Idiopathic epilepsy: causes and treatment

Idiopathic epilepsy is most common in all age groups. In percentage terms, it is approximately 30-35% of all detected cases. Idiopathic epilepsy causes serious disturbances in the functioning of the nervous system, which, in turn, significantly reduces the patient’s quality of life. This type of epilepsy is considered the most common form among other types. A third of all moments, not only among the younger generation, are due to idiopathic epilepsy.  

One third of all cases of epilepsy are idiopathic epilepsy. The mentioned type of disease in 70% of cases manifests itself in childhood, sometimes adolescence against the background of a genetic predisposition. If the disease manifests itself after the age of 20, it is necessary to examine the cerebral cortex for changes in its structure. 

This disease is devoid of any changes in organic brain damage and is independent. If at the same time the form is generalized, then a more favorable outcome can be expected in comparison with the localized one, since it is treatable.

Epilepsy is most common in high-development countries, but this is not a fact, the reason for the detection may be a higher level of medical care.

The disease occurs due to the transmission of nerve impulses at higher frequencies, while pathological activity involves all parts of the brain, hence the name idiopathic. Among other things, the harmonious interaction of mediators that are responsible for the inhibition or excitation of the nervous system goes into discord.

More significant differences in the disease:

• Absence of injuries and pathologies of the brain;
• Manifestation in infancy;
• Genetic predisposition;
• Absence of reasons, such as diseases, causing the formation of an epilepsy focus.

Despite systematic seizures, the child continues to develop mentally and physically. It is important to start timely active treatment with appropriate drugs in order to prevent complications in the future. 

Symptoms and signs of idiopathic epilepsy

The idiopathic form of epilepsy is characterized by the absence of any pathological changes in the brain with a bright external manifestation. The following typical syndromes are distinguished:

• absences ;
• myoclonic phenomena;
• classic seizures.

The above syndromes can be combined with each other, or they can manifest themselves separately.

The main manifestations of the disease are considered:

•  Seizures of various kinds;
•  Loss of consciousness;
•  Convulsions of general and local significance;
•  Lack of response to the environment;
•  Visual impairment;
•  Desire to vomit.

Diagnosis

1. The primary diagnosis of the disease is carried out using EEG – this will help to identify the focus of the disease, the characteristics of waves and changes in the state between attacks.

2. CT scan or magnetic resonance imaging is performed to confirm the diagnosis.

3. Positron emission tomography is performed to exclude neoplasms of any form .

4. Try to identify the root cause in order to start therapy based on it.

5. Decipher the blood test for the karyotype.

6. The newborn is prescribed observation by a neurologist and an epileptologist.

Below will be considered in more detail the symptoms of the disease, depending on the forms of manifestation.

Typical symptoms

1. Absances . This condition means a short-term loss of consciousness, while the gaze is directed to one point. Motor automatisms are also possible, in which a person repeatedly performs the same actions. Speech may be interrupted. The duration of the absence varies from a few seconds to 2-3 minutes. Absances are not a very common occurrence. So, in 100,000 patients, idiopathic epilepsy is expressed in asbestosis in 2-8 people. 
2. Myoclonus . This form is characterized by the occurrence of uncontrolled muscle contractions. This can occur as part of a seizure, then all muscles are involved in the contractions, but also only certain groups can participate. 
3. Generalized seizure. Phase sequence is characteristic of this type. At first, continuous convulsions occur (up to 40 seconds), they are replaced by individual intermittent contractions. In this case, loss of consciousness is often observed. After the attack, the patient enters a phase of complete relaxation, this period is characterized by the onset of weakness, the person tends to sleep. 

Seizures are often accompanied by involuntary salivation, fecal and urinary incontinence. As a rule, after a seizure, the patient does not remember what happened.

Classification of idiopathic epilepsy by type of seizure

In order to identify the problem at an early age, it is enough to perform an EEG, which will help to easily establish a diagnosis, since the symptoms due to age-related changes in children differ, the classification system derived in 1989 distinguishes the following forms:

• Benign common and familial seizures in infants;
• Myoclonic in children;
• Absolute ;
• Absorption juvenile and juvenile myoclonic ;
• A disease with a specific factor;
• Generalized attacks of arousal;
• Other types.

For a correct definition, you should understand them in more detail:

1. Absances – has a generalized nature, this condition is characterized by a short loss of consciousness with a frozen gaze. They were first defined in 1705, and the terminology was applied in 1824. 

Important: statistics show that this type accompanies any type of disease in 2 to 8 people with 100,000. In most cases, girls have 2 times more than boys.

The duration of absence is from a few seconds to 2 – 3 minutes. An atypical absence can be interrupted by external factors.

2. Myoclonus – an idiopathic form of the disease often manifests itself in the convulsive contraction of muscles with joint activity. Myoclonus can be generalized – a general seizure, focal – certain muscle groups are involved. If you observe convulsions on the EEG, then any flash corresponds to an electric discharge . 
 

3. Generalized tonic-clonic seizure – a phase when continuous convulsive contractions alternate with intermittent ones. It is accompanied in most incidents by an unconscious state, the tone phase consists of 30 – 40 seconds, followed by sharp rhythmic movements. After the attack comes complete impotence and deep sleep for up to 3-4 hours, since a lot of energy has gone. At the time of a seizure, uncontrolled salivation, urination, and bowel movement may occur. Biting of the tongue happens . 
 

