*2.1.1 Psychotherapy*

*Epilepsy - Advances in Diagnosis and Therapy*

ent authors, from 7 to 25% [5–7].

development of ADRs [2, 9, 10].

stimulation) (see **Table 1**).

These effects cause induction or inhibition of the liver enzymes, making other AEDs displaced from protein linkages. These reactions increase the rate of metabolism and cause the reduction of the plasma concentration of ADRs, which may lead to difficulties in the choice of AEDs' dosage. On average, the frequency of ASEs and complications of antiepileptic therapy remains high and varies, according to differ-

Therefore, the presence of ADRs requires the immediate withdrawal of AEDs, even if the drug-induced epilepsy remission is achieved. It should be noted that 40% of epileptic patients need polytherapy. This leads to the increase in the ADRs' frequency, adverse drug-drug interactions, and teratogenicity [8]. Also, there are difficulties in assessing the effectiveness of ADRs of a single drug. Drug-drug interactions often decrease antiepileptic treatment efficiency and contribute to the

Consequently, nondrug methods of epilepsy treatment should also be used, both as an additional therapy and (in some cases) as the basic therapy (e.g., vagus nerve

The principle of the dominant was introduced in neurophysiology by the outstanding Russian physiologist Uchtomsky in 1911 [11]. Under "the dominant" he meant the dominant reflex system, which determines the integral nature of the functioning of the nerve centers in any period of time and ensures the appropriate behavior of animal and human. He also described the dominants' properties, the main of which were increased excitability, the ability to summation, high resistance, and inertia of excitation. Also, a theory of pathological dominant was suggested. Within this theory, pathological dominant represents sharply enhanced focus of excitation in the central nervous system, caused by "pathogenic effects of the environment." Later, in 1980, Kryzhanovskii developed the doctrine of "pathological determinant." The latter was described as a "modified formation of the central nervous system, forming a pathological system and determining the nature of its activities" [12]. According to this doctrine, the determinant can form a pathological system in the central nervous system. The feature of the pathological system is the ability to suppress the physiological system. Such pathophysiological mechanisms underlie most neurological disorders. Kryzhanovskii proposed a mechanism of fighting the pathological dominant by introducing another, more powerful dominant [13]. A significant part of the research dedicated to the hand tapping is based on this

According to Rudnev, the cyclical nature of movements in wrist tapping is a natural statistical regularity that is a standard you can compare different parameters

Psychotherapy Percutaneous stimulation of the trigeminal Nerve

**Noninvasive methods Invasive methods** Physical activity Vagus nerve stimulation Transcranial magnetic stimulation Deep brain stimulation

Music therapy Surgery

**134**

**Table 1.**

mechanism.

Aromatherapy Acupuncture

Tapping

Referential bioadaptation

*Nondrug methods of epilepsy treatment.*

Currently, it is the practice to distinguish three fundamental categories of psychotherapeutic techniques, used in epileptology: rewards/sanctions, self-control, and neurofeedback. "Rewards/sanctions" and "self-control" categories are used for self-induced seizures and for so-called reflective attacks as well as for epileptic seizures, amplifying under the influence of emotional factors. Neurofeedback is a nonpharmacological method of epilepsy treatment with objective registration, amplification, and "feedback" of physiological information to the patient. This method is based on the principle of self-identification of one's own EEG data.

Based on the information from different authors, using neurofeedback can lead to a great reduction in the number of seizures in 50% cases of patients with epileptic risk factors. From this 50%, in 10% of cases, it is possible to completely discontinue AEDs without reappearance of epileptic seizures for 2–3 years and more, and in the remaining 40–50% of cases after the use of the neurofeedback method, it is possible to have pharmacological treatment [15].
