture by Professor Karin Edebol EEG -Olofsson was greeted with unconcealed interest!
The technique of surgical treatment, first of all is based on identifying the focus of epileptic activity. There are several stages:
- Topical diagnostics of epileptic site with the help of surface continuous (sometimes till 5 days) video EEG monitoring. It is necessary for the defining the area of further research. It is known that impulses received by scalp electrodes do not coincide with the are of their origin. Especially if they are inducted by subsurface brain structures.
- To make MRT by the devices of high permission (not less then 3 tesls) and PET (positron-emission tomography) This research has the aim to find out structural brain injury in the area of supposed epileptical activity.
- Trepanation of skull is made in the area of supposed epileptical site and whole “Napkins” are put on the uncover brain. Such electrodes can be from 8 to 50! Then trepanation hole is closed and a patient is attached to the system of EEG monitoring. This research should be conducted till the seizures appear. If attacks do not appear for a long time stimulating drugs should be used.
- If the data of all listed tests are coincided dissection of this area is done. If they are not coincided so operative treatment is conducted according another principle.
- If well-defined site is not found or seizures threaten a patient’s life symptomatic operations should be used: nerves stimulations, gemisphereectomy, lobotomy, etc.
Unfortunately, we have the equipment and specialists to carry out only the first two paragraphs. But since 2009, the Laboratory of epilepsy, convulsions, headache problems research and family monitoring by V.M. Savinov. (www.svs.kz) became the scientific basis of clinical neurosurgery of the National Center in Astana (www.nsi.kz).
Under the guidance of Professor S K Akshulakov and V.M. Savinov Laboratory SVS the preparation of the program «Master Class on surgical treatment of epilepsy» with the involvement of foreign experts has been started.
Therefore, to hear a lecture on the subject, especially from the Professor Karin Edebol EEG -Olofsson was extremely necessary.
In addition to schema-based approach to surgical treatment the following operating maintenance of patients was discussed in details.
In spite of impossibility of having operation at home, tens and thousands of our citizens go to have operation abroad.
Despite the fact that in our country there is no possibility of surgery at the epilepsy, but tens and hundreds of our citizens operated abroad.
And coming home they get wrong advice, until the abolition of therapeutic treatment.
It was observed that after surgical removal of an epileptic focus, the patient, with the full electroencephalographic and clinical remission, should continue to receive drugs at least for two years!
And then gradually during a year, under the control of video EEG monitoring get drug canceled. And then another two years to hold regular EEG monitoring and counseling of professionals.
Professor Belousova and Associate Professor Yermakov again raised the theme of misuse of anti-epileptic drugs and unnecessary medications prescription of other groups with epilepsy.
It was noted that the difference in the pharmacokinetics of Depakin in syrup and tablets form. Depakin in syrup should be taken at least three times, and depakin Chrono tablets has a retard form and can be applied twice a day.
To change the prescription of medicine is not a good idea. Even if they are of one line, they have different famakodynamic. And this may lead to a resumption of seizures.
Speaking about the prescription of medicine like noofen, cerebrolizin and other non-anticonvulsants, but declared to be necessary for treatment of epilepsy we can say that it is the evidence of non – professionalism of doctors who did it Moreover, nootrops and other drugs can trigger epileptic seizure!
For these reasons in 2004 Public Association SVS Nevro (www.svsnevro.kz) initiated a research of this issue and the result of it is a list of drugs contraindicated with epilepsy.
The magnificent lecture of the assistant professor Alexander Yermakov on photosensitive epilepsy has shown that this pathology is not so rare. Revelation is suffered!
Senior Research Fellow of the Department of psycho neurology and epileptology of Moscow Research Institute of Pediatrics and Pediatric Surgery of Rosmedtechnology, Candidate of Medical Sciences, Alexander Yermakov
On the basis of concrete examples, it was shown the effects of techniques and equipment for the diagnosis of photosensitive epilepsy. In a survey of patients with suspicion on these forms records on a digital EEG machine should be done. The most important thing is correct work of Photo stimulator and corresponding to the protocol of research. Photo stimulation should be held only in a dark room. Photo stimulator lamp should be at a distance of no more than 30 cm from an eye. The eyes should be closed, but the sight is aimed at stroboscope. Rhythmic Photo stimulation must begin from one hertz and gradually get up to 60 hertz.
Not jumping and not hurrying events. If, after the procedure no characteristic changes are revealed in the EEG, it is recommended to repeat the research.
Life functions recommendations for the patients suffered from this form of epilepsy were very valuable
To reduce the risk of attacks when watching the TV and computer, you should be maximally far from the screen and the room should not be dark.
To be in the street are recommended to wear polarizing or dark glasses. In the room there should be no blinds or wallpaper in the small strips visiting discos and nightclubs should be minimized,
All above mentioned is only a small part of knowledge received from the lecturers.
All the above listed only a small part of the knowledge that the lecturer handed listeners.
As a sign of deep gratitude on behalf of the course participants some gifts were presented.
The Director of the Laboratory of epilepsy, convulsions, headaches problems and family monitoring SVS Sergey Victorovich Savinov, presenting a souvenir, was telling its story, and the way to use it.
