In clinical practice, a classification of three varieties of epileptic seizures is most often used.
- The first group includes primary and secondary generalized seizures, with primary no focal signs are detected, in contrast to secondary.
- The second group consists of focal or partial seizures.
- The third group includes a seizure of non-classical type epilepsy.
Most often, the disease begins to develop in childhood or infancy, when the child has paroxysms:
- spasmophilic type;
- hypoglycemic type;
- febrile type.
A seizure of a generalized type can be foreseen by the patient in a few days. The level of irritability increases, the mood is destabilized, and a severe headache occurs.
The initial clinic is as follows: tonic convulsions appear with a distortion of the face and blueness, the patient bites his tongue. Associated Phenomena:
- rapid breathing;
- lack of reaction of the pupil to light.
After a seizure, a person’s muscles relax, consciousness is impaired, he falls asleep. The seizure can last from 2 to 30 minutes, a person does not remember what happened to him at that time. In childhood, epilepsy can occur only in convulsions:
Attacks can be single or serial, which drag on up to 5 hours. There are minor seizures – absences, they are short-term and can cause loss of consciousness up to 100 times a day.
The mechanism of occurrence of an attack is determined by the functional interaction of two indicators of the brain: a convulsive focus (a zone of structural damage to GM, in the place of which irritation of nerve cells of the motor zone or convulsive swelling may occur) and convulsive readiness (the likelihood of excitation in the cerebral cortex is higher than the level of ability of the anticonvulsant GM system to work) .
In the first case, irritation of the problem area leads to convulsive contractions of the skeleton muscles. Excitation of a part of the brain can spread throughout the entire cortex of GM, which leads to loss of consciousness.
In the second case, the frequency and severity of seizures is determined by the anatomical features of the KGM structure (the higher the seizure readiness, the easier it is to provoke a seizure).
Epileptic seizures can occur quite multifaceted – from general seizures to a barely noticeable several-second loss of consciousness.
Sometimes there are visual hallucinations (sensation of a change in the shape of objects), twitching of the eye, discomfort in the abdomen, tingling in the finger, trance state, short-term speech deprivation and the like.
There are more than 30 types of epileptic seizures.
The international classification of epileptic seizures distinguishes generalized (extends to all areas of GM) and partial (focal, focal) seizures.
They are divided into subspecies: absences, tonic-clonic seizures, complex and simple partial seizures, etc.
Usually it has the following symptoms: fever, anxiety, anxiety, sound, taste, visual hallucinations, abdominal discomfort, deja vu for no reason or unrecognizability of the previously seen, dizziness.
This is epilepsy, in which the attack covers both hemispheres of GM.
Generalized include tonic-clonic seizures, absences.
Similar attacks are diagnosed in 40% of patients with epilepsy.
They are accompanied by a loss of consciousness, tension of the trunk, legs, arms (tonic convulsions), twitching of the body and limbs (clonic convulsions).
It is sometimes possible to hold your breath for a short time, but suffocation as a result does not occur. The attack lasts 1-5 minutes usually. After a seizure, the patient may sleep for some time, feel some stupor, lethargy, less often – a headache.
If there was a focal seizure or aura before tonic-clonic, then the manifested symptoms are defined as a partial seizure with secondary generalization.
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- Causes of the disease
- Interictal manifestations of epilepsy
- Main features
- Minor attacks
- Types and classification of pathology
- Epilepsy development factors
- First Aid Seizure
- Epilepsy Complications
- Life with epilepsy
- First A >
- Partial seizure
- Folk remedies
- Epilepsy Therapy
These are short-term blackouts (1-30 sec), not accompanied by convulsions.
the first signs of epilepsy in children – absences
Abscesses can occur quite often – up to 100-300 seizures per day.
But they are rarely noticed by others, attributing them to a pensive state.
Aura does not occur before this type of attack.
During the seizure, the movement of the epileptic abruptly stops, the gaze freezes (becomes lifeless and empty), there is no reaction to the outside world.
Sometimes there are rolling of the eyes, a change in the color of the skin on the face.
After this kind of “pause”, the person continues to move, as if nothing had happened.
The first signs of epilepsy in children are most often these are abscesses. May develop into more complex forms of seizures over time.
Most characteristic of adolescence (a large chance of occurrence during puberty and up to 20 years).
It is characterized by very sharp and quick twitching of the hands, sometimes accompanied by a tonic or tonic-clonic attack. The patient, as a rule, remains conscious.
Often this type of seizure occurs several hours after waking up or up to 1-2 hours before bedtime.
Additionally, increased photosensitivity is noted.
Myoclonic epilepsy is relatively easy to treat.
They arise as a result of paroxysmal electrical activity in a separate section of the GM. Found in 60% of patients with epilepsy. Distinguish between simple and complex partial attacks:
- During simple attacks, a person retains consciousness. Manifested by twitching or discomfort in certain parts of the body. Often simple partial seizures resemble an aura.
- Complex attacks are characterized by impaired consciousness and pronounced motor disorders.
For the treatment of partial seizures, a neurological examination of the problem area of the brain is performed to exclude possible concomitant diseases.
Signs of rolandic epilepsy occur in children 6-12 years old. Partial symptoms are manifested (swallowing, twitching of the corner of the mouth, salivation). Usually occur during sleep.
In the event of an epileptic status, urgent delivery to the intensive care unit is necessary.
This condition is consciously or unconsciously caused by the person himself, outwardly very similar to a real attack. Often pseudo-occurrence arises in tense situations or with a lack of attention.
Basically, an attack mimics a child or female body, with hysteria, conflicts, certain mental abnormalities.
After pseudo-attacks, a person very quickly returns to a normal state. It is extremely rare that there will be any damage to the body or further negative psychological manifestations. With the help of EEG, pseudo-occurrence can be detected.
It is extremely important to diagnose this seizure in a timely manner so that the “patient” does not begin drug treatment without real need.
Pediatric epilepsy is very different from the course of the disease in adults.
Signs of epilepsy in infants are such – tonic seizures are noted (in connection with the predominant functioning of the stem parts of the brain). Very often they are confused with the usual motor activity of the child.
