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Epilepsy is associated with stretching the body, convulsions, loss of consciousness. There are nearly 70 types of epilepsy and its seizures vary - sometimes almost imperceptibly. 400 thousand Poles with epilepsy are trying to live a normal life. Most succeed. What are the causes and symptoms of epilepsy? How is epilepsy treated?

Epilepsy( epilepsy ) is a neurological disease. It consists in the fact that the functions of a group of neurons (nerve cells) concentrated in a specific part of the brain, i.e. in the so-called an epileptic focus, which leads to a seizure.

Epilepsy has always been considered a mysterious disease. Even today it is difficult to diagnose it correctly and treatment is not always effective - epilepsy causes anxiety among patients and their environment.

Normally, neurons transfer information to each other through electrical impulses. However, when nerve cells are overstimulated, impulse transmission and discharge are disturbed.

It is as if there is a short circuit in the electrical system that is confined to a small area and disappears or extends to the entire brain.

The group of neurons responsible for epilepsy seizures is the same as other neurons, he althy ones, with only "broken" bioelectric properties.And therefore discharges occur. They can start in different parts of the brain, but they usually happen in the temporal or frontal lobe, less commonly in the parietal and occipital.

Epilepsy - Symptoms

The symptoms of epilepsy are mostly associated with convulsions and loss of consciousness, but this is not entirely true.

Almost 60 percent of epileptic seizures areseizures , of which 2/3 are focal and 1/3 are generalized.

Seizuresmake up the remaining 40 percent of all seizures.

In the case of a grand mal seizure, that is, a tonic-clonic seizure, the following follows:

  • loss of consciousness
  • body flexing
  • then convulsions
  • cyanosis
  • "foam from the mouth"
  • biting your tongue
  • sometimes involuntary urinating.

This type of seizure usually lasts from several seconds to 3 minutes. After the attack, the patient feelsfatigue and drowsiness, muscle pain and headache.

Before the seizure occurs, some patients experience fear, an unpleasant smell or taste, and hear music. This phenomenon is called the aura.

The symptoms of a myoclonic seizureare usually upper limbs convulsions, less often lower limbs, without loss of consciousness. A separate group of epileptic seizures are absences, which are more common in children. The sick person does not react to the words addressed to him, he is "absent", after a few or a dozen or so seconds he returns to the previously performed activity.

During a complex partial seizure, the patient does not make contact for about 2-3 minutes, most often his eyes are open, so-called automatisms may occur, i.e. activities performed automatically (e.g. smacking, swallowing saliva, picking clothes, undoing buttons) .

It should also be remembered that about 6 percent of seizures are caused by external factors, such as flashing lights or sudden sounds.

In 13 percent of people with epilepsy, Todd's palsy (hemiplegia, self-limiting and not requiring treatment) may develop after a seizure, which some authors believe increases the risk of another seizure.

Polish estimates show that about 400,000 people live with epilepsy, and every year 50 to 70 people out of 100,000 find out that they have epilepsy, and as many as 75 percent of them are children and adolescents under 19 life.

Epilepsy: causes

Epilepsy can present at any age, but most often it begins before the age of 20.

Epilepsy is the most common neurological disease in childhood. About 75% of diagnoses occur between birth and 19 years of age.

Epilepsy affects both sexes equally. Unfortunately, the cause of epilepsy can be established in less than half of the patients. It can be, for example, the result of brain damage still in the womb or during an abnormal delivery or just after it.

In childhood, the main causes of epilepsy include perinatal hypoxia and cerebral palsy, genetic and congenital diseases, neuroinfections, hypoglycemia and head injuries.

In adults, the most common causes of epilepsy are head injuries, tumors of the central nervous system, multiple sclerosis, hippocampal sclerosis, and vascular malforations.

Epilepsy in the elderly can be caused by stroke, brain tumor, brain injury and dementia.

In addition, epilepsy may occur as a result of colonization of the organism by an armed tapeworm - neurocysticercosis.

In allIn these cases, there are structural changes in the brain, i.e. damage to its tissue, and this is where epileptic foci form.

