What is epilepsy in humans. Epilepsy: Causes in Adults and Children

Now epilepsy belongs to the category of polyetiological diseases, that is, those that can be caused by many different factors. Interestingly, researchers still do not fully understand why some patients suddenly develop seizures, sometimes leading to disability. This is probably why the diagnosis of epilepsy sounds so frightening for everyone.

The causes, classification, symptoms and methods of treatment of the named ailment described in this article will help to better understand what exactly leads to the onset of the disease and how to deal with it.

How impaired transmission of electrical impulses affects the development of an epileptic seizure

The human brain - neurons - constantly generate and transmit electrical impulses at certain sizes and at a certain speed. But in some cases, they suddenly begin either spontaneously or under the influence of some factors to produce impulses of much greater strength.

The main reason for the onset of epilepsy, as the researchers found, is precisely the very erratic and excessive electrical activity of nerve cells. True, in order for a seizure to develop, in addition, it is also necessary to weaken certain brain structures that protect it from excessive overexcitation. These structures include segments as well as the caudate and wedge-shaped nucleus.

What are generalized and partial seizures of epilepsy?

Epilepsy, the causes of which we are considering, at its core, as you already understood, has an excessive electrical activity of the brain neurons, causing a discharge. The outcome of this activity can be different:

• the discharge stops within the boundaries where it originated;
• the discharge spreads to neighboring areas of the brain and, encountering resistance, disappears;
• the discharge spreads to the entire nervous system, after which it disappears.

In the first two cases, there is, and in the last - generalized. It always leads to loss of consciousness, while it may not cause this symptom.

By the way, researchers have found that epilepsy develops when a specific part of the brain is damaged, not destroyed. It is the affected, but still viable cells that cause pathological discharges that lead to the appearance of seizures. Sometimes, at the time of a seizure, new damage to cells occurs next to existing ones, and sometimes even at a distance from them, new epileptic foci are formed.

Epilepsy: causes of seizures

The disease can be either independent or be one of the symptoms of an existing ailment. Depending on what exactly causes epileptic seizures, doctors distinguish several types of pathology:

• symptomatic (secondary, or focal);
• idiopathic (primary, or congenital);
• cryptogenic epilepsy.

The symptomatic causes of the described disease can be called any structural defects of the brain: cysts, tumors, neurological infections, developmental disorders, strokes, as well as drug or alcohol dependence.

The idiopathic cause of epilepsy is the presence of an inherited predisposition to epileptic seizures. This type of epilepsy manifests itself already in childhood or early adolescence. In this case, by the way, the patient does not show damage to the brain structure, but an increase in the activity of neurons is noted.

Cryptogenic causes are difficult to determine even after the entire range of examinations.

Classification of seizures in the diagnosis of epilepsy

The causes of this disease in children and adults directly affect how the patient's seizures proceed.

When we talk about epilepsy, we imagine a seizure with loss of consciousness and seizures. But the course of seizures in many cases turns out to be far from the established ideas.

So, in infancy, propulsive (minor) seizures are most often observed, which are characterized by short-term tilting of the head forward or flexion of the upper body. The cause of epilepsy in this case is explained, as a rule, by delays in the development of the brain in the prenatal period.

And in older childhood and adolescence, there are myoclonic seizures, which are expressed by a sudden short-term of the whole body or its individual parts (most often the hands). As a rule, they develop against the background of metabolic or degenerative diseases of the central nervous system, as well as in cases of cerebral hypoxia.

What is a seizure focus and convulsive readiness?

When diagnosed with epilepsy, the causes of an attack depend on the presence of an epileptic focus in the brain of the patient and his convulsive readiness.

An epileptic (convulsive) focus appears, as a rule, as a result of brain trauma, intoxication, circulatory disorders, tumors, cysts, etc. All these injuries cause excessive irritation of cells and, as a result, convulsive muscle contraction.

Convulsive readiness means the likelihood of pathological excitation in the cerebral cortex in excess of the level at which the body's anticonvulsant system functions. By the way, it can be both high and low.

High and low convulsive readiness

With a high convulsive readiness, even a slight irritation of the convulsive focus is the cause of epilepsy in the form of a deployed seizure. And sometimes this readiness is so high that it leads to short-term blackouts even without the presence of a convulsive focus. In these cases, we are talking about attacks called absences (short-term freezing of a person in one position with a loss of consciousness).

If convulsive readiness is absent in the presence of an epileptic focus, so-called partial seizures occur. They are not accompanied by a blackout.

The onset of increased convulsive readiness often lies in intrauterine brain hypoxia or a hereditary predisposition of a person to the development of epilepsy.

Features of the disease in children

Idiopathic epilepsy is most common in childhood. The causes of this type of disease in children, as a rule, are rather difficult to establish, since the diagnosis itself is at first almost impossible to determine.

After all, children can hide under obscure pain attacks, umbilical colic, fainting or acetonemic vomiting caused by the accumulation of acetone and other ketone bodies in the blood. At the same time, sleepwalking, enuresis, syncope, and conversion seizures will be perceived by others as signs of epilepsy.

The most common in childhood is the reasons for its occurrence are attributed to hereditary predisposition. Attacks look like the patient freezing in place for a few seconds while playing or talking. Sometimes they are accompanied by slight clonic twitching of the muscles of the eyelids or the entire face. After the attack, the child does not remember anything, continues the interrupted lesson. These conditions respond well to treatment.

Features of epilepsy in adolescents

In (from 11 to 16 years old), myoclonic epilepsy may develop. The causes of this disease in adolescents are sometimes associated with a general restructuring of the body and the instability of the hormonal background.

Seizures of this form of epilepsy are characterized by symmetrical muscle contractions. Most often these are the extensor muscles of the arms or legs. At the same time, the patient suddenly feels a "blow under the knee", from which he is forced to squat or even fall. When the muscles of his arms contract, he can unexpectedly drop or throw objects that he was holding far away. These attacks, as a rule, pass with the preservation of consciousness and are provoked most often by sleep disturbances or sudden awakening. This form of the disease responds well to therapy.

Basic principles of treatment

Epilepsy, the causes and treatment of which we are considering in the article, is a special disease, and its therapy requires adherence to certain rules.

The main one is that the treatment of the disease is carried out with one anticonvulsant (anticonvulsant drug) - this technique is called monotherapy. And only in rare cases, the patient is selected several medicines... Taking the drug should be regular and long-term.

Only a neuropathologist can choose the right anticonvulsant drug, since there are no medicines that are equally effective for the whole variety of epileptic seizures.

The basis for the treatment of the described pathology is currently the drugs "Carbamazepine" ("Finlepsin", "Tegretol"), as well as "Depakin" and "Depakin Chrono". Their dose should be calculated by the doctor personally for each patient, because an incorrectly selected dosage of drugs can lead to an increase in seizures and a deterioration in the patient's general condition (this phenomenon is called "aggravation of epilepsy").

Is the disease treated?

Due to the development of pharmacology, 75% of epilepsy cases are amenable to seizure frequency control with the use of a single anticonvulsant. But there is also a so-called catastrophic epilepsy that is resistant to such therapy. The causes of this resistance to the prescribed drugs in adults and children may lie in the presence of structural defects in the patient's brain. Such forms of the disease are currently successfully treated with the help of neurosurgical intervention.

Epilepsy is a common chronic neurological ailment that manifests itself in sudden seizures. Previously, this pathology was called "epileptic" and was considered divine punishment. The disease of epilepsy is often congenital in nature, as a result of which the first seizures occur in children who are at the age stage from five to ten years or during puberty. Clinically, epileptic seizures are characterized by transient sensory, mental, motor, and autonomic dysfunction.

Epilepsy in adults is subdivided into idiopathic (inherited, often even after tens of generations), symptomatic (there is a certain reason for the formation of foci of pathological impulses) and cryptogenic (it is impossible to establish the exact cause of the appearance of untimely impulse foci).

