Rehabilitation needs of patients with pharmacoresistant epilepsy in neurosurgery from the perspective of the biopsychosocial concept

D. Yu. Shalygin; E. N. Lebedeva; A. G. Mikheeva; D. A. Komarova; K. B. Abramov; N. O. Dengina; M. K. Lapshina; G. V. Odintsova; N. E. Ivanova

doi:10.56618/2071-2693_2025_17_2_111

Rehabilitation needs of patients with pharmacoresistant epilepsy in neurosurgery from the perspective of the biopsychosocial concept

D. Yu. Shalygin, E. N. Lebedeva, A. G. Mikheeva, D. A. Komarova, K. B. Abramov, N. O. Dengina, M. K. Lapshina, G. V. Odintsova, N. E. Ivanova

https://doi.org/10.56618/2071-2693_2025_17_2_111

EDN: ITUGVP

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Abstract

INTRODUCTION. Epilepsy is a prevalent chronic neurological disorder, characterised by a high frequency of comorbid pathologies. The disease has a significant negative impact on the quality of life of patients, and the development of pharmacoresistant forms necessitates the use of surgical methods of treatment and a comprehensive multidisciplinary approach. The key unsolved problem is the absence of a unified system of rehabilitation care for this category of patients. AIM. To explore the impact of the aforementioned factors on the subject’s performance. The objective of this study is to ascertain the primary directions and requirements for rehabilitation in patients diagnosed with pharmacoresistant epilepsy (PRE) during the preparatory phase preceding surgical intervention. MATERIALS AND METHODS. A single-centre, non-randomised, prospective-retrospective study in parallel groups was conducted in 2025 within the framework of State task No. 123021000127-7. The focal point of this study is pharmacoresistant epilepsy. The subject of the study is the rehabilitation needs of individuals. Patients from the “Register of neurosurgical patients with FRE” were included in the study. An investigation was conducted into demographic, clinical and social status factors, with specially designed questionnaires being utilised for the purpose of data collection. RESULTS. Cognitive habilitation in the preoperative period is required in 76 % of patients, and the level of need in this respect is comparable with the need in postoperative rehabilitation. The prevalence of depression was observed to be 32 % among the patient cohort. Concurrently, there was an escalation in anxiety levels, with the proportion of patients experiencing anxiety rising from 74 % to 78 %. Psychogenic non-epileptic seizures (PNES) were detected in 4.3 % of cases. The correction of fatigue was necessary in 62 % of cases, and increased physical activity was required in 42 % of observations. It is evident that a significant proportion of patients require labour rehabilitation, with 57 % of cases being attributable to non-working and non-disabled patients, 46 % to patients with II–III disability groups, and 49 % to patients with I disability groups. Somatic comorbid pathologies require observation and correction in 38.5 % of cases. CONCLUSION. The study revealed a significant need for rehabilitation of patients with FRE from the position of biopsychosocial approach.