Children’s spasm (2-5 years) is manifested by involuntary bringing the hands to the chest, tilting the body or head forward, straightening the legs. Most often, an attack can happen in the morning, after waking up; lasts a few seconds.
Sometimes a spasm is localized in a small area of the muscles (expressed, for example, by involuntary nods of the head). By the age of 6, seizures can either stop or develop into another type of epilepsy.
Clonic (atonic) seizures occur at the age of 7-15 years.
In this case, the symptoms of epilepsy in children are characterized by a sudden loss of consciousness (as a result of relaxation of all muscle groups). From the side it may look like a regular fainting.
Other possible signs of epilepsy in children:
- nightmares, awakenings with tears and screams;
- headaches (sharp, accompanied by vomiting and nausea);
- short-term inability to speak, answer questions.
Of course, the presence of the latter symptoms does not necessarily indicate epilepsy. However, if you have certain suspicions – it is better to consult with your doctor in addition, go through an examination if necessary.
The manifestation of epilepsy can be associated with very different types of seizures.
The classification of these types is as follows:
primary and secondary epilepsy;
during an attack (an attack accompanied or not accompanied by loss of consciousness);
excessive electrical activity (deep parts of the brain, cortex of the left or right hemisphere).
Generalized attacks are accompanied by a complete loss of consciousness and the inability to control the actions performed. This is due to excessive activation of the deep departments and the subsequent involvement of the brain as a whole. This condition is not necessarily accompanied by a fall, since muscle tone is not violated in all cases.
In a tonic-clonic attack, tonic muscle tension of all groups occurs first, followed by a fall, after which the patient has rhythmic flexion-extensor movements in the jaw, head, and limbs (the so-called clonic convulsions).
Abscesses are manifested, as a rule, in childhood and are accompanied by a suspension of the child’s activity – his gaze loses consciousness, it seems to freeze in one place, in some cases this can be accompanied by twitching of the facial and eye muscles.
Partial epileptic seizures occur in 80% of adults and in 60% of cases in children. They appear when a focus of excessive electrical excitability is formed in a particular area of the cerebral cortex. Depending on the place where such a focus is located, the manifestations of a partial attack also differ: sensitive, motor, mental and autonomic.
Causes of the disease
We have already said that there are two types of epilepsy: symptomatic and idiopathic. Most often, symptomatic epilepsy is partial, and idiopathic is generalized. This is due to various reasons that cause them. In the nervous system, signals between nerve cells are transmitted using an electrical impulse generated on the surface of all cells.
in the end, it manifests itself as a convulsive readiness, capable of “enslaving” the cortex of all hemispheres at any time and leading to an attack.
Partial epilepsy is characterized by the formation of a focus with epileptic nerve cells in a single cerebral hemisphere. These cells form an excess electric charge. In response to this, healthy antiepileptic structures form a “protective shaft” near a similar focus. Convulsive activity is restrained until a certain point, but the culmination occurs when epileptic discharges break out beyond the borders of the shaft and take the form of an attack. Most likely, a second attack will come after some time, since the “road” is now open to him.
insufficient development of brain structures – appears not as a result of genetic rearrangements (as in the case of idiopathic epilepsy), but during fetal maturation, it can be detected on MRI;
infections of the central nervous system (meninencephalitis, encephalitis, brain abscess);
taking a number of medications (antipsychotics, antidepressants, bronchodilators, antibiotics);
drug use (especially cocaine, amphetamines, ephedrine);
a number of hereditary metabolic diseases.
In most cases, the disease occurs for no apparent reason (idiopathic form), a genetic predisposition plays a role. If the cause of epilepsy can be established, then this is a secondary form of the disease.
Why does secondary epilepsy occur:
- Traumatic brain damage (traumatic brain injury).
- Intranasal pathology – acute fetal hypoxia at birth, birth injury.
- Tumors of the brain.
- Infections of the central nervous system: meningitis, encephalitis.
- Postponed ischemic or hemorrhagic stroke.
With epilepsy, the seizures are repeated, their occurrence can be associated with a number of factors – the menstrual cycle, fatigue, physical stress, strong emotions and stress, taking alcohol or drugs, lack of sleep.
Often, patients think about what causes epilepsy, because this is a very dangerous disease that requires immediate treatment. There are three main groups of factors that can contribute to its development: 1. Idiopathic – the disease is transmitted through the hereditary path, even through dozens of generations. There are no organic lesions, but a specific reaction of neurons is present.
This form is inconsistent, often attacks occur for no reason; 2. Symptomatic – there is always a reason for the development of foci of pathological arousal. The occurrence of epilepsy can occur after injuries, cysts, tumors, intoxication. This form is the most unpredictable; a seizure can develop from the slightest irritant. 3.
It is these groups that can explain the onset of disease symptoms in patients of different ages. To protect yourself, you need to know who is most exposed to this ailment.
An unequivocal answer to the question of what happens epilepsy does not exist, since it arises from many different reasons. This ailment is not a hereditary disease, but in those families where one of the relatives suffered from it, the likelihood of illness increases significantly. According to statistics, more than forty percent of patients have relatives suffering from epilepsy.
There are several types of seizures, which are accompanied by different severity and consequences. An attack in the formation of which only one part of the brain is to blame is called partial. If the whole brain suffers, then this is a generalized seizure. There are mixed seizures, as a rule, they begin with one part, gradually covering the other.
In almost seventy percent of cases, what causes epilepsy is unknown. But the following causes of the disease are quite common: stroke, trauma to the skull, tumor or abscess of the brain, oxygen deficiency, meningitis, viral and parasitic diseases, hereditary factors. It all depends on the age at which epileptic seizures occur, if they appeared before twenty years, perhaps the reason lies in brain damage during childbirth.