Epilepsy causes

In almost 60% of cases, the exact cause of epilepsy cannot be established. More often diagnosed idiopathic and cryptogenic form of epilepsy of unknown etiology.

Epilepsy, what is it? It occurs against the background of an increase in the activity of the structural units of the brain. Presumably, such an increase is based on the chemical characteristics of brain cells and some properties of the cell membrane. It has been established that in patients suffering from this disease, brain tissue is highly sensitive to changes in chemical compositionthat occur due to exposure to a variety of stimuli. Similar signals entering the brain of a healthy individual and a sick person, in the first case, go unnoticed, and in the second, they lead to a seizure.

The causes of epilepsy can be determined depending on the age stage at which the disease first appeared. The ailment in question cannot be attributed to diseases of a hereditary nature, but 40% of individuals with epilepsy have relatives suffering from seizures. A child can inherit specific features of brain activity, functions of inhibition and excitation, high level readiness for a paroxysmal brain reaction to external changes and fluctuations in internal factors. If one parent suffers from this ailment, then the probability of its occurrence in the baby is approximately 6%, if both - 12%. More often, a tendency to disease is inherited if the seizures are characterized by a generalized course, rather than focal.

Epilepsy causes. The probable reasons giving rise to the development of the ailment under consideration include, in the first turn, brain damage during the period of intrauterine formation of the fetus. In addition, among the factors contributing to the onset of epilepsy, one should highlight:

- craniocerebral injuries;

- genetic changes;

- congenital defects;

- a circulatory disorder in the brain;

- various infectious pathologies (meningitis, encephalitis);

- abscesses and tumor processes in the brain.

The provoking factors of epilepsy are considered psycho-emotional overstrain, stressful conditions, overwork, lack of sleep or excess sleep, climate change, bright light. The main cause of convulsive conditions in babies is perinatal complications. Birth and postpartum head injuries lead to brain hypoxia. It is believed that in 20% of cases, the cause of epilepsy is precisely oxygen starvation of the brain. Brain injuries in about 5-10% of cases lead to the occurrence of the ailment in question.

Epilepsy in humans can occur after a severe head injury, due to a traffic accident, gunshot wound... Post-traumatic seizures often develop immediately after a bruise or injury, but there are times when they appear after several years. Experts say that people who have suffered severe head injury, which led to long-term loss, have a high probability of developing this ailment. The pathology in question can rarely develop due to minor brain damage.

The transfer of a number of infectious or somatic diseases can also give rise to epileptic seizures... These diseases include: neoplastic processes in the brain, cerebral palsy, meningitis, encephalitis, vascular pathologies, etc. In about 15% of cases, seizures are the first sign of systemic lupus erythematosus.

About 35% of brain tumors provoke repeated seizures of this disease. Moreover, the brain tumors themselves are the cause of approximately 15% of cases of convulsive conditions. Most individuals with a history of epilepsy do not have other visible brain abnormalities. Dysplasia of the capillaries of the brain also often leads to repeated attacks. Metabolic disorders often become factors that provoke the onset of epilepsy. Moreover, such violations can be hereditary or be acquired, for example, due to lead poisoning. A metabolic disorder in about 10% of cases leads to the onset of epilepsy. Regular consumption of high-calorie foods rich in carbohydrates and fats can seriously affect metabolism and provoke convulsions in almost any subject. People with diabetes, as well as healthy individuals, can experience epileptic seizures due to a significant increase in blood sugar. Convulsions can also accompany liver and kidney disease.

Stroke can lead to epileptic seizures, in which the supply of blood to the brain is disrupted, which often leads to short-term or long-term speech impairments, disturbances in thought and movement. This disease relatively rarely leads to convulsions, in only 5% of cases, patients develop chronic seizures of epilepsy. Stroke-induced seizures tend to respond well to therapy.

Attacks of epilepsy of the cause can be triggered by exposure to insecticides, drugs, for example, cocaine, cessation of the use of drugs, derivatives of barbituric acid, for example, Valium, Dalman, alcohol-containing liquids. Skipping one dose of an antiepileptic drug prescribed by your doctor can also trigger a seizure. It should also be borne in mind that convulsions appear not only due to drug abuse.

Strong antipsychotics (Aminazine), monamine oxidase inhibitors (Nialamide), tricyclic antidepressants (Amitriptyline), and drugs of the penicillin group can cause seizures in subjects with a low threshold of convulsive readiness. The interaction of antiepileptic drugs with other medications can sometimes also trigger an epileptic seizure.

If there are no reasons suggesting the presence of primary brain pathology, then we can talk about spontaneous (genuinic) epilepsy. This form of the disease includes, in addition to generalized seizures, myoclonic convulsions of puberty, generalized nocturnal seizures, as well as certain types of this disease with myoclonic-astatic focal convulsions.

Types of epilepsy

The classification of epileptic convulsions is becoming wider every year due to the discovery of previously unknown factors that stimulate the development of the disease. Today there are two large groups convulsions, the symptoms of which cause one or another form of epilepsy: partial or focal seizures and generalized seizures.

Focal epileptic convulsions occur as a result of damage to one or more areas of the brain. The severity of partial seizures and the part of the body affected by the seizure depends on the affected hemisphere. Among the seizures of the focal type, the following can be distinguished: a mild form of partial convulsions, complex partial convulsions, Jacksonian, temporal and frontal epilepsy.

A mild form of epilepsy is characterized by a disorder of motor functions in the area of \u200b\u200bthe trunk controlled by the affected area of \u200b\u200bthe brain, the appearance of an aura state, which is accompanied by a sensation of deja vu, the appearance of an unpleasant taste or aroma, nausea and other manifestations of the disorder digestive system... An attack of this form lasts less than 60 seconds, while the individual's consciousness remains clear. The symptoms of an attack pass relatively quickly. Seizure light form does not have any visible negative consequences.

Complex focal convulsions are accompanied by altered consciousness, behavioral and speech dysfunction. During the seizure, the individual begins to perform various unusual actions, for example, constantly straightens his clothes on himself, makes strange unintelligible sounds, and spontaneously moves his jaw. This form of attack lasts one to two minutes. The main symptoms of epilepsy disappear after a seizure, but confusion of thoughts and consciousness is saved for a couple of hours.

Jacksonian epilepsy is manifested by partial seizures that begin in the muscles of a part of the body on one side.

The following types of convulsions can be distinguished:

- Jackson's march, consisting of a series of seizures following one after another with a small interval between them;

- an attack that affects the facial muscles;

- an attack located in the muscles of a separate part of the body.

A characteristic feature of this form of convulsions is the occurrence of seizures against the background of clear consciousness.

The first seizures of frontal lobe epilepsy can occur at any age. First of all, to clinical manifestations, should include characteristic ictal symptoms such as motor manifestations. Frontal attack proceeds as follows. In the first turn, a motor phenomenon (postural, tonic or clonic) is observed, which is often accompanied by gesture automatisms at the onset of a seizure. The duration of such an attack is usually several seconds. Postictal confusion is either absent or minimal. More often attacks occur at night. Consciousness can be preserved or partially disturbed.

Name temporal lobe epilepsy comes from its place of localization. This form of the disease is located in the temporal region of the brain. It manifests itself in partial seizures. With the further development of this pathology, secondary generalized attacks and appear.

Generalized forms of epilepsy are subdivided into:

- idiopathic, characterized by an association with age-related changes;

- symptomatic (cryptogenic) epilepsy;

- symptomatic seizures of non-specific etiology;

- specific epileptic syndromes.

Age-related idiopathic seizures are generalized convulsions at the onset of the disease. In the period between seizures, generalized discharges are observed on the electroencephalogram, increasing during slow wave sleep, and normal background activity.

The types of idiopathic generalized epilepsy are as follows:

- benign neonatal familial convulsions;

- benign neonatal seizures;

- benign myoclonic seizures of childhood;

- juvenile myoclonic convulsions;

- Childhood and youth absence seizures;

- generalized tonic-clonic convulsions upon awakening;

- reflex convulsions.

