Idiopathic epilepsy: causes of occurrence, treatment features

Epilepsy in a child is a pathological condition of a neurological nature, manifested by sudden convulsive seizures. Much more often than in adults, the disease in question is observed in childhood. An epileptic seizure is a manifestation of a pathological and excessive electrical discharge in the brain structures, which provokes the occurrence of sudden motor and mental dysfunctions, autonomic disorders, as well as a modification of consciousness.

Epilepsy in children is characterized by a variety of clinical symptoms of seizures and a large number of varieties resistant to therapeutic effects.

Causes

The causes of epilepsy in children are still poorly understood. Sometimes the cause of epilepsy in a child cannot be determined, but in most cases the pathology is hereditary.

The main causes of epilepsy in a child:

• Unfavorable pregnancy if the child has impaired brain development in the womb. This happens if the mother's pregnancy was accompanied by alcohol and nicotine consumption.
• Pregnancy occurred with colds, severe gestosis or late first pregnancy (over 27 years).
• Children suffering from infectious diseases of the nervous system or frequent colds are characterized by high fever.
• Blunt head trauma or concussion.
• Hereditary predisposition. If parents suffer from epilepsy, a predisposition to pathology is passed on to their children through DNA.
• A brain tumor.

Diagnostic methods

Idiopathic generalized epilepsy requires timely diagnosis. A person will definitely have to undergo an examination so that he can assess the condition of the body and understand what form of the disease he is dealing with.

An electroencephalogram is required, which can be used to record a person’s brain activity. To obtain a complete clinical picture, it is important to record changes during the attack, which is why doctors, with the consent of the person, can give special provoking medications.

Magnetic resonance imaging and CT are also used to confirm idiopathic generalized epilepsy. Using these studies, it will be possible to confirm the presence or absence of other diseases. For example, with idiopathic epilepsy, doctors may suspect that a person has a brain tumor.

To make a final diagnosis, you will need to consider the following factors:

• A complete clinical picture should be collected. It is often recommended to install a video camera at home so that seizures and their symptoms can be recorded. This will greatly simplify the process of determining the specific type of epilepsy.
• Family history. It is important to find out whether close and distant relatives have had similar symptoms. Because the appearance of idiopathic generalized epilepsy is often associated with a hereditary factor.
• You will need to obtain complete test results. It is also important to assess the mental and physical level of development of the minor. Only based on the results of all important studies can idiopathic epilepsy be confirmed.
• Deciphering the blood test for karyotype.

If an idiopathic form of epilepsy is suspected in newborns, then it becomes more difficult to establish an accurate diagnosis . This is due to the unclear picture of the disease. In addition, parents cannot always notice the symptoms of pathology in time. After all, the child sleeps most of the time, and when there are no obvious symptoms, minor manifestations can rarely be detected.

Even if it was not possible to accurately confirm idiopathic generalized epilepsy, the person is prescribed standard treatment. In this case, you need to be regularly monitored by a neurologist, as well as an epileptologist. In this case, it will be possible to achieve good results in therapy.

Classification

In Russian medicine, forms of epilepsy are classified taking into account 2 main parameters: the causes that provoke seizures and their localization in the brain. There are main forms of epilepsy: focal and generalized. In turn, the forms are divided into various types and subspecies.

Focal

• Symptomatic - epilepsy caused by a concomitant disease, when eliminated, the attacks stop.
• Types depending on the area of ​​the brain where the malfunction occurs: chronic progressive (Kozhevnikov syndrome), frontal, temporal, occipital and parietal (rare). Frontal and temporal lobe epilepsy in children is diagnosed in 80% of pathological cases.
• Idiopathic is a pathology, the causes of which have not been established, but a focus of epileptic activity exists. Idiopathic epilepsy is considered a mild form of the disease and has a favorable prognosis.
• Rolandic epilepsy in children can manifest at any age. Its peculiarity is facial seizures during sleep. The prognosis of the pathology is mostly positive.
• Gastaut syndrome (pathology occurs only in childhood against the background of a neurological disease and is manifested by almost uncontrollable seizures).
• Cryptogenic – epilepsy is caused by unknown factors. Cryptogenic pathology is the most common among other types of epilepsies.

Generalized

Generalized forms of the disease are manifested by convulsive attacks that cover the entire body : symptomatic, idiopathic, cryptogenic. Epileptic seizures in a child are also divided according to the time of occurrence:

• only nocturnal attacks;
• mostly nocturnal;
• attacks at unspecified times of the day or night;
• exclusively daytime.

Sick children often suffer from epileptic seizures during sleep. In official medicine, the term “nocturnal epilepsy” does not exist. Nocturnal epilepsy was defined by patients. The typical time of occurrence of attacks during sleep is falling asleep or waking up. Nocturnal epilepsy is explained by physiological processes occurring during sleep.

Absence

There are unclassified forms of epilepsy, for example, absence. Childhood absence epilepsy is considered the most studied form of pathology. The disease is characterized by seizures both during sleep and while awake. Absence epilepsy has a hereditary predisposition , therefore, if parents or relatives have this disease, immediate examination is necessary.

