Earlier epilepsy was called a divine diseaseor epilepsy, and the people, in whom it manifested, stigmatized, that is, they were put in a psychological brand in society, and in most cases negative. Even in our cosmic age in some countries, people who are diagnosed with generalized or focal epilepsy are not allowed to work in many professions, drive a car, engage in some kinds of leisure activities, such as diving.
There is an opinion among the people that the epilepticSeizure necessarily looks like this: the patient falls to the ground, starts to beat in cramps, from his mouth appears foam. If a person at this time to cover with a dark cloth, the attack passes, and the patient falls asleep. In fact, epilepsy can manifest itself in different ways, and treat it in specialized medical institutions. One of the best in Russia is the Bekhterev Clinic, which uses modern methods of diagnosis and treatment. Concerning focal epilepsy, patients and their relatives have many questions: where does it come from, is it inherited, is it contagious, why are young children affected by epilepsy, can it be cured completely, what is fraught with it, how dangerous it is to life and many others. In this article we will try to give full information about this disease.
First, let's explain what kind of ailment this is -focal epilepsy. In the human nervous system, there are microscopically small structural-functional formations called neurons. Their specific structure allows them to store and transfer information from other similar units, as well as from muscles and glands. In fact, any reaction of the body is determined by the behavior of these tiny particles. In the human brain, there are more than 65 billion. Many of them intertwined and created a so-called neural network. Figuratively they can be imagined as a kind of coherent system, living by its own laws. Epileptic seizures appear when sudden (paroxysmal) electrical discharges arise in neurons that disrupt their work. It can happen in many diseases, most of which are related to neuroses of different etiology. There is focal epilepsy and generalized. The word "focal" comes from the Latin "focus". Epilepsy is considered focal when neuronal excitation is focused in one place (focus) or, quite simply, there is a lesion of a certain area of the brain. Epilepsy is considered generalized, when the lesion either directly affects both hemispheres of the brain, or, having arisen in a certain place, spreads to the entire brain.
In 1989, the existing classification of focal epilepsy and its symptoms was updated. Now, within the framework of this pathology, there are such syndromes:
1. Idiopathic.
2. Symptomatic.
3. Cryptogenic.
Syndromes of idiopathic and symptomatic epilepsy are distinguished in generalized.
There are also a number of states where both focal and generalized features are present.
This type of pathology develops when neuronsthe brain begin to work more actively than necessary. In this case, a so-called epileptic focus is formed in which unnecessary electrical discharges are generated, but the patient does not have structural brain lesions. At first, the body in response to this around the hearth creates a kind of protective shaft. When the discharges acquire intensity, allowing them to escape beyond its limits, a person has an epileptic attack. The cause of idiopathic epilepsy in the overwhelming majority of cases is an innate mutation in the genes, so it can be hereditary. This pathology can manifest itself at any age, but often its first signs are observed in children. With timely access to specialists, the disease can be eliminated, and without proper treatment, patients begin structural changes in the hemispheres of the brain, which leads to various neurological disorders, including mental activity. Epilepsy in children is benign, because there is no danger to life. It is classified according to the location of the focus of active neurons and it happens:
As the name suggests, this kind of pathologyDiagnosed if the focus of too active neurons is concentrated in the region of the temples. Temporal focal epilepsy can occur in infants by the following reasons:
In adults, pathology can develop for the following reasons:
With this pathology epileptic seizurepasses without loss of consciousness, and its precursors (aura) may or may not be present. Patients may experience auditory, taste or visual hallucinations, dizziness, sometimes pain in the peritoneum, nausea, a feeling of discomfort in the heart, choking, chills, arrhythmia, a sense of fear, thoughts of changing the course of time, sensations of one's own body.
If the excitation of neurons leaves the regionhearth and spreads to both hemispheres of the brain, that is, epilepsy from focal to generalized, seizures can occur with loss of consciousness, memory impairment, falling, but without seizures. Also in this phase of the disease, patients can experience repetitive actions - patting their hands, scratching, sobbing, repeating some sounds, blinking.
With the progression of temporal epilepsy, there are attacks called secondarily generalized. They are characterized by loss of consciousness, a patient's fall, cramps in any muscle.
The main drug for epilepsy of this form is the drug "Carbamazepine", and in the absence of effect, substitution therapy is performed. In extremely severe cases, surgical intervention is indicated.
This pathology is also consideredbenign and occurs at any age, but in 76% of cases of its manifestation is registered in children aged 3 to 6 years. Occipital focal epilepsy in children is characterized by the fact that seizures can occur with great differences and may be short (about 10 minutes) or prolonged (more than 30 minutes, sometimes several hours).
In about 10% of patients onlyvegetative disorders (nausea, usually resulting in vomiting, headache, poor health, lethargy, sweating, pallor, or vice versa, redness of the skin, cough, impaired cardiac activity, miase, mydriasis, urinary incontinence, fever).
Approximately 80% of patients have a deviation (wrong position) of the eye. Most often the child looks away.
