And whether you know...
January 26, 2013
Epilepsy is a psychoneurological illness which has chronic character. The main characteristic of epilepsy is tendency of the patient to periodically repeating attacks which arise suddenly. At epilepsy attacks of different types can be shown, however, a basis of such attacks is abnormal activity of nervous cells in a brain of the person because of which there is an electric discharge.
Epilepsy (so call epilepsy) is known to people since the most ancient times. Historical data that many famous people had this disease remained (epileptic seizures happened at Julius Caesar, Napoleon, Dante, Nobel, etc.).
Today it is difficult to say about as far as this disease as many people just do not realize that they show epilepsy symptoms is widespread in the world. Still part of patients hide the diagnosis. So, there are data on what in some countries prevalence of an illness can make to 20 cases on 1000 people. Besides about 50 children on 1000 people, at least, once in life had an epilepsy attack while at them body temperature strongly increased.
Unfortunately, till today there is no method allowing to cure completely this disease. However, using the correct tactics of therapy and selecting suitable medicines, doctors reach the termination of attacks approximately in 60–80% of cases. The illness only in rare instances can lead both to death, and to serious violations of physical and intellectual development.
Till today the reasons for which at the person the epilepsy attack begins are definitely not known to specialists. Periodically epileptic seizures happen at people to some other diseases. As scientists testify, symptoms of epilepsy at the person are shown if a certain zone of a brain is damaged, but at the same time completely it does not collapse. Brain cells which suffered, but at the same time nevertheless kept viability, become sources of pathological categories because of which epilepsy is shown. Sometimes effects of an attack are expressed by new injuries of a brain, and the new centers of epilepsy develop.
Specialists up to the end do not know what is epilepsy and why one patients suffer from attacks, and others do not have them at all. The explanation for that fact that at one patients the attack happens single is also unknown, and at others attacks repeat often.
Answering a question whether epilepsy is descended, doctors speak about influence of a genetic favor. However in general displays of epilepsy are caused by both hereditary factors, and influence of environment, and also diseases which the patient had earlier.
The brain tumor, brain abscess, meningitis, encephalitis, inflammatory granulomas, vascular frustration can be the reasons of symptomatic epilepsy. At a tick-borne encephalitis at the patient displays of so-called kozhevnikovsky epilepsy are observed. Also symptomatic epilepsy can be shown against intoxication, an endointoxication.
The craniocereberal injury is the reason of traumatic epilepsy. Its influence is especially expressed if such injury was repeated. Attacks can be shown even in several years after an injury.
Classification of epilepsy is carried out taking into account its origin, and also like attacks. The localizable form of an illness is allocated (partial, focal). It is frontal, parietal, temporal, occipital epilepsy. Also specialists allocate generalized epilepsy (idiopathic and symptomatic forms).
Idiopathic epilepsy is defined if its reason is not established. Symptomatic epilepsy contacts existence of organic lesion of a brain. In 50-75% cases the idiopathic type of a disease takes place. Cryptogenic epilepsy is diagnosed if the etiology of epileptic syndromes is not clear or unknown. Such syndromes are not an idiopathic form of an illness, but also symptomatic epilepsy at such syndromes cannot be defined.
Jacksonian epilepsy is a form of an illness at which the patient has somatomotor or somatosensory attacks. Similar attacks can be as focal, and to extend to other body parts.
Considering the reasons which provoke emergence of attacks, doctors define primary and secondary (acquired) illness forms. Secondary epilepsies develops under the influence of a number of factors (diseases, pregnancy).
Posttraumatic epilepsy is shown by spasms at patients who transferred injury of a brain owing to a head injury earlier.
Alcoholic epilepsy develops at those who systematically take alcohol. This state is complication of alcoholism. Sharp convulsive attacks which periodically repeat are characteristic of it. And, after a while such attacks develop already irrespective of whether took sick alcohol.