When it is not possible to find the cause of the disease, experts talk about the so-called idiopathic form of epilepsy.

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Seizures (epilepsy) - types

The seizures vary depending on the area of ​​the brain in which the epileptic site is located, as well as the patient's age.

The course of epilepsy can vary greatly. Some people experience seizures several times a day, and others - several times throughout their lives.

Seizures are divided into:

  • petit mal seizures , consisting in a brief loss of consciousness, often not even noticed by the patient and the environment
  • grand mal seizures , e.g. tonic-clonic seizures, during which there is often loss of consciousness, convulsions, drooling, trismus, sometimes rapid eye movements (similar to like in REM sleep) or temporary apnea.

We divide generalized seizures into:

  • tonic-clonic seizures
  • tonic
  • clonic
  • myoclonic
  • atonic
  • absences

During generalized seizures, there is a sudden loss of consciousness.The muscles of the whole body are tense (this is the tonic phase), during which the patient often bends his head back and flexes his arms and legs. He has trouble breathing and starts turning blue.

After several seconds, convulsions shake the body (this is the clonic phase). The sick person may then bite the tongue and urinate unknowingly. After a seizure, he is distracted, confused and usually wants to sleep.This seizure takes about 4-5 minutes.

Generalized seizures also include absences.They occur only in children and consist in "turning off" for several seconds, which looks as if the child stuttered. Then it goes back to what it was doing and doesn't even know it has had a seizure. If epilepsy is left untreated, these conditions can reappear many times a day.

During focal seizures of epilepsy, which is the most common form of epilepsy and can occur at any age - the patient stops the activity for a moment and turns off completely for a moment.

May, for example, look at one point and not come into contact with the environment. It has no convulsions, does not fall, and can make automatic reminding movementse.g. fastening buttons or searching for something.

After a seizure, he returns to his job and sometimes does not even realize the momentary loss of consciousness. Usually, however, there is a short period of post-paroxysmal confusion and confusion.

Read also:

Psychogenic pseudo-epileptic seizures: causes, symptoms, treatment

Seizure (epilepsy): causes

The occurrence of an epileptic seizure is difficult to predict (sometimes it is preceded by the so-called aura). It is known, however, that seizures can be provoked e.g. by:

  • head injuries
  • exhaustion, especially lack of sleep
  • severe stress, emotions
  • strenuous exercise (moderate exercise is beneficial)
  • fever
  • hypoglycemia
  • drinking alcohol and taking drugs
  • light flashes can cause photogenic epilepsy
  • sounds can cause audiogenic epilepsy
  • Sudden auditory and visual stimuli or a sudden change in body position may cause surprise epilepsy
  • hormonal fluctuations in women (attacks are more frequent, e.g. before menstruation)

Status epilepticus

Seizures last from several seconds to several minutes. But sometimes they are long (10 minutes or more), follow each other, and the patient does not regain consciousness between them. This is called status epilepticus.

If it occurs in a person who has never had epilepsy - it is usually the result of severe head injuries (e.g. after an accident) or developing brain disease (e.g. cancer, encephalitis, vascular stroke).

However, status epilepsy is more common in those who have known epilepsy. In this case, it can be the result of, for example, sudden discontinuation of drugs without consulting a doctor or withdrawal syndrome in people abusing alcohol. Regardless of the cause, such a condition is life-threatening, therefore the patient always requires urgent medical attention.

Epilepsy syndromes

Epilepsy syndromes mostly occur in children and adolescents. Taking into account the International Classification of Epilepsy and Epilepsy Syndromes (1989) and the proposed Diagnostic Scheme for People with Epileptic Seizures or Epilepsy (2001), it is now possible to identify about 60 epilepsy syndromes.

Epilepsy syndromes differ in terms of the causes that led to them, as well as the age at which the patient developed the disease, the response to antiepileptic treatment, and the prognosis for remission of seizures, so their precise classification is important both for the treatment of an individual patient and for the conduct of research.