Inscription from the left to the right: Sergey Victorovich Savinov, Director of the Laboratory of epilepsy, convulsions, headaches problems and family monitoring SVS , Director of the project “The faculty of past diploma education in neurophysiology neurovisualisation, President of Public Association SVS Nevro board, Chief Editor of Kazakhstan Medical Internet portal SVS Medical (www.svsmedical.kz).
Leading Science Fellow of psycho neurology and epileptology department of Moscow ISR of pediatrics and child surgery of Rosmedtechnology Alexander Urievich Ermakov
Pr Elena Dmitrievna Belousova, Doctor of medical Science the chief of the Department of psycho neurology and epileptology of Moscow ISR of pediatrics and child surgery of Rosmedtechnology
and Dr of Medical Science, Pr. of University Hospital of neurocentre of neurophysiology Uppsala Karen Edebol EEG -Olofsson.
Our dear guests listened with interest to the story of a National Instrument Dombry. The purpose of a national jug made from skin - Tostagan is for keeping kumys. They were surprised to hear about splendid drink - kumys and its role in the life of Kazakhstan peoples.
Director of SVS Laboratory S.V.Savinov will always remember the warm embrace of a beauty specialist and a beautiful woman - Dr of Medical Science, Pr. of University Hospital of neurocentre of neurophysiology Uppsala Karen Edebol EEG-Olofsson.
Approval has caused a lot of love and knowledge of Kazakh national customs by a representative of the Russian Diaspora.
All students and professors teaching staff were constantly surrounded by a concern of the organizers of the seminar.
At the photo: on the left – Natalia Derepaskina, on the right – Elena Nebogina.
From pens to the three-time board and lodging of the visitors, our sponsors that provide the maximum facilities for obtaining knowledge.
The Laboratory of epilepsy, convulsions, headaches problems and family monitoring SVS staff really appreciate Natalia Derepaskina and Elena Nabogina’s contribution into epileptology development in Kazakhstan.
We can imagine the amount of lab our nested into the epileptology school session organization.
Activities of such level require a coordinated teamwork, of course, self- denial of its avant-garde!
We kept watching professionalism and personal interest of each member Sanofi –Aventis member with great pleasure.
To organize the visit of an internationally recognized authority - great responsibility!
After all, how they will be met, what audience will be chosen and how the material will be perceived the whole country will be assessed.
No doubt that the entire team of Sanofi group and each member personally do everything so that the view of Kazakhstan was the highest!
And what is most important, the students, including our staff, received tremendous knowledge and optimism!
And, of course, it helps us to avoid many mistakes in the application of anticonvulsants, particularly depakin and vigabatrin! And even more effectively to carry out treatment by the medicines manufactured by Sanofi!
Each of us will remember those days for a long time. Days which allows us to get higher with our knowledge.
Days, which were full of communication with such splendid doctors and professionals.
In our time of global crisis to get such kind of opportunity is another guarantee of stability and confidence in future.
As professionals are always claimed. Even in the time of global crisis.
This farewell photo will be like a guiding star for our team in the future!
At the photo from the left to the right:
Sergey Victorovich Savinov, Director of the Laboratory of epilepsy, convulsions, headaches problems and family monitoring SVS , Director of the project “The faculty of past diploma education in neurophysiology neurovisualisation, President of Public Association SVS Nevro board, Chief Editor of Kazakhstan Medical Internet portal SVS Medical (www.svsmedical.kz),.
Dr of Medical Science, Pr. of University Hospital of neurocentre of neurophysiology Uppsala Karen Edebol EEG -Olofsson. (Sweden)
Ivan Urievich Sitnikov – neurologist, epileptolog, the chief of neurophysiologic department of the Laboratory of epilepsy, convulsions, headaches problems and family monitoring SVS named after V M Savinov, the President of neurophysiologists and specialists of neurovisualisation Association board of Kazakhstan,
A leading neurology – neurophysiology of the Laboratory SVS Yana Evgenievna Akchurina
Pr. Elena Dmitrievna Belousova, Doctor of Medical Science, the chief of psycho neurology and epileptology of Moscow ISR of pediatrics and child surgery of Rosmedtechnology.
Leading scientific executive of psycho neurology and epileptology of Moscow ISR of pediatrics and child surgery of Rosmedtechnology. Alexander Urievich Ermakov
Pr Marzhan Mahmutovna, the chief of neurology department of ASY, Doctor of medical Science, the president of child neurologists Association of Kazakhstan
Kairat Kenesbayevich Kairullaev – a leading neurologist – neurophysiologist of the Laboratory of epilepsy, convulsions, headaches problems and family monitoring SVS named after V M Savinov, a member of the board of neurophysiologists and specialists of neurovisualisation Association of Kazakhstan
Tatiana Nikolayevna Sinicina - a leading neurologist – neurophysiologist of the Laboratory of epilepsy, convulsions, headaches problems and family monitoring SVS named after V M Savinov, a member of the board of neurophysiologists and specialists of neurovisualisation Association of Kazakhstan
The article is written by:
Sergey Victorovich Savinov, Director of the Laboratory of epilepsy, convulsions, headaches problems and family monitoring SVS , Director of the project “The faculty of past diploma education in neurophysiology neurovisualisation, President of Public Association SVS Nevro board, Chief Editor of Kazakhstan Medical Internet portal SVS Medical.