In most cases epilepsy is inborn, thus, attacks are shown at children (aged from 5 till 10 flyings) and at teenagers (in the age category of 12-18 years). In this situation damages of the substance of a brain are not defined, changes affect the only electric activity of nerve cells and also reduction of the threshold of excitability of a brain is noted. An epilepsy of such look carries the name idiopathic, or primary. It is distinguished by a good-quality current, it is safely treated, as a result of age patients can exclude the intake of medicines completely.
There is also symptomatic, or secondary, an epilepsy type. Its development is connected with the postponed damage of the structure of a brain or failure in its exchange processes which are a consequence of several pathological influences (craniocerebral injuries, underdevelopment of structures of a brain, strokes, infections, tumors, narcological and alcohol addiction and so forth). Such a form of epilepsy can develop at people of any age, she demands more difficult treatment. However in certain cases, when it turns out to overcome a basic disease, perhaps full treatment.
Types of epileptic attacks
The manifestation of epilepsy can be connected with very different types of attacks. Classification of such types looks as follows:
- because of the emergence of attacks: primary and secondary epilepsy; according to the scenario of a succession of events during an attack (the attack which is followed or not
- followed by a loss of consciousness);
- in the location of the initial center of excessive electric activity (deep departments of a brain, bark of the left or right hemisphere).
Generalized attacks are followed by dead faint and impossibility to control the made actions. It is the result of excessive activation of deep departments and the subsequent involvement of a brain in general. A similar state not necessarily is followed by falling as the tone of muscles is broken not in all cases.
At a tobiko-clonic attack at first, there is a tonic muscle tension of all groups then falling than at the patient rhythmical flexion and extensive movements in a jaw, the head, extremities (so-called clonic spasms) are noted follows.
Absentia epileptica is shown, as a rule, at children's age and is followed by suspension of activity of the child – his look loses sensibleness, it as if stiffens in one place, in certain cases, it can be followed by twitching of facial and eye muscles.
Partial epileptic attacks are noted at 80% of people of adult age and in 60% of cases at children. They appear when in some concrete sites of a cerebral cortex the center of excessive electric excitability is formed. Depending on the place where the similar center is located, also manifestations of a partial attack differ sensitive, motive, mental and vegetative.
If the attack simple, the patient is in consciousness, however, he cannot control a concrete part of own body or notes feelings, unfamiliar for itself. In case a difficult attack consciousness is broken (it is lost partially), that is the patient does not realize what occurs around where it is, at the same time he does not make contact. The difficult attack, as well as idle time, is followed by an uncontrolled physical activity of a certain part of a body, in certain cases it can gain the nature of purposive movement – the patient goes, talks, smiles, "dives", sings, "kicks the ball" or continues the action begun with it before an attack (chewing, walking, a conversation). Generalization can be a result of both types of attacks, both simple, and difficult.
All kinds of attacks differ in transience – duration is them from several seconds to three minutes. After the most of attacks, except for absentia epileptic, there comes drowsiness and confusion. When the attack is followed by a disturbance or a loss of consciousness, the patient does not remember the event. Different types of attacks can meet at one patient and also the frequency of their emergence can change.
Manifestations of epilepsy between attacks
All know that epilepsy is shown in the form of epileptic attacks. However, researches show that the overestimated electric activity and readiness of a brain for spasms do not abandon patients even in intervals between attacks when no symptoms of a disease, at first sight, are observed.
The danger of epilepsy consists that epileptic encephalopathy, that is such a state at which the mood decreases can develop there is a concern, the level of memory, attention and informative functions falls. This problem is particularly acute at children as can become the lag reason in development and interfere with forming of skills of reading, the speech, account, letter and so forth Besides, the incorrect electric activity in intervals between attacks is capable to cause such serious illness as migraine, autism, a syndrome of hyperactivity and a syndrome of deficiency of attention.
We already told that there are two kinds of epilepsy: symptomatic and idiopathic. Most often symptomatic epilepsy is partial, and idiopathic – generalized. It is connected with the different reasons causing them. In a nervous system signals between nerve cells are transmitted using the electric impulse which is generated on a surface of all cells. Sometimes there are excess, excess impulses, however, if the brain normally functions, these impulses are neutralized by anti-epileptic structures. If there is a genetic defect of data of structures, idiopathic generalized epilepsy develops. In such a situation the brain does not control excessive electric excitability of cells, as a result, it is shown as the convulsive readiness capable at any time "to enslave" bark of all hemispheres and to lead to an attack.
