epileptolog

soderzhanie stati:

• kto takoj epileptolog?
• kogda neobhodimo prijti na konsultaciu k epileptologu?
• kak prohodit priem u epileptologa?
• metody diagnostiki, ispolzuemye epileptologm

epileptologiya yavlyaetsya uzkospecializirovannoj otraslu nevrologii, kotoraya obektom izucheniya imeet lechenie epilepsii, kak bolezni.

epileptolog yavlyaetsya vrachom, kotoryj zanimaetsya diagnostikoj pristupov i paroksizmalnyh rasstrojstv, terapiej epilepsii. on imeet pravo naznachat lekarstvennye preparaty bolnym epilepsiej, osushestvlyaet kontrol i profilaktiku posleduushih pristupov.

kto takoj epileptolog?

• elektrofiziologii;
• metodov vizualizacii struktury, biohimicheskih parametrov i funkcionirovaniya golovnogo mozga;
• rasstrojstv paroksizmalnogo rasstrojstva;
• geneticheskih osobennostej cheloveka;
• metodov i sposobov socialnoj reabilitacii bolnyh s epilepsiej;
• farmakologii sredstv, ispolzuemyh dlya terapii epilepsii i pr.

takaya raznostoronnyaya podgotovka specialistov neobhodima dlya togo, chtoby vrach imel vozmozhnost rabotat s pacientami, imeushimi tyazhelye i redkie formy epilepsii.

krome togo, est detskie epilepotologi, obladaushie eshe bolee uzkoj specializaciej. delo v tom, chto terapiya etogo zabolevaniya v detskom vozraste otlichaetsya ot lecheniya epilepsii u vzroslyh. eto kasaetsya, v pervuu ochered, podbora medikamentoznyh sredstv.

vrach-epileptolog presleduet v svoej rabote cel izbavit pacienta ot pristupov navsegda, libo svesti chislo ih vozniknoveniya k minimumu. pri etom neobhodim gramotnyj podbor lekarstvennogo preparata i opredelenie ego dozirovki. imenno na eto mozhet ujti neskolko mesyacev.

specialisty-epileptologi mogut praktikovat v specializirovannyh stacionarah, v poliklinikah, v epileptologicheskih centrah. tyazhelyh bolnyh specialisty prinimaut v krupnyh nauchnyh centrah, gde raspolagautsya osnashennye dlya lecheniya takih pacientov otdeleniya. tam zhe vozmozhno vypolnenie hirurgicheskogo vmeshatelstva, esli takovoe neobhodimo. odnako, chashe vsego pacientam neobhodimo dlitelnoe ambulatornoe lechenie pod kontrolem gramotnogo specialista.

esli v naselennomparagraph epileptologist is missing, patients should see a neurologist.

Read more: Epilepsy in adults - the causes, signs and symptoms of epilepsy, the effects of

When it is necessary to come on consultation to epileptology?

As a rule, on the advice of epileptology patients come from another specialist. Often it is either a neurologist or a therapist. Mandatory for admission to epileptology need to get patients who suffered an attack of loss more than once, either during the attack was broken consciousness.

It is understood that the attacks of the disease is not always accompanied by loss of consciousness or severe seizures. Sometimes they can be invisible to others and the patient. This so-called absence seizures. They are often interpreted as excessive absent-mindedness of a man, as they can be expressed in repetitive operations, such as chewing movements, to stop speech. In this case the patient himself to such attacks are not paying attention. Therefore, if the relatives notice their loved ones such manifestations, a person needs to take a consultation with epileptology. It must be done as quickly as possible.

Often epileptic seizures are symptoms of a tumor, cyst or abscess of the brain. They can occur as a result of a traumatic brain injury or during the acute phase of stroke (see also: stroke - causes, types, symptoms and consequences).

How is the reception at epileptology?

During the reception, the doctor will interview the patient regarding his seizures. The doctor will be interested in their duration, frequency and nature of the flow. It is important, whether the patient experiences before the seizure aura, if Yes, can you describe how it manifests itself.

Important is the time of the first attack and its correlation with certain events and diseases. The history of the development of the disease also will be interested in epileptology at the first appointment. In order to provide the doctor with much information, it is best to bring all available documentation regarding the disease. It is important to inform the doctor about the facts of epilepsy in close relatives, if any.

After the survey is completed, the doctor will proceed to the next stage of consultation. It will be a neurological examination of the patient. Its purpose is to identify neurological symptoms have come on the intake of the patient. If neurological symptomsobnaruzhivaetsya, to eto yavlyaetsya dokazatelstvom togo, chto epilepticheskie pristupy imeut vzaimosvyaz s porazheniem mozga organicheskogo haraktera.

odnako, polnocenno vyyavit i podtverdit diagnoz «epilepsiya» nevozmozhno bez prohozhdeniya pacientom instrumentalnogo obsledovaniya. poetomu vrach v obyazatelnom poryadke otpravit bolnogo na dopolnitelnuu diagnostiku.

metody diagnostiki, ispolzuemye epileptologm

• elektroencefalogicheskoe obsledovanie ili sokrashenno – eeg;
• eeg s provokacionnymi probami, libo eeg vo vremya sna (esli standartnogo eeg nedostatochno);
• video-eeg;
• ispolzovanie metodov provokacii – eto deprivaciya sna, giperventilyaciya i fotostimulyaciya;
• sutochnyj monitoring eeg;
• kartirovanie golovnogo mozga, kotoroe pozvolyaet vyyavit mesto raspolozheniya ochaga patologicheskoj aktivnosti;
• mrt golovnogo mozga, pozvolyaushaya iskluchit opuholi, kisty, gamartomy, angiomy, displaziu kory i inye ochagi vospaleniya.

esli u bolnogo obnaruzhivaetsya v golovnom mozge obemnoe obrazovanie, to emu pokazana konsultaciya nejrohirurga. krome rezultatov instrumentalnyh obsledovanij.

vrachu ponadobyatsya dannye nekotoryh laboratornyh analizov, sredi kotoryh:

• oak;
• issledovanie fermentov pecheni;
• bak;
• analizy na obshij i pryamoj bilirubin;
• ldg i pr.

kogda diagnoz vystavlen i neepilepticheskaya priroda pristupov polnostu iskluchena, doktor naznachit lechenie protivosudorozhnymi preparatami. ih vybor osnovyvaetsya na tipe pristupov, na diagnostirovannoj forme epilepsii. esli diagnoz vystavlen nepravilno, to eto mozhet lish usugubit sostoyanie bolnogo, tak kak on nachnet prinimat nepodhodyashie emu silnodejstvuushie lekarstvennye sredstva. poetomu tolko kvalificirovannyj vrach-epileptolog mozhet zanimatsya lecheniem pacientov s epilepsiej. takzhe v ego obyazannost vhodit monitoring sostoyaniya pacienta vo vremya poluchaemoj terapii.