Why epilepsy develops, and what are the causes of its occurrence in adults, are of interest to many people. Can provoke the debut of the disease:
- genetic predisposition;
- traumatic brain injuries of varying severity (concussion, injury, contusion, concussion);
- cerebrovascular accident and organic changes in the brain structures (stroke, atherosclerosis, etc.);
- infectious diseases affecting brain tissue;
- parasitic diseases of the central nervous system;
- neurodegenerative pathologies of the nervous system;
- severe brain intoxication as a result of inflammation provoked by prolonged use of alcohol or drugs;
- diseases caused by impaired metabolic processes;
- tumor formations related to nerve tissue.
The first signs of epilepsy in mature women may be due to hormonal failure caused by menopause. In girls, the pathology often manifests itself during pregnancy. In men, the cause of the disease can be low testosterone or alcohol abuse. Children are faced with a “lap” with:
- pathologies of intrauterine development;
- prolonged fetal hypoxia;
- birth injuries;
- poisoning with toxic substances;
- mental disorders, neurosis, overstrain of the nervous system.
If we talk about what can provoke an attack of epilepsy, then the patient should avoid:
- flickering light;
- loud intermittent sound;
- insomnia and lack of sleep;
- frequent stress;
- depressive state;
- psycho-emotional shocks;
- taking certain medications;
- drinking alcohol;
- unnatural (too deep or too frequent) breathing;
- some types of physiotherapy.
The risk group includes:
- People whose brain is affected by infections, vascular diseases (for more details, see the description of symptomatic epilepsy).
- With abnormalities in the development of the brain.
- Whose family members (s) suffer from this disease.
- Whose activity is associated with possible head injuries (various types of wrestling, construction).
- Older than 60 years (due to weakened immunity, increased risk of problems with GM vessels).
- Children under 12 years of age (increased likelihood of injuries, an active period of infectious diseases – chickenpox, measles – which can adversely affect the work of GM).
Interictal manifestations of epilepsy
The danger of epilepsy is that epileptic encephalopathy can develop, that is, a condition in which mood decreases, anxiety appears, the level of memory, attention and cognitive functions decreases. This problem is especially acute in children, since it can cause a developmental delay and impede the formation of reading, speaking, speaking, writing, and so on.
As a rule, the symptoms are individual in each case. It depends on the affected areas of the brain. Symptoms are directly related to the functions that these departments perform. With the disease, the following disorders can occur: • motor disorders • speech is disturbed • decline or increase in muscle tone • dysfunction of various mental processes.
The main set of signs depends on what kind of epilepsy happens in a particular case. There are several types of illness.
In this case, pathological irritation is localized in a certain area of the brain, without affecting neighboring areas. That is why symptoms appear on certain muscle groups. Typically, such disorders do not last long, a person is fully conscious, but at the same time loses contact with the outside world. The patient does not accept help from outsiders, as he is not aware of a dysfunction. The seizure lasts several minutes, then the condition returns to normal.
The attack is accompanied by convulsive twitching or numbness of the hands, feet, lower leg. Therefore, there are several answers to the question of what causes epilepsy. Over time, numbness can spread throughout the body, causing a seizure, or as it is also called generalized. A large attack consists of phases that replace each other: 1.
Harbingers – before the epileptic seizure of the patient, an anxiety state covers, then nervous excitement gradually increases. 2. Tonic cramps – they are characterized by a sharp contraction of the muscles, as a result of which the patient falls off balance. A person has difficulty breathing, his face turns blue. This phase lasts about a minute. 3.
Clonic convulsions – when all the body muscles begin to contract frantically. The patient turns blue, excessive salivation from the mouth, similar to foam. To understand how often epilepsy attacks occur, it is recommended to undergo a specialist examination. 4. Stop – strong inhibition begins, the patient’s muscles completely relax, involuntary excretion of urine, feces is observed. A similar attack can last for half an hour.
After departing from an epileptic seizure, a person will be tormented for three days by weakness, the presence of headaches, motor impairments is possible.
Small seizures are weaker. Often, symptoms are expressed by a reduction in facial muscles, a sharp drop in their tone, or vice versa, tension. Then the patient either loses balance, falling sharply, or freezes in one position, while his eyes roll back. Consciousness is fully preserved. After the attack, he does not remember what happened.
In mild forms, epilepsy in adults can be hidden. Short-term loss of consciousness, some convulsive movements are perceived as an echo of overwork or stress. The more severe stage of the disease proceeds with pronounced signs: convulsions and seizures.
A few days before the attack, the mood changes, apathy, nervousness, irritability, nausea appear. A person has a headache, blood pressure rises, general well-being worsens, tingling of hands or feet may occur, the sense of smell and taste may change. Experienced epileptics perfectly recognize the pre-epileptic syndrome (aura) and foresee the impending “storm”.
Not every seizure is regarded as epileptic. You can distinguish it by the following criteria:
- sudden occurrence at any time of the day;
- short duration. The duration of the episode can vary from a few seconds to several minutes;
- self completion. Epipressure does not require external intervention, as it terminates independently;
- propensity for regularity and increase in frequency. In the absence of proper treatment, convulsions, repeated once a month, occur more often and more with time;
- similarity of episodes. Often, the patient each attack is no different from the previous one.
Signs of a neurological disorder in infants and young children are not particularly different from the clinical symptoms of the disease in adults. Observed:
- spontaneous emptying of the bladder or intestines;
- breath holding
- lack of response to stimuli;
- head tilting;
- sharp rolling eyes;
- fading (freezing).
Scientists claim that the onset of the disease is due to the presence of a stable focus with epileptic activity due to organic damage to the brain. If a person has a primary focus, then convulsive activity spreads through:
- cortical neural complexes;
- commissural fibers;
- the brain brain system.
Long convulsive activity can provoke the development of secondary foci, which, under the influence of certain factors, can become independent and independent. This will lead to the fact that one attack in the primary focus fades, but in the secondary – not. This pattern is observed in patients after 2 years of illness, and tertiary foci of convulsive activity may develop over some time.
Epilepsy can occur due to the interaction of a number of reasons. At the heart of the pathology is a violation of metabolic processes in the brain. As a result, nerve fibers become excessively excitable, which contributes to the emergence of a strong discharge, leading to a seizure.
