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Causes, signs and symptoms of epilepsy

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What is epilepsy?

Epilepsy is a common neuropsychiatric illness with a chronic latent course. Despite this, the disease is typically sudden appearance of epileptic seizures. They are caused by the emergence of numerous foci of spontaneous excitation (neural level) in certain areas of the brain.

Clinically these seizures are characterized by temporary disorder of the sensory, motor, cognitive and autonomic functions.

The detection rate of this disease is an average of 8-11% (classic detailed attack) among the General population of any country, regardless of climate location and economic development. In fact, every 12th person sometimes experiences a certain microprismatic epilepsy.

The overwhelming majority of people believe that the disease is incurable epilepsy, and is a kind of "divine punishment". But modern medicine refutes this opinion. Antiepileptic remedies to help suppress the disease in 63% of patients and 18% significantly reduce its clinical manifestations.

The main treatment is long-term, regular and ongoing drug therapy with adherence to a healthy lifestyle.

The causes of epilepsy are various, who grouped them into the following groups:

  • Idiopathic cases, when the disease is inherited, often through dozens of generations. Organically brain damaged, but there is a specific reaction of the neurons. This form is fickle and seizures occur without explainable causes;
  • Symptomatic – there is always a reason for the development of foci of pathological impulses. This can be trauma, intoxication, tumors or cysts, malformations, etc. This is the most unpredictable form of epilepsy, because a seizure can be triggered by the slightest stimulus, for example, fear, fatigue or heat;
  • Cryptogenic is not possible to accurately establish the true cause of uncharacteristic (of late) pulsed lesions.

When there is epilepsy?

The seizures in many cases, thereonly babies at high temperature of the body. But this does not mean that in the future a person will have epilepsy. This disease can develop in any person at any age. But more often it affects children and adolescents.

75% of the patients with epilepsy – people to 20 years. As for people in their late twenties, here are usually various kinds of injuries or strokes. Risk group were older than sixty years.


Symptoms of epilepsy

Symptoms of epilepsy may vary in different patients. First and foremost, the symptoms depend on the areas of the brain where occurs and spreads abnormal discharge. In this case, the signs will be directly connected with the functions of the affected parts of the brain. Can occur movement disorders, speech disorders, an increase or a decrease in muscle tone, dysfunction of mental processes, and, both in isolation and in various combinations.

The severity and set of symptoms will also depend on the specific type of epilepsy.

Jacksonian seizures

So, when Jacksonian seizures pathological irritation covers a certain area of the brain has not spread to neighboring, and therefore manifestations relate to well-defined groups of muscles. Usually psychomotor disorders short, the man is conscious, but it is characterized by confusion and loss of contact with others. The patient is aware of impaired functions and rejects the attempts of help. After a few minutes of completely normal.

Jerking, or numbness starts in the wrist, foot or lower leg, but they can spread to the entire half of the body or to go into a tonic-clonic seizure. In the latter case we speak of secondary generalized seizure.

Tonic-clonic seizure consists of a series of successive phases:

  • The harbingers for a few hours before the attack the patient covers the alarming state, characterized by the increase of nervous excitement. The focus of pathological activity in the brain gradually expands, covering new departments;
  • Tonic cramps , muscle strain sharply, head throws, the patient falls, hitting the floor, his body arched arc, and is held in this position. Because of the breath of the person is blue. Phase short, about 30 seconds, rarely up to one minute;
  • Clonic seizures – the muscles of the body rhythmically, quickly reduced. Increasedsalivation with foam in his mouth. Duration – up to 5 minutes, and then gradually recovered breath, face goes lividity;
  • Stupor – in the focus of the pathological electrical activity starts heavy braking all the muscles of the patient relax, possibly involuntary discharge of urine, feces. The patient loses consciousness, the reflexes are absent. Phase lasts up to 30 minutes;
  • Sleep.

After waking up sick for another 2-3 days can torment headaches, weakness, movement disorders.

