Epileptologist

An epileptologist is a neurologist or psychiatrist who is an expert in the diagnosis of seizures and paroxysmal disorders, in the treatment of epilepsy ^[1] , in the use of antiepileptic drugs ( anticonvulsants ), and also in the management of special patients with epilepsy (patients with uncontrolled - resistant - forms of epilepsy, women ^[2] , ^[3] , children ^[4] ).

Epileptology (the term was first used in 1904 ^{[5] by} William P. Spratling ) is a neurology that studies and treats epilepsy . Practitioners, as a rule, have specialization in neurology (less often - in psychiatry), but receive additional education, having studied in depth paroxysmal disorders, electrophysiology, neuroimaging, pharmacology of antiepileptic drugs, genetics and social rehabilitation of patients. Such comprehensive training is necessary to work with patients with rare, severe forms of epilepsy, as well as with ineffective standard therapy.

Among epileptologists, children's epileptologists have a narrower specialization. The treatment of children can significantly differ from the treatment of adults, since it is in childhood that many special forms of epilepsy are found, and other drugs for the treatment of epilepsy at this age may also be required.

The goal of treatment is to completely stop the attacks or minimize them in the absence of significant undesirable effects of antiepileptic drugs. Often it takes many months to select the optimal regimen for taking medications under the supervision of an epileptologist.

Epileptologists work in specialized hospitals, conduct admission to outpatient facilities (clinics) and epileptological centers. Specialized departments for patients with severe resistant forms of epilepsy (according to the European classification - the tertiary center) are located, as a rule, in large scientific centers. Often in these departments an in-depth examination is carried out to resolve the issue of surgical treatment of epilepsy and, if necessary, surgical intervention itself (Quaternary center). However, most patients with a favorable course of the disease require long-term outpatient treatment by an epileptologist, which allows for optimal treatment at different stages of the course of the disease.

In the second half of the 1990s, a wide network of ambulatory epileptological centers (secondary center) was created in Russia, including both adult and pediatric epileptologists. A significant contribution to the creation of such centers and the training of specialists in epileptology was made with the support of the pharmaceutical company Sanofi .

In the absence of an epileptologist, patients with mild forms of epilepsy, which respond well to standard treatment, can be observed by neurologists and general practitioners (primary center) ^[6] .

An important area of ​​epileptology is research, which allows us to study in more detail the pathogenetic mechanisms in various forms of epilepsy and to develop new approaches to treatment. Research in the field of epileptology can be sponsored by the state, various foundations and pharmacological companies developing new antiepileptic drugs.