The following causes of the development of epilepsy can be distinguished:
- hereditary predisposition: if parents have a history of convulsive symptoms, then the child is more likely to develop them;
- infectious brain damage;
- underdevelopment of brain structures;
- birth trauma that causes oxygen starvation in the cells and tissues of the brain.
Provoking factors include:
- hormonal failures;
- alcoholism and drug addiction;
- constant stressful situations;
- severe mental strain;
- chronic overwork.
Epilepsy with convulsive seizures may not be the primary, but secondary symptoms of other disorders in the human body that appear due to:
- brain tumors;
- vascular abnormalities;
- hemorrhages in the head area;
- poisoning by harmful components.
It is very important to identify the disease in the early stages to reduce the likelihood of complications. Which doctor treats epilepsy? For quality therapy, it is necessary to be observed by a neurologist, epileptologist, psychotherapist. As clinical symptoms progress, the help of a physiotherapist or pharmacologist may be required.
The course of the pathology is paroxysmal, after the seizure is completed, cognitive abnormalities and other non-specific symptoms may be noted. The clinical picture of the disease depends on the type of attack: partial or generalized. In addition, the severity and localization of the focus are taken into account.
A partial attack has the following symptoms in adults:
- at the initial stage, nausea, dizziness, weakness, tinnitus appear;
- with a simple seizure, the patient is conscious, with a complex one – unconscious.
Further such deviations appear:
- motor: local cramps with the defeat of one of the sides – right or left, face, lower and upper limbs;
- Sensitive: numbness in the whole body or in its separate parts, hallucinations may appear;
- autonomic: redness or pallor of the skin, excessive sweating, dizziness, compression of the chest;
- mental deviations can lead to a loss of a sense of reality, cause the appearance of strange thoughts and fears, and provoke aggression.
What to do with an attack of epilepsy? A neurologist can answer this question. The patient must provide first aid and call an ambulance. This can be artificial respiration, prevention of swallowing of the tongue, release of the airways, it is necessary to put a person in a comfortable position, taking into account muscle tension.
A generalized seizure appears suddenly, the patient is in an unconscious state. He may have convulsions:
- tonic – muscle structures are in good shape, they are petrified, all muscles are involved in the lesion process, which leads to a fall. This type of seizure is rarely diagnosed;
- clonic – are manifested by rap >
Alcoholic epilepsy can occur with or without convulsive abnormalities. The main symptoms before the attack: pallor and cyanosis of the upper body. After this comes a fit.
Parents can not always suspect the onset of an attack in the baby, as he can behave restlessly most of the time. Up to 1 year, a child may have three types of seizures:
- Small fit. The kid throws back his head and freezes in one pose. His gaze is directed to one point, he does not respond to sound and stroking, it is possible to increase body temperature, rolling his eyes.
- A large seizure of epilepsy leads to the fact that the whole baby is elongated, his legs bend sharply, he takes the pose of an embryo, there is a loss of consciousness, convulsions and respiratory arrest.
- Night attacks are quite common, they are characterized by unexpected awakening, crying out. The baby’s face changes; after the attack, the baby cannot fall asleep for a long time.
Children with epilepsy may experience symptoms such as developmental delay from peers, poor memory, and mental disorders.
Temporal epilepsy is characterized by the fact that the focus of epileptic activity is in the temporal lobe of the brain. It includes simple and complex partial epiprises, the further progression of the disease leads to secondary generalization and the occurrence of mental disorders.
Structural focal epilepsy occurs most often, its debut covers a wide age range, the lesion focus is in the temporal zone of the brain. Pathology can provoke a person’s feeling of acceleration or slowness of time, a familiar environment can be perceived as a new one, and a new incident as a long-lived experience.
Types and classification of pathology
There are no two patients in whom the disease proceeds absolutely identically. Epilepsy is a multifaceted disease, and it has a lot of varieties:
- Symptomatic It is characterized by local and generalized seizures due to organic changes in the brain (tumor growth, head trauma).
- Cryptogenic. It is accompanied by vivid signs of epilepsy in adult women and men, but without an identified cause. It occurs in 70% of patients. The most common subspecies is cryptogenic focal epilepsy. Her exact focus is established during the examination.
- Idiopathic. Symptoms are manifested due to dysfunction of the central nervous system without organic changes related to brain structures.
- Alcoholic It occurs due to toxic damage to the body due to abuse of alcoholic beverages. Another binge can end for an alcoholic with an attack of epilepsy during a hangover.
There is also a non-convulsive, manifested by several subspecies of epilepsy:
- sensory seizures without loss of consciousness, in which vision, hearing, taste, smell are disturbed, and dizziness is also observed;
- vegetative-visceral seizures characterized by indigestion. The patient begins pain in the stomach, reaching the throat, nausea, vomiting, a malfunction of the cardiac and respiratory system;
- mental attacks, accompanied by impaired speech, memory, consciousness, thinking.
According to the localization of foci, they distinguish:
- temporal lobe epilepsy, accompanied by generalized seizures with loss of consciousness and simple local episodes;
- parietal epilepsy, in which focal simple seizures are recorded. Its first symptoms include impaired perception of the body, dizziness, visual illusions;
- frontotemporal epilepsy with the presence of an abnormal focus in the frontal and temporal lobe. It can cause both complex and simple attacks with a lack of consciousness and without its loss.
At the time of debut, the form of the disease occurs:
- Congenital, manifested against the background of abnormal fetal development.
- Acquired. It manifests itself as a result of the influence of negative factors affecting the integrity and functionality of the central nervous system.
There is nocturnal epilepsy when seizures occur in a dream. During the period of brain activity, a person can bite his tongue, scratch his body, hit his head, and in the morning do not remember anything about what happened. As a rule, this type of disease over time flows into the daily form.
According to the international classification of epileptic seizures, partial (local, focal) forms and generalized epilepsy are distinguished. Attacks of focal epilepsy are divided into: simple (without impaired consciousness) – with motor, somatosensory, autonomic and mental symptoms and complex – accompanied by impaired consciousness. Primary generalized seizures occur with the involvement of both cerebral hemispheres in the pathological process. Types of generalized seizures: myoclonic, clonic, absences, atypical absences, tonic, tonic-clonic, atonic.