Epilepsy night is shown by an illness attack in a dream. Owing to characteristic changes of activity of a brain at part of patients in a dream attack symptoms – tongue biting, an urine upuskaniye, etc. develop.
But what form of a disease would not be shown at the patient, it is important to each person to know how first aid at an attack is given. As the help at epilepsy is sometimes necessary for those at whom the attack happened in the public place. If at the person the attack develops, it is necessary to watch that passability of respiratory tracts was not broken, to warn a zakusyvaniye and retraction of language, and also not to allow traumatizing the patient.
Types of attacks
In most cases the first symptoms of an illness appear at the person in the childhood or at teenage age. Gradually intensity and frequency of attacks increases. Often intervals between attacks are reduced from several months to several weeks or days. In development of an illness often character of attacks considerably changes.
Specialists allocate several types of such attacks. At generalizirovanny (big) convulsive attacks at the patient pronounced spasms develop. As a rule, before an attack there are its harbingers that can be noted also in several hours, and for several days before an attack. Harbingers is high excitability, irritability, changes in behavior, appetite. Before an attack often at patients the aura is noted.
The aura (a state before an attack) is shown at different patients with epilepsy differently. The touch aura is an emergence of visual objects, olfactory and auditory hallucinations. The mental aura is shown by experience of horror, pleasure. Changes in functions and a condition of internals are characteristic of vegetative aura (strong heartbeat, pains in epigastriums, nausea and dr). The motor aura is expressed by emergence of motive avtomatizm (the movement of hands and legs, the zaprokidyvany heads, etc.). At speech aura of people, as a rule, pronounces senseless separate words or exclamations. The sensitive aura is expressed by paresthesias (cold sense, numbness, etc.).
When the attack begins, the patient can shout and make a peculiar grunting sounds. The person falls, faints, his body is extended and strains. Breath is slowed down, the person turns pale.
After that in all body or only in extremities twitchings appear. At the same time pupils extend, arterial pressure sharply increases, saliva from a mouth is emitted, the person sweats, blood rises to the person. Sometimes urine and kcal is involuntarily emitted. The patient in an attack can bite tongue. Then muscles relax, spasms disappear, breath becomes deeper. Gradually the consciousness returns, but still approximately for days drowsiness and signs of confusion of consciousness remains. The described phases at generalizirovanny attacks can be shown also in other sequence.
The patient does not remember such attack, sometimes, however, memories of aura remain. Attack duration – from several seconds to several minutes.
Kind of a generalized attack are febrile spasms which are shown at children to four-year age on condition of high temperature of a body. But most often only a few such attacks which do not pass into true epilepsy take place. As a result, there is an opinion of specialists that febrile spasms do not belong to epilepsy.
Only involvement of one part of a body is characteristic of focal attacks. They are motor or touch. At such attacks the person has spasms, paralysis or pathological feelings. At displays of jacksonian epilepsy attacks move from one part of a body to other.
After spasms in an extremity stop, at it about days there is paresis. If such attacks are observed at adults, then after them there is an organic lesion of a brain. Therefore it is very important to address at once after an attack specialists.
Also patients with epilepsy often have small convulsive attacks at which the person for a certain time faints, however at the same time he does not fall. In seconds of an attack on a face of the patient convulsive twitchings are shown, pallor of the person is observed, the person at the same time looks in one point. In certain cases the patient can be turned on one place, pronounce some incoherent phrases or words. After the termination of an attack of people continues to be engaged in what did before, and does not remember what happened to it.
Polymorphic paroxysms before which, as a rule, for several minutes the vegetative aura is observed are characteristic of temporal epilepsy. At paroxysms of the patient makes inexplicable acts, and, they can sometimes be dangerous to people around. In certain cases heavy changes of the personality take place. At the period between attacks the patient has serious vegetative violations. The illness in most cases proceeds chronically.
