In recent years, the number of diagnosed cases of stroke in children and adolescents has significantly increased. Purpose : to study the prevalence and structure of calls from emergency medical teams (EMS) to children and adolescents with a preliminary diagnosis of stroke, taking into account age, gender and seasonality in Moscow. Objectives : to analyse calls from emergency medical services teams in Moscow to children and adolescents, to study the prevalence of childhood stroke. To establish the structure of childhood strokes and the most common types of stroke. To track the dynamics of average monthly indicators of EMS calls to pediatric patients with a preliminary diagnosis of stroke and to clarify the patterns specific to the prevalence of calls to EMS teams during the year. Materials and methods : there was carried out an analysis of the prevalence and structure of calls from emergency medical teams to patients with a preliminary diagnosis of acute cerebrovascular accident among the child population of Moscow. The distribution of cases of acute cerebrovascular accident was analysed depending on the gender and age of the child, and types of stroke. Results of the study: Age, gender and seasonal characteristics, prevalence and structure of nosological forms and types of stroke were identified. It was found that stroke is more common in children aged 7 to 15 years — 1 453 cases (57%). In 73.5% of cases, the visiting medical staff of the EMS diagnosed a transient ischemic attack, in 19.3% — a stroke not specified as a cerebral hemorrhage or infarction, in 4.4% — a subarachnoid hemorrhage, in 1.7% — a hemorrhagic stroke, and in 1.1% — cerebral infarction. An increase in the number of calls is observed from September to April (77.8% of all calls from emergency medical services teams).

The main goal of epilepsy therapy is to improve the patient’s quality of life (QoL), which is a holistic indicator that reflects satisfaction with life in various areas. Currently existing questionnaires: QOLIE-89, QOLIE-31 and QOLIE-10 are adapted for use in Russia, but require a certain, sometimes considerable amount of time to complete them and then process. The five-point scale for assessing the QoL of epilepsy patients (SCALE 5) requires answering only one question: “Grade your general well-being on a five-point school scale at this moment?” and allows to get the necessary information in seconds, without using special forms and calculation formulas. The QoL is assessed by analogy with a Russian five-point school grading system, where 5 is an excellent grade, 4 is good etc. The resulting score serves as an immediate guideline for the doctor for further treatment of the patient: with a score of 3 (satisfactory), the cause of the reduced QoL should be identified and corrected (whether it is related to the illness, adverse events, anxiety/depression, etc.), and with scores of 2 and 1, immediate intervention is required: correction of therapy, consultation with a psychiatrist, possibly hospitalization. Here we present the results of more than 25 years of using SCALE 5. SCALE 5 is easy for patients to understand and for clinicians to use in the limited time of an outpatient appointment. The typical clinical scenarios and practical recommendations for determining the SCALE 5 score presented in the article are intended to facilitate the work of specialists in the fields of neurology, epileptology and psychiatry.

There are currently about 15 million women of childbearing age worldwide who suffer from epilepsy. Overall, 0.3–0.4% of newborns are born to mothers with epilepsy, and almost half of these women experience recurrent seizures. The article discusses issues related to pregnancy planning, the prognostic impact of seizure frequency, type and course of epilepsy on pregnancy outcomes, and potential risks associated with this condition. Summarized data from the latest recommendations for correction of therapy and data on changes in the pharmacokinetics of antiepileptic drugs during pregnancy are presented. A classification of antiepileptic drugs according to their teratogenic potential and their effect on the development and behaviour of the child is presented. Various approaches to pregnancy management are discussed. In addition, scenarios for pregnancy management in poorly controlled epilepsy and status epilepticus are discussed as well as adjustment of therapy in the postpartum period and measures for the safe care of newborns.