There are unclassified epileptic seizures – not suitable for any of the above types of seizures, as well as some neonatal seizures (chewing movements, rhythmic eye movements). Repeated epileptic seizures (provoked, cyclical, random) and long seizures (epileptic status) are also distinguished.
Epilepsy development factors
In some cases, the genetic defect does not take the form of idiopathic epilepsy and the person is not exposed to the disease. However, if “favorable” conditions arise (one of the above conditions or diseases), some form of symptomatic epilepsy may appear. Moreover, in young people in most cases
and in elderly people – as a result of a stroke or brain tumors.
First Aid Seizure
Many people get lost if they suddenly witness an epileptic seizure. They act intuitively, trying to help the victim and sometimes making the most unacceptable and dangerous actions for the patient. Experienced epileptics communicate on forums and remember about teeth knocked out by metal objects, a tormented tongue and other injuries sustained during the implementation of the “first aid” by caring passers-by. In order to prevent such errors, you should find out what to do if a person has an epiprote:
- Do not panic and immediately call an ambulance if the attack does not end longer than three minutes;
- turn the victim on his side and try to protect his head from involuntary blows on a hard surface;
- put something soft under your head;
- if the patient regained consciousness, stay close to him until he finally orientates himself in the space surrounding him.
When epiprote is impossible:
- stick fingers in your mouth, trying to get your tongue out;
- try to hold the patient, grab him by the arms or legs;
- put an object in your mouth;
- open the jaw;
- pour water on the victim;
- screaming, beating on the cheeks, bringing him to life;
- try to drink or give medicine.
If an attack occurs that threatens a person’s life, turn him over on his stomach, place a pillow under his head. If vomiting occurs, turn it on its side (so that the masses do not get into the airways).
Insert something firm between the teeth (so that the tongue does not bite). Do not give him water, do not keep him in a certain position by force.
Be sure to call a doctor.
Read in more detail how to provide first aid for a seizure of epilepsy.
If the epileptic seizure lasts longer than half an hour or if the seizures follow one after another, while the patient is unconscious, this condition is called status epilepticus. This condition in most cases occurs if you sharply stop taking antiepileptic drugs.
, as well as coma on the background of cerebral edema.
It is worth noting such:
- an increase in the number of seizures, up to epileptic status;
- aspiration pneumonia (caused by the ingestion of foreign objects, food particles, vomit during an attack);
- sudden death (especially during an attack with extensive cramps, or a seizure in water, extreme forms of rest)
- injuries (in the fall);
- an attack in a pregnant woman threatens the development of defects in the fetus;
- negative emotional states, asociality.
Timely diagnosis of the disease is a step towards recovery!
The prognosis for disability in epilepsy depends on the frequency of seizures. At the stage of remission, when seizures occur less frequently and at night, the patient’s ability to work is preserved (with the exception of night shift work and business trips). Daytime seizures of epilepsy, accompanied by loss of consciousness, limit the patient’s ability to work.
Epilepsy affects all aspects of the patient’s life, therefore it is a significant medical and social problem. One of the facets of this problem is the scarcity of knowledge about epilepsy and the associated stigmatization of patients, whose judgments about the frequency and severity of mental disorders that accompany epilepsy are often unfounded. The vast majority of patients receiving the right treatment lead a normal life without seizures.
Prevention of epilepsy provides for the possible prevention of head injury, intoxication and infectious diseases, the prevention of possible marriages between patients with epilepsy, an adequate decrease in temperature in children in order to prevent fever, which can lead to epilepsy.
In general, the prognosis for the treatment of epilepsy is favorable. Even if it is impossible to completely get rid of the disease, you can stop the attacks or reduce their frequency. Many patients are helped by modern drugs that stabilize the activity of the brain. However, it is almost impossible to recover from the disease itself forever.
With refusal of treatment and uncontrolled epiprists, various complications and serious consequences appear:
- epileptic status occurs in which seizures occur one after another. As a result, there is a serious disruption of the brain. Each seizure lasting longer than half an hour irrevocably destroys a huge number of neural connections, which leads to a change in personality. Often, epilepsy in adulthood changes the nature of the patient, causes problems with memory, speech, sleep;
- the patient in the fall may get life-threatening injury.
If a person managed to stop attacks and refuse anticonvulsant drugs, this does not mean that he is absolutely healthy. To make a diagnosis, it will take at least five years, during which persistent remission persists, there are no complications, mental disorders, and encephalography does not reveal convulsive activity.
The presence of the disease can be suspected by the characteristic clinical picture (recurring epileptic seizures), but a complete examination is required to make a final diagnosis. The main diagnostic method is electroencephalography (EEG), in addition, MRI and CT of the brain, a number of general clinical studies can be prescribed.
As soon as the first symptoms of epilepsy occur in a child or adult, you need to contact a neurologist or epileptologist. Such a person needs an emergency examination and the selection of appropriate treatment. Even if it was a single attack, you should not hope that it does not happen again. The patient goes through:
- Electroencephalography. This method helps to evaluate the activity of the brain and the electrical impulses supplied by it in all parts of the head.
- MRI is a highly informative diagnostic method that gives a complete picture of the state of brain structures and the nervous system.
- Positron emission tomography – assesses the functional activity of brain tissues, examines glucose metabolism, provides information about oxygen saturation of cells, the presence of tumors and abscesses.
Diagnosis of epilepsy should be based on medical history, physical examination of the patient, EEG and neuroimaging data (MRI and CT of the brain). It is necessary to determine the presence or absence of epileptic seizures according to the medical history, clinical examination of the patient, the results of laboratory and instrumental studies, as well as to differentiate epileptic and other seizures; determine the type of epileptic seizures and the form of epilepsy. To familiarize the patient with the recommendations on the regimen, assess the need for drug therapy, its nature and likelihood of surgical treatment. Despite the fact that the diagnosis of epilepsy is based primarily on clinical data, it should be remembered that in the absence of clinical signs of epilepsy, this diagnosis cannot be made even if there is epileptiform activity detected on the EEG.