Symptoms

The main symptom of epilepsy is regular seizures. Signs of pathology differ depending on the type of disease and the child’s age category. Epilepsy in children symptoms:

• convulsions, lasting on average from 2 to 20 minutes;
• loss of consciousness;
• stopping breathing for a short period of time;
• in some cases, sudden urination;
• involuntary bending of the elbows and extension of the knee joints.

Teens may foam at the mouth and bite their tongue. Often such attacks stop during sleep. In infants under one year old, it is not easy to recognize epilepsy, since the signs may be similar to manifestations of other diseases or physiological phenomena.

A child aged 1 to 3 years exhibits the following symptoms:

• the baby throws his head back;
• freezes for a while;
• trembling of the eyelids, squinting of the eyes;
• spontaneous twitching of legs or arms.

Absence epilepsy more often affects girls than boys and manifests itself as non-convulsive seizures lasting up to 30 seconds. The main signs that can help you suspect absence epilepsy in a child:

• sudden interruption of activity (freezing);
• lack of response to stimuli;
• focus of gaze on a single point;
• after the attack ends, the baby simply continues to do what he was doing before.

Very often, children suffering from epileptic seizures exhibit symptoms such as poor sleep due to nightmares, after which the kids may wake up with tears in their eyes, or sleepwalking (walking in their sleep).

The disease is characterized by symptoms expressed by attacks that affect only certain parts of the child’s body (tongue, leg or arm). Sometimes sick children experience sensory hallucinations (auditory, visual or gustatory).

Principles of drug treatment

Idiopathic partial epilepsy is often treated with special medications. A specific group of medications is used, and active therapy begins only after a recurrent attack. If a seizure occurs once, then it can often occur due to stress, metabolic problems, and fever.

First, a minimum dose of the drug is prescribed for a person. If there is no effect, then it is necessary to increase the amount of the drug taken. Agents such as Topiramate, Valproate, and Carbamazeline are often used . In this case, with idiopathic partial epilepsy, it will be necessary to avoid provoking factors such as stress, lack and disturbance of sleep, and poor nutrition.

If convulsive attacks in generalized epilepsy continue, then the treatment regimen will need to be reconsidered. Only a doctor can definitely say what measures will help a person improve their well-being. It is worth understanding that therapy for idiopathic generalized epilepsy will take more than one month, and even after the symptoms disappear, maintenance therapy must be carried out. Partial and other types of disease can disappear only with complex treatment. The doctor’s task is to choose the right measures that will be effective in a particular situation.

Treatment

Treatment of epilepsy in children requires a long time, and in some forms the disease is treated throughout the child’s life. The treatment regimen is prescribed by the doctor, taking into account the age category and condition of the baby, and the course of the disease. To cure a disease means to eliminate recurrent seizures.

First aid

During an epileptic attack, it is important to skillfully provide first aid. Children with epilepsy, in principle, require constant close attention. Parents should be ready to provide first aid at any time.

How to carry out first aid:

1. To prevent the child from hitting himself during an attack, fix his head and place something soft (you can use a jacket, bag, etc.);
2. If breathing stops, mouth-to-mouth artificial respiration must be performed;
3. It is necessary to unclench the child's teeth. To do this, you can insert something hard between the teeth, but under no circumstances put your fingers in the patient’s mouth;
4. Call an ambulance!

There are attacks for which emergency assistance should be provided only by qualified specialists:

• child's first seizure;
• the attack lasts more than 5 minutes;
• the interval between the previous and subsequent seizure is less than 30 minutes;
• the child was injured during a seizure;
• The baby's breathing is not restored.

Medication

The doctor decides how to treat your baby and what medications to use only after an accurate diagnosis has been established. Anticonvulsants are prescribed to treat epilepsy to prevent affected children from having more frequent seizures. If the prognosis of the disease is positive and there have been no seizures for about 3-5 years, the epileptologist may discontinue medications.

Antiepileptic drugs are used with a gradual increase in dose, while the doctor watches how clinical signs change and studies the occurrence of side effects.

The drugs are classified as follows:

• anticonvulsant barbiturates (benzonal, hexamidine, phenobarbital);
• hydantoin derivatives (diphenin);
• oxalidinediones (trimethine);
• succinimides (suxilep);
• iminostilbenes (carbamazepine);
• benzodiazepines (clonazepam);
• valproate (acediprole).

Parents should ensure that the child takes medications regularly. If monotherapy is ineffective, the epileptologist prescribes 2 or more anticonvulsant medications.

Folk remedies

In Russia you can find many recipes for treating epilepsy with folk remedies. Therapy with folk remedies in combination with other methods increases your chance of curing the disease.

Various herbal infusions are especially popular:

1. An infusion of lavender herbs and flowers. Making an infusion is simple: boil 1 teaspoon of the dry mixture and let it brew for about 30 minutes. You can use the product 1-2 months after lunch and 1 teaspoon before bedtime. After the course you need to take a break for about 2 weeks and you can repeat the therapy.
2. Infusion of crushed valerian root. 1 tbsp. a spoonful of root is poured into a glass of cold water and infused for about 7-8 hours. The product is filtered and taken 1 spoon 3 times a day.
3. Infusion of tansy. 10 baskets of tansy flowers are poured with half a glass of boiling water and left for 20-25 minutes, after which the infusion is squeezed out. You can take the medicine 1 tablespoon 3 times a day.