Absence status epilepticus (ASE) is a type of nonconvulsive status epilepticus, in which varying grade of consciousness impairment lasting more than 15 minutes and are accompanied by constant generalized spike-wave complexes with a frequency of 2.5-4 Hz on the electroencephalogram (EEG). ASE can be observed in various epileptic syndromes, usually detected in children. In some cases, ASE manifests in adulthood as a late complication of idiopathic generalized epilepsy or status for the first time (de novo), without history of epilepsy. A review of reported cases of ASE manifestation in adulthood is presented and two of our own clinical observations of ASE that occurred in adult patients who did not have a previously established diagnosis of epilepsy are discussed. Quite clear clinical and EEG syndromic delineation of ASE in adults and the elderly, high effectivenefe of therapy and good outcome of the disease allow distinguishing recurrent ASE as a separate epileptic syndrome, in contrast to nonconvulsive status epilepticus in other neurological diseases.

The constant increase in cases of arterial ischemic stroke requires the development of algorithms for the diagnosis and management of stroke patients. Currently, there are no effective methods for diagnosing arterial ischemic stroke (AII) in children at the stage of emergency medical care (SMP). In 2020, the Prehospital Stroke Diagnosis Scale (DDI) was developed, which may be the optimal algorithm for prehospital diagnosis of childhood stroke.The purpose of the study. To determine the optimal algorithm for prehospital diagnosis of arterial ischemic stroke in children. Objectives of the study: To determine the frequency of occurrence of «masks» of stroke and separately migraine in the structure of cases of hospitalization with suspected ONMC. To evaluate cases of hospitalization with confirmed diagnoses of ischemic stroke and migraine on the DDI Scale. To determine the statistical indicators of the effectiveness of the DDI Scale as the optimal algorithm for prehospital diagnosis of stroke in children.Materials and methods. 401 cases of hospitalization of children to the Center via the NSR channel with symptoms of ONMC for the period from June 2023 to June 2024 were analyzed. All patients were evaluated by the staff of the NSR and the doctors of the Center on the DDI scale. Statistical data on the effectiveness of the DDI Scale are determined.The results of the study. «Masks» of stroke in the structure of cases of hospitalization with suspected ONMC are detected in 94.26 %. Migraine is the main «mask» of AII and is detected in 69 % of cases of stroke «masks» and in 65.05 % of cases among all children with suspected ONMC. High indicators of the effectiveness of the DDI Scale in the differential diagnosis of AII and migraine in children have been established: sensitivity 96 % and specificity 95 %.Conclusion. Thus, the DDI scale can be used as an effective algorithm for diagnosing AII in children, used by NSR staff.

Sleep disorders occur twice as often in epilepsy patients compared to healthy people and have a negative impact on seizure control and general quality of life. International and Russian publications on the effect of perampanel (PER) on sleep emphasise the positive effect of the drug on sleep quality, daytime sleepiness and sleep architecture. Objective : to evaluate the effect of PER (Fycompa®) on sleep quality and daytime sleepiness when used as an adjunct antiepileptic drug (AED) in the treatment of epilepsy in adults. Material and methods . The study included 106 patients aged 18 to 73 years with absolute predominance of focal epilepsy (n=96) who were prescribed PER as an adjunctive AED when previous therapy was insufficient, regardless of whether or not complaints of insomnia were present. The study was conducted from April 2022 to June 2023. The maximum observation period was 12 months. The study was multicenter (10 Russian clinical centres) and designed as an observational study, with patients being monitored prospectively, but some of the indicators were collected retrospectively, taking into account the conditions of real-life clinical practice. We assessed: sleep quality using the Pittsburgh Insomnia Scale (Ya.I. Levin modification), daytime sleepiness according to the Epworth scale, anxiety/depression level (Hospital Anxiety and Depression Scale, HADS), adverse events (AEs), efficacy/tolerability of combination therapy with PER for epilepsy at baseline, and after 1, 3, 6 and 12 months of therapy based on the number of completed questionnaires at each visit in the real-life clinical practice. Results . After a follow-up period of 12 months, the retention rate for complex therapy with PER was 84.9%. PER was discontinued in 15.1% of patients and in only 5.7% due to AEs. The most common AE was dizziness, which was observed with a frequency of over 10% (n=21), followed by irritability (n=9) and drowsiness (n=9) with the same frequency. No new, previously undescribed AEs were observed in this study. The use of PER as an additional AED led to a significant reduction in daytime sleepiness and an improvement in sleep quality after the first month of use; by the 12-month follow-up period, the daytime sleepiness index gradually decreased and reached normal levels, and sleep quality improved. The use of PER as part of a complex therapy led to a significant reduction in the initially elevated anxiety level. Conclusion . The use of PER as an additional AED in adults in dynamics significantly improves sleep quality and reduces daytime sleepiness after the first month of use, regardless of the duration of the disease and the order of PER administration. The use of PER as part of a complex therapy led to a decrease in the initially elevated anxiety level from subclinical to normal.