Small attacks

Small attacks occur less bright. Can happen a series of twitching of the facial muscles, the sudden drop of muscle tone (causing a person falls), or, conversely, the tension of all muscles, when the patient freezes in a certain position. Preserved consciousness. Possible temporary "absence" – an absence seizure. Sick fades for a few seconds, maybe roll his eyes. After an attack he doesn't remember what happened. Small attacks often begin in the preschool years.

Epileptic status

Epileptic status is a series of attacks, following each other. In the intervals between them the patient regains consciousness, have reduced muscle tone and lack of reflexes. His pupils may be dilated, constricted or be of different sizes, the pulse is either rapid or barely detectable. This condition requires immediate medical attention, as characterized by increasing hypoxia and brain edema. The lack of timely medical intervention leads to irreversible consequences and death.

All seizures have a sudden beginning and end spontaneously.

On topic: All forms of epilepsy


The causes of epilepsy

No one of the common causes of epilepsy, which could explain its emergence. Epilepsy is not a hereditary disease in the literal sense, but in certain families where someone in the family suffering from this disease, the risk is higher. About 40% of epilepsy patients have close relatives with the disease.

There are several kinds of epileptic seizures. The severity is different. Attack is responsible for only one part of the brain is called partial, or focal. If you suffer from the whole brain, the seizure is called generalized. There are mixed seizures: start with one part of the brain, and later cover the entirebody.

Unfortunately, in seventy percent of cases the cause of the disease remains unclear.

Common causes: traumatic brain injury, stroke, brain tumor, lack of oxygen and blood supply at birth, disorders of the structure of the brain (malformation), meningitis, viral and parasitic diseases brain abscess.

Epilepsy is transferred whether by inheritance?

Undoubtedly, the presence of brain tumors in the ancestors leads to a high probability of transfer of the whole complex of the disease to their descendants is the idiopathic variant. Especially if there is a genetic predisposition of the cells to the Central nervous system hyperreactivity, epilepsy has the maximum possibility of manifestation in the offspring.

At the same time there is a dual option – symptomatic. The crucial factor here is the intensity of the genetic transmission of the organic structure of the neurons of the brain (the property of excitability) and their resistance to physical impacts. For example, if people with normal genetics can "withstand" any blow to the head, then the other, with a predisposition to react to it a generalized seizure.

With regard to the cryptogenic form, it is little studied and not well understood the causes of its development.

Can I drink with epilepsy?

The answer is no! In epilepsy, in any case, drinking alcoholic beverages can not be otherwise with 77% guarantee, you can provoke a generalized convulsive seizure, which may be the last in life!

Epilepsy is a serious neurological disease! At observance of all recommendations and the "right" way of life, people can live in peace. But in violation of the treatment regimen or disregard for the prohibitions (alcohol, drugs) can provoke the condition, which will directly endanger the health!

What needs examination?

In order to diagnose the disease, the doctor examines the medical history of the patient and his relatives. To make an accurate diagnosis very difficult. Doctor before it does a lot of work: examines the symptoms, frequency of seizures, a seizure is described in detail – this helps to determine its development, because the person has had a seizure, he remembers nothing. In the future, do electroencephalography. The procedure is not painful is the record of the activities of your brain. Can also be used such techniques as computer, positron emission andmagnetic resonance imaging.


What is the prognosis?

If epilepsy is properly treated, then eighty per cent of people with this disease live without any seizures and no limitations in activity.

Many have a lifetime to take antiepileptic drugs to prevent seizures. In rare cases, the doctor may cancel the medication, if the person for several years is experiencing seizures. Epilepsy is dangerous because conditions such as asphyxiation (which may occur if the person fell face down on the pillow, etc.) or a fall causing injury or death. In addition, epileptic seizures may occur in succession within a short time, which can lead to respiratory failure.

As for generalized tonic-clonic seizures, they can lead to death. People who experience these attacks, in need of constant surveillance, at least on the part of relatives.

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What are the consequences?

Epilepsy patients are often faced with the fact that their attacks are scaring other people. Children can suffer from the fact that they will avoid your classmates. Also, young children with this disease will not be able to participate in games or competitions. Despite proper selection of anti-epileptic therapy, may cause hyperactive behavior and learning difficulties.

