Epilepsy - chronic neurological diseasein which the patient periodically has epileptic seizures.
However, they can be of varying degrees of severity and occur with different frequencies: in one epileptic seizure can occur every few months, in another - many times a day.
Epilepsy in psychiatry is also being investigated., since in some patients pathological personality changes occur over time.
General information
Epilepsy is considered a common neurological disease: about 50 million people worldwide have this diagnosis.
This disease is well treatable.: in most cases it is possible to take it under control with the help of medicines, in some cases an operation is performed.
Who is an epileptic? People who suffer from epilepsy are colloquially called epileptics.
Epilepsy Is it a mental illness or not? It is important not to confuse neurological diseases with mental ones: epilepsy is not a mental illness, and its occurrence is associated with the presence of epileptic activity in one of the brain regions.
However, a small part of epileptics may experience various mental abnormalities: stupefaction, personality changes. The longer and harder the disease, the higher the likelihood of mental disorders.
Experts associate this with social constraints, which society imposes on epileptic, negative reaction of others and other difficulties.
Previously it was believed that any epileptic a priori has mental abnormalities and is prone to aggression due to his illness.
However, this is a misconception.: in patients living in comfortable conditions, having a friendly environment and receiving full treatment, pathological changes in the personality are extremely rarely detected. The link between aggression and epilepsy is also not found.
Etiology and causes of development
The appearance of epiphriscues is associated with the presence of a convulsive focus in one of the areas of the brain, most often in the temporal one.
Occurring in it paroxysmal dischargescausing seizures. What causes epilepsy?
There are many causes of this disease in adults and children. The main ones are:
- Pathological course of pregnancy, birth trauma of the head, hypoxia. Also, the likelihood of developing epilepsy is increased by infections carried out during gestation (rubella, measles, chicken pox, and others), smoking, drinking alcohol by the mother, and taking medicines not recommended for pregnant women.
- Traumatic brain injury. 10-20% of people who have undergone TBI, are faced with epiphrista, and the more serious the injury, the higher the likelihood of an intracerebral focus of seizure activity.
- Transferred neuroinfections, such as meningitis, encephalitis and others. Convulsive seizures can be observed during the course of the disease and persist for a long time after treatment, along with other neurological disorders (paresis, hyperkinesis).
- Stroke. 10% of stroke patients experience convulsive seizures that further complicate the recovery process.
- Benign and malignant neoplasms. Many tumors and cystic formations are accompanied by epileptic seizures; seizures often become the first sign of a neoplasm. Therefore, in the process of diagnosis, the patient's brain is examined to exclude the possibility of a tumor.
In some cases, a clear cause of the disease can not be identified. This "causeless" epilepsy is called idiopathic. However, she has reasons: most often they are genetic.
Varieties
This disease has an extensive list of types and forms, therefore in one epileptic it may proceed completely differently from the other..
Depending on the degree of involvement of the brain, the following types of epilepsy are distinguished:
- Partial (focal): seizures affect a particular area of the brain and are not in contact with the rest;
- Generalized: convulsive activity affects a large part of the brain.
In this case, the seizures may begin as partial, that is, affect only one area of the brain, and move into generalized ones.
Depending on the location of the convulsive focus, emit:
- temporal;
- frontal;
- parietal;
- occipital.
Each region of the brain performs certain functions, so the symptoms in people with different localization of the pathological focus will vary.
For example, in temporal epilepsy, the patient can hear the music, feel certain emotions, and in the case of frontal epilepsy, repeat certain movements continuously. Parietal and occipital forms of epilepsy are less common.
Depending on the causes, emit:
- Symptomatic. The disease occurs under the influence of unfavorable factors: injuries, past infectious diseases, strokes, on the background of alcoholism or other chronic poisonings and so on.
- Idiopathic. The causes of its occurrence cannot be established. Most often observed at a young age, including children and adolescents. If generalized seizures are observed in idiopathic epilepsy, it is called idiopathic generalized. Also, the idiopathic form (not associated with brain damage) is called true, or genuin by form. This species has the most favorable prognosis.
Also exists absense epilepsy. In this form, convulsions are absent, therefore it is often called non-convulsive.
When it is observed absans: the patient's consciousness is turned off for a short time, he stops, dialogue with him becomes impossible. After a short period of time, he regains consciousness and does not remember what was happening.
Symptoms and signs
Since there are a lot of varieties of this disease, the set of symptoms can vary considerably in each case.
With different forms of epilepsy can be observed:
- Absans, both simple and complex. Disconnection of consciousness during absans usually lasts no more than half a minute, while the person does not fall and in principle does not change his posture, only his look changes: it becomes empty, frozen. In this case, the patient can perform actions: lick lips, change the direction of gaze. The muscles in his face may twitch. If this happens, the absence is considered difficult.
- Generalized seizures. These are the classic epileptic seizures, the ones that are associated with epilepsy in most people. The patient loses consciousness, falls, his limbs begin to twitch. After the end of the attack, he falls asleep and on waking does not remember anything.