Introduction . Oxcarbazepine is the first-line therapy for newly diagnosed focal epilepsy in children, but data on its use in adult patients in the Russian population are limited. Aim. Improvement of the efficacy of initial therapy with oxcarbazepine and controlled-release carbamazepine for newly diagnosed focal epilepsy in adults. Patients and methods. The study included 74 adult patients, 39 of them were included in the oxcarbazepine group and 35 in the controlledrelease carbamazepine group. During the 6-month follow-up period, patients completed 5 visits, during which adverse events and effectiveness were assessed, as well as video-EEG monitoring with an assessment of the epileptiform activity index. Results. The proportion of patients with a reduction in seizure frequency of more than 50 % was comparable in both groups, constituting 82.4 % (n = 28) and 85.2 % (n = 23) in the oxcarbazepine and carbamazepine group, respectively. Adverse events developed in 20 % (n = 7) of patients taking carbamazepine, and in the oxcarbazepine group in 12.8 % (n = 5) of patients. The 6-month initial monotherapy retention rate was higher in oxcarbazepine group (71.8 %) compared to carbamazepine group (65.7 %). In both groups, a 2.0–3.5-fold decrease in the average and total epileptiform activity index and epileptiform activity index during sleep was registered. Conclusions. The obtained results indicate similar effectiveness of oxcarbazepine and controlled-release carbamazepine in the treatment of newly diagnosed focal epilepsy in adults and better tolerability of oxcarbazepine in terms of both adverse events rate and lower frequency of drug discontinuation due to adverse events. A decrease in the epileptiform activity index by 2.0–3.5 times is evidence of possible use of the epileptiform activity index as an objective marker of the disease dynamics

Objectives . To perform a comparative analysis of symptoms in arterial ischemic stroke (AIS) and stroke-like conditions in children and to develop and analyze the Suspected Stroke Scale in Children for prehospital diagnosis of AIS in children (referred to as the Scale). Materials and methods . Emergency hospitalizations of children at the Stroke Center with suspected cerebrovascular pathology were analyzed. Symptoms detected in patients with suspected AIS were analyzed, referral and final diagnoses were compared, and the main maskers of stroke and their symptomatologies were identified. Data were compared with results obtained at an earlier phase in this research. Results . The study results suggest a predominance of motor and coordination disorders in AIS and cerebral symptoms in stroke-like conditions in children. The most common stroke masker was migraine. The study results led to proposal of the Scale, and preliminary assessment of the effectiveness of the Scale was carried out using examples of confirmed cases of AIS and stroke maskers. Conclusions . Prompt hospitalization of children with AIS can not only reduce mortality, but also allows up-to-date diagnostic and treatment methods to be used to reduce the extent of brain damage and provide the opportunity for complete restoration of motor and cognitive functions. Further analysis of the sensitivity and specificity of the proposed Scale is needed.

