What it is: epilepsy is a mental nerve disease that is characterized by recurring seizures and is accompanied by various paraclinical and clinical symptoms.
At the same time, in the period between the attacks, the patient may be completely normal, no different from other people. It is important to note that a single seizure is not yet epilepsy. A person is diagnosed only when there are at least two seizures.
The disease is known from ancient literature, Egyptian priests (about 5000 years BC), Hippocrates, doctors of Tibetan medicine, etc. mention it. In the CIS, epilepsy is called "epilepsy", or simply "epilepsy."
The first signs of epilepsy can occur between the ages of 5 and 14 years and have an increasing character. At the beginning of development, a person may have mild seizures at intervals of up to 1 year or more, but over time, the frequency of seizures increases and in most cases reaches several times a month, their nature and severity also changes with time.
What it is? The causes of epileptic activity in the brain, unfortunately, are not yet sufficiently clear, but are presumably related to the structure of the membrane of the brain cell, as well as the chemical characteristics of these cells.
Epilepsy is classified because of its occurrence on idiopathic (if there is a hereditary predisposition and no structural changes in the brain), symptomatic (if a structural defect of the brain is detected, for example, cysts, tumors, hemorrhages, malformations) and cryptogenic (if it is not possible to identify the cause of the disease ).
According to WHO data worldwide, about 50 million people suffer from epilepsy - this is one of the most common neurological diseases on a global scale.
Symptoms of epilepsy
In epilepsy, all the symptoms occur spontaneously, less often provoked by bright blinking light, a loud sound or fever (a rise in body temperature above 38 ° C, accompanied by chills, headache and general weakness).
- Manifestations of a generalized convulsive seizure lie in general tonic-clonic convulsions, although there may be only tonic or only clonic convulsions. A patient falls ill during a seizure and often suffers significant damage, very often he bites his tongue or misses urine. The seizure basically ends with an epileptic coma, but epileptic agitation also occurs, accompanied by a twilight clouding of consciousness.
- Partial seizures occur when a center of excessive electrical excitability is formed in a particular area of the cerebral cortex. Manifestations of a partial attack depend on the location of such a focus - they can be motor, sensitive, autonomic and mental. 80% of all epileptic seizures in adults and 60% of seizures in children are partial.
- Tonic-clonic seizures. These are generalized convulsive seizures that involve the cerebral cortex in the pathological process. The seizure begins with the fact that the patient freezes in place. Further, the respiratory muscles are reduced, the jaws are compressed (the tongue can bite). Breathing can be with cyanosis and hypervolemia. The patient loses the ability to control urination. The duration of the tonic phase is approximately 15-30 seconds, after which the clonic phase occurs, at which rhythmic contraction of all muscles of the body occurs.
- Absansy - bouts of sudden blackouts of consciousness for a very short time. During a typical abscess, a person suddenly, absolutely for no apparent reason for himself or others, ceases to react to external irritants and completely freezes. He does not speak, does not move his eyes, limbs and torso. Such an attack lasts a maximum of several seconds, after which it also suddenly continues its actions, as if nothing had happened. The seizure remains completely unnoticed by the patient.
In the mild form of the disease, seizures occur rarely and have the same character, in severe form they are daily, occurring in succession 4-10 times (epileptic status) and have a different character. Also, the patients have personality changes: flattery and softness alternate with malice and pettiness. Many have mental retardation.
Usually, an epileptic seizure begins with the fact that a person has convulsions, then he ceases to control his actions, in some cases he loses consciousness. Once there, you should immediately call an ambulance, remove all piercing, cutting, heavy objects from the patient, try to lay him on his back, with his head thrown back.
If vomiting is present, it should be planted, slightly supporting the head. This will prevent vomit from entering the respiratory tract. After improving the condition of the patient can drink a little water.
Intericidal manifestations of epilepsy
Everyone knows such manifestations of epilepsy as epileptic seizures. But, as it turned out, increased electrical activity and convulsive readiness of the brain do not leave sufferers even in the period between attacks, when, it would seem, there are no signs of illness. Epilepsy is dangerous in the development of epileptic encephalopathy — in this condition, the mood worsens, anxiety appears, and the level of attention, memory, and cognitive functions decrease.
This problem is especially relevant in children, because can lead to a lag in development and interfere with the formation of skills in speech, reading, writing, counting, etc. As well as improper electrical activity between attacks can contribute to the development of such serious diseases as autism, migraine, attention deficit hyperactivity disorder.
Life with epilepsy
Contrary to popular belief that a person with epilepsy will have to limit himself in many ways, that many roads in front of him are closed, life with epilepsy is not so strict. The patient himself, his family and others must be remembered that in most cases they do not even need disability registration.