Diagnosis of epilepsy is done by neurologists and epileptologists. The main method for examining patients diagnosed with epilepsy is EEG, which has no contraindications. EEG is performed for all patients without exception in order to detect epileptic activity. More often than others, there are such variants of epileptic activity as sharp waves, adhesions (peaks), complexes “peak – slow wave”, “acute wave – slow wave”. Modern methods of computer analysis of EEG make it possible to determine the localization of the source of pathological bioelectric activity. When conducting EEG during an attack, epileptic activity is recorded in most cases; in the interictal period, EEG is normal in 50% of patients. On EEG in combination with functional tests (photostimulation, hyperventilation), changes are detected in most cases. It must be emphasized that the absence of epileptic activity on the EEG (with the use of functional tests or without them) does not exclude the presence of epilepsy. In such cases, re-examination or video monitoring of the EEG performed.
In the diagnosis of epilepsy, the most valuable of the neuroimaging methods of research is brain MRI, which is indicated for all patients with a local onset of an epileptic seizure. MRI allows you to identify diseases that affect the provoked nature of the attacks (aneurysm, tumor) or etiological factors of epilepsy (mesial temporal sclerosis). Patients with a diagnosis of pharmacoresistant epilepsy, in connection with the subsequent referral to surgical treatment, also have an MRI scan to determine the location of the central nervous system lesion. In some cases (elderly patients), additional studies are necessary: a biochemical blood test, fundus examination, ECG.
Epilepsy attacks must be differentiated with other paroxysmal conditions of a non-epileptic nature (fainting, psychogenic attacks, autonomic crises).
When the diagnosis of epilepsy is made, the main thing is to establish whether it is secondary or idiopathic (that is, to exclude the presence of the underlying disease, which is the background for the progression of epilepsy), and in addition, the type of attack. This measure is needed to correctly prescribe treatment. Directly
That is, the information that the patient’s environment can provide, people present at the manifestations of epilepsy are extremely important.
EEG (electroencephalography) – reflects the altered electrical brain activity. When an attack occurs, changes on the EEG are always visible. However, in the intervals between EEG attacks, it corresponds to the norm in
cases, therefore, provocative tests, repeated examinations and video-EEG monitoring are needed;
general and detailed biochemical analysis
CT (computed tomography) or MRI (magnetic resonance imaging) of the brain,
if there is a suspicion of a specific underlying disease in case of symptomatic epilepsy, additional examinations are required.
Life with epilepsy
Many believe that a person suffering from epilepsy is forced to limit himself in many ways, many life paths are inaccessible to him, but living with epilepsy is not so difficult. The patient himself, as well as his relatives and the people around him, should know that, as a rule, an epilepsy sufferer may not even make a disability.
A full life is ensured by regular continuous intake of medications prescribed by a doctor. The brain under the protection of medications loses its susceptibility to provoking factors. Therefore, the patient can live a full life, work (even at the computer), watch TV, play sports, fly on airplanes and so on.
work with automated mechanisms;
cancellation or skipping of the administration of tablets at will;
swimming in open water or in the pool unattended.
regular use or abuse of drugs and alcohol;
night shift work, lack of sleep, daily routine.
All methods of treating epilepsy are aimed at stopping seizures, improving the quality of life and stopping medication (at the stage of remission). In 70% of cases, adequate and timely treatment leads to the cessation of epilepsy attacks. Before prescribing antiepileptic drugs, it is necessary to conduct a detailed clinical examination, to analyze the results of MRI and EEG. The patient and his family should be informed not only about the rules for taking the drugs, but also about possible side effects. Indications for hospitalization are: for the first time in life a developed epileptic seizure, status epilepticus and the need for surgical treatment of epilepsy.
One of the principles of drug treatment of epilepsy is monotherapy. The drug is prescribed in a minimum dose, followed by its increase until the seizure stops. In case of insufficient dose, it is necessary to check the regularity of taking the drug and find out whether the maximum tolerated dose has been reached. The use of most antiepileptic drugs requires constant monitoring of their concentration in the blood. Treatment with pregabalin, levetiracetam, valproic acid begins with a clinically effective dose, with the appointment of lamotrigine, topiramate, carbamazepine, it is necessary to conduct a slow dose titration.
Treatment of newly diagnosed epilepsy begins with both traditional (carbamazepine and valproic acid) and the latest antiepileptic drugs (topiramate, oxcarbazepine, levetiracetam) registered for use in monotherapy. When choosing between traditional and latest drugs, it is necessary to take into account the individual characteristics of the patient (age, gender, concomitant pathology). Valproic acid is used to treat unidentified epilepsy attacks. When prescribing one or another antiepileptic drug, one should strive for the lowest possible frequency of its administration (up to 2 times / day). Due to the stable plasma concentration, sustained release drugs are more effective. The dose of the drug prescribed for an elderly patient creates a higher concentration in the blood than the same dose of the drug prescribed for a young patient, so it is necessary to start treatment with small doses followed by titration. Drug withdrawal is carried out gradually, taking into account the form of epilepsy, its prognosis and the possibility of the resumption of seizures.
Pharmacoresistant epilepsies (ongoing seizures, ineffectiveness of adequate antiepileptic treatment) require additional examination of the patient to resolve the issue of surgical treatment. Preoperative examination should include video-EEG recording of seizures, obtaining reliable data on the localization, anatomical features and the nature of the spread of the epileptogenic zone (MRI). Based on the results of the above studies, the nature of the surgical intervention is determined: surgical removal of epileptogenic brain tissue (cortical topotomy, lobectomy, hemispherectomy, multilobectomy); selective surgery (amygdalo-hippocampectomy for temporal lobe epilepsy); callosotomy and functional stereotactic intervention; vagus stimulation.
There are strict indications for each of the above surgical interventions. Their implementation is possible only in specialized neurosurgical clinics that have the appropriate equipment, and with the participation of highly qualified specialists (neurosurgeons, neuroradiologists, neuropsychologists, neurophysiologists, etc.).