Cryptogenic epilepsy, characterized by an association with age-related changes, in turn, can be subdivided according to the international classification of ailments into:

- Lennox-Gastaut syndrome;

- childhood spasms or West syndrome;

- myoclonic-astatic seizures.

Symptomatic seizures of nonspecific etiology are divided into early myoclonic encephalopathy, encephalopathy of infancy with zones of isoelectric electroencephalogram and other symptomatic generalized variations.

Specific epileptic syndromes include: febrile, alcoholic, drug seizures.

Febrile convulsions are usually seen in children between six months and 5 years of age. Attacks occur against a background of a temperature exceeding 38 ° C, with a normal neurological status. They have a primary generalized character with tonic-clonic convulsions. Simple febrile seizures are single and short, they are also not characterized by the presence of focal manifestations, after themselves and do not leave long-term confusion or drowsiness. Complicated febrile seizures can be prolonged, serial, or focal. Such seizures require more serious examination. Febrile convulsions occur in about 4% of children, while about 1.5% of them may recur.

Alcohol attacks are observed in the second or third stage of alcoholism during the period of abstinence. They are characterized by the development of clonic-tonic seizures.

Seizures are most often caused by cocaine or amphetamine use. The use of large doses of drugs of the penicillin series, Isoniazid, Lidocaine, Aminophylline can also provoke seizures. Tricyclic antidepressants and phenothiazines are characterized by the ability to lower the seizure threshold, and if there is some predisposition, they can cause a seizure. Seizures are also possible with the withdrawal of barbiturates, baclofen, benzodiazepines. In addition, at a toxic dose, many anticonvulsants have epileptogenic properties.

Epilepsy symptoms

As mentioned above, the main manifestation of this ailment is an extensive convulsive attack, which begins, mostly suddenly. As a rule, such a seizure is not characterized by the presence of a logical connection with external factors... In some cases, it is possible to determine the time of the attack.

The disease of epilepsy can have the following precursors: a couple of days before a possible seizure, a person has general malaise, impaired appetite, disorder of dreams, headaches, excessive. In some cases, the onset of a seizure is accompanied by the appearance of an aura, which is a sensation or experience that invariably precedes an epileptic seizure. The aura can also be an independent attack.

A seizure of epilepsy is characterized by the presence of tonic seizures, in which the head is thrown back, limbs and trunk, which are in a tense state, are stretched. In this case, breathing is delayed, and the veins located in the cervical region swell. On the face there is a "deathly" pallor, the jaws are clenched. The duration of the tonic phase of the seizure is approximately 20 seconds, then clonic convulsions occur, which manifest themselves in jerky muscle contractions of the whole body. This phase is characterized by a duration of up to three minutes. With her, breathing becomes hoarse and noisy, due to the accumulation of saliva, retraction of the tongue. Foam may also come out of the mouth, often bloody as a result of biting the tongue or cheeks. Gradually the frequency of convulsions decreases, their completion leads to muscle relaxation. This phase is characterized by a lack of response to any stimuli. The patient's pupils at this stage are dilated, there is no reaction to light exposure. Reflexes of the protective and deep type are not triggered, involuntary urination is often observed.

The symptoms of epilepsy and their variety depend on the form of epilepsy.

Epilepsy of the newbornthat occurs against a background of high fever is defined as intermittent epilepsy. The nature of the seizures in this form of the disease is as follows: convulsions move from one part of the body to another, from one limb to the other. As a rule, there is no formation of foam and biting of the tongue and cheeks. Also absent after paroxysmal sleep. Upon the return of consciousness, you can find a characteristic weakness on the right or left side of the body, its duration can be several days. In infants, observations have shown that seizures are predicted by headaches, general irritability, and appetite disorders.

Temporal epilepsy is expressed in polymorphic paroxysms, which are preceded by a kind of aura. The seizure of this form of epilepsy is characterized by the duration of manifestations of more than a few minutes.

Temporal lobe epilepsy symptoms and features:

- manifestations of an abdominal nature (increased peristalsis, nausea, abdominal pain);

- cardiac symptoms (palpitations, pains, rhythm disturbances);

- the occurrence of involuntary manifestations in the form of swallowing, sweating, chewing;

- shortness of breath;

- personality changes manifested by paroxysmal mood disorders;

- lack of action;

- autonomic disorders of a high severity that occur between seizures (violation of thermoregulation, change in pressure, allergic reactions, disorders of water-salt and fat metabolism, sexual dysfunction).

Most often, this form of epilepsy has a chronic progressive course.

Absorption epilepsy is a disease in which the typical symptoms of epilepsy are absent, namely falling and convulsions. This view the disease is observed in children. It is characterized by the sinking of the child. During an attack, the baby stops responding to what is happening around.

Absolute epilepsy is characterized by the following symptoms and features:

- sudden freezing with interruption of activity;

- inability to attract the baby's attention;

- fixed or absent gaze directed to one point.

Often, absence epilepsy is diagnosed more often in girls than in boys. In two thirds of cases, sick children have relatives suffering from this disease. On average, this type of ailment and its manifestations last up to seven years, becoming gradually less common and completely disappearing, or developing into another form of pathology.

Myoclonic epilepsy is characterized by twitching during seizures. This form of pathology affects both sexes equally. A characteristic feature of this type of ailment is the identification of cells of the brain, heart, liver, heart, deposits of carbohydrates during morphological examination.

Myoclonic epilepsy usually debuts between 10-19 years of age. It is manifested by epileptic seizures, which are later joined by myoclonus (that is, muscle contractions of an involuntary nature with the presence or absence of a motor effect). The frequency of seizures can range from daily seizures to several times a month.

Post-traumatic epilepsy is directly related to brain damage resulting from head injury. In other words, seizures occur some time after damage to the brain as a result of a blow or penetrating injury.

Seizures are a reaction to pathological electrical discharges occurring in the brain. Seizures can also occur two years after injury. The symptomatology of this form of the disease usually depends on the area of \u200b\u200bthe pathological activity in the brain. This type of epilepsy is more often characterized by generalized tonic-clonic seizures or partial seizures.

Alcoholic epileptic seizures are a consequence overuse alcoholic beverages. This pathology manifests itself in convulsive seizures that occur suddenly. The onset of a seizure is characterized by loss of consciousness, after which the patient's facial skin acquires a "deathly" pallor, gradually reaching a bluish tint. Foaming and vomiting may appear.

After an epileptic seizure, consciousness gradually returns, giving way to prolonged sleep.

The symptoms of alcoholic epilepsy can be as follows:

- fainting;

- convulsions;

- Severe "burning" pain;

— muscle spasm;

- a feeling of squeezing, tightening of the skin.

The seizure can occur after stopping the use of alcoholic liquids for several days. Often the attacks are associated with alcoholism.

Non-convulsive epilepsy, that is, the disease proceeds without the presence of seizures. It manifests itself in the form of a twilight consciousness, which comes suddenly. It can last from a couple of minutes to several days. It also suddenly disappears. With an attack, consciousness narrows. In other words, patients perceive only those phenomena or parts of objects that have emotional significance for them. Often, hallucinations of a rather frightening character can be observed and. Hallucinations can provoke the patient's attack on others. This type of epilepsy is characterized by the presence of mental pathologies. After seizures, patients forget what is happening to them, residual memories of events can rarely be noted.

Epilepsy and pregnancy. Epileptic seizures can first be detected during pregnancy. This is due to the fact that during this temporary physiological state, the load on the body increases. In addition, if a woman had the disease before pregnancy, then attacks may become more frequent during gestation. The main manifestations of epilepsy during pregnancy are frequent migraines, fainting, dizziness, hysterical states, and insomnia.

Epilepsy and pregnancy are two non-mutually exclusive conditions. You can become pregnant and give birth with this ailment, only to approach the decision on procreation is necessary consciously. For a successful pregnancy in a woman suffering from epilepsy, it is necessary to establish close cooperation between the pregnant woman herself, her relatives, therapist, neuropathologist, gynecologist, and geneticist. If all medical prescriptions and recommendations are not followed, the consequences of epilepsy during pregnancy can be dire for the baby. For example, pregnancy can sometimes be interrupted by a classic attack. If the pregnancy continues, then oxygen starvation of the fetus may occur.

Convulsive syndrome (generalized seizures), in which abortion occurs as a result of abdominal trauma, is a great danger for a baby's life. Also, in such cases, there may be a violation of the uteroplacental circulation, which will result in placental abruption.

Signs of epilepsy

The most specific symptom that allows the diagnosis of epilepsy is a large seizure, which is preceded by a prodromal period, possibly lasting from a couple of hours to two days. In this phase, patients are characterized by irritability, decreased appetite, and behavioral changes.

Signs of epilepsy - precursors or aura, which may be accompanied by nausea, muscle twitching, or other unusual feelings, such as excitement, creeping sensation, occur just before the seizure. At the end of such precursors, the epileptic falls, losing consciousness, after which he has the following signs of epilepsy: first, tonic convulsions (the trunk tenses and bends), lasting about 30 seconds, then clonic muscle contractions occur in the form of rhythmic oscillations, lasting up to two minutes. Due to the contraction of the respiratory muscles, the patient's face becomes bluish-black due to suffocation. In addition, epileptics often bite own language or the cheeks, due to the contraction of the jaws. Foam flows from the patient's mouth, often mixed with blood due to a wound on the tongue or cheeks.

The seizure of epilepsy ends with involuntary urination and fecal excretion. A person does not come to consciousness immediately, and confusion can persist for several days. Epileptics do not remember anything about the attack.

A type of generalized seizure is febrile convulsions, observed in babies from four months to six years of age. They are accompanied by high temperature body. Basically, such seizures happen several times and do not turn into true epilepsy.

In addition to large convulsive seizures, epileptics can often have small seizures, which are manifested by loss of consciousness without falling. The muscles of the face cramp, the epileptic commits illogical acts or repeats the same actions. After the seizure, the person is unable to remember what happened and will continue to do what they did before the seizure.

The consequences of epilepsy, its severity are different and depend on the forms of the disease and the area of \u200b\u200bbrain damage.

Epilepsy diagnostics

To understand how to treat epilepsy, to outline certain steps that contribute to a prolonged remission, in the first turn, it is necessary to exclude other pathologies and establish the type of disease. For this purpose, in the first turn, anamnesis is collected, that is, a thorough interview of the patient and his relatives is carried out. In the collection of anamnesis, every little thing is important: whether the patient feels the approach of a seizure, whether a loss of consciousness occurs, whether convulsions begin in four limbs at once or in one, which he feels after a convulsive attack.

Epilepsy is considered quite insidious disease, which can often be unrecognized for a long time.

Can epilepsy be cured? Doctors are often asked this question because people are afraid of this ailment. Any treatment begins with a diagnosis, so the doctor can ask many questions to the patient himself and his immediate environment in order to obtain the most accurate description of the pathology. The survey helps to determine the form and type of attack, and also allows you to presumably establish the area of \u200b\u200bbrain damage and the area of \u200b\u200bfurther spread of pathological electrical activity. All of the above depends on the possible help for epilepsy and the choice of an adequate treatment strategy. After the collection of the anamnesis is completed, a neurological examination is carried out, the purpose of which is to identify the following neurological symptoms in the patient - headache, unstable gait, one-sided weakness (hemiparesis) and other manifestations indicating organic brain pathology.

Diagnosis of epilepsy includes magnetic resonance imaging. It helps to exclude the presence of dysfunctions and pathologies. nervous systemcausing seizures, such as brain tumor processes, abnormalities of capillaries and brain structures. Magnetic resonance imaging is considered an important part of the diagnosis of epilepsy and is done when the first convulsive episode occurs.

Electroencephalography is also necessary method diagnostics.
Brain electrical activity can be recorded using electrodes placed on the head of the person being diagnosed. Outgoing signals are magnified many times and are recorded by the computer. The research is conducted in a darkened room. Its duration is approximately twenty minutes.

If the disease is present, electroencephalography will show transformations called epileptic activity. It should be noted that the presence of such activity on the electroencephalogram does not yet mean the presence of epilepsy, since in 10% of the completely healthy population of the planet, various violations of the electroencephalogram can be detected. At the same time, in many epileptics, the electroencephalogram between seizures may not show any changes. In such patients, one of the ways to diagnose epilepsy is to provoke abnormal electrical signals in the brain. For example, encephalography can be performed while the patient is sleeping, since sleep causes an increase in epileptic activity. Other ways to induce epileptic activity on an electroencephalogram are photostimulation and hyperventilation.

Epilepsy treatment

Most people are concerned about the question: "can epilepsy be cured", since there is an opinion that this pathology is incurable. Despite the danger of the described ailment, it is possible to cure it from it, subject to timely detection and adequate treatment. In approximately 80% of cases of morbidity, it is possible to achieve a stable remission. If this disease is detected for the first time and adequate therapy is started immediately, then in 30% of people with epilepsy, seizures no longer recur or stop for at least two to three years.

How is epilepsy treated? The choice of treatment methods for the pathology in question, depending on its form, type, clinical picture, patient's age, lesion focus, is carried out either surgicallyor conservative method. Modern medicine often resorts to drug treatment, since taking antiepileptic drugs gives a lasting effect in almost 90% of cases.

Conservative therapy covers several steps:

— differential diagnosis, which allows you to determine the form of the disease and the type of seizures for the correct selection of drugs;

- establishing the factors that gave rise to epilepsy;

- prevention of seizures to completely eliminate risk factors such as overwork, stress, lack of sleep, hypothermia, alcohol consumption;

- relief of epileptic seizures by providing emergency care, the appointment of an anticonvulsant.

It is important to inform relatives about the diagnosis and instruct them on precautions and first aid for seizures. Since during seizures, there is a high probability of injury to patients and respiratory arrest, due to the sinking of the tongue.

Medical treatment for epilepsy involves the regular use of antiepileptic drugs. A situation in which the epileptic drinks medications only after the onset of an epileptic aura should not be allowed, since with the timely administration of an antiepileptic drug, the harbingers of an impending seizure, in most cases, do not appear at all.

What to do with epilepsy?

Conservative treatment of epilepsy involves following the following rules:

- strict adherence to the schedule of taking medications and dosages;

- upon achieving positive dynamics, you cannot stop taking medications without the permission of a specialist;

- promptly notify your doctor about all unusual manifestations, changes in health, changes in condition or mood.

Patients suffering from partial seizures are prescribed such groups of drugs as carboxamides, valproates, phenytoins. Patients with generalized seizures are shown to prescribe a combination of valproate with carbamazepine; in the idiopathic form, valproate is used; with absence epilepsy - Etosuximide; with myoclonic convulsions - only valproates.

With persistent remission of epilepsy lasting at least five years, you can consider stopping drug therapy.

Treatment of epilepsy should be completed gradually, with dose reduction until complete cessation within six months.

First aid for epilepsy involves, in the first place, preventing the tongue from sinking, by inserting between the jaws of the patient any object, preferably made of rubber or other material, but not very hard. It is not recommended to carry the patient during a seizure, but to avoid injury, it is necessary to put something soft under the head, for example, clothes coiled into a sack. It is also recommended to cover the eyes of the epileptic with something dark. With limited access to light, the seizure goes away faster.

The information provided in this article is intended solely for informational purposes and cannot replace professional advice and qualified medical assistance... At the slightest suspicion of the presence of this disease, be sure to consult a doctor!

Epilepsy is an endogenous organic disease of the central nervous system, characterized by large and small seizures, epileptic equivalents and pathocharacterological personality changes. Epilepsy occurs in humans and other lower mammals such as dogs and cats.

The historical name - "epilepsy" disease - got epilepsy due to obvious external signs, when patients before the attack fainted and fell. Stories are known for epileptics who left behind a cultural and historical heritage:

• Fedor Dostoevsky;
• Ivan the Terrible;
• Alexander the Great;
• Napoleon;
• Alfred Nobel.

