Symptomatic epilepsy is a chronic neurological disease characterized by recurrent seizures caused by excessive electrical activity of a certain group of neurons (nerve cells) in the brain. This activity is always associated with the presence of one or another cerebral pathology in the patient. In the overall structure of the incidence of epilepsy, the symptomatic form accounts for 25% of cases.
Symptomatic epilepsy develops as a symptom of an underlying disease
Features pathologists
Symptomatic epilepsy in children is characterized by polyetiological developing neurosystem disorders in their final stage, which are manifested by types of convulsive or often non-convulsive seizures and paroxysmal states. Leads to the following consequences: personality changes, intellectual disabilities, confusion, psychosis.
Symptomatic epilepsy refers to a form of dysfunction of the head, its functioning and is considered a common pathology. The disease develops in people around the world. Approximately 6% of patients have experienced epileptic-like seizures at least once in their lives . Symptomatic epilepsy is distinguished by its onset at an early age, but the disorder occurs after a specific cause.
Variants of the disease:
- Epilepsy that occurs after diseases of the nervous system that cease before the first symptoms appear.
- Epileptic syndrome is an actively developing progressive condition and processes in nervous activity. In this case, the disease occurs as a concomitant.
Epilepsy is divided into many types; the disorder is characterized by precise localization of excessive bioelectrical activity of neurons, so it is not difficult to determine the source of inflammation. When lucidity is lost, the seizures stop. They may vary in intensity. Petite seizures are classified into different categories. Status epilepticus refers to generalized seizures.
Focal or patchy seizures are not always distinguishable and accurately classified. The patient remains conscious during such seizures. Classification of seizures: motor, mental, sensory, conversational, reflex.
The essence of the disease
Changes in electrical activity between neurons in the brain may explain why epileptic seizures occur. More often it affects children who have already had such symptoms along their hereditary line.
When they first begin to experience seizures from birth or from the age of 5, and perhaps only from the age of 18, depending on the influence of negative factors. Another option is also possible, when epileptic seizures occur in the adult generation as a result of diseases or brain injuries suffered earlier.
It follows that epilepsy is of two types, congenital or acquired. When hereditary manifestations, determined in childhood, allow doctors to begin early rehabilitation and achieve long-term remission through prescribed procedures and medications, or complete recovery of the patient.
If the patient’s epilepsy was determined to be secondary, then in this case difficulties may arise in providing assistance to the victim. Explained by the presence of concomitant diseases that need to be treated first. Since if you do not focus on this, seizures can recur at any time, thereby greatly changing a person’s life.
Causes
Let's list the main ones: neoplasms in the circulatory system of the head, trauma during childbirth, asphyxia, hypoxia, other complications, concussions, damage to brain tissue, viral infections, bacteria, chronic pathological processes, complex diseases in childhood, intoxication, stroke, cerebral palsy, dystonia, atherosclerosis.
Symptoms
Epilepsy attacks are often accompanied by uncontrolled activity of the nervous system, loss of consciousness, and clouding of reason. Convulsions occur; in this case, it is better for the person to take a horizontal position. Features of the manifestation of symptoms are determined by the localization of the focus of abnormal neuronal activity.
The mild form is characterized by discomfort and excitement. When a seizure begins, the patient feels unwell, the receptors perceive information that is not actually there. A person is not able to completely control his body .
The severe form has more pronounced symptoms: voluntary uncontrolled activity, lack of understanding of what is happening, difficulty controlling the functioning of the limbs, convulsions, vomiting.
- Symptomatic frontal epilepsy is characterized as follows: seizure duration is about 40 seconds, spontaneous onset, problems with fine motor skills, seizures occur frequently.
- The temporal form is characterized by the following symptoms: a person does not understand what is happening to him, hallucinations from visual and auditory receptors, facial automatisms.
- Parietal forms: spasms in all muscles, problems with thermoregulation, unpleasant feelings, increased libido.
- Occipital form: head twitches, eyes move, blinking, visual hallucinations.
What are the dangers of epilepsy for pregnant women?
Rarely, there are cases when women have to deal with epilepsy during pregnancy. Occurring due to severe overload of the female body at these moments. In this case, the frequency of seizures will depend on whether the woman had seizures before the moment of conception. If so, then she suffers from seizures, perhaps more often and even more painfully.
Precursors of epilepsy can be:
- Frequent tantrums.
- Insomnia.
- Migraine or dizziness.
In extreme cases this is a state of fainting. If this happens, then the pregnant woman needs to see a doctor as soon as possible in order to cope well with all stages of pregnancy. Since patience can end with the baby being born sick, premature, or dying without being born in the womb.
As a rule, bearing a child with epilepsy is very dangerous. However, if conception does occur, then it is necessary that not only the pregnant woman’s attending physician, but also her close people know about it. When it is also necessary to be constantly monitored by a neurologist, gynecologist, therapist and constantly consult with a geneticist.