Twenty years ago, epilepsy was considered a lifelong diagnosis, but even now the question of whether it is treatable is in the first place. Medical statistics show that regular administration of PEP (antiepileptic drugs) with a clear dosage can permanently relieve seizures or significantly alleviate the patient’s condition. Which drug to choose is decided by the neurologist after receiving the results of the tests. Of the most popular means distinguish:
- Carbamazepine (Finlepsin) – an anticonvulsant drug, normotimic belonging to the group of carboxamide derivatives. It has an analgesic, antipsychotic, antiepileptic effect.
- Oxcarbazepine (Trileptal) – is prescribed for simple and complex partial epipristes with or without loss of consciousness.
- Valproic acid (Valparin) – anticonvulsant, normotimic. Used for bipolar affective disorder, tics, epilepsy, seizures, cramping.
- Lamotrigine – used for partial and generalized seizures, tonic-clonic seizures, Lennox-Gastaut syndrome.
- Phenazepam is used for phobias, anxiety, neurasthenia, tics, insomnia, epilepsy, and disorders of the autonomic nervous system.
If the selected medicine does not have a positive effect, then the specialist will either increase the dose or prescribe another drug. Cancellation of PEP therapy occurs gradually, over a period of six months or more.
In addition to taking medications, the patient must comply with some treatment conditions:
- adhere to a proper, balanced diet;
- do not drink alcohol, do not take drugs, do not smoke;
- do not abuse strong tea and coffee;
- avoid overheating, hypothermia, overeating;
- avoid stressful situations and other irritating factors that provoke another convulsive episode.
Treatment depends on the mechanism that provokes the disease. If the disease is caused by a malfunction of the GM, then eliminating the main problem will help get rid of seizures.
If epilepsy is caused by anatomical or genetic causes, then drugs are prescribed that will help minimize seizures or even eliminate them. Sometimes an operation may be prescribed.
Regardless of the fact that this disease is dangerous and serious, with timely diagnosis and with the help of competent treatment in half the cases of epilepsy is treatable. Also, modern medicine has learned to achieve remission in eighty percent of patients. If doctors found out what causes epilepsy in a particular case and prescribed the right treatment, then in two-thirds of patients, seizures either stop altogether or fade for several years.
However, it is the second one that is most often used, since taking antiepileptic drugs is effective, it helps to achieve steady positive progress. Drug treatment is divided into several stages: 1. Differential diagnosis – necessary in order to determine what kind of epilepsy is and to choose the right medication; 2.
The patient is required to strictly comply with all the rules, namely, take the drugs at the exact time, avoid risk factors that contribute to the onset of seizures.
Doctors resort to a surgical method of treatment when symptomatic epilepsy is observed, that is, the main reason is caused by various diseases of the brain. Such a disease can be cured if you immediately consult a doctor if you identify symptoms. After all, it is very important what causes epilepsy, since treatment is prescribed, guided by the reasons.
All therapy is aimed at reducing the incidence of seizures and stopping medication during remission. According to statistics, in 70% of cases, adequately selected treatment helps to almost completely remove paroxysmal activity in patients.
How to treat epilepsy? Only the attending physician can answer this question, all therapy is selected individually, the dosage is designed for a specific case. Before prescribing drugs, the patient and his relatives are informed about possible adverse reactions.
Taking medications begins with the initial minimum dosages, which gradually increase. The following drugs are prescribed:
- succinim >
Such patients are sent for treatment in a sanatorium, especially if a history of other pathologies is present.
Idiopathic focal epilepsy is benign, it occurs due to genetic abnormalities and requires symptomatic treatment. With focal forms with a frequency of seizures of 2-3 times per month, an operation may be required with the condition that they appear in series and contribute to an increase in mental changes. This is a stereotactic procedure or a combined neurosurgical intervention.
First aid for epilepsy is very important, the right actions will help save a person’s life. It is necessary:
- give the victim the most convenient horizontal position;
- put something soft under your head;
- in the presence of severe convulsions, prevent the possibility of self-harm;
- the jaw should be unclenched and a soft tissue placed in the mouth;
- the patient must be tilted to one side, the mouth should be ajar;
- try to keep a person in this position until the arrival of a qualified team.
If necessary, you can do artificial respiration.
What to do with epilepsy? The most important thing is not to be nervous, if you feel the onset of an attack, try to take a more secure position, preferably lie down. It is worth informing friends or passersby about your condition and gaining support. Try not to leave the house at times of increased risk of a seizure.
To achieve the optimal result in treatment, patients are prescribed drugs for epilepsy of the following properties:
- anticonvulsants – contribute to muscle relaxation, they are prescribed for both adults and children;
- tranquilizers – allow you to remove or reduce the excitability of nerve fibers, agents have shown a high degree of effectiveness in the fight against small attacks;
- sedatives – help relieve nervous tension and prevent the development of severe depressive abnormalities;
- Injections – used for twilight conditions and affective disorders.
First A >
The specific signs and symptoms of epilepsy and its consequences – epileptic seizures depend on the area of the brain lesion (focal or generalized epilepsy) and how far it has spread.
In addition to the “generally accepted” seizure, there may be temporary symptoms: disorientation, loss of consciousness, motor disorders, disturbances in the taste, sound or visual perception, sudden changes in mood, aggressiveness, numbness of the body part – typical for focal lesions.
Generalized epilepsy manifests itself in the form of convulsive seizures throughout the body, short-term respiratory arrest, twitching, biting of the tongue, screaming, and urinary incontinence. It can occur without convulsions (trembling of the eyelids, a slight throwing of the head, inability to look away from one point).
Also, people with epilepsy are more likely to suffer from fractures, their skin is more prone to damage.
Their immunity is less resistant to other diseases, they can often suffer from psychoemotional disorders (depression, anxiety), their range of interests can be narrowed, their character can become more picky and petty, they easily pass from a calm state to aggression.
Vindictive, revengeful (classified as “epileptic”).
But not always signs of epilepsy in adults or children can be seen by others or defined as epileptic.