The key to a full life without restrictions is the regular uninterrupted reception of drugs selected by the doctor. Drug-protected brain is not as susceptible to provocative effects. Therefore, the patient can lead an active lifestyle, work (including at the computer), do fitness, watch TV, fly on airplanes and much more.
But there are a number of activities that are essentially a “red rag” for the brain of a patient with epilepsy. Such actions should be limited:
- car driving;
- work with automated mechanisms;
- swimming in open water, swimming in the pool without supervision;
- self-cancellation or skipping pills.
And there are also factors that can cause an epileptic seizure, even in a healthy person, and they too should be wary:
- lack of sleep, work in night shifts, daily operation.
- chronic use or abuse of alcohol and drugs
Epilepsy in children
It is difficult to establish the true number of patients with epilepsy, since many patients do not know about their disease or hide it. In the United States, according to recent studies, at least 4 million people suffer from epilepsy, and its prevalence reaches 15–20 cases per 1000 people.
Epilepsy in children often occurs when the temperature rises - about 50 out of 1000 children. In other countries, these figures are probably about the same, since the incidence does not depend on gender, race, socio-economic status or place of residence. The disease rarely leads to death or gross violation of the physical condition or mental abilities of the patient.
Epilepsy is classified according to its origin and seizure type. By origin, there are two main types:
- idiopathic epilepsy, in which the cause can not be identified;
- symptomatic epilepsy associated with a specific organic brain damage.
In about 50-75% of cases, idiopathic epilepsy occurs.
Epilepsy in adults
Epileptic seizures that appear after twenty years, as a rule, have a symptomatic form. The causes of epilepsy can be the following factors:
- head injuries;
- brain abscess;
- meningitis, encephalitis, or inflammatory granulomas.
Symptoms of epilepsy in adults manifest in various forms of seizures. When an epileptic focus is located in well-defined areas of the brain (frontal, parietal, temporal, occipital epilepsy), this type of seizure is called focal or partial. Pathological changes in the bioelectrical activity of the whole brain provoke generalized epilepsy episodes.
Based on the description of the attacks by people who observed them. In addition to interviewing parents, the doctor carefully examines the child and prescribes additional examinations:
- MRI (magnetic resonance imaging) of the brain: allows you to exclude other causes of epilepsy;
- EEG (electroencephalography): special sensors, superimposed on the head, allow you to record the epileptic activity in different parts of the brain.
Epilepsy is she treated
Anyone suffering from epilepsy is tormented by this question. The current level in achieving positive results in the treatment and prevention of disease, suggests that there is a real opportunity to save patients from epilepsy.
In most cases, after a single attack, the prognosis is favorable. Approximately 70% of patients during treatment comes remission, that is, seizures are absent for 5 years. In 20-30% of the attacks continue, in such cases it is often required the simultaneous appointment of several anticonvulsants.
The goal of treatment is to stop epileptic seizures with minimal side effects and to guide the patient so that his life is as full and productive as possible.
Before prescribing antiepileptic drugs, the doctor should conduct a detailed examination of the patient - clinical and electroencephalographic, supplemented with an analysis of the ECG, kidney and liver function, blood, urine, CT or MRI data.
The patient and his family should receive instructions on taking the drug and be informed about the actual achievable results of treatment, as well as possible side effects.
Principles of treatment of epilepsy:
- Compliance with the type of seizures and epilepsy (each drug has a certain selectivity for one type of seizure and epilepsy);
- Whenever possible, use monotherapy (use of a single antiepileptic drug).
Antiepileptic drugs are chosen depending on the form of epilepsy and the nature of the attacks. The drug is usually prescribed in a small initial dose with a gradual increase until the optimum clinical effect. With the ineffectiveness of the drug, it is gradually canceled and the next one is appointed. Remember that under no circumstances should you change the dosage of the medicine yourself or stop the treatment. A sudden change in dose can cause deterioration and an increase in seizures.
Drug treatment is combined with a diet, determining the mode of work and rest. Patients with epilepsy recommend a diet with a limited amount of coffee, hot spices, alcohol, salty and spicy foods.
- Anticonvulsants, another name for anticonvulsants, reduce the frequency, duration, in some cases completely prevent seizures.
- Neurotropic medications - can inhibit or stimulate the transmission of nervous arousal in different parts of the (central) nervous system.
- Psychoactive substances and psychotropic drugs affect the functioning of the central nervous system, leading to changes in the mental state.
- Racetam is a promising subclass of psychoactive nootropic substances.
- Voight method;
- Osteopathic treatment;
- Ketogenic diet;
- The study of the influence of external stimuli that affect the frequency of attacks, and the weakening of their influence. For example, the frequency of attacks can be influenced by the daily routine, and it may be possible to establish an individual connection, for example, when wine is used, and then it is washed down with coffee, but this is all individually for each patient's body with epilepsy;