Kozhevnikov syndrome
This is a complicated, rapidly developing disease, endowed with epileptic syndromes. Kozhevnikov syndrome is caused by information agents. At the same time, the muscles of the arms and face tremble, mental disorders intensify, and part of the body is paralyzed.
The etiology of the disease is not fully understood today. Blood examinations for pathogens do not provide specific results. There are three main causes of pathology: acute, chronic, infectious diseases, autoimmune disorders.
Kozhevnikov syndrome occurs due to previous infections. They are provoked by simple motor seizures, the patient is conscious. Convulsions may appear in one area and then spread to the entire body.
There are 3 main stages of disease development:
- Develops with focal motor seizures preceded by a somatosensory aura . Transient hemiparesis and numerous attacks may occur. The frequency of attacks is getting worse. This stage lasts from several weeks to months.
- Attacks occur more frequently and vary in duration . Hemioclonus spreads to more muscles. After the seizures, there are long-term signs of prolapse. Transient hemiparesis turns into permanent. Higher nervous activity worsens. There is loss of visual fields. The performance of sensors from the opposite area from the source deteriorates.
- At this stage, neurological symptoms develop and the number of attacks decreases . In a quarter of the examples, endocrine disorders occur, weight gain, and premature hormonal changes in adolescents. The stage develops over three years.
During MRI, foci of hemiatrophy are identified, which are often located in the temporal region. Interictal hypoperfusion and a decrease in metabolism in damaged areas are detected. This type of epilepsy is a treatment-resistant form.
Medications can be used to maintain the patient’s condition normal. The chances of recovery will increase significantly. This can only be achieved at the beginning of the disease. Postoperative remission will be approximately 25-30%.
Helping someone with a seizure at home
If you need to help a person who is having a seizure, follow a number of rules:
- First of all, stay calm yourself. From the beginning of the attack, you are responsible for the person.
- Stay close to him during the seizure. Look around, perhaps some objects need to be moved so that the person does not hit himself.
- In addition to these little things, it is important to look at the clock at the beginning of an attack to note the time.
- If possible, place the patient on a hard, flat surface and place something soft under the head.
Prevention and treatment of epilepsy: helping people
note
There is no need to hold the person during convulsions. This will not help, but will lead to complications and injuries.
Also, many people are mistaken that it is necessary to put something in a person’s mouth. This is wrong. There is a risk that the patient will crush his teeth or bite you.
Please also note that if the attack lasts more than 5 minutes or after the attack the person is breathing poorly, you should immediately call an ambulance.
Main photo: ponchikov.net
Generalized forms
Generalized epilepsy means a condition with encephalogram transformations without brain damage. Diseases appear due to birth injuries and infections during pregnancy.
Gastaut's disease appears in patients from early childhood. Various attacks occur, distinctive changes occur in the electroencephalogram and characteristic disturbances: memory, speech, concentration, coordination. Therapy for this disease is complex and not always successful.
The onset of pathology falls in the age category from 3 to 5 years. Seizures are characterized by increased polymorphism, most often a combination of tonic and atypical abscesses and status epilepticus is observed. The attacks occur at different times during wakefulness. The pathognomic symptom is a disorder of memory and brain function. The ability to perceive information deteriorates. Often the prognosis is unfavorable, but with timely surgical procedures the condition of patients worsens.
Epilepsy with the presence of astatic seizures is detected in small quantities. The disease is predominantly diagnosed in women.
Tissady syndrome or epilepsy with pyoclonic abscesses according to the ICD is related to benign forms of the disorder. Myoclonus occurs as a contraction of muscle tissue in the neck, accompanied by nodding of the head. This condition is often triggered by hyperventilation.
Tissardi syndrome is related to forms that are resistant to therapy. If valproic acid is used in large quantities, stable stabilization of the condition is achieved in approximately 50% of patients. Due to intellectual and mnestic disorders, adaptation to society in such patients involves difficulties.
Course and prognosis
Symptomatic epilepsy is more difficult to treat than idiopathic epilepsy. Patients often develop mental disorders, and the frequency of their occurrence does not depend on the frequency of attacks.
The most serious complication is the development of status epilepticus. Its mortality rate reaches 18%. The prognosis worsens with long-lasting seizures. Thus, the probability of death when an attack lasts more than 12 hours is 80%.
If, against the background of anticonvulsant therapy, the patient does not experience epileptic seizures for two years, then drug treatment is gradually discontinued. However, a third of patients subsequently experience a relapse of the disease.
Diagnostics
Symptomatic epilepsy is manifested using the following methods:
- Initial examination by a specialist.
- The patient talks about his complaints.
- The doctor gets acquainted with the data on the medical history.
- Chronic disorders.
- Close relatives are interviewed about the presence of a hereditary predisposition to the pathology.
- Blood and urine are tested to determine inflammation in the body.
The following hardware is used for diagnostics:
- CT and MRI to visualize pathological changes in the nervous system, determine the size of the inflammation and its location.
- PET if a tumor appears or is suspected.
- An EEG is performed to monitor brain activity at rest and during seizures, and the nature of epileptic activity is determined.