Cefepime is a fourth-generation cephalosporin antibiotic widely used in clinical practice for various organ systems pathology treatment. The article describes the clinical observation of a patient who, 3 days after cefepime administration, had a decrease in the level of consciousness, regarded as encephalopathy. Cefepime-induced neurotoxicity is characterized by toxic encephalopathy, which manifests 2–6 days after the start of the treatment with this drug and disappears 1–3 days after its withdrawal. Electroencephalography (EEG) abnormalities include generalized periodic discharges (GPR) of triphasic morphology or a pattern corresponding to the criteria for non-convulsive status epilepticus (BSES). In our observation, the EEG recorded stimulus-induced GPRs of triphasic morphology with a frequency of 1.5 Hz; a test with intravenous administration of an antiepileptic drug (levetiracetam) was negative. A day after the withdrawal of cefepime, the patient’s level of consciousness returned to the initial level, and on the EEG periodic discharges completely regressed. Thus, cefepime may cause encephalopathy in patients with rhythmic or intermittent EEG activity, especially in the presence of a stimulus-induced component. In some cases, the use of cefepime may develop epileptic seizures and BSES.

Objective : to analyze the course of epilepsy in women after withdrawal of valproic acid (VA) during pregnancy. Material and methods . The study was conducted in the Center of paroxysmal conditions of Vitebsk Regional Clinical Diagnostic Center. The study included 58 women with epilepsy who gave birth in 2018–2020; a prospective analysis was also done using the Russian Register of Pregnancy and Epilepsy (RRPE) data. The study group included 112 women with epilepsy who were taking VA at the time of conception. In 16.1% of cases (n=18 out of 112) VA was discontinued in the first trimester (withdrawal group), in 83.9% of cases (n=94) VA therapy was continued. We analyzed the frequency of epileptic seizures depending on the use of VA during pregnancy for each trimester and for the entire pregnancy as a whole. Results . According to the Vitebsk Regional Clinical Diagnostic Center, 32 out of 58 (55.2%) patients took VA, all of them had generalized tonicclonic seizures in the structure of epileptic seizures. Seven of 32 patients (21.8%) received VA at a dose of <700 mg/day; 10 (31.3%) – 700–1000 mg/day, 15 (46.9%) – 1000–1500 mg/day. VA was canceled in two cases, in one of them a tonic-clonic seizure developed. According to the RRPE data, in 9 out of 65 (13.8%) cases VA was discontinued in the first trimester (withdrawal group), in 55 out of 65 (84.6%) cases the therapy with VA was continued, and in one case - the drug was changed. The number of women with epilepsy taking VA during pregnancy has decreased from 38.9% (275 out of 707) in 2017 to 24.9% (112 out of 450) by January 2023. According to the RRPE, the majority of patients continued VA therapy during gestation if pregnancy occurred while taking this antiepileptic drug. A high fraction of prescribing VA in patients with focal epilepsy was registered – 58.9% (66 out of 112) with continuation of VA therapy during pregnancy in 61.7% of cases. Among patients with generalized form of epilepsy, VA drugs were taken by 36.6% (41 out of 112). The majority of patients (35.1%; 33 of 94) continued to take VA throughout the entire gestation. About half of the patients took VA at a dose of >700 mg/day in the first trimester and throughout gestation. There were no statistically significant differences in the frequency of tonic-clonic and other types of epileptic seizures during pregnancy in patients who canceled VA and continued therapy, according to RRPE. Conclusion . Further prospective and controlled studies with large sample sizes are needed to determine the most effective and safe strategy for VA withdrawal.

