Epilepsy causes, symptoms, diagnosis and treatment

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Epilepsy causes, symptoms, diagnosis and treatment

Quite a large number of people are deeply mistaken when they believe that epilepsy cannot be cured.

In fact, epilepsy is not a death sentence and responds well enough to treatment until the stage of remission is reached and even complete recovery with drug withdrawal.

The most important thing is timely diagnosis and referral to highly qualified doctors, refusal of bad habits (especially alcohol and cigarettes), timely intake of all medications prescribed by the doctor and a correct lifestyle (for some forms of epilepsy, strict adherence to the sleep / wake regime is required) …

It is noteworthy that an epilepsy attack itself can manifest itself only once and go into a long stage of remission, and vice versa, latent epilepsy can become a constant companion throughout life.

What is the diagnosis of epilepsy?

Epilepsy is a common disease of the nervous system. As a rule, it is expressed in seizures and disorders of motor, mental, tactile functions, which occur due to a large number of neural discharges in the brain (or, to be more precise, in the gray matter). The external manifestation of this diagnosis is considered to be sudden convulsions that paralyze the entire body.

Epilepsy: classification of seizures

Today, in modern world medicine, it is customary to distinguish two main groups of seizures caused by epilepsy. Usually, each of them is determined by the initial source, which most often begins to localize in areas of one or another part of the brain, thereby causing an epileptic discharge.

In the event that an attack occurs in some areas of the cerebral cortex, then it is customary to call it either a partial or focal attack. After that, epileptic discharges do not spread to individual areas of the cortex, but to almost the entire gray matter as a whole. Also, epileptic seizures can be characterized by simultaneous discharge activity in both hemispheres of the cerebral cortex and are called generalized seizures.

If the focus of the main activity falls on the frontal and temporal lobes or, in rare cases, in the occipital regions, it is commonly referred to as a focal epileptic seizure. Those types of seizures that physicians cannot logically attribute to either of the two groups are called unclassified.

Various generalized types of epileptic seizures include:

Generalized tonic-clonic seizures. Most often, they manifest themselves when the discharge spreads throughout the cerebral cortex and can manifest itself with a piercing cry of the patient + an unnatural bite of the tongue, tension and twitching of the whole body, an increase in heart rate, high blood pressure. 

Absances. They may first appear at a young age or early adolescence. Usually, at the time of an epileptic seizure, a child’s gaze sharply freezes, is directed at one point, while his eyelids may twitch. Then, more often, swallowing movements, throwing the head back, or vice versa, the patient drops his head forward, can rarely be manifestations of a vegetative nature. The duration of these attacks is no more than 30-45 seconds. 

Myoclonic seizures. They arise quite suddenly for the person himself, but they have a very long duration. This attack externally manifests itself in involuntary muscle contraction, which often affects not only the head, arms and legs, but also the entire body. 

Tonic seizures. They manifest themselves in the form of a sharp different duration of tension of various muscle groups, mainly from two sides, can be accompanied by a fall, including a sharp fall forward with trauma. 

Atonic (attacks of falling). Perhaps, they are still considered the rarest types of this disease and accounting for only 1.5% of the total number of epileptic seizures, they are diagnosed in the most complex forms of epilepsy. 

The causes of epilepsy

According to experts, this disease has a fairly wide range of causes that can affect not only the occurrence, but also its further development. There are also individual cases when it is simply impossible to determine with exact certainty a definite cause-and-effect relationship of seizures.

The two main risk groups, doctors include:

  • a predisposition to this diagnosis for a consanguineous line (i.e., a genetic cause). This feature is already laid in utero and encoded in the genes, transmitted from generation to generation;
  • a predisposition that was acquired due to a number of certain damaging factors or pathological diseases of the cerebral cortex.

