Personality changes in patients with epilepsy
They are caused by the duration of the course of the disease, when the patient suddenly has such traits and features in his character that he had never had before. This is the so-called epileptic character. Thought processes also change in a very peculiar way, which ultimately leads to the formation of epileptic dementia.
The whole circle of interests of the patient becomes very narrow, for the most part petty selfish thoughts remain. The richness of perception of the surrounding world in all its diversity is lost. Among the interests of the patient, concern for his own health comes to the fore. No warm feelings are experienced towards others, however, this is very well disguised with the help of external ostentatious benevolence, even some sweetness. But in general, patients become very petty, picky, they really like to instruct others, often try to present themselves as defenders of justice, but at the same time they have a very one-sided concept of justice.
The patient’s condition is, as it were, a combination of two opposites, it quite often and very abruptly goes from one extreme to the other. Patients are kind, friendly, complacent, but in other cases they become very spiteful and vindictive.
The most characteristic feature of epileptic patients is the tendency to sudden outbursts of anger. They are so vivid and demonstrative that examples of them are contained in almost all known reference books and manuals. The emotions and feelings of such patients are characterized by very tight mobility: the patient remembers the insult inflicted for a very long time and at any time may decide to take revenge.
Changes in the thinking of epileptic patients are very characteristic. It gradually becomes inactive, viscous, the patient tends to detail and clarify individual properties of objects. Gradually, these changes are increasing, the patient’s condition is getting worse, and the formation of the so-called epileptic dementia occurs. When describing certain phenomena and objects of the surrounding world, the patient completely loses the ability to determine the main and the secondary, all even insignificant details seem very important to the patient. The patient turns out to be completely entangled in the little things, he with great difficulty switches from one thought to another. Thought processes are more concerned with specific images, the ability to abstract is reduced. The patient’s vocabulary is significantly depleted. Memory is decreasing. In a conversation, the patient uses a small set of standard words and expressions. A tendency to use diminutive-affectionate suffixes in conversation, for example, “doctor”, “son”, “krovatochka”, is quite characteristic.
At the same time, it is not at all a prerequisite for the presence of all of the above signs in the same patient. One or another manifestation may prevail.
Despite such clinical diversity, the most characteristic manifestation that allows one to suspect the presence of epilepsy in a patient is a classic large seizure. Difficulty in diagnosis arises during the course of the disease in the form of the so-called non-convulsive form. As already mentioned above, there is the so-called reflex epilepsy, in which seizures occur as a result of various external stimuli acting on the body. A typical example is photogenic epilepsy, which develops in response to light stimuli.
Features of epilepsy in childhood
In the course of presenting the material in this chapter, it is advisable to highlight this information as a separate paragraph. First, it should be noted that epilepsy occurs relatively often in childhood, but, despite this fact, its diagnosis during this period of life is the most difficult. This is due to the fact that young children have an increased need for oxygen in the brain, there are some peculiarities in all types of metabolism. As a result, the child’s body has an increased threshold of seizure activity. Very often they develop various conditions with the appearance of seizures, which are practically unrelated to epilepsy as a disease. So, epileptiform seizures can be the result of various secondary diseases, such as intestinal worms, respiratory diseases, food intoxication, especially often convulsions occur with significant increases in body temperature.
Another circumstance that determines the difficulties in the diagnosis of childhood epilepsy is the fact that it very rarely manifests itself in its debut with classical generalized seizures. Much more often at the onset of the disease, atypical seizures, absences and minor epileptic seizures develop, and only then, with further progression, seizures take the form of classic large generalized seizures. The onset of the disease, among other things, can also take place in a completely uncharacteristic way in the form of sleepwalking, mood disorders, children may also have sudden onset of fears, attacks of pain in various organs, the cause of which cannot be established, and various periodic behavioral disorders. If these phenomena occur singly, then they can be caused by a huge number of very different reasons. But if, once having arisen, they subsequently repeat again and again, then such a fact should always be alarming in terms of the possibility of the development of the disease.
In general, the epileptic process in children is characterized by a greater malignancy of the course than in adults. There is such a pattern: the younger age is affected by epilepsy, the more serious consequences should be expected in the future. Violation of normal speech and impairment of intelligence in children always occurs faster and to a greater extent. This is due to the immaturity and, as a consequence, the greater vulnerability of the child’s brain. The changes that take place in the personal sphere at an early age are very peculiar. Younger children are characterized by an increase in motor excitement, impaired attention in the form of increased distraction and absent-mindedness; in the future, concentration on one object for a long time becomes very difficult. At the same time, in adolescents, personal changes are practically no different from those in an adult. From the characteristics of childhood, it should also be noted that the child during seizures, as a rule, reactions from internal organs and skin are very pronounced.
Disorders from other organs and the nervous system
There are no special signs on the part of the physique and organ systems inherent in epileptics. However, among children, there are quite often those who have certain congenital developmental abnormalities. Very often, among them, violations of the endocrine glands are revealed. Some of the patients are obese, short or too tall. The size of the skull is too small or excessively increased due to an increase in intracranial pressure.With a prolonged course of the disease, examination of the patient’s body reveals various traumatic injuries that the patient received during seizures. On the part of the nervous system, disturbances can be very different: disturbances in the functioning of the nerves of the face and head, disturbances in motor function, disturbances in the innervation of internal organs and blood vessels. But one should not think that all of the above is necessarily found in all patients. Epilepsy may well proceed without these changes.