Epilepsy is a widespread disease that includes a number of syndromes and disorders based on organic and functional changes in the central nervous system. In adults with epilepsy, there are a number of psychopathological syndromes such as epileptic psychosis, delirium, or somnambulism. Therefore, speaking of epilepsy, doctors do not mean seizures per se, but a set of pathological signs, syndromes and symptom complexes that gradually develop in a patient.

The pathology is based on a violation of the processes of excitation in the brain, due to which a paroxysmal pathological focus is formed: a series of repeated discharges in neurons, from which an attack may begin.

What can be the consequences of epilepsy:

1. Specific concentric dementia. Its main manifestation is bradyphrenia or stiffness of all mental processes (thinking, memory, attention).
2. Personality change. Due to the rigidity of the psyche, the emotional-volitional sphere is upset. Personality traits specific to epilepsy are added, for example, pedantry, grumbling, stinging.

Complications of the disease:

• Status epilepticus. The condition is characterized by repeated epileptic seizures within 30 minutes, between which the patient does not regain consciousness. Complication requires the use of resuscitation measures.
• Death. Due to the sharp contraction of the diaphragm - the main respiratory muscle - gas exchange is disrupted, as a result of which hypoxia of the body and, most importantly, the brain increases. The formation of oxygen starvation leads to a disorder of blood circulation and tissue microcirculation. A vicious circle turns on: respiratory and blood circulation disorders increase. Due to tissue necrosis, toxic metabolic products are released into the bloodstream, affecting the acid-base balance of the blood, leading to severe intoxication of the brain. In this case, death may occur.
• Injuries resulting from slaughter during an attack. When a patient develops convulsive seizures, he loses consciousness and falls. At the time of the fall, the epileptic hits the asphalt with his head, body, knocks out his teeth and breaks his jaw. In the expanded stage of the attack, when the body contracts convulsively, the patient also beats his head and limbs against the hard surface on which he lies. After the episode, hematomas, bruises, bruises and abrasions of the skin are found on the body.

What, then, to do in case of epilepsy? For those around and witnesses of the epileptic status, the main thing is to call the ambulance team and remove around the patient all blunt and sharp objects with which the epileptic in a seizure can harm himself.

Causes

The causes of epilepsy in adults are:

Not every seizure is called epileptic, therefore, the clinical characteristics of seizures are isolated in order to classify them as "epileptic":

• Sudden appearance anytime, anywhere. The development of a seizure does not depend on the situation.
• Short duration. The duration of the episode varies from a few seconds to 2-3 minutes. If the seizure has not stopped within 3 minutes, they talk about status epilepticus, or about a hysterical seizure (an attack similar to epilepsy, but not).
• Self-termination. An epileptic seizure does not need external intervention, since after a while it stops by itself.
• A tendency to be systematic with a desire to increase frequency. For example, a seizure will recur once a month, and the frequency of episodes per month increases with each year of illness.
• "Photographic" seizure. Usually, in the same patients, an epileptic seizure develops according to similar mechanisms. Each new attack repeats the previous one.

The most typical generalized epileptic seizure is the grand mal seizure.

The first signs are the appearance of harbingers. A few days before the onset of the disease, the patient's mood changes, irritability appears, the head breaks, and general health worsens. Usually, precursors are specific to each patient. "Experienced" patients, knowing their forerunners, prepare in advance for a seizure.

How to recognize epilepsy and its onset? Harbingers are replaced by an aura. Aura is a stereotypical short-term physiological change in the body that occurs an hour before an attack or a few minutes before it. The following types of aura are distinguished:

Vegetative

The patient appears excessive sweating, general deterioration of health, increased blood pressure, diarrhea, impaired appetite.

Motor

Small tics are observed: eyelids twitch, finger.

Visceral

Patients note unpleasant sensations that do not have precise localization. People complain of stomach pains, colic in the kidneys, or heaviness of the heart.

Mental

Simple and complex hallucinations are included. In the first option, if these are visual hallucinations, there are sudden flashes before the eyes, mainly of a white or green hue. The content of complex hallucinations includes seeing animals and people. Content is usually associated with phenomena that are emotionally significant for the individual.

Auditory hallucinations are accompanied by music or voices.

The olfactory aura is accompanied by unpleasant odors of sulfur, rubber or paved asphalt. The gustatory aura is also accompanied by unpleasant sensations.

The psychic aura itself includes déjà vu (deja vu) and jamais vu (jamevu) - this is also a manifestation of epilepsy. Déjà vu is the sensation of what has already been seen, and jamevu is a state in which the patient does not recognize a previously familiar environment.

Illusions belong to the psychic aura. Typically, this disorder of perception is characterized by the feeling that the size, shape, and color of familiar shapes have changed. For example, on the street a familiar monument has increased in size, the head has become disproportionately large, and the color has acquired a blue color.

The psychic aura is accompanied by emotional changes. Before a seizure, some have a fear of death, some become rude and irritable.

Somatosensory

Paresthesias occur: tingling of the skin, crawling sensation, numbness of the limbs.

The next phase after the harbingers is a tonic attack. This stage lasts an average of 20-30 seconds. Convulsions involve all skeletal muscles. Especially the spasm captures the extensor muscles. Muscle chest and the anterior abdominal wall are also reduced. Air passes through the spasmodic glottis when falling, so when the patient falls, others can hear a sound (epileptic cry) that lasts 2-3 seconds. The eyes are wide open, the mouth is half open. Usually, cramps originate in the muscles of the trunk, gradually passing to the muscles of the limbs. The shoulders are usually pulled back, the forearms are bent. Due to cuts facial muscles various grimaces appear on the face. The skin tone becomes blue due to impaired oxygen circulation. The jaws are tightly closed, the eye sockets rotate chaotically, and the pupils do not respond to light.

Why is this stage dangerous: the rhythm of respiration and cardiac activity are disturbed. The patient stops breathing and the heart stops.

After 30 seconds, the tonic phase flows into the clonic phase. This stage consists of short-term contractions of the flexor muscles of the trunk and limbs with periodic relaxation. Clonic muscle contractions last up to 2-3 minutes. Gradually, the rhythm changes: the muscles contract less often, and more often they relax. Over time, clonic seizures disappear completely. In both phases, patients usually bite their lips and tongue.

The characteristic signs of a generalized tonic-clonic seizure are mydriasis (dilated pupil), the absence of tendon and ocular reflexes, and increased saliva production. Hypersalivation in combination with biting the tongue and lips leads to mixing of saliva and blood - frothy discharge from the mouth appears. The amount of foam is also increased by the fact that during an attack, excretion in the sweat and bronchial glands increases.

The last stage of the big seizure is the resolution phase. 5-15 minutes after the episode occurs coma... It is accompanied by muscle atony, which leads to relaxation of the sphincters - because of this, feces and urine are released. Superficial tendon reflexes are absent.

After all the cycles of the attack have passed, the patient returns to consciousness. Patients usually complain about headache and feeling unwell. There is also partial amnesia after the attack.

Petit mal, absence, or small seizure. This epilepsy manifests itself without seizures. How to determine: the patient's consciousness is switched off for a while (from 3-4 to 30 seconds) without precursors and aura. At the same time, all motor activity is "frozen", and the epileptic freezes in space. After the episode, mental activity is restored in the same rhythm.

Epileptic seizures at night. They are fixed before sleep, during sleep and after it. Falls in the phase of rapid eye movement. An epileptic seizure during sleep is characterized by a sudden onset. The patient's body assumes unnatural postures. Symptoms: chills, tremors, vomiting, respiratory failure, foam at the mouth. After awakening, the patient has impaired speech, he is disoriented and frightened. After the attack, there is a severe headache.

One of the manifestations of nocturnal epilepsy is somnambulism, sleepwalking or sleepwalking. It is characterized by the performance of stereotyped patterned actions with the mind off or partially on. Usually he makes such movements that he makes in the waking state.