You may be interested in:

Lennox-Gastaut syndrome: childhood epilepsy syndrome Rolandic epilepsy: causes, symptoms, treatment Childhood epilepsy with absences (pycnolepsy, Friedman syndrome) West's epilepsy: causes, symptoms, treatment

Epilepsy - diagnosis

One seizure does not make you sick. But if it happens again, it requires consultation with a neurologist (or preferably an epileptologist). The doctor conducts a detailed interview regarding the patient's he alth status as well as the circumstances and course of the seizure.Witness accounts are very helpful.Then a neurological examination is performed and an EEG (brain electroencephalography) is ordered. The EEG can detect the abnormal bioelectrical activity of the brain, which is the essence of epilepsy.

Sometimes a specialist recommends the so-called video-EEG, i.e. extending the examination time to several or several hours with the possibility of observing the patient's behavior thanks to a special camera.

In diagnostics, computed tomography and magnetic resonance imaging (MRI) of the brain are also used. With the exception of some unequivocal pediatric syndromes, examination, especially MRI, should be performed in all patients with epilepsy. Especially when the applied treatment is ineffective or the disease is progressing. Other tests, e.g. blood chemistry, cerebrospinal fluid tests) are performed to confirm or rule out other conditions that may be causing the seizures.

You must do it

When you witness an epileptic attack:

  1. Stay calm. Most seizures last 2-4 minutes.
  2. Ensure the patient's safety (e.g. move him from the street to the bench).
  3. Put it on its side. This position protects against choking.
  4. Do not press the sick person to the ground. It is enough to protect his head from injuries.
  5. Don't put anything between gritted teeth! Do not give any medications.
  6. After the seizure, stay with the patient until their condition normalizes. If possible, give him at least a brief, benevolent sleep.
  7. Call an ambulance service if the seizure lasts longer than 10 minutes or if the seizures occur within a short period of time (this could be severe status epilepticus).

Epilepsy (epilepsy): treatment

Epilepsy must be treated as otherwise it can lead to irreversible changes in the brain and result in death.

Depending on the type, course and causes of the disease - the doctor chooses the appropriate therapy. If epilepsy is caused by other conditions, such as a hematoma, tumor or hemangioma, the underlying disease is treated first, usually surgically.

The primary treatment is pharmacotherapy , which aims to control epileptic seizures. Both conventional (older) and new generation drugs are effective, but the new ones cause fewer side effects, such as sleepiness, concentration disorders.

Some of them (like Levetiracetam and Gabapentin) do not interact with other drugs. This is especially important in people with drug-resistant epilepsy who need to take several medications, and in elderly people who take multiple medications.

Most patients get one drug, but sometimes doctors reach for the so-called combination therapy and use 2-3 simultaneously.

Treatment begins with small doses of the drug and gradually increases them.Usually, after 2-3 weeks, the so-called full therapeutic dose.

Ok. 80 percent the sick can be effectively treated. The treatment lasts for several or several years (sometimes until the end of life).U approx. 20 percent epileptics do not manage to completely control seizures- often it is to blame for the wrong drug, its irregular use or premature discontinuation of the preparation.

You can try to stop taking the drug after three years without a seizure. The dose is reduced gradually, even over a period of several months, while the brain is monitored by an EEG during this time.

Recurrences of seizures occur in 25-30% children(in adults they are more common). Most of them occur in the first year after stopping medication. After five years, the risk of relapse is very small.

For those who do not respond to drug treatment, a vagus nerve stimulator can help.

More on epilepsy treatment:

Treatment of epilepsy: pharmacological treatment, surgery and side effects Telemedicine in the treatment of epilepsy

Important

If either parent has epilepsy, there is a very slight but increased risk (about 1.5%) that the child may have epilepsy. It all depends on what kind of disease you are dealing with. Medical data shows thatover 90 percent. mothers suffering from this condition give birth to he althy children.

Women who suffer from epilepsy can have children.They only need to be under the constant supervision of a doctor and follow his recommendations. Sometimes, before you become pregnant, you need to switch to a drug that's safer for the fetus, so conception should be planned.

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Neurology