Diagnosis of epilepsy
First of all, in the course of establishment of the diagnosis it is important to conduct detailed survey, both the patient, and his close people. Here it is important to learn all details concerning his health, to ask on features of attacks. Important information for the doctor are data on whether there were epilepsy cases in a family when the first attacks, what their frequency began.
Collecting the anamnesis is especially important if children's epilepsy takes place. Parents have to suspect signs at children of display of this disease as soon as possible if for this purpose there are bases. Epilepsy symptoms at children are shown similar to a disease at adults. However diagnosis often is at a loss in view of the fact that the symptoms which are often described by parents testify to other diseases.
Further the doctor conducts neurologic examination, defining existence at the patient of a headache, and also some other signs which demonstrate development of organic lesion of a brain.
To the patient the magnetic and resonant tomography allowing to exclude diseases of a nervous system which could provoke spasms is surely carried out.
In the course of an electroencephalography electric activity of a brain is registered. At patients with epilepsy at such research reveal changes — epileptic activity. However in this case it is important that results of research were considered by the experienced specialist as epileptic activity is registered and approximately at 10% of healthy people. Between epilepsy attacks at patients normal picture EEG can be observed. Therefore often doctors initially by means of a number of methods provoke pathological electric impulses in a cerebral cortex, and then conduct research.
Very important in the course of establishment of the diagnosis to find out what type of an attack takes place at the patient as it defines features of treatment. To those patients at whom different types of attacks are observed appoint treatment using a combination of drugs.
Treatment of epilepsy
Treatment of epilepsy is very labor-intensive process which is not similar to therapy of other illnesses. Therefore, the scheme how to treat epilepsy, the doctor after establishment of the diagnosis has to define. Epilepsy medicine needs to be taken at once after all researches were conducted. The speech does not go here how to cure epilepsy, and, first of all, about the prevention of progress of an illness and display of new attacks. It is important to both patient, and his close people to explain well sense of such treatment, and also to stipulate all other moments, in particular the fact that at epilepsy it is impossible to manage only treatment by folk remedies.
Treatment of an illness always long, and, administration of drugs has to be regular. The dosage is defined by the frequency of display of attacks, illness duration, and also some other factors. In case of inefficiency of therapy drugs are replaced with others. If result of treatment positive, then doses of medicines gradually and very accurately reduce. In the course of therapy it is necessary to trace a physical condition of the person without fail.
At treatment of epilepsy different groups of drugs are applied: anticonvulsant, nootropic, psychotropic drugs, vitamins. Recently doctors practice use of tranquilizers which weakening influence muscles.
At treatment of this illness it is important to adhere to the balanced work-rest schedule, to properly eat, exclude alcohol, and also other factors provoking attacks. It is about an overstrain, a sleep debt, loud music, etc.
At the correct approach to treatment, observance of all rules, and also with the assistance of close people the condition of the patient improves considerably and stabilized.
In treatment of the children sick with epilepsy, the most important point correctness of approach of parents to its implementation is. At children's epilepsy special attention is paid on a dosage of drugs and its correction in process of growth of the kid. Initially the doctor as some medicines can cause allergic reactions and intoxication of an organism has to watch a condition of the child who began to accept a certain drug.
Parents have to consider that the provocative factors influencing developing of attacks is vaccination, sharp rise in temperature, an infection, intoxication, ChMT.
It is worth consulting with the doctor before beginning treatment with medicamentous drugs of other diseases as they can not be combined with means against epilepsy.
One more important point – to take care of a psychological state of the child. It is necessary to explain to him, whenever possible, of features of an illness and to take care of that the kid comfortably felt in children's collective. There have to know about his illness and be able to help it during an attack. And the child needs to realize that in his disease there is nothing terrible, and it is not necessary to be ashamed of an illness to it.
To avoid attacks patients should exclude completely alcohol, smoking, to get enough sleep fully every day. It is worth keeping to a diet in which the milk and vegetable food prevails. The correct way of life in general and the attentive relation of the person to a condition of an organism is important.
Section: Brain diseases