The content of the article
Types of epilepsy.
Causes of epilepsy.
Symptoms of epilepsy.
Diagnosis of epilepsy.
Treatment of epilepsy.
Probably, many of us have ever seen a picture of a person in a crowded place: a person standing suddenly suddenly falls, his body breaks in a convulsive fit, foam comes from his mouth … Such is the unsightly grin of one of the most frequently encountered and delivering a lot of problems, both to doctors and patients of neurological diseases – epilepsy . Epileptic brain damage, which disrupts motor, vegetative, sensory and thought processes and manifests itself in short sudden relatively rare attacks, occurs in every one hundredth inhabitant of the Earth.
Outwardly a person becomes sick only in moments of attacks. Between them, it is absolutely normal (with relative assumptions, which will be discussed below). It should be noted that a single seizure, which arose, for example, against a background of high fever, fright, blood sampling – is not yet a verdict. A sign of epilepsy is the presence of repeated causeless seizures.
Types of epilepsy
Epilepsy is congenital (idiopathic) and acquired (symptomatic), with the first occurring more often and manifests itself already in childhood and adolescence. It is characterized by a benign course and a favorable prognosis with a gradual withdrawal from drug therapy. With such epilepsies, the brain substance is not damaged, but the electrical activity of neurons and, consequently, the excitability of the brain increases. Congenital epilepsy is characterized by generalization, i.e. complete loss of consciousness during attacks.
For acquired epilepsy there are no age limits, it can be treated with great difficulty. It is based on structural or metabolic disorders of brain activity that have occurred under the influence of certain external factors (see “Causes of epilepsy”). Acquired epilepsy proceeds partially, i.e. During attacks, a person is conscious, but unable to control a certain part of his body.
Causes of epilepsy
To understand the cause of congenital epilepsy, one must understand its nature. The transmitter of signals within the nervous system is the electrical impulse generated on the surface of the neuron. “Superfluous” impulses can occur in normal conditions, but for this purpose special structures are provided in the brain, which “extinguish” the excessive excitability of the cells. So: the condition for the development of congenital epilepsy are genetic defects of these very structures, as a result of which the brain is in constant convulsive readiness, which at any moment can “detonate” by attack.
Such genetic defects do not develop from scratch: they are provoked by the following factors:
- hypoxia during pregnancy;
- infection in the prenatal period (rubella, toxoplasmosis, herpes infection, etc.);
- birth injury.
The cause of acquired epilepsy is the effect on the brain of some unfavorable factor, which results in the formation of a specific epileptic focus in one hemisphere that generates an excessive electrical impulse. Up to a certain point, the anti-epileptic structures of the brain are able to level it, but at the “rush hour” the electric discharge still “breaks through” the defense and is manifested by the first seizure. The next attack will be easier to manifest. What factors can trigger these disastrous changes in the brain? Here they are:
- acquired in the intra-uterine period underdevelopment of individual brain structures, not considered in the context of idiopathic epilepsy;
- craniocerebral trauma;
- neoplasms in the brain;
- chronic alcoholism and drug addiction;
- infection of the CNS (meningitis, encephalitis);
- a side effect of some drugs (antipsychotics, antidepressants, antibiotics);
- multiple sclerosis.
Symptoms of epilepsy
As already mentioned, the generalized attack is characterized by tonic (persistent, prolonged) and clonic (fast) seizures and loss of consciousness. Before the attack, there is often a short hallucinatory obscuration of consciousness, immediately preceding the seizure. At the moment of the onset of the tonic phase, the patient with a cry (because the muscles of the larynx contract) loses consciousness, bites the tongue and falls because of the cramps that have begun throughout the body and extremities. There is a violation of pupillary reactions to light, a pause of breathing, pallor, and then a cyanotic face.
A partial (small) attack is a short-term clouding of consciousness. The patient remains on his feet, but his face turns pale, his eyes glaze, there may be clonic seizures of individual muscles.
Chronic epileptics over time, there is a transformation of personal characteristics: poorer sphere of interests, develops selfishness, pickiness, excessive attention to detail, rapid transitions from politeness to aggression, rancor. It is possible to develop dementia. The body, long suffering from human epilepsy, is a map of “battles” with illness: scars in the tongue from permanent bites, traces of injuries, burns resulting from seizures, etc.
It is impossible not to mention such a life-threatening state as an epileptic status . It can be said that this is a non-stop attack, woven from a series of seizures, without clearing consciousness. In this condition, it is necessary to immediately start therapeutic activities.
Diagnosis of epilepsy
First of all, you need to recognize the type of epilepsy (congenital or acquired). In the second case – to establish a primary disease. Interrogating the patient himself is a hopeless occupation, because epileptic attack provides amnesia. Therefore, the importance of the information provided by the family and friends of the patient increases.
What research is required for the diagnosis of epilepsy? First of all – electroencephalography (EEG), reflecting deviations in the electrical activity of the brain and fixing the epileptic focus. In the interstitial interval, EEG indices are often not different from normal ones, therefore, additional magnetic resonance imaging and computed tomography of the brain are performed.
Treatment of epilepsy
The treatment of epilepsy is based on the principles of timeliness, complexity, duration and continuity. It provides for a constant reception of anticonvulsants, which either completely eliminate seizures, or make them much more rare. To stop generalized seizures apply Phenobarbital, Diphenin, Chlorakon, Hexamidine (Primidon), Benzobarbital (Benzonale), Carbamazepine (Finlepsin, Zeptol).
When partial seizures are used Suxilep, Diazepam (Relanium, Sibazon), Enkorat (Depakin, Valparin) , the same Carbamazepine, Diphenin .
The effects of drugs on a particular patient are strictly individual. Term of treatment, as a rule – not less than 2-3 years after the last generalized and 1,5-2 years after a partial attack. EEG normalization is also an important criterion for the abolition of drug treatment. Drug therapy is not interrupted abruptly, it is done gradually by smoothly reducing dosages.
Diet for epilepsy should include a minimum of salt, seasonings, cocoa, coffee. Consumption of liquids is limited, alcohol is excluded.
Emergency assistance to the patient directly during an attack should be aimed at preventing asphyxia. Speaking Russian, it is necessary to make sure that the patient does not suffocate because of tongue twisting or not vomited by vomit masses. It is also necessary to stimulate cardiac activity and stop cramps. To do this, release the oral cavity from the vomit, enter the airway, make an injection of Cordiamin.