OBJECTIVE:To evaluate the efficacy and tolerability of extended release carbamazepine (finlepsin-retard and tegretol CR) in adult patients with new-onset focal epilepsy (FE) with the assessment of epileptiform activity index (EAI). MATERIAL AND METHODS:The study included 62 patients (38 (61.3%) men and 24 (38.7%) women) with new-onset FE aged ≥18 years (mean age 42.9±18.4 years). All patients underwent video-ECG-monitoring with EAI assessment at each visit. Treatment efficacy was assessed using the criteria of seizure absence (medically induced remission), seizure rate decrease by >50% (responders), seizure rate decrease by <50% - insufficient efficacy, retention on treatment and seizure rate increase compared to baseline and/or development of new type of seizures (aggravation). Overall study period was 12 months. RESULTS:By the end of the 12-month follow-up period, there was a 4.3-fold decrease of the total EAI compared to baseline (p<0.001). Retention on carbamazepine treatment during 12 months was achieved in 61.3% (n=38) patients; medically induced remission - in 40.3% (n=25); seizure rate decrease by >50% - in 21.0% (n=13). In 29.1% (n=18) of patients, treatment change was performed; double-drug therapy, including carbamazepine, was prescribed in 9.6% (n=6) of patients. Incidence of adverse events was 29.1% (n=18). CONCLUSIONS:Carbamazepine is an effective and promising drug for initial monotherapy of FE. Its use in the treatment of FE results in a 4.3-fold decrease of EAI (p<0.001), which reflects the efficacy of treatment. EAI is an additional objective measure of treatment efficacy.

The report presents data on the evaluation of efficacy and tolerability, as well as the dynamics of epileptiform activity index in adolescents and adults with newly diagnosed focal epilepsy during lacosamide therapy.

Objective: to evaluate the role of seizure severity and epileptiform activity index (IEA) assessment in newly-diagnosed idiopathic generalized epilepsy with generalized tonic-clonic awakening seizures (GTCS).Material and methods. The study included 31 patients with newly-diagnosed generalized epilepsy with GTCS aged 14–52 years (mean age 25.06±9.3 years), which were divided into two groups depending on seizure severity: Group 1 (n=9, 29%) with <18 points, and Group 2 (n=22, 71%) with ≥18 points. Seizure severity was analysed by using National Hospital Seizure Severity Scale (NHS3). All patients underwent video-electroencephalography monitoring (8–24 hours) with IEA assessment at baseline and at 1, 3, 6 and 12 months after the beginning of treatment. Therapeutic efficacy was assessed using the criteria of seizure absence (medically induced remission), seizure rate decrease by >50% (responders), seizure rate decrease by <50% (insufficient efficacy), seizure rate increase and retention in treatment.Results. Total EAI at baseline was significantly higher in patients from Group 2 (p=0.019). Despite markedly reduced EAI level in both groups, in Group 1 (less than 18 points by NHS3) EAI was significantly lower compared to Group 2 (≥18 points) at all subsequent visits: visit 2 (p=0.038), visit 3 (p=0.035), visit 4 (p=0.047), and visit 5 (p=0.022).Conclusions. Assessing seizure severity may become an additional objective criterion while evaluating treatment efficacy.

Pharmacodynamic aggravation (PA) is an unpredictable increase in the frequency, the severity of existing seizures, and/or development of new seizure types despite rational (adequate for seizure type and epilepsy form) antiepileptic drug (AED) prescription. Many mechanisms and predictors of its development are still poorly understood.Objective: to analyze PA of seizures in patients with newly diagnosed focal epilepsy receiving monotherapy with sodium channel blockers with epileptiform activity index (EAI) assessment.Patients and methods. We enrolled 201 patients with newly diagnosed focal epilepsy aged 16—81 years. In twelve months, patients had five follow-up visits. At each visit, treatment tolerability and efficacy were assessed, taking into account changes in the type, severity, and frequency of seizures. Additionally, at each visit, video-electroencephalographic monitoring was performed with EAI assessment. PA of seizures occurred in patients on oxcarbazepine, carbamazepine, and lacosamide therapy.Results and discussion. Five patients with PA of seizures had increased total EAI and EAI before sleep at the second follow-up visit after sodium channel blockers prescription. Electroencephalographic correlates of PA occurred earlier than clinical manifestations. In patients with PA, the absolute increase in EAI was minimal in patients receiving oxcarbazepine, and lacosamide therapy was associated with a minimal relative increase in EAI. At the end of the follow-up, total EAI decreased by 54—80% relative to its initial value in all five patients. The difference in the total index during the first and last visits was statistically significant.Conclusion. Due to the low level of knowledge about PA of seizures, it seems necessary to consider its possibility in all cases of increased frequency, aggravation, or change in the type of seizures after the AED treatment initiation or an increase in its dose. It is also possible to use changes in total EAI and EAI before sleep as an early objective marker of PA in adults with focal epilepsy.