- Focal paroxysms. They are subdivided into simple ones (the consciousness is preserved during an attack) and complex ones (the conscious activity is disturbed to some extent).
With simple seizures, there may be twitching of individual muscles, redness or blanching of the skin, rapid breathing, increased sweating, dizziness.
There may be hallucinations or other disorders (strange thoughts, worries, fears). With a complex focal fit, consciousness is essentially absent, the patient is not aware of what he is doing. He can walk, pull at something in his hands, grimace, whisper.
Sometimes epilepsy manifests itself with extremely simple seizures, accompanied by mental disabilities.
Patients with similar symptoms should be carefully examined so as not to confuse epilepsy with mental illness, such as schizophrenia.
Before the attack, many epileptics feel the symptoms of aura. This condition in each patient manifests itself in different ways: it can be sensations, emotions (anxiety, anxiety, feeling of deja vu, sadness, joy), abdominal discomfort, unusual smells, fever.
Descriptions of sensations with aura helps the treating physicians to determine the location of the convulsive focus.
Generalized An epileptic seizure has stages, which usually include:
- precursors (specific symptoms that occur a few days before an attack, such as headaches, weakness, worsening of mood);
- aura;
- the tonic part of the seizure;
- clonic part;
- sleep.
If a person has a generalized attack for the first time, you should immediately call an ambulance or go to the hospital as soon as possible.
If the patient has already been diagnosed, but the attack does not go as usual, also it is important to contact the doctors.
In a small number of patients (3-5%) are observed epileptic psychosis: mental disorders that may be accompanied by various symptoms. In most cases, such psychosis is detected in patients with severe and long-lasting epilepsy.
They may include twilight stupor, oneiroids, affective psychosis (manic - increased activity, inadequate mood elevation, loss of time - or depressive - mood decline, apathy, self-loathing), paranoid states in which the patient begins to think that threatens to make fun of him.
Duration of psychosis - from several days to several weeks.
Consequences and prognosis
In most cases, epilepsy well amenable to drug control, does not entail the occurrence of pathological changes in the personality and in the intellect.
About 70% of patients with time pass into a state of remission: seizures are not observed for at least five years. Some may be diagnosed and canceled.
The prognosis depends on the severity of epilepsy and the formas well as on etiology. The course of symptomatic epilepsy is closely related to the underlying pathology: if it can be taken under control, the seizures will cease.
If the disease occurs in a child at an early age, it may impede the process of its cognitive development, especially if seizures occur frequently.
How are they treated?
The basis of drug treatment is the use of anticonvulsants: drugs that inhibit seizure activity.
This can significantly reduce the frequency of seizures or completely rid the patient of them.
Drugs are selected individually, in the course of treatment, the dosage and quantity can be adjusted. The use of drugs such as Carbamazepine, Lamotrigine.
In some cases, other drugs are prescribed: for example, sedatives and sleeping pills, if the patient has difficulty sleeping.
Afobazole in epilepsy, it can be prescribed, but it is a rather controversial drug that did not pass a randomized controlled trial and is practically not used outside of Russia. It is more reasonable to use more reliable means if necessary to reduce anxiety.
If the seizures cannot be controlled with medication, an operation may be indicated, during which the specialists act on the area of the brain that has pathological activity.
In the majority of patients (60-70%), after surgery, a decrease in the frequency of seizures is observed, in the remaining part they disappear completely.
What to do with epilepsy and how to live with an epileptic?
If any signs indicate epilepsy, seek medical attention immediately and undergo a comprehensive examination.
If the diagnosis is confirmed, treatment will begin: the doctor will select the epileptic medication and give general recommendations.
Those close to the patient should talk with their doctor and listen carefully to all his recommendations. It is important to create houses as much as possible. comfortable and safe environment, organize good nutrition, avoid night work and stress.
Epilepsy is not a sentence. Epileptics should not be considered crazy, defective: modern medicine allows most of them to live in the same way as healthy people live, and does not differ from them.
A person with this disease is very important help and support of loved ones, especially if the seizures are observed frequently and are difficult to medically correct. It is important for them to learn how to provide first aid correctly and to be ready to contact medical professionals if the attack was atypical.
Lack of awareness of relatives often leaves the patient sideways: for example, there is a perception that during a generalized seizure, it is imperative to open your teeth and stick something in, say, a spoon in order to prevent the epileptic from biting his tongue.
Such "help" can lead to injuries of the oral cavity, including the loss of front teeth. During an attack, it is enough to put something soft under the head, turn it to the side whenever possible, make sure that there is no vomiting, and periodically wipe out saliva.
The main adviser of relatives should be the attending physician. During the consultation, it is important to ask all your questions, discuss the organization of life, find out what you can do and what is not recommended, and help the patient to adhere to these recommendations.
It is important to remember that in most cases, epilepsy can be fully controlled during the first few years.
But even if this fails, living comfortably with this diagnosis is more than possible (with the exception of extremely severe forms, an operation is indicated for such cases)
What is epilepsy:
