Epilepsy
The content of the article:
- What it is
- Epilepsy: causes
-
Disease symptoms
- Partial seizure
- Generalized seizure
- Diagnostic methods
-
How to be treated
- First aid
- Drug treatment
- Video
Epilepsy is a chronic neurological disorder that manifests itself in recurrent seizures in the form of movement and / or sensory disturbances. The most common symptom of the disease is seizures. The disease is characterized by a wave-like course, after the attack comes the stage of remission. Treatment has several directions - providing first aid during an attack, reducing the seizure activity of the brain and preventing complications of the disease.
Epilepsy is one of the most common neurological diseases
What it is
Epilepsy is a disease characterized by increased convulsive readiness of the brain. Every year around the world, the disease is diagnosed in 2.4 million people. Anyone can get sick, both a child and an adult. The incidence of epilepsy is up to 10 cases per 1000 people.
The disease is based on the occurrence of paroxysmal discharges (excessive activity) in the cells of the brain. Such a discharge becomes the cause of convulsive syndrome, loss of consciousness, or other manifestations of an epileptic seizure. Pathological discharges can occur in different parts of the brain: the temporal, frontal, parietal and occipital lobes, or they can completely capture both hemispheres.
Epilepsy: causes
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 we are talking about a secondary form of the disease.
Why secondary epilepsy occurs:
- Traumatic brain injury (traumatic brain injury).
- Intranasal pathology - acute fetal hypoxia at birth, birth trauma.
- Brain tumors.
- Central nervous system infections: meningitis, encephalitis.
- Postponed ischemic or hemorrhagic stroke.
With epilepsy, seizures are repeated, their occurrence may be associated with a number of factors - menstrual cycle, fatigue, physical strain, strong emotions and stress, alcohol or drugs intake, lack of sleep.
Disease symptoms
The course of epilepsy is paroxysmal; after the end of the seizure, there are usually no signs of the disease, but cognitive impairments and other nonspecific symptoms may occur. Clinical manifestations depend mainly on the type of seizures - partial or generalized seizure. The severity of epilepsy (mild, moderate, severe) and the localization of the focus also affect. Epilepsy is indicated by the occurrence of more than two seizures, and one person may have both partial and generalized seizures.
Partial seizure
A partial seizure is usually preceded by the appearance of an aura (nausea, dizziness, general weakness, ringing in the ears, etc.), that is, the patient has a premonition of another exacerbation. Partial seizures are of two types - simple and complex. With a simple attack, the patient is conscious, and for a complex one, loss of consciousness is characteristic. A partial attack is accompanied by motor, sensory and vegetative-visceral and mental manifestations.
| Partial seizure component | What's happening |
| Motor | Local convulsions appear. For example, only the left or right arm twitches, while other parts of the body remain motionless. Local seizures can be localized in any part of the body, but more often affect the upper or lower extremities, face. |
| Sensitive | The sensitive component often manifests itself in the form of unusual sensations in the body (numbness, creeping sensation). Gustatory, olfactory, auditory, or visual hallucinations may also appear. |
| Vegetative-visceral | The vegetative-visceral component manifests itself in the form of redness or paleness of the skin, increased sweating, dizziness, a lump in the throat, a feeling of squeezing behind the sternum. |
| Mental | Attacks with impaired mental functions are manifested in the form of derealization (sensation of a change in the real world), unusual thoughts and fears, and aggression. |
A pathological focus in the brain can spread, in this case, a partial attack turns into a generalized one.
Generalized seizure
A generalized seizure often appears suddenly, without a preceding aura. A pathological discharge in a generalized seizure covers both hemispheres of the brain completely. The patient is unconscious, that 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).
| Type of attack | Characteristic how it looks | Consciousness |
| Tonic | Tonic seizures are rare (about 1% of cases). The muscle tone increases, the muscles become as if stone. Tonic cramps affect all muscle groups, so the patient often falls. | Absent |
| Clonic | Clonic seizures appear in the form of rapid and rhythmic twitching, all muscle groups are affected. | Absent |
| Tonic-clonic | A tonic-clonic seizure occurs most often, it consists of two phases - tonic and clonic. In the tonic phase, there is a strong muscle tension. The patient often falls, breathing stops, tongue biting may occur. Then comes the clonic phase - twitching of all muscles occurs. Gradually the seizures stop, involuntary urination may occur, after which the patient usually falls asleep. | Absent |
| Absances | Absance is a non-convulsive form of generalized seizure that develops in most cases in children and adolescents. When absence develops, the child suddenly freezes. There may be eyelid tremors, throwing the head back, with a difficult absence, the child can make automatic movements. Attacks last a few seconds and can go unnoticed for a long time. | Disrupted but not completely shut down |
Diagnostic methods
It is possible to suspect the presence of the disease by the characteristic clinical picture (recurrent 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.
How to be treated
Epilepsy treatment includes several directions - first aid, prevention of new seizures and complications. For this, non-drug methods are used, medications, and in some cases, surgical intervention.
First aid
In case of an epileptic seizure, it is necessary to protect a person from possible injuries and complications (injuries during a fall, asphyxia). The main thing to do is to soften the fall during the seizure. If a person begins to lose consciousness, it is necessary to try to pick him up, put a soft object under his head. If the attack is accompanied by profuse salivation, you need to turn the person on their side, this will allow him not to choke.
What absolutely cannot be done:
- force to restrict convulsive movements of the patient;
- try to open the jaw;
- give water or medicine.
Drug treatment
Specific drug treatment consists of taking anticonvulsants. Treatment should be selected by a doctor after a complete examination, but you can take the drugs at home.
An important principle of epilepsy therapy is monotherapy, that is, if possible, treatment is carried out with one drug. The main antiepileptic drugs are valproate (valproic acid derivatives) and carbamazepine. Valproic acid derivatives are used advantageously in generalized epilepsy, and carbamazepine in partial epilepsy.
Carbamazepine is one of the drugs used to treat epilepsy
Other, more modern anticonvulsants can be used to treat epilepsy:
- pregabalin (trade name Lyrica);
- lamotrigine (Lamictal, Lamitor);
- topiramate (Topamax);
- gabapentin (Neurontin).
The drugs are selected depending on the form of epilepsy. The patient's age, the presence of concomitant diseases and drug tolerance are also taken into account. The antiepileptic drug should be taken with a minimum dose, gradually increasing it.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