The person may have to limit any activities- for example, driving a car. People who are seriously ill with epilepsy, need to monitor their mental state, which is inseparable from the disease.


How to treat epilepsy?

Despite the seriousness and danger of the disease, subject to timely diagnosis and correct treatment of epilepsy in half of the cases treated. And to achieve sustained remission is possible in approximately 80% of patients. If diagnosed for the first time, and immediately underwent a course of drug therapy, two thirds of patients with epileptic seizures during life, or never again, or fade for at least several years.

The treatment of epilepsy, depending on the type of disease, forms, symptoms and age of the patient is surgical or conservative method. Often resort to the latter, since taking antiepileptic drugs provides a positive effect in almost 90% of patients.

Drug treatment of epilepsy involves several key steps:

  • Differential diagnosis – to determine the form of the disease and the type of attacks to choose the right product;

  • Establishing the causes – if symptomatic (the most common) form of epilepsy careful examination of the brain for the presence of structural defects: aneurysms, benign or malignant tumors;

  • Preventing attacks is desirable to completely eliminate the risk factors: fatigue, lack of sleep, stress, hypothermia, alcohol intake;

  • Relief of status epilepticus or isolated seizures is made by first aid and the appointment of one of antiepileptic medication or combination of medications.

It is important to inform the immediate environment about the diagnosis and proper behavior during a seizure, to let people know how to protect patients with epilepsy from injury when falling and convulsions, to prevent sticky and prokusyvanie language and stop breathing.

Drug treatment of epilepsy

Regular intake of prescribed medicines can confidently count on a quiet life without seizures. Unacceptable the situation, when the patient begins to take medications only at the appearance of the epileptic aura. If the tablets were taken all the time, harbingers of the coming attack, most likely, would not have occurred.

In the period of conservative treatment of epilepsy the patient should adhere to the following rules:

  • Strictly follow the schedule of taking the drugs and not to change the dosage;
  • In any case, do not assign yourself other medications at the pharmacy or pharmacist;
  • If you need to go to the assigned analogue of the drug due to the lack of it in pharmacies or prices too high, to notify the attending physician and get advice on choosing a suitable replacement;
  • Do not stop treatment on reaching the counter positive dynamics without the permission of the neurologist;
  • Inform the doctor of all unusual symptoms, positive or negative changes in the condition, mood and General health.

More than half of patients after primary diagnosis and assigned to a single antiepileptic drug live without seizures for many years, constantly adhering to the chosen monotherapy. The main task of the neurologist is to find the optimal dosage. Begin medical treatment of epilepsy with small doses, the patient's condition carefully monitored.If the attacks fails to stop immediately, the dosage is gradually increased until a stable remission.

Patients with partial epileptic seizures prescribe the following groups of drugs:

  • Carboxamide – Carbamazepine (40 rubles per pack 50 table). Finlepsin (260 rubles per pack 50 table). Actinerval, Timonel, Septal, Karbasan, Targetal (300-400 rubles per pack of 50 the table below);

  • Valproaty is Depakine Chrono (580 rubles per pack of 30 tabl.), Anchorat Chrono (130 rubles per pack of 30 tabl.), Konvuleks (in the drops - 180 rubles, in syrup - 130 rubles), Konvuleks Retard (300-600 rubles per pack 30-60 table). Valparin Retard (380-600-900 rubles per pack 30-50-100 the table below);

  • Fenitoina – Phenytoin (40-50 rubles per pack of 20 the table below);

  • Phenobarbital – domestic production – 10 to 20 rubles per pack of 20 tab., foreign analogue Luminal – 5000-6500 rubles.

The first-line drugs in the treatment of epilepsy are those valproaty and carboxamide, they give a good therapeutic effect and cause a minimum of side effects. A day patient is prescribed Carbamazepine 600-1200 mg or 1000-2500 mg Depakine, depending on the severity of the disease. The dosage is divided into 2-3 reception during the day.

Phenobarbital and drugs fenitoina series are considered to be today outdated, they give a lot of dangerous side effects that depress the nervous system and can be addictive, so modern neurologists refuse to try.