4. Atonic attack – occurs unexpectedly, lasting up to 1 minute. From the side, it seems that the child quietly slid to the floor. 

Certain forms of idiopathic epilepsy and their manifestation in children, prognosis

1. Children’s absence form – begins in the period from 2 to 10 years, mostly in 3 – 4.5 years. According to the observations of specialists, febrile convulsions become the predecessor of the problem. In 80% of cases, complex absences are observed , sometimes there is an alternation of complex and simple seizures.  

Forecast: the course of this type can be interrupted and stopped altogether by the age of 14 – 15 with timely and active treatment. If everything is left to chance, one can wait for generalized tonic-clonic complications. In adolescence, the absence type is mixed with generalized and occurs at most at 9-12 years, sometimes from 13 to 20 years.  

2. Benign myoclonic form – makes itself felt from a year to a year and a half, although sometimes it occurs at a very young age. It occurs due to a lack of sleep and a sudden awakening. 

Forecast: the timely adoption of appropriate medications will help the baby to fully develop mentally and physically. 

3. The juvenile myoclonic form occurs from 8 to 26 years. The peak of its manifestation is 14-15 years. At certain moments, her harbingers of absences . 

The provocateurs are flickering of light, changing images on the screen, for example, in a movie theater, lack of sleep, menstruation, intense excitement and a sharp awakening. Most patients have mild coordination disorder, slow thinking, hyperactivity. 

Prognosis: this type is very resistant to medication, so that over time, the patient’s condition worsens, attacks become more frequent and more complex. 

4. The photosynthetic form is exacerbated during: 

• Watching TV;
• Computer games;
• Reflection of glare of light;
• Flickering sun rays;
• Flashes of color music;
• A sharp change between dark and light.

Often children complain in this case of a headache, pain in the eyes from the light. Mental development does not suffer. If seizures are isolated generalized type, their manifestation occurs in 10 – 18 years. 

Prognosis: favorable, in 95% of cases, specialists completely achieve remission and in 4-5 years get rid of symptoms. 

Causes of idiopathic epilepsy 

The main impetus to the onset of the disease was not found, which complicates the process of its treatment. However, it has been precisely proven that its occurrence is not a violation of the composition of the gray matter or the structure of the brain. The degree of excitability of the brain and nervous system is simply disturbed.
 

There are certain risk factors:

 • Damage to the nervous system; • Strokes; • Hereditary predisposition; • Overwork ; • Alcohol abuse; • Sexual development; • Taking medications for a long period.
 
 
 
 
 
 

The main reason is a gene mutation, scientists have already discovered several genes, changing, they provoke this disease.

Important: if one of the parents suffers from this problem, then the probability of its occurrence in a child is only 8 – 10%, a very small ratio.

Treatment for idiopathic epilepsy

In the case of a congenital idiopathic form, the patient cannot be completely cured. A person will have to adhere to the chosen treatment tactics until the end of his life. The most favorable options are observed with early diagnosis. With the passage of an intensive therapeutic course lasting from 3 to 5 years, persistent remission may occur. The full course requires not only regularity, but also significant material costs.

In pediatric practice, ethosuximide is used , but only in the case of absences (it is ineffective in seizures).
Additionally, drugs that have a relaxing effect (barbiturates, carbamazepine ) may be prescribed 

A patient with idiopathic epilepsy is susceptible to long-term treatment with special drugs, while complete deliverance is not always necessary. In most cases, with timely intervention, seizures can be eliminated for a long time. A person will have to adhere to the chosen treatment tactics until the end of his life. The most favorable options are observed with early diagnosis. With the passage of an intensive therapeutic course lasting from 3 to 5 years, persistent remission may occur. The full course requires not only regularity, but also significant material costs. 

Therapy should be started after the final diagnosis and with small doses, gradually increasing them. The exception is severe cases when the patient has to give the highest possible amount of the drug in the name of saving life. 

Today, you can choose drugs from among dozens of proposals, but it is important to use medicines with minimal side effects:

• Valproate – the dose, depending on the complexity of the case, ranges from 15 mg / kg to 100 mg / kg;
• Topiramate – dosage 5 – 8 mg / kg;
• Carbamazepine or Finlepsin 20 mg / kg.

In most practices, doctors tend to use a single means to achieve a stable remission, but this is not always possible, and then a combination of the drug with Suxilep or Lamictal is used .

At certain times, with drug resistance, it is possible to resort to surgery, but for this there must be idiopathic partial epilepsy in the appropriate form and the necessary somatic condition.

Lifestyle and Precautions for Idiopathic Epilepsy 

 A patient with idiopathic epilepsy in any form must have disabled status, since he cannot work in certain types of work:

• Conveyor lines ;
• Computing technology ;
• Near open fire ;
• At maximum and minimum temperature conditions;
• With chemistry and water .

Leisure should be extremely limited:

• Do not overuse the daily routine;
• Bad habits ;
• Excessive entertainment ;
• The patient should sleep the prescribed time.

For prevention purposes, you should:

• Do medical gymnastics ;
• He is supposed to exercise therapy;
• Sanatorium rest up to 2 times a year;
• Taking a vitamin to support the body during long-term drug intake.

Important: observation by a specialist throughout the entire period is necessary. Do not change the dosage yourself.

Epilepsy in any form and for any reason of occurrence makes it possible to live fully, and not exist. Only this is all possible with the strict administration of drugs for years.

You should not panic and think that life is over, it is important to fight for the health of your relatives and follow the instructions of specialists.