Before treating your child with folk remedies, make sure there is no allergic reaction by first consulting with your doctor.

In addition to alleviating attacks with folk remedies, you can carry out strengthening therapy with vitamin juices . Natural juices have an effective effect: onion, cherry, garden spinach juice.

Ketogenic diet

A ketogenic diet for children is prescribed by a doctor in the absence of effective effects of antiepileptic drugs. Sick children need a special diet according to their condition (weight, age, height, physical activity).

• Important information: treatment of epilepsy in clinics in Germany and Israel

The ketogenic diet is indicated for patients with uncontrolled seizures. The ketogenic diet has the following features:

• consuming foods rich in fat while controlling the amount of carbohydrates and proteins, which contributes to the accumulation of ketones;
• strict control of fluid intake.

Sick children should start a ketogenic diet, first fasting. The child is constantly under the supervision of a doctor in order to further change the nature of his diet.

The ketogenic diet begins with the child's hospitalization for up to 5 days, during which doctors need to do tests showing the stage of ketosis. After this, the ketogenic diet gradually becomes a daily diet. Parents should learn all the strict rules of the ketogenic diet and food combinations.

Operation

There are many contraindications for performing surgery to remove a focus of epilepsy in sick children. If the doctor raises the question of the need for surgical intervention, stereotactic destruction and open brain surgery (lobectomy, resection of the temporal lobe, etc.) are used.

Russian clinics do not have many years of experience in performing such operations. However, in Moscow there were successful attempts to operate on an epileptic focus using the vagus nerve method. The best clinics and epileptologists accept patients in Moscow, whose main goal is to bring them closer to European standards of medicine.

Rehabilitation

Rehabilitation of patients in specialized epilepsy departments is an important task and is carried out in conjunction with treatment. A child suffering from epilepsy needs social adaptation. Rehabilitation is developed individually for each patient, the main goal of which is to improve the general condition of the baby.

Many rehabilitation centers successfully use occupational therapy so that children have the opportunity to communicate and forget about their ailments.

The cessation of attacks in a medical institution entrusts further care of the baby to his parents and relatives. Rehabilitation of children will be successful if there is a favorable environment in the family, good attitude and care from others. In this case, the patient’s rehabilitation should be accompanied by visits to the epilepsy outpatient clinic and consultations with the attending physician.

Epilepsy is difficult to treat, the process of restoring brain function is long and complex, so many parents decide to take their child for rehabilitation after epilepsy to clinics in Germany.

Symptoms

The specific symptoms of idiopathic epilepsy directly depend on what kind of attack a person has. There are different types of seizures, and they differ in their manifestations. In general, it can be noted that in all cases the symptoms arise suddenly, while the person cannot predict exactly when he will have a seizure.

There are no motor, intellectual or cognitive consequences observed. A person has unusual electroencephalographic activity at the time of an attack . The following types of seizures that occur in idiopathic epilepsy can be distinguished:

• Absence crisis . A person loses consciousness during an attack, and there is no reaction to various stimuli.
• Myoclonic crises . They appear suddenly and last a few seconds. Often during them there is trembling of the limbs. In some cases, a person remains conscious, but still does not understand what exactly is happening to him.
• Tonic-clonic crisis . It is also called a major attack, in which vivid symptoms are observed. A person experiences a sudden loss of consciousness, while the whole body tenses significantly and the head falls back. Breathing stops, causing the face to take on a bluish tint. Foam and blood often come out of the mouth due to damage to the tongue and cheeks. Urinary and fecal incontinence may occur.

During an attack, a person experiences convulsions that last for about 5 minutes. After this, they gradually subside, and the patient falls into a pathological sleep. When he wakes up, he feels an intense headache, discomfort in the muscles and increased weakness. After an attack, a person does not remember what exactly happened to him.

Idiopathic epilepsy requires immediate treatment, because it allows you to avoid recurrent attacks or at least reduce their frequency. You should not wait until your health condition worsens significantly. The sooner a person takes action, the better it will be for his health.

Forecast

The prognosis for epileptic pathologies in a child can be made taking into account the following parameters:

• form and severity of the disease, frequency of occurrence and duration of attacks;
• the age category of the baby who had the first attack, timeliness of diagnosis and treatment;
• the presence of concomitant diseases that worsen the course of epilepsy.

The most unfavorable malignant form of the disease is epilepsy with frequent generalized “grand” seizures caused by severe brain pathology. The most favorable are considered to be: frontal epilepsy, benign convulsions of newborns and rolandic epilepsy.

Prevention

Prevention of epilepsy in children begins at the “pregnancy” stage. Mothers absolutely need to give up alcohol and smoking. Women suffering from pathology need to plan pregnancy with further monitoring by an epileptologist, geneticist and other specialists.

Parents of a sick baby need to monitor the daily routine (full sleep, balanced menu). The child is encouraged to do light physical exercise and solve mental problems every day.