Three periods are distinguished in the clinical picture of epilepsy: ictal (period of an attack), postictal (post-attack) and interictal (interictal). In the postictal period, there may be a complete absence of neurological symptoms (except for the symptoms of the disease causing epilepsy – traumatic brain injury, hemorrhagic or ischemic stroke, etc.).
There are several main types of aura that precede a complex partial attack of epilepsy – vegetative, motor, mental, speech and sensory. The most common symptoms of epilepsy include nausea, weakness, dizziness, a feeling of constriction in the throat, a feeling of numbness of the tongue and lips, chest pain, drowsiness, ringing and / or tinnitus, olfactory paroxysms, a lump in the throat, etc. Moreover, complex partial seizures in most cases are accompanied by automated movements that seem inadequate. In such cases, contact with the patient is difficult or impossible.
A secondary generalized attack usually begins suddenly. After a few seconds that the aura lasts (each patient has a unique aura), the patient loses consciousness and falls. The fall is accompanied by a kind of scream, which is due to spasm of the glottis and a convulsive contraction of the muscles of the chest. Next comes the tonic phase of an epilepsy attack, so named for the type of seizure. Tonic cramps – the trunk and limbs are stretched in a state of extreme tension, the head tilts and / or turns to the side, the contralateral lesion focus, breathing is delayed, the veins in the neck swell, the face becomes pale with slowly growing cyanosis, the jaws are tightly compressed. The duration of the tonic phase of the attack is from 15 to 20 seconds. Then comes the clonic phase of the epilepsy attack, accompanied by clonic convulsions (noisy, hoarse breathing, foam from the mouth). The clonic phase lasts from 2 to 3 minutes. The frequency of seizures gradually decreases, after which complete muscle relaxation occurs, when the patient does not respond to stimuli, the pupils are dilated, their reaction to light is absent, protective and tendon reflexes are not caused.
The most common types of primary generalized seizures, characterized by involvement in the pathological process of both cerebral hemispheres, are tonic-clonic seizures and absences. The latter are more often observed in children and are characterized by a sudden short-term (up to 10 seconds) stopping the child’s activity (games, talking), the child freezes, does not respond to a call, and after a few seconds continues to interrupt activity. Patients do not realize and do not remember seizures. The frequency of absences can reach several tens per day.
The course of epilepsy is paroxysmal in nature, after the end of the attack, the signs of the disease are usually absent, but cognitive disorders and other non-specific symptoms may be observed. Clinical manifestations depend mainly on the type of seizure – a partial or generalized seizure. The severity of epilepsy (mild, moderate, severe) and the localization of the focus also affect. The appearance of more than two seizures indicates epilepsy, in one person both partial and generalized seizures can be repeated.
A partial seizure is usually preceded by the appearance of an aura (nausea, dizziness, general weakness, tinnitus, etc.), that is, the patient anticipates another exacerbation. A partial seizure can be of two types – simple and complex. With a simple attack, the patient is conscious, and a complex one is characterized by loss of consciousness. A partial attack is accompanied by motor, sensory and autonomic-visceral and mental manifestations.
A pathological focus in the brain can spread, in which case a partial seizure becomes generalized.
A generalized seizure often appears suddenly, without a previous aura. A pathological discharge in a generalized seizure completely covers both hemispheres of the brain. The patient is unconscious, that is, he is not aware of what is happening, most often (but not always) the seizure is accompanied by convulsions. Generalized seizures are convulsive – tonic, clonic, tonic-clonic, and non-convulsive (absences).
All varieties of seizures are transient – their duration is from several seconds to three minutes. After most seizures, with the exception of absences, drowsiness and confusion sets in. When an attack is accompanied by a violation or loss of consciousness, the patient does not remember what happened. In one patient, different types of seizures can occur, and the frequency of their occurrence can also change.
Depending on the form of epilepsy and taking into account the characteristics of each patient, the signs and symptoms of epilepsy are distinguished. The symptoms that
this is a combination of feelings and experiences that indicate the imminent onset of an attack of epilepsy. It happens visual, somatosensory, olfactory, auditory, mental, taste.
An epileptic aura can manifest itself as a change in smell or taste, a feeling of nervousness or general tension, a deja vu sensation, or an inexplicable certainty that the seizure is coming.
The main symptoms of epilepsy are:
extremely strong sensation of a non-existent unpleasant or pleasant smell,
cases of “disconnecting” the patient and the disappearance of the reaction to the surrounding reality,
cases of sudden loss of consciousness and muscle tone,
involuntary turning of the head to the side or involuntary tilting of the body and head forward,
episodes of muscle twitching or rhythmic movements in the limbs that are not dependent on the patient’s will,
involuntary bowel movements or loss of urine, accompanying loss of consciousness or cramps.
Having identified the first signs of epilepsy in a child or adult, you should immediately consult a doctor. As soon as drug therapy is determined, you can use folk, home recipes. However, their use should be discussed with your healthcare professional. Of the popular means distinguish:
- stone oil with antispasmodic and immunomodulating properties;
- herbal preparations with peony, licorice root, duckweed, which have a calming effect;
- infusion of marin root with relaxing properties.
The essence of the treatment of epilepsy is
To stabilize the membrane of brain nerve cells and thereby increase the level of convulsive readiness and reduce electrical excitability, antiepileptic drugs are prescribed. The result of this drug exposure is a decrease in the risk of another epileptic seizure.
and so on. Which drug to choose and at what dosage to use, the doctor decides.
If the epilepsy is secondary, additional treatment of the underlying disease is carried out.
Symptomatic treatment (for example, medications that reduce depression or improve memory).
To protect themselves, patients with epilepsy must take antiepileptic drugs over time. Alas, drugs in this group can lead to side effects, such as lethargy, decreased cognitive activity and immunity, and hair loss. To timely detect unwanted effects, an ultrasound of the kidneys and liver, biochemical and general blood tests are done every six months.
The path to getting rid of epilepsy is long, thorny and requires considerable effort, however, after 2,5-3 years from the last attack, a comprehensive examination is carried out again, including brain MRI and video-EEG monitoring, and then gradually begin to reduce the dose of antiepileptic drug, until it is completely canceled.
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