Factors of development of epilepsy
In certain cases, the genetic defect does not take the form of idiopathic epilepsy and people are not exposed to a disease. However, if there are "favorable" conditions (one of the listed above states or diseases), some form of symptomatic epilepsy can appear. At the same time at people at young age epilepsy after ChMT and against the background of drug and alcohol addiction, and at people of advanced age – as a result of a stroke or tumors of a brain in most cases develops.
Life with epilepsy
Many consider that the person having epilepsy is forced to limit in many respects himself, many courses of life are inaccessible to him, however, to live with epilepsy not so hard. The patient and also his relatives and people surrounding him have to know that, as a rule, having epilepsy disability can even not make out.
Full-fledged life is provided by regular continuous intake of the drugs appointed by the doctor. The brain under the protection of medicamentous drugs loses susceptibility to provocative factors. Therefore the patient can lead a full life, work (even at the computer), to watch TV, to play sports, to fly by planes and so on.
However, there are several types of activity influencing the epileptic's brain like a red rag on a bull. It is necessary to limit such actions as:
- work with the automated mechanisms;
- cancellation or admission of reception of tablets at own will;
- swimming in open reservoirs or the pool without supervision.
Besides, there are factors capable to lead to the emergence of an epileptic attack even at the person without problems with health, then it is also necessary to be protected:
regular use or abuse of drugs and alcohol;
work during night shifts, a lack of a dream, a daily operating mode.
Symptoms and symptoms of epilepsy
Depending on a form of epilepsy and taking into account the features of each patient signs and symptoms of epilepsy differ. Symptoms that precede an attack are allocated; the symptoms accompanying an attack; the symptoms following an attack.
Epilepsy signal symptoms. Epileptic aura
Every fifth person who approximately has epilepsy for some time (minutes, hours, days) begins to feel the approach of an attack. The epileptic aura is a set of feelings and experiences which indicate the fast approach of an attack of epilepsy. It is visual, somatosensory, olfactory, acoustical, mental, flavoring.
The epileptic aura can be shown as a change of sense of smell or taste, feeling of nervousness or the general tension, feeling of "deja vu" or inexplicable confidence that the attack already approaches.
Diagnostics of epilepsy
When the diagnosis "epilepsy", the main thing is made – to establish what character it has: secondary or idiopathic (that is to exclude the presence of a basic disease which is a background for progressing of epilepsy), and besides, attack type. This measure is necessary competently to appoint treatment. Directly sick often do not remember as well as what happens to it when there is an attack. That is data in which the patient's environment can report the people who are present at manifestations of epilepsy are extremely important.
Researches which need to be conducted:
EEG (electroencephalography) – reflects the changed electric brain activity. When the attack comes, changes on EEG are visible always. However in intervals between attacks EEG meets the standard in 40% of cases, therefore, provocative tests, repeated inspections, and video-EEG-monitoring are necessary; the general and developed biochemical analysis of blood; CT (computer tomography) or MRT (magnetic resonance imaging) of a brain, if there are suspicions on a concrete basic disease in case of symptomatic epilepsy, it is necessary to conduct the required additional examinations.
Therapy of epilepsy
The essence of treatment of epilepsy consists of the normalization of the electric activity of a brain and a stop of attacks. To stabilize a membrane of nerve cells of a brain and at the expense of it to increase the level of convulsive readiness and to reduce electric excitability, register antiepileptic drugs. The reduction of risk of emergence of the next epileptic attack becomes a result of similar medicinal influence. To reduce the excitability of a brain between attacks that promote additional stabilization of a state and to prevent progressing of epileptic encephalopathy, it is possible using a Lamictal and Valproatums.
antiepileptic drugs, such as Valproatums (Depakinum Chrono), carbamazepine (Finlepsinum), tokamaks, Lamictal, clonazepam, gabapentin and so forth. What to choose drug and in what dosage to use, the doctor solves.
If epilepsy secondary is carried out additional treatment of the main disease. Symptomatic treatment (for example, the drugs reducing depression or improving memory).
To protect itself, patients with epilepsy antiepileptic drugs have to take for a long time. Alas, drugs of this group can lead to the emergence of side effects, such as slackness, decrease in informative activity and immunity, loss of hair. For early detection of undesirable effects, every six months do ultrasonography of kidneys and a liver, biochemical and general blood test.
The way to disposal of epilepsy is long, thorny and demands considerable forces, however in 2.5-3 from the moment of the last attack conduct the comprehensive examination including MRT of a brain and video-EEG-monitoring again and then begin to reduce smoothly a dose of the antiepileptic drug until it is completely canceled. The patient leads a usual life, observes the same precautionary measures, however it does not depend on the intake of medicines anymore. Similar treatment is done in 75% of cases of epilepsy.