Epilepsy: causes, symptoms, diagnosis and treatment

In the modern sense, epilepsy is a chronic disease of the brain, the only or dominant symptom of which is repeated seizures.

What it is?

Epilepsy has been known since ancient times. In ancient Greece and Rome, epilepsy was associated with magic and magic and was called “holy disease.” It was believed that the gods sent this disease to a person leading unrighteous life.

Already in 400 BC Hippocrates wrote the first treatise on epilepsy “On the sacred disease.” The greatest doctor of antiquity believed that seizures are provoked by the sun, winds, and cold, which change the consistency of the brain. In the era of the Middle Ages, epilepsy was feared, as an incurable disease, transmitted through the breath of the patient during an attack. At the same time, she was admired, as many great people, saints and prophets, suffered from epilepsy.

In the modern sense, epilepsy is a chronic disease of the brain, the only or dominant symptom of which is repeated seizures.

Epilepsy is a fairly common disease that affects about 40 million people worldwide.

Why does this happen?

Now we know that an epileptic seizure is the result of the simultaneous excitation of all neurons (nerve cells) of a separate part of the cerebral cortex — the epileptogenic focus. The cause of such a site can be a head injury (for example, concussion), stroke, meningitis, multiple sclerosis, alcoholism (every tenth alcoholic suffers from epileptic seizures), drug addiction and many other reasons. It is also known that predisposition to epilepsy can be inherited.

In 2/3 of people with epilepsy, the first attack develops up to 18 years of age.

Epilepsy should not be confused with a hysterical seizure. Spasms of hysteria develop most often after any strong experiences associated with grief, resentment, fright, and, as a rule, in the presence of relatives or outsiders. A person may fall, but tries not to cause severe damage to himself and maintains consciousness. The duration of a hysterical seizure is 15-20 minutes, less often up to several hours. When a person comes to a normal state, he does not feel at the same time a state of stupor or drowsiness, as is usually the case with epilepsy.

What’s happening?

Mild epilepsy episodes can look like an instant short-term loss of communication with the outside world. Attacks can be accompanied by light twitching of the eyelids, faces and are often invisible to others. It may even give the impression that a person seemed to be thinking for a second. Everything proceeds so quickly that others do not notice anything. Moreover, even the person himself may not know that he has just had an attack of epilepsy.

An epileptic seizure is often preceded by a special condition called an aura. The manifestations of the aura are very diverse and depend on the area of ​​the brain where the epileptic focus is located: it can be fever, anxiety, dizziness, the state of “never seen” ( jamais vu ) or “already seen” ( deja vu ), etc.

It is important to understand that a person during an attack does not realize anything and does not experience any pain. The attack lasts only a few minutes.

What to do during the attack

  • do not try to forcibly restrain jerky movements;
  • do not try to open your teeth;
  • Do not do artificial respiration or heart massage, place the person with seizures on a flat surface and place something soft under his head;
  • do not move the person from the place where the attack occurred, unless it is life-threatening;
  • turn the patient’s head on its side to prevent sticking of the tongue and saliva into the respiratory tract, and in cases of vomiting, gently turn the whole body on its side.

After the end of the attack, you need to give the person the opportunity to calm down and, if necessary, sleep. Often, on completion of an attack, confusion and weakness may occur, and some time (usually from 5 to 30 minutes) must pass, after which the person will be able to stand up on his own.

Of particular danger are several large convulsive seizures, following without interruption one by one. This condition is called epileptic status . It is deadly, as the patient stops breathing and may die from suffocation. Status epilepticus is the main cause of death for patients with epilepsy and requires immediate medical attention.

Diagnosis and treatment

If you or your loved ones had an epileptic seizure, you should contact your neurologist as soon as possible. To create a more complete picture of the causes and nature of the attack, you will also need to consult an epileptologist. A method to accurately determine the presence of this disease is electroencephalography (EEG). To determine the location of the epileptogenic focus using methods of magnetic resonance and computed tomography. Often, various non-epileptic conditions are masked for epileptic seizures, for example, some fainting, sleep and consciousness disorders. In this case, the video EEG monitoring method is used to clarify the diagnosis.

Modern medical treatment allows in 70% of cases to completely free a person from seizures. If there is no result in the treatment of epilepsy with drugs, surgery may be prescribed.

Use of the substance Gabapentin in epilepsy
Gabapentin is indicated for partial epileptic seizures with or without secondary generalization in adults and children over 12 years old (as an additional agent), partial epileptic seizures in children 3–12 years old (as an additional agent), and also for the treatment of postherpetic neuralgia in adults.

Leave a Reply