[Betolepsy in patients with multiple lesions of major cerebral blood vessels]

The reported cases of betolepsy, namely convulsive fits and syncopal attacks induced by cough were observed in patients suffering from different pulmonary diseases, vegetovascular dystonia, and venous encephalopathy. The extracerebral mechanism occurring by the Valsalva type related to the lowering of cardiac output and blood supply to the brain was assumed to be implicated in the origin of betolepsy. In the described group of the patients with multiple occlusive lesions of the cerebral arteries, the pathogenesis of betolepsy is obviously connected with a decrease of the arteriovenous gradient of cerebral circulation to the level close to the critical one. In this case, enhancement of the cerebral blood flow attained by different approaches including reconstructive operations on cerebral vessels rather than administration of anticonvulsants is an effective means of counteracting betolepsy.