The most easy to use are prolonged form of valproate (Depakine Chrono, Chrono Anchorat) and carboxamido (Finlepsin Retard, Tergitol PTS). These medicines enough to take 1-2 times a day.

Depending on the type of seizure, epilepsy treatment is carried out with the following medications:

  • Generalized seizures – complex of valproate with Carbamazepine;

  • Idiopathic form – valproaty;

  • Absence Seizures – Ethosuximide;

  • Myoclonic seizures – only valproaty, Carbamazepine and Phenytoin have no effect.

Latest innovations among ANTIEPILEPTICS – drugs, Tiagabine and Lamotrigine – have proven themselves in practice, so if a doctor recommends and finances allow, it is better to opt for them.

On the cessation of drug therapy you can think after a minimum of five years of sustained remission. Epilepsy treatment is complete, gradually reducing the dosage of the drug to complete failure within six months.

Withdrawal status epilepticus

If the patientis in a state of status epilepticus (a seizure that lasts many hours or even days), it is intravenously administered any of the drugs sibazonom groups (Diazepam, Seduksen) in the dose of 10 mg in 20 ml glucose solution. After 10-15 minutes, you can repeat the injection if the epileptic status is maintained.

Sometimes Sibazon and its analogues are ineffective, and then resort to Fenitoina, Hexenal or thiopental sodium. Intravenous 1-5% solution with a content of 1 g of the drug, making a three-minute pause after each 5-10 ml to prevent fatal deterioration of hemodynamic and/or respiratory arrest.

If no injections do not help to bring the patient from a state of status epilepticus, we have to use the inhalation solution of oxygen and nitrogen (1:2), but this technique is not applicable in the case of difficulty breathing, collapse or coma.

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Surgical treatment of epilepsy

In the case of symptomatic epilepsy caused by an aneurysm, abscess or a brain tumor, doctors have to resort to surgery to correct the cause of the seizures. This is a very complex operation that is usually performed under local anesthesia, the patient remained conscious, and his condition could be to control the integrity of parts of the brain responsible for vital functions: motor, speech, visual.

The so-called temporal lobe epilepsy also lends itself well to surgical treatment. During surgery, the surgeon either makes a complete resection of the temporal lobe of the brain, or only removes the amygdala and/or hippocampus. The success rate of such interventions is very high – up to 90%.

In rare cases, namely, children with congenital hemiplegia (underdevelopment of one of the hemispheres of the brain) performed the operation of hemispherectomy, that is, completely remove the diseased hemisphere to prevent global pathology of the nervous system, including epilepsy. Forecast for the future of these kids is good, since the potential of the human brain is huge, and one hemisphere is enough for healthy living and clear thinking.

When initially diagnosed with idiopathic epilepsy is very effective operation of callosotomy (cutting of the corpus callosum provides communication between the two hemispheres of the brain). Such intervention prevents re-occurrence of seizures in about 80% of patients.


First aid

How to help a sick person, if he be a fit? So, if a person suddenly fell and began it is unclear to jerk his hands and feet,throwing your head back, look and make sure that the pupils are dilated. This is an attack of epilepsy.

Find out more: First aid for epilepsy what to do?

First move from person all items during a seizure it can drop on yourself. Then flip it on its side and put under your head something soft to prevent injury. If a person has had vomiting, turn his head to the side, in this case, it will help to prevent the penetration of vomit into the respiratory tract.

During an epileptic seizure, do not attempt to feed the patient and do not try to forcibly stop him. Your strength is still not enough. Ask others to call the doctor.


okov, Andrey Vladimirovich, doctor-neurologist

Find out more: First aid for epilepsy what to do?

First move from person all items during a seizure it can drop on yourself. Then flip it on its side and put under your head something soft to prevent injury. If a person has had vomiting, turn his head to the side, in this case, it will help to prevent the penetration of vomit into the respiratory tract.

During an epileptic seizure, do not attempt to feed the patient and do not try to forcibly stop him. Your strength is still not enough. Ask others to call the doctor.