There are no gender differences in the clinical picture: the signs of epilepsy in women are exactly the same as in men. However, gender is taken into account in treatment. Therapy in this case is partially determined by the leading sex hormones.

Classification of the disease

Epilepsy is a multifaceted disease. Types of epilepsy:

• Symptomatic epilepsy is a subspecies characterized by a vivid manifestation: local and generalized seizures due to organic pathology of the brain (tumor, brain injury).
• Cryptogenic epilepsy. It is also accompanied by obvious signs, but without an obvious or not at all established reason. It is about 60%. A subspecies - cryptogenic focal epilepsy - is characterized by the fact that an exact focus of abnormal excitation is established in the brain, for example, in the limbic system.
• Idiopathic epilepsy. Clinical picture appears as a result of functional disorders of the central nervous system without organic changes in the substance of the brain.

There are separate forms of epilepsy:

1. Alcoholic epilepsy. It appears as a result of the toxic effects of alcohol breakdown products due to prolonged abuse.
2. Epilepsy without seizures. It manifests itself in the following subspecies:
   • sensory seizures without loss of consciousness, in which abnormal discharges are localized in sensitive areas of the brain; characterized by somatosensory disorders in the form of sudden disturbances in vision, hearing, smell, or taste; dizziness often joins;
   • vegetative-visceral seizures, characterized mainly by a disorder of the gastrointestinal tract: sudden pain spreading from the stomach to the throat, nausea and vomiting; the cardiac and respiratory activity of the body is also disturbed;
   • mental attacks are accompanied by sudden speech impairment, motor or sensory aphasia, visual illusions, complete loss of memory, impaired consciousness, impaired thinking.
3. Temporal lobe epilepsy. The focus of excitation is formed in the lateral or median region of the temporal lobe of the telencephalon. It is accompanied by two options: with loss of consciousness and partial seizures, and without loss of consciousness and with simple local seizures.
4. Parietal epilepsy. It is characterized by focal simple seizures. The first symptoms of epilepsy: impaired perception of the scheme of one's own body, dizziness and visual hallucinations.
5. Frontal-temporal lobe epilepsy. The abnormal focus is localized in the frontal and temporal lobes. It is characterized by many options, including: complex and simple seizures, with and without switching off consciousness, with and without perceptual disorders. Often manifests itself as generalized seizures with convulsions throughout the body. The process repeats the stages of epilepsy in the form of a grand mal seizure.

Classification by time of onset of the disease:

• Congenital. Appears against the background of intrauterine fetal developmental defects.
• Acquired epilepsy. It appears as a result of exposure to vital negative factors that affect the integrity and functionality of the central nervous system.

Treatment

Epilepsy therapy should be comprehensive, regular and long-term. The meaning of the treatment is that the patient takes a number of drugs: anticonvulsant, dehydration and tonic. But long-term treatment usually consists of one drug (the principle of monotherapy), which is optimally selected for each patient. The dose is selected empirically: the amount active substance increase until the attacks disappear completely.

When the effectiveness of monotherapy is low, two or more drugs are prescribed. It should be remembered that a sudden discontinuation of the drug can lead to the development of status epilepticus and lead to the death of the patient.

How to help with a seizure, if you are not a doctor: if you witness a seizure, call ambulance and time the attack start. Then control the course: remove stones, sharp objects and everything else that can injure the patient around the epileptic. Wait for the seizure to end and help the ambulance transport the patient.

What is not allowed with epilepsy:

1. touch and try to hold the patient;
2. stick your fingers in your mouth;
3. hold your tongue;
4. put something in your mouth;
5. try to open your jaw.

Epilepsy is a nervous disease mental nature, characterized by several characteristic features.

The period between exacerbations may be completely normal and not accompanied by symptoms. The disease gained fame even from ancient literature, because there are references to it in Egyptian scriptures, several millennia have passed since that moment.

The first signs of epilepsy in adults can appear at absolutely any age. At first, seizures can be mild with huge intervals, but then they happen more and more often with a change in character.

Why does epilepsy appear in adults?

The course of epilepsy in adults is caused by a variety of causes. After all, this is a disease, which is sometimes problematic to establish. It is more competent and rational to talk about risk factors than about the immediate causes of the disease.

There are several points among them.

• Hereditary predisposition. It implies a special state of neural options, because they become prone to generation.
• The acquired condition is the process of the consequence of previously transferred diseases, which include TBI, meningitis, tumors and cancer, toxic damage, adhesions.

Each of the factors presented has properties and characteristics to lead to the formation of neurons in the brain, which are characterized by a low excited threshold.

It is through this group that the formation of an epileptic focus occurs, in which an impulse is localized that has the ability to spread to surrounding elements.

When all this happens, a seizure occurs. These are the causes of epilepsy in adults, and as you can see, it is not always possible to prevent them.

Symptoms of the disease

With this ailment, clinical signs are of a spontaneous nature of manifestation. Their provocation by a flashing light or a febrile state is least often observed. Basically, the symptoms of epilepsy in adults are limited to certain manifestations.

1. Generalized seizures - during these seizures, the patient is faced with serious injuries, often bites the tongue, or involuntary urination occurs.
2. Partial seizures appear during the formation of a focus of excessive excitability in a certain area of \u200b\u200bthe cortex. Their manifestations are influenced by the location of the focus.
3. Convulsive seizures of a clonic or tonic form. Through their influence, the entire cerebral cortex is involved in this process, while the pain can freeze in one place.
4. Abrupt blackouts of consciousness for short periods, while the person ceases to have a reaction to environmental factors and is in a completely frozen position.

In the mild stage of epilepsy, symptoms in adults are almost not manifested, and if the form is severe, they are repeated daily and can occur several times in a row. Also, the patient traditionally suffers from personality changes. At the same time, there may be a sharp transition from flattery and softness to anger. Many people are mentally retarded.

Features of diagnostic measures

For quality therapy, you must first determine the causes of epilepsy in adults. This can only be done with the help of an experienced specialist. The diagnosis is based on how the patient himself or his relatives describe the observed attack.

In addition to the interview, the doctor will conduct a thorough examination.

It includes several basic activities.

1. MRI of the brain, this analysis allows you to exclude other causal factors and the nature of the disease.
2. EEG involves the use of special sensors, which, superimposed on the head, help to record the activity of the epileptic plan.
3. ECG to check the quality and efficiency of the patient's heart muscle.
4. Checking the functioning of the kidneys and liver, as well as other internal organs.
5. Analysis of blood and urine, according to the obtained data of the MRI study.

The question is directly about the treatment of epilepsy in adults, namely, is epilepsy treated in adults? Thanks to the development of modern technologies, including in the field of prevention, you can easily achieve the required health indicator.

What is the prognosis of the therapeutic process

In the lion's share of clinical situations, if the seizure is single, the prognosis for the treatment of epilepsy is more than favorable. In about 70% of patients' situations during therapy, remission occurs, that is, it implies the absence of seizures over a 5-year period.

It is also worth noting that in 30% of situations, seizures continue, so it is necessary to simultaneously prescribe anticonvulsants. It also happens that remedies assigned in the complex, but this will be discussed later.

Features of the therapeutic process

Many are interested in the question of how to treat epilepsy in adults, especially people who are faced with this disease face to face.

In fact, the goal of therapy is to stop seizures. At the same time, special attention is paid to minimizing side effects and in getting a fulfilling and productive life afterwards.

Before prescribing antiepileptic drugs, the attending physician performs a high-quality detailed examination of the patient. It involves the implementation of clinical measures and the adoption of electroencephalographic decisions.

What are the principles of the therapeutic process

If a seizure occurs, and it happens all the time, you should visit your doctor. Before using any drugs the patient should be informed about the medication regimen and possible side effects.

Usually, the specifics of treatment, if this symptom occurs, includes several key fundamental features.

1. Full compliance of the taken medicinal composition with the type of seizures. This is due to the fact that each drug is adapted for specific signs and symptoms.
2. If possible, it is necessary to apply mono therapy in practice. It implies the use of an antiepileptic drug.

