Drug-resistance epilepsy (DRE) is a key problem in neurology. It is possible that damage to the blood–brain barrier (BBB) may affect resistance in DRE. The aim of this work was to assess the damage and dysfunction in the BBB in the area of epileptic foci in patients with DRE under conditions of neuroinflammation. The changes to the BBB in temporal lobe epilepsy (by immunohistochemistry and transmission electron microscopy), levels of neuroinflammatory proteins, and cytokine levels in the blood (by multiplex analysis) were studied. Increased levels of vascular endothelial growth factor (VEGF) and growth-regulated protein (GRO), and decreased levels of epidermal growth factor (EGF) in plasma, combined with overexpression of the VEGF-A receptor by endotheliocytes were detected. Malformation-like growths of the basement membrane of the capillaries of the brain complicate the delivery of antiepileptic drugs (AEDs). Dysplasia of the basement membrane is the result of inadequate reparative processes in chronic inflammation. In conclusion, it should be noted that damage to the microcirculatory network of the brain should be considered one of the leading factors contributing to DRE.

The purpose of this study was to evaluate the parameters of somatosensory evoked potentials (SSEPs) in healthy children of different age groups (n = 94). The amplitudes of the main cortical peaks and the central sensory conduction time (CSCT) from n. medianus and n. tibialis in children aged under 12 months, 1–12 years, and 12–17 years were estimated and compared. No significant cortical peaks were recorded from the tibial nerve in five children younger than 1 year (5 out of 23, 22%). Significant differences in CSCT were observed between the children younger than 1 year and two other groups. The amplitudes did not significantly differ between the groups. Thus, SSEPs may be used for the evaluation of somatosensory pathways in children aged one month to 17 years. CSCT differs significantly between children younger than 1 year and other age groups. Age-related reduction in CSCT and elevation of the cortical peak amplitudes may reflect the myelination of somatosensory pathways and the improvement in nervous system integration.

Relevance. Primary-multiple cerebral tumors of various histological types represent a poorly studied group of diseases. The development of multiple pathological formations in a single patient becomes a clinical problem since such situations are not regulated by recommendations, and the doctor has to make a decision based solely on their own experience and common sense. The situation where several independent neoplasms develop in the patient’s body generates scientific interest and leads to the idea of genetic determinism of processes, as well as a number of typical epigenetic abnormalities that lead to their occurrence. The article examines possible causes that lead to the simultaneous development of meningiomas, schwannomas of cranial nerves, astrocytic tumors, pituitary adenomas, and other rarer cerebral tumors, including the phenomenon of «tumor collision.» Conclusions. Apparently, primary-multiple cerebral tumors of various histological types constitute a nosological cluster that includes conditions caused by different pathogenetic processes. In some cases, neoplasms are associated with clear genetic determinism of carcinogenesis processes. Many of them are linked to hereditary tumor syndromes (neurofibromatosis types 1 and 2, schwannomatosis; tuberous sclerosis; Noonan, LEOPARD, Costello, Legius, Turcot, Li-Fraumeni, DICER1, von Hippel-Lindau syndromes, and many others). In other cases, mechanisms of paracrine nature are observed. Thirdly, some cases appear to be random combinations of sporadically occurring tumors.

Surgical treatment of MRI-negative drug resistant epilepsy in children

The goal of the present study was to test the method of forming or actualizing preverbal concepts in the conditions of an independent search for a task solution in order to use the method in clinical practice. The conditions of the absence of researchers instructions allow: 1) to compare in ontogenetic and clinical aspects; 2) to develop the skills of an independent search for solutions in problem situations; 3) to improve the creative potential of a child; 4) to develop the ability to achieve a goal. The advantage of using the preverbal concepts of size and shape is that this method can be applied to children of primary preschool age and children with a delay in speech development. To test the method, 7 healthy children of the middle preschool age (4-5-year-old children) were selected. The first task was to form or actualize the concept of a bigger or smaller size in children during the simultaneous presentation of 4 flat or volume geometrical figures. The second task was to form or actualize the concept of a flat or volumetric object among simultaneously presented 4 figures of the same size (small, medium or big). To get reward children should have chosen the figure, which was different from the other 3 ones in a trial during the formation of both the concepts. In the both tasks, we calculated the quantity of trials, which were needed for the single attainment or excess of the 70% level of the correct task performance per each type of learning. The behavioral results showed that the learning speeds during the formation of the concepts of the bigger/smaller size and flat/volumetric shape did not significantly differ from each other. It could be suggested that those concepts were equally important for the 4-5-year-old children. The study showed that the concept formation model is a convenient psychological method for testing the level of the development of the higher cognitive functions in participants and its use is possible in clinical practice with the parallel recording of the brain activity (EEG, evoked potentials etc.) in children in the process of their performing cognitive tasks. The described model is promising for identifying intellectual developmental delays in preschool children and can be used to test children with various cognitive abnormalities.

Brain tumors are the most common group of neoplasms in children, which is in the top-3 causes of infant mortality from oncopathology.   The aim of the study is to make a literature review of modern approaches to the personalization of treatment of CNS tumors in children based on the study of molecular genetics, immunohistochemical and imagingт characteristics. The article provides a description of the most common types of neoplasms of the nervous system — low grade gliomas (LGG), high grade gliomas (HGG), mixed glioneural tumors, etc. The molecular genetics, immunohistochemical, visualization characteristics of each type of gliomas are described. Modern information on prognosis and treatment of tumors is also given in the publication. The prognosis of the course of LGG/GNT in children depends more often on the patient’s age, histology, and location of the tumor, as well as its molecular profile. Older patients have a more favorable prognosis than younger children. Well-visualized tumors located superficially have a better outcome than diffuse gliomas, as well as deeply located tumors. Detection of BRAF mutations and FGFR rearrangements may indicate a better prognosis than in the presence of SNV. Local mutations of BRAF with concomitant deletion of CDKN2A, as well as mutations with H3.3 pK27 are the most dangerous.