A multi-year career path and overwhelmingly rich legacy of Professor V.A. Karlov are presented in the report. Prominent publications related to the main research directions of his work as an outstanding scientist and clinician are outlined.

Objectives. To assess the dynamics of the index of epileptiform activity (IEA) as indicator of the efficacy and tolerance of treatment with valproic acid formulations in patients with new diagnoses of generalized and focal epilepsy. Materials and Methods. The study included 93 patients (53 men, 38 women) with focal (n = 27) and idiopathic generalized (n = 66) epilepsy. Patients with idiopathic and age-dependent focal epilepsy were not included in the study. Video EEG monitoring was run at each visit and diffuse and generalized epileptiform activity in waking to sleep, during sleep, after sleep, and during fragmentary waking was evaluated, with assessment of the quantitative IEA, at the beginning of treatment and at 1, 3, 6, and 12 months. Therapeutic drug monitoring was run by titrating drug at one month of treatment or at treatment adjustment. Treatment efficacy was assessed in terms of the absence of seizures and decreases in seizure frequency by more than 50% (responders) and less than 50% (inadequate effect). Adverse events were evaluated on the SIDAED scale. Results. The highest IEA values were seen in both subgroups of patients – with focal and idiopathic generalized epilepsy – before valproic acid treatment initiation. Total IEA in patients with idiopathic generalized epilepsy (52.8 ± 7.8) was significantly greater, while during waking to sleep (3.4 ± 0.8) and during sleep (4.3 ± 0.8) IEA was significantly lower than in patients with focal epilepsy, where the index was 27.1 ± 5.5 (p = 0.027) and 10.5 ± 5.5 (p = 0.003), 8.9 ± 3.7 (p = 0.046), respectively. Valproic acid displayed high efficacy and good tolerance in the treatment of idiopathic generalized and focal epilepsy: by the end of 12 months of observations, remission was obtained in 69 patients (74.2%) and decreases in seizures by more than 50% were seen in 22 patients (23.7%); inadequate effects were obtained in only two subjects (2.1%). Adverse events were recorded in a few cases. Conclusions. Valproic acid remains one of the drugs of choice for the treatment of idiopathic generalized and focal epilepsy. IEA may provide an additional objective criterion in difficult cases to discriminate idiopathic generalized from focal epilepsy in terms of total IEA, IEA before sleep, IEA during sleep, and IEA during fragmentary waking in the first months of treatment (1–3 months), objectively reflecting the dynamics of valproic acid treatment efficacy,