With the onset of seizures, medications are selected based on the form and nature of the disease. Typically, tablets, solutions, or other forms are given immediately at the initial dosage and are gradually increased.

If this or that drug is ineffective, it is canceled, and then the next composition is prescribed for use.

It is strictly forbidden to change the funds or stop using them on the basis of an independent decision, even if the symptoms that appear have been eliminated. If the instructions are not followed, deterioration may occur again very soon.

Features of drug therapy for epilepsy

These methods of treatment involve a combination with a strict diet, adherence to sleep and wakefulness. Also, patients should refrain from consuming large amounts of hot spices, coffee drinks and alcohol. After a seizure occurs, doctors usually prescribe the following groups of drugs.

• Anticonvulsants provide a reduction in the frequency and duration of all attacks;
• means that help suppress or stimulate the transfer of excitement in different departments;
• psychotropic compounds that have a powerful effect on the work of the central nervous system, changing the mental state as a whole.

With epilepsy, the causes of occurrence in adults are determined by a doctor who prescribes effective methodology therapy.

Alternative interventions

There is a wide variety of current therapeutic interventions and new therapies are often emerging.

Usually, alternative methods of treatment include several areas:

• surgery;
• voight's method;
• ketogenic diet.

The frequency of attacks can be influenced by the daily regimen, and factors can be individual in nature. Also, nighttime epilepsy may sometimes appear, which consists in the formation of seizures at night. Its course and treatment should also be studied by a strictly treating specialist.

The surviving documents indicate that many well-known figures (Caesar, Nobel, Dante) suffered from epilepsy - epilepsy.

In modern society, it is difficult to determine the percentage of patients - some of them carefully conceal the problem, and the rest do not know the symptoms. It is necessary to consider in detail what epilepsy is.

Today, treatment helps 85% of people prevent epileptic seizure and lead a familiar existence. The causes of epilepsy in adults have not always been identified.

However, the occurrence of an epileptic seizure is not a sentence, but a manifestation of the disease, amenable to treatment.

Epilepsy in adults occurs when neurons are overactive, resulting in excess, abnormal neuronal discharges.

It is believed that the root cause of these pathological discharges (depolarization of neurons) is the cells of the injured parts of the brain. In some cases, a seizure stimulates the appearance of new foci of epilepsy.

The main factors contributing to the development of this pathology are meningitis, arachnoiditis, encephalitis, tumors, trauma, and circulatory disorders.

Often, the causes of epilepsy in adults remain uncertain, and doctors tend to favor a chemical imbalance in the brain. In children, epilepsy is associated with a hereditary factor.

But at any age, the causes of epilepsy can be infection or damage to the brain. The later the disease manifests itself in people, the higher the risk of developing severe brain complications.

Why does epilepsy occur? This is facilitated by:

• low birth weight, premature delivery (congenital epilepsy);
• birth trauma;
• anomalies in the development of the vascular system;
• traumatic brain injury (blow to the head);
• oxygen deficiency;
• malignant neoplasms;
• infections;
• alzheimer's disease;
• hereditary metabolic disorders;
• thromboembolism blood vessels, the consequences of a stroke;
• mental disorders;
• cerebral paralysis;
• drug and alcohol abuse, antidepressants and antibiotics.

Separately, there is myoclonic epilepsy, which is diagnosed in children or adolescents during puberty. Pathology is inherited, but there are acquired forms.

Symptoms

The peculiarity of the disease is that the patient cannot fully understand what is happening. Others are not always able to provide the right help when an attack occurs.

The main symptoms of epilepsy in adults and children are recurrent seizures, during which there are:

• convulsive movements;
• lack of response to external influences;
• loss of consciousness;
• jerky convulsions of the whole body;
• the head is thrown back;
• profuse salivation.

Sometimes it can happen that with epilepsy, intellectual capabilities suffer, and work capacity decreases. In some patients, on the contrary, sociability, attention and hard work increase.

Epileptics thought processes slowed down, which affects behavior and speech. Even a clear speech is laconic, but rich in diminutive turns. People begin to detail and explain the obvious. They find it difficult to change topics of conversation.

Forms of epilepsy

Its division is based on the genesis and category of seizures:

1. Local (partial, focal) - epileptic disease of the frontal, temporal, parietal or occipital zone.
2. Generalized:

• idiopathic - the root cause remains undetected in 70-80% of cases;
• symptomatic - due to organic brain damage;
• cryptogenic - the etiology of epileptic syndromes is unknown, the form is considered intermediate between the two previous ones.

There is primary or secondary (acquired) epilepsy. Secondary epilepsy occurs under the influence of external agents: pregnancy, infections, etc.

Post-traumatic epilepsy is the occurrence of seizures in patients after physical damage to the brain, loss of consciousness.

In children, myoclonic epilepsy is characterized by seizures with massive symmetrical manifestation and does not provoke psychological deviations.

Alcoholic epilepsy is associated with alcohol abuse.

Nocturnal epilepsy - seizures occur during sleep due to decreased brain activity. People with epilepsy may bite their tongue while sleeping; the attack is accompanied by uncontrolled urination.

Seizures

An epileptic seizure is a brain reaction that disappears after the underlying causes are eliminated. At this time, a large focus of neural activity is formed, which is surrounded by a restraining zone, like insulation of an electric cable.

The extreme nerve cells do not allow the discharge to travel throughout the brain as long as their power is sufficient. When a breakthrough occurs, it begins to circulate over the entire surface of the cortex, causing "shutdown" or "absence".

Experienced doctors know how to recognize epilepsy. In a state of absence, the epileptic moves away from the world around him: he stops abruptly, concentrates his gaze on the spot and does not react to the environment.

Absance lasts a couple of seconds. When a discharge hits the motor zone, a convulsive syndrome appears.

The epileptic learns about the absence form of the disease from eyewitnesses, since he himself does not feel anything.

Types of seizures

Epileptic seizures are classified according to several criteria.

Knowing the exact type of disease allows you to choose the most effective treatment.

The classification is based on the reasons, the flow scenario and the location of the focus.

For root reasons:

• primary;
• secondary;

According to the development scenario:

• preservation of consciousness;
• lack of consciousness;

By the location of the hearth:

• the cortex of the left hemisphere;
• the cortex of the right hemisphere;
• deep departments.

All epileptic seizures are divided into 2 large groups: generalized and focal (partial). In generalized seizures, both cerebral hemispheres are affected by pathological activity.

With focal seizures, the focus of excitation is localized in any one area of \u200b\u200bthe brain.

Generalized seizures are characterized by loss of consciousness, lack of control over their actions. The epileptic falls, throws back his head, his body is shaken by convulsions.

During a seizure, a person begins to scream, loses consciousness, the body tenses and stretches, skin turn pale, breathing slows down.

At the same time, the heart rate increases, frothy saliva flows out of the mouth, blood pressure, involuntary excretion of feces and urine. Some of the listed syndromes may be absent in epilepsy (non-convulsive epilepsy).

After the seizures, the muscles relax, breathing becomes deeper, and the cramps subside. Consciousness returns over time, but still a day remains increased sleepiness, confused consciousness.

Types of seizures in children and adults

A febrile seizure of epilepsy can appear in children under 3-4 years of age with an increase in temperature.

Epilepsy was recorded in 5% of children. Children have two types of epilepsy:

• benign - seizures stop autonomously or with minimal treatment (myoclonic epilepsy);
• malignant - any appointment does not lead to improvements, the disease progresses.

Seizures in children are vague and atypical, without specific symptoms. Parents sometimes do not notice the onset of seizures.

Modern medicines are highly effective - in 70-80% of cases, the seizure focus in the brain is blocked.

Myoclonic epilepsy is accompanied by several types of seizures:

• A tonic-clonic epileptic seizure is first accompanied by tension of the extensor muscles (the body bends in an arc), and then - flexor muscles (the epileptic hits his head on the floor, may bite his tongue).
• Absences are characterized by a suspension of activity and are common in childhood. The child "freezes", sometimes twitching of the facial muscles may occur.