It has also been proven that the cause of epilepsy in both children and adult men and women can be:

  • Traumatic brain injury;
  • Acute or chronic meningitis, encephalitis;
  • Serious circulatory disorders of the brain (especially if direct hemorrhage has occurred);
  • Volumetric processes in the brain (i.e., the formation and rapid development of a tumor);
  • Due to frequent and excessive use of drugs or alcohol;
  • The presence of cysts, adhesions, aneurysms, etc. in the left, right or in both hemispheres of the brain at once

Almost all of the above risk factors, for the most part, one way or another lead to the emergence of a certain category of neurons, with a low threshold of excitation. It is this category of neuronal cells that provides a fertile ground for the emergence of an epileptic focus. Further, a nerve impulse arises in it, which infects nearby cells, having time to cover new healthy neural networks. By the way, this is where convulsions or, in other words, epileptic seizures appear.

What symptoms directly indicate epilepsy?

It is noteworthy, but a vivid manifestation of an epileptic seizure can be not only general (generalized) convulsions, but barely noticeable changes in the internal state of a person with this diagnosis.

The main symptoms of epilepsy in adults include:

Focal seizures. Most often, medical practice associates them with the occurrence of an excessive electrical discharge in one of the areas of the cerebral cortex. With these attacks, cramps or sharp numbness or other sensations in the area of ​​arms, legs, facial muscles, etc. are usually observed. Most often, a person remains conscious and clearly remembers his feelings. The duration of a focal attack lasts from 15-20 seconds to several minutes (rarely up to several tens of minutes).

Generalized seizures:

Convulsive. Often the first sign of epilepsy in an adult is tension in the muscles of the chest and larynx, a shrill scream, and even an unnatural bite of the tongue. Within a few seconds, muscle tension occurs, then twitching and relaxation after 3-4 minutes (in this case, involuntary urinary incontinence or defecation can often occur). Further, a person may experience severe drowsiness, fuzzy and unclear consciousness, aching headache in the occiput with rapid onset of sleep. 

Non-convulsive (absences). As mentioned above, these non-convulsive seizures occur more often in childhood or early adolescence. At the time of an epileptic seizure, the child’s gaze sharply freezes and is directed to one point, while his eyelids may twitch, his head may be thrown back, or light nods forward are noted. The duration of these attacks is usually no more than 30 seconds.  

Epilepsy: First Aid

In the event that you become an unwitting witness of an epileptic seizure of your relative, a good friend or just a stranger from the outside, you need to follow these steps:

Throw panic aside and come to your senses, because you should not forget that now the life of another person is completely yours and only you can help him. Call an ambulance immediately.

While the attack lasts, it is imperative to be near the patient and in no case leaves him.

Take a look at everything that is around. Is there any threat around you? After making sure that everything is fine, do not touch the person, much less move him. It is best to dispose of nearby items such as furniture, sharp or stabbing objects that could accidentally harm or hurt.

Urgently turn on the timer or count by ear the time from the second when the epileptic seizure occurred.

If a person is standing, you should carefully lower his body to the ground and put any soft object under his head (jacket, hat, empty backpack, etc.)

In no case try to forcibly keep a person in a constrained state in order to supposedly prevent a convulsive state. This will not help to relax the muscles, but it can cause serious injury.

Do not open or put anything in the patient’s mouth. It will be superfluous to try to open his jaw in a state of seizure.

The last thing is to check once again whether the timer has timed.

After it’s over, give him moral support and, if possible, calm the person down. Your speech should not be harsh and look like a quick set of phrases.

Treatment for epilepsy

If you believe the results of modern drug therapy, then it, like no other, is the main and main way of fighting against epilepsy. The effectiveness of drug therapy is up to 69%, which can significantly lower the threshold for the occurrence of epileptic seizures, as well as their further spread.

In addition, in the twenty-first century, surgical techniques have also found wide application (in the treatment of epilepsy). Of course, the intervention with the help of brain surgery is most often used only in cases where medications are already powerless. 

According to highly qualified neurologists and psychiatrists, several more methods of treating the disease have shown themselves to be successful, namely:

A diet called ketogenic. Today, this is one of the methods that can reduce the number of epileptic seizures, but this diet is prescribed exclusively for severe forms of epilepsy in cases where drugs are already powerless.

Alternative treatments for epilepsy include vagus nerve stimulation and multiple subpial transection. The latter was created with the aim of controlling or eliminating an epileptic focus in the brain, which can no longer be safely removed. That is why, the surgeon makes small cuts in the brain tissue, while not disrupting its normal activity at all.  

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