Introduction. Video-electroencephalography (EEG) monitoring (VEEGM) is an indispensable functional method in epileptology. However, virtually no trials on assessing efficacy of antiepileptic drugs (AED) by using VEEGM are available.Objective: to improve efficacy of EEG-diagnostics and evaluate the epileptiform activity index (EAI) in newly-diagnosed idiopathic generalized epilepsy in adult patients receiving alproic acid and levetiracetam.Material and methods. T here w ere e nrolled 130 p atients: 6 0 (46.2%) m ales a nd 7 0 (53.8%) f emales w ith n ewlydiagnosedidiopathic generalized epilepsy (IGE), aged 22.51±8.9 years. All patients underwent VEEGM with quantitative EAI analysis at baseline visit and 1 3, 6 and 12 months later after treatment. Each seizure episode developed during the VEEGM study were assessed for type, time of seizure onset, relation to wake-sleep cycle, duration, ictal EEG pattern followed by diagnosing epileptic syndrome. Valproic acid and levetiracetam were used for initial therapy in groups per 65 patients in each. Treatment efficacy was assessed using parameters such as retention on therapy, absence of seizures, decrease of seizure frequency by >50%, decrease of seizure frequency by <50% – insufficient efficacy.Results. It was found that seizures during baseline VEEGM were recorded in 43.1% (n=56) patients, who were assigned to group 1, whereas remaining 74 (56.9%) patients were assigned to group 2. EAI was significantly higher in patients with seizures recoded at baseline VEEGM, compared to those lacking seizure episodes during initial VEEGM (p<0,001), mean EAI was also higher in group I at second (p<0.001) and third (p<0.001) visits. EAI magnitude at 6 and 12 months of study became virtually comparable in all groups and did not depend on AED prescribed. Treatment efficacy was higher in patients with IGE, with no eizures recorded during the initial VEEGM.Conclusion. Long-term VEEGM allows unbiased assessment of treatment dynamics based on EAI analysis. The first 6 months of initial treatment titration in represent most crucial period for patients with newly-diagnosed IGE.

There is a number of unsolved issues in management of epilepsy associated with primary and metastatic brain tumors (BTs). In particular, no consensus approaches to treatment of patients with epilepsy associated with BTs have been proposed regarding use of current anti-epileptic drugs (AEDs). The review presents the relevant data on epidemiology, features of clinically manifested epilepsy at varying stages of BTs, aspects of drug-drug interaction between AEDs and anti-tumor agents, AED-related effects on cognitive functions as well as quality of life in patients with epilepsy associated with BTs. Levetiracetam and valproic acid comprise the first-line drugs for treating seizures in patients with BTs. It is unreasonable to use AEDs acting as hepatic microsomal enzyme inducers for therapy of epileptic seizures in BTs, because it may decrease efficacy of chemotherapy agents and glucocorticoids along with elevated rate of side effects. Perampanel acting as a selective noncompetitive AMPA receptor antagonist, may be one of the drugs of choice for the adjunctive therapy of epileptic seizures associated with BTs.

Oxcarbazepine (OXC) is an antiepileptic drug (AED) used in children and adults as initial and adjunctive therapy for focal epilepsy (FE). It has been used in Russia since 2007; however, only a few studies have been published on its use in Russian patients to date.Objective: to assess the effectiveness and tolerability of OXC as initial therapy for FE in adults and adolescents, as well as to study epileptiform activity index (EAI) changes during treatment and its relationship with treatment effectiveness and tolerability.Patients and methods. We evaluated treatment effectiveness and tolerability and EAI in 89 adults with newly diagnosed FE aged 15–75 years for 12 months. Patients were divided into three subgroups according to the OXC treatment regimen. Side Effects of Anti-Epileptic Drugs (SIDAED) scale was used to assess treatment tolerability. Retention rate and seizure frequency changes were used to evaluate treatment effectiveness. EAI changes were assessed with video electroencephalography monitoring (4–24 h) during each visit (baseline, after 1, 3, 6, and 12 months).Results and discussion. The retention rate in patients on OXC monotherapy after 12 months was 71.9%, almost one-half of them (46.1%) achieved sustained remission. More than half of patients (52.9%) were prescribed 1200 mg/day of OXC, 12.3% – <1200 mg/day, and only in 6.7% of patients the dose exceeded 1200 mg/day. Side effects were observed in 9% of the cases. A 2.54-fold reduction in mean EAI index was observed during follow-up representing treatment effectiveness.Conclusion. OXC, as the initial AED for FE, has demonstrated high treatment effectiveness and tolerability. In addition, total EAI 2.5-fold reduction allows its usage as an additional quantitative marker of OXC treatment effectiveness.