Epilepsy, or “Hercules’s disease” today

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Epilepsy, or “Hercules’s disease” today

This is what the ancient Greeks called her and believed that she was a sign of divine intervention. In Russia, this disease was called easier – “epilepsy”, simplifying its Latin name “caduca”. Epilepsy – namely, it is hidden behind these two terms – such celebrities as V. Van Gogh, G. Flaubert and F. Dostoevsky suffered, but this did not prevent them from becoming geniuses. So what is epilepsy and what can modern medicine oppose to it? ..    

From Antiquity to the Present

Epilepsy is one of the most common neurological diseases. According to statistics, 1% of the world’s population suffers from epilepsy in one form or another. The mention of this ailment can be found both in ancient Greek historians and in the surviving manuscripts of the Inca era. So, the wife of the Inca king Saras suffered from a mysterious disease called “night bird attack”, which manifested itself in convulsive seizures several times a day. Ultimately, this led to the fact that the king abandoned the patient and took another girl as his wife … 

Causal epilepsy can be:

  • head trauma (so-called traumatic epilepsy)
  • damage to the diencephalic structures of the brain (diencephalic epilepsy)
  • past infections of the brain (post-infectious epilepsy)

Epilepsy is manifested, as a rule, by a sudden loss of consciousness, which is preceded by convulsions. The basis of the development of seizures is increased excitation of brain neurons. Epileptic seizures are divided into partial and generalized. Partial seizures can occur with or without impaired consciousness. The resulting cramps can be in one arm or leg, or pass from limb to body. Generalized seizures are characterized by a mandatory loss of consciousness, while seizures affect both halves of the body symmetrically.   

The most famous form of epilepsy is a large seizure , which is a generalized seizure. It is preceded by an “aura” – the sensation of an extraneous smell, sound or taste. As a rule, in the same patient the aura with repeated seizures is the same. Therefore, its appearance, a person helps him to “foresee” an attack. The next stage of the clinical picture of epilepsy after the aura is loss of consciousness and convulsive syndrome, accompanied at first by tonic convulsions (periodic muscle contractions), gradually turning into clonic (with the involvement of the respiratory muscles, temporary cessation of breathing, biting the tongue and involuntary urination). After the end of the seizure, a short restful sleep occurs, and after waking up, the patient does not remember the moment of the seizure. Sometimes, on the contrary, after a seizure, sleep does not come, and the patient rushes to go somewhere and is very irritated. The famous epileptic F. Dostoevsky, according to the memoirs of his contemporaries, became very moody after a seizure. “He was often drawn to a scandal,” A.G. recalled. Dostoevskaya. “Fedya scolded, why the alleys are straight, why is there a pond, why – then, why – different.”    

The second common form of epilepsy is considered to be “small seizure”, during which there is a brief shutdown of consciousness, accompanied by a slight short spasms of the facial muscles (tics) or course stey. In this case, the patient also does not have any memories of what happened. 

And, finally, absence is least often observed – short – term loss of consciousness, but without convulsions.   

New trends in the treatment of epilepsy

It is believed that the earlier epilepsy is detected, the greater the chances, if not completely defeat it, then at least suspend the progression of the disease with the development of specific personality changes. To diagnose the cause of epilepsy and identify the localization of the focus of neuronal excitation after the first recorded epileptic seizure, it is necessary to make an electroencephalogram (EEG) to the victim. A neurologist will select a therapy that includes anticonvulsant, neurotropic and psychotropic drugs, depending on the specific characteristics of the patient. They stop taking these drugs only if there are no seizures within 3 years.

But modern science continues to look for ways of final deliverance of humanity from the “epileptic” Today, there are two “fresh” concepts for the treatment of epilepsy. One group of scientists, notably British researchers Samuel Weebie and Michael Nicole of the Department of Clinical Neurology at the University of Western Ontario in Canada, are in favor of surgical treatment for epilepsy. Back in the middle of the twentieth century, the lobotomy operation was popular in the United States, in which the structures connecting the cerebral hemispheres were dissected. Its consequence was a barrier to pathological impulses, passing during an attack from one hemisphere to another. However, only the presence of temporal lobe epilepsy (when the focus of pathological impulse is located in the temporal lobe) was considered an absolute indication for surgical treatment. 

Another group of scientists, including Dr. Joseph Goetz from the Department of Cellular and Molecular Genetics at Adelaide Hospital, Australia, is leaning towards a hereditary theory of epilepsy. So, scientists managed to find a gene, which, in their opinion, may be responsible for the development of epilepsy. Unlike other known genes, to one degree or another associated with epilepsy, the newly discovered gene regulates the work of other genes, thereby affecting the functioning of the brain as a whole. Researchers are working to isolate a mutation in the found gene that can cause both epilepsy itself and West syndrome (also known as “infant spasm” or “salaam seizures”), muscle hypertonia, impaired attention and learning ability. However, the answer to the question of how this gene regulates the work of other genes has not yet been found. According to Dr. Getz, they have yet to isolate other genes under the control of this gene in order to understand why such different diseases arise with the same mutations. 

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