In 26% of reported cases, hemiclonia is observed (indiscriminate muscle twitching).
And, finally, in 90% of cases, vegetative symptoms may be accompanied by loss of consciousness.
In 1/5 of children there may be convulsions, Jacksonian march, and in some people blindness or bright hallucinations.
At the end of the attack, the child feels normal, without neurological symptoms and intellectual problems.
Duration of seizures and autonomicSymptoms are very frightening to parents who think that a child can die. However, assistance with epileptic seizure of a short duration is not required. If the attack with occipital epilepsy is protracted and has pronounced vegetative symptoms, there is an emergency aid consisting in injections of intravenous benzodiazepines. If a child has seizures often, prophylactic treatment with "Carbamazepine" is carried out.
The rarest manifestation of the disease that occursin boys in comparison with girls in the ratio of 2: 1. This form of epilepsy manifests itself in early school age. Attacks begin with chin jerking, twitching of the muscles of the lower jaw, less frequent difficulty in breathing, sensory abnormalities during reading, especially if it is done out loud. At occurrence of the first harbingers the child should stop reading, otherwise the attack can develop into a strong attack. Some parents, and teachers, too, do not take seriously this state of the child, but epilepsy must be treated, since later seizures may begin to appear during games, during conversation or eating. The main cure for epilepsy of this form is Valproat. Also, doctors can prescribe "Flunarizine" and "Clonazepam".
This pathology is diagnosed when in the cortexThere are structural disorders of the brain, the cause of which is reliably determined. Symptomatic epilepsy is registered in adults and children with approximately the same frequency. The reasons for its occurrence may be:
Symptomatic epilepsy can manifest itself even a few years after the trauma or disease that has been transmitted.
In this pathology, four forms are distinguished, depending on the location of structural changes:
Also in this group, the syndromeKozhevnikovsky (chronic and simultaneously progressing epilepsy) and a syndrome in which focal seizures of epilepsy start because of any external stimuli, for example, after a sudden awakening.
Temporal symptomatic epilepsy is characterized by hearing impairment, logical thinking, behavioral peculiarities.
With the frontal, speech disorders, memory loss, cognition and other cognitive deviations from age norms are most often observed.
Occipital epilepsy leads to visual impairment, rapid fatigue, impaired coordination of movements.
Temenna has in the active of her symptoms cramps, pareses, impaired motor functions.
Seizures with symptomatic epilepsy canto be simple (minor vegetative, motor and sensory abnormalities with a working mind), complicated (violation of consciousness and work of internal organs) and secondary generalized (loss of consciousness, seizures, significant vegetative disorders).
When symptoms of epilepsy need to be addresseda neurologist or a psychiatrist in his polyclinic. An excellent reputation is enjoyed by the Bekhterev Clinic in St. Petersburg, where, among others, the Neurology and Child Psychiatry Department functions. There is a modern diagnostic base, biochemical, hormonal, general material studies are carried out, coronary risk factors are determined, drug monitoring is carried out, functional diagnostics, ultrasound, ECG, vascular examination are performed.
The word "cryptogenic" is derived from the Greek"Crylo", which means "hidden", "hidden". The diagnosis of "cryptogenic epilepsy" is set when the cause of the disease can not be identified. Quite often such a pathology is observed in people older than 16 years. Possible causes may be various head injuries, tumors, many diseases, circulatory disorders. The uncertainty of the cause of the disease makes it difficult to treat it. In this case, if possible, it is advisable to contact the central clinics, where there is a diagnostic base with modern progressive equipment, for example, the Institute of the Brain (St. Petersburg). Here, experienced specialists perform an extensive study of vessels in the head, electroencephalography, electroneuromyography, brain potential studies and a range of biochemical and laboratory analyzes.
The clinical picture of seizures in cryptogenicepilepsy can be very different. Attacks in this pathology are observed with loss of consciousness and without it, with symptoms of vegetative disorders, seizures or without them, seizures of varying intensity and duration, or simply minor motor and / or sensory disturbances.
In the focus of the focus of overexcited neurons, the following forms are distinguished:
Cryptogenic epilepsy can also be accompanied bythe Lennox-Gastaut syndrome. It is observed more often in boys from 4 to 6 years and consists in involuntary flinching, loss of muscle tone, falling and loss of consciousness.
The first help in case of epileptic seizure should be provided by relatives and others, in whose eyes this happened. What to do? The algorithm is as follows:
What not to do:
Treatment of epilepsy is carried out after the establishmentcauses of the disease and accurate diagnosis, so if possible, it is advisable to contact specialized clinics, for example, the Brain Institute (St. Petersburg), the Clinic for Restorative Neurology (Moscow) and other specialized medical facilities where there are epileptologists.
Treatment of epilepsy is carried out in several directions:
In some cases,compulsory treatment in specialized psychiatric clinics. Methods of treatment include taking medications, dieting, osteopathy, the Voight method, and in complicated cases - surgery.
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