Focal (partial) seizures occur in 80% of the elderly and 60% in childhood.

They begin when the focus of excitation is localized in one area of \u200b\u200bthe cerebral cortex. There are attacks:

• vegetative;
• motor;
• sensitive;
• mental.

In difficult cases, consciousness is partially lost, but the patient does not come into contact and is not aware of his actions. After any attack, generalization can occur.

In adults, after such attacks, organic brain damage progresses. For this reason, it is important to get tested after a seizure.

An epileptic seizure lasts up to 3 minutes, after which confusion and drowsiness sets in. When "out", a person cannot remember what happened.

Harbingers of an attack

Before large seizures, precursors (aura) appear for a couple of hours or days: irritability, excitability, inappropriate behavior.

The first signs of epilepsy in adults are different types of aura:

• sensory - auditory, visual hallucinations;
• psychic - a feeling of fear, bliss appears;
• vegetative - a violation of the functioning of internal organs: nausea, heart palpitations;
• motor - motor automatism is manifested;
• speech - meaningless pronunciation of words;
• sensitive - the appearance of a feeling of numbness, cold.

Interictal manifestations

Recent research suggests that symptoms of epilepsy in adults are not all about seizures.

A person has a constantly high readiness for seizures, even when they do not appear outwardly.

The danger lies in the development of epileptic encephalitis, especially in childhood. Unnatural bioelectrical activity in the brain between seizures causes severe illness.

First aid

The main thing is to stay calm. How is epilepsy defined? If a person has convulsions and the pupils are dilated, then this is an epileptic seizure.

First aid for an epileptic seizure includes ensuring safety: the epileptic's head is placed on a soft surface, sharp and cutting objects are removed.

Do not restrain convulsive movements. It is forbidden to put any objects in the patient's mouth or to unclench the teeth.

When vomiting occurs, a person is turned on their side so that the vomit does not end up in the airways.

The duration of the convulsions is a couple of minutes. If the duration is more than 5 minutes or if there are injuries call an ambulance. After the patient is laid on his side.

Small attacks do not involve external intervention.

But if a seizure lasts more than 20 minutes, then there is a high probability of occurrence of status epilepticus, which can only be stopped intravenous administration medications... First aid for this type of epilepsy is to call a doctor.

Diagnostics

Diagnostics begins with a detailed survey of the patient and those around him, who will tell you what happened. The doctor should know general state the patient's health and the characteristics of seizures, how often they occur.

It is important to find out the presence of a genetic predisposition.

After collecting an anamnesis, they proceed to a neurological examination to identify signs of brain damage.

An MRI is always done to rule out diseases of the nervous system, which can also provoke seizures.

Electroencephalography examines the electrical activity of the brain. Decoding should be done by an experienced neurologist, since epileptic activity occurs in 15% of healthy people.

Often between attacks, the EEG picture is normal, then the attending physician before the examination provokes pathological impulses.

During diagnosis, it is important to determine the type of seizures for the correct prescription of drugs. For example, myoclonic epilepsy can be differentiated only in a stationary manner.

Treatment

Almost all types of epileptic seizures can be controlled with medication. In addition to drugs, diet therapy is prescribed. In the absence of a result, they resort to surgical intervention.

Treatment for epilepsy in adults is determined by the severity and frequency of seizures, age and health status. Correct identification of its type increases the effectiveness of treatment.

Medications should be taken after examinations. They do not treat the cause of the disease, but only prevent new attacks and progression of the disease.

The drugs of the following groups are used:

• anticonvulsants;
• psychotropic;
• nootropic;
• tranquilizers;
• vitamins.

High efficiency is noted in complex treatment subject to the balance of work / rest, exclusion of alcohol, proper nutrition.

Loud music, lack of sleep, physical or emotional stress can provoke epileptic seizures.

You need to be prepared for long-term treatment and regular medication. If the frequency of attacks decreases, then the amount of drug therapy may be reduced.

Surgical intervention is prescribed for symptomatic epilepsy, when the cause of the disease is aneurysms, tumors, abscesses.

Surgeries are performed under local anesthesia to monitor the integrity and response of the brain. The temporal form of the disease lends itself well to this type of treatment - 90% of patients feel better.

In the idiopathic form, callosotomy may be prescribed - cutting the corpus callosum to connect the two hemispheres. This intervention prevents recurrence of seizures in 80% of patients.

Complications and consequences

It is important to be aware of the dangers of epilepsy. The main complication is considered status epilepticus, when the patient does not return to consciousness between frequent seizures.

The strongest epileptic activity leads to cerebral edema, from which the patient can die.

Another complication of epilepsy is injury due to a person falling on a hard surface, if any parts of the body hit moving objects, or loss of consciousness while driving.

Biting the tongue and cheeks is most common. With low bone mineralization, strong muscle contraction causes fractures.

In the last century, it was believed that this disease provokes a mental disorder, the epileptic was sent for treatment to psychiatrists. Today, neurologists are leading the fight against the disease. However, it has been established that some mental changes do take place.

Psychologists note the emerging types of deviations:

• characterological (infantilism, pedantry, egocentrism, affection, vindictiveness);
• formal thinking disorders (detailing, thoroughness, perseveration);
• permanent emotional disorders (impulsivity, softness, viscosity of affect);
• decreased intelligence and memory (dementia, cognitive impairment);
• change in temperament and sphere of hobby (increased instinct of self-preservation, gloomy mood).

Even with the right medication, children may experience learning difficulties associated with hyperactivity. They suffer the most psychologically, which is why they begin to have complexes, choose loneliness, and are afraid of crowded places.

The attack can happen at school or elsewhere public place... Parents are obliged to explain to the child what kind of illness it is, how to behave in anticipation of an attack.

Adults have restrictions on some activities. For example, driving a car, working with machines, swimming in water. In a severe form of the disease, you should control your psychological state.

The epileptic will have to change the lifestyle: exclude the strong physical exercise and playing sports.

Epilepsy in pregnant women

Many antiepileptic drugs inhibit the effectiveness of contraceptives, which increases the risk of an unwanted pregnancy.

If a woman wants to be a mother, then she should not be persuaded - not the disease itself is inherited, but only genetic predisposition To her.

In some cases, the first seizures of epilepsy appeared in women while carrying children. For these women, an emergency treatment plan was developed.

With epilepsy, it is possible to give birth to a healthy baby. If the patient is registered with an epileptologist, then when planning a pregnancy, scenarios for its development are prepared in advance.

The expectant mother should know the effect of anticonvulsants on the fetus, undergo examinations in time to identify pathologies in the development of the child.

6 months before the intended pregnancy is revised drug therapy... Often, doctors completely cancel anticonvulsants if there have been no seizures in the last 2 years and there are no neurological abnormalities.

Then there is a high probability of a pregnancy without seizures in the presence of epilepsy.

The greatest danger during pregnancy is hypoxia and hyperthermia caused by status epilepticus. There is a threat to the life of the fetus and mother due to disruption of the brain and kidneys - 3-20% of women in labor do not survive in such a situation.

In developed countries, this indicator is minimal, modern equipment allows you to identify deviations in the early stages.

The most common fetal pathologies are prematurity, congenital anomalies, many of which are corrected surgical intervention in the first year of a baby's life.

Conclusion

The diagnosis of epilepsy is not a death sentence for people of any age. Today, every neurologist knows how to treat epilepsy in adults without disability. The drugs can block seizures in 85% of cases.

Timely diagnosis and correct treatment allow you to achieve remission of epilepsy on long time - the disease will not manifest.

Epileptics are ordinary people, those around whom should not be afraid, but know what to do in case of an epilepsy attack. The prognosis for life with epilepsy is quite favorable.

We hope the article helped you find out what epilepsy is, how it manifests itself and what are the principles of its treatment. If you like the post, please give it 5 stars!