- An x-ray is taken.
Samples of cerebrospinal fluid are taken. The patient is examined by the following doctors: gynecologist, therapist, ophthalmologist, endocrinologist, geneticist, surgeon.
Symptoms and signs of symptomatic epilepsy
Diagnosis of symptomatic epilepsy has clear criteria, according to ICD 10. Organic substances leading to lesions of the brain, for example due to head injury, neuroinfections. To make a diagnosis, it is important to find the cause. Seizures have a characteristic repeatability, the development mechanism is hypersynchronous neural impulses and discharges in certain areas of the brain. The presence of twilight and similar psychoses. Affective disorders associated with mood, such as dysphoria. The presence of permanent disorders of mental manifestations, specific personality changes, the formation of dementia. The course is progressive, that is, some seizures change others, changes in the person are formed in the form of a specific personality, dementia, the dynamics lead to the appearance of epileptic psychoses. On the EEG there are foci that increase in size and change as the epileptic focus develops.
Symptomatic partial epilepsy is manifested by simple seizures of the same name. These are separate twitches. Symptomatic partial epilepsy with motor seizures appears as a twitching in the arm or leg, sometimes the spasm moves from the distal part of the limb, involving more of the body, and can even lead to loss of consciousness. Symptomatic partial epilepsy can also manifest itself as psychosensory seizures appearing in different analyzers. It seems to the person that her body has changed, that the objects around her are bent and twisted. Sometimes even paroxysms of fictionality of the environment or one’s own self may occur. There are also seizures with psychoemotional disturbances. Aphasic with a complete absence of speech, difficulty pronouncing words with complete muscle integrity. Dysmnestic with the presence of characteristic psychosensory disorders, similar to something already seen before or never seen. There is also an attack with mental infidelity, when the only complaint is a change in the flow of thoughts, sometimes worsening to illusory and hallucinatory with the same disorders.
Symptomatic temporal lobe epilepsy is formed when the ammonium horn is damaged and is characterized by a polymorphic picture with various abnormalities. Symptomatic temporal lobe epilepsy has its focus in the temporal lobe of the brain and it is this lobe that provokes epileptoid activity with the appearance of symptoms. Symptomatic temporal lobe epilepsy is provoked by damage and sclerosis of the median structures. Most often it begins unnoticed, first an aura, like an unpleasant feeling or headache. But over the days and time, complex massive manifestations with seizures and personality changes can occur. Symptomatic temporal lobe epilepsy progresses, subsequently leading to seizures with loss of awareness and absence seizures.
Treatment of pathology
Treatment for symptomatic epilepsy depends on the nature of the symptoms; medications or surgery may be used. The operation can be performed in situations where hemorrhages occur, problems with the blood supply to the head, neoplasms, and aneurysms appear.
In most examples, the pathology is eliminated with the help of a course of treatment individually determined by a specialist . The types and causes that provoke epilepsy are always taken into account.
The main goal of therapy is to control the disorder to achieve long-term remission. It is necessary to achieve a result in which the number of seizures will be reduced and side effects will not occur.
Sometimes patients have to take anticonvulsants for life. Today, the choice of therapeutic methods and medications, as well as the need for surgical intervention, is determined by:
- Types of symptomatic epilepsy.
- The reasons for its occurrence.
- Localization and area of the epileptic focus and the possibility of its elimination. The most successful are surgical operations for small foci of abnormal bioelectrical activity, with a precisely established location and the absence of contraindications to surgical procedures.
- Identification and elimination of large tumors in the head, which are considered the main cause of secondary epilepsy.
The main principles of epilepsy treatment are: combating the pathology that causes seizures, treating all neurological and psychological disorders, therapy is carried out in relation to factors contributing to the occurrence of seizures.
Today, great results can be achieved in the treatment of epilepsy: the disorder is classified in detail, the use of new diagnostic techniques, and the possibility of using a large number of medications.
List of remedies for severe seizures
Doctors may prescribe the following medications to prevent grand mal seizures:
- AlgericaBenzobital;
- IC Benzonal;
- IC Benzonal-ArpiValproate;
- 500-TevaValproate;
- OrionValprocom 300;
- ChronoValprocom 500;
- ChronoGabagamma 100.
Seizure-preventing pills include:
- Topamax;
- Gabantin;
- Lamitril;
- Zeptol.
Of course, each medicine has its own contraindications, so before use you need to consult a specialist.
Prevention and treatment of epilepsy: a list of remedies against severe seizures
Physical therapy for epilepsy
People with epilepsy often refuse to exercise, and this is a mistake. According to research by doctors, patients who have high physical activity recover from seizures faster.
Therapeutic exercises at home or in a specialized gym should be prescribed personally by your doctor, and he will also calculate how much stress is permissible on your heart. It is physical exercise that helps teach the body to properly excite and inhibit the brain, thereby creating normal tone in the muscles.
Therapeutic gymnastics includes exercises for:
- muscle stretching;
- relaxation of the whole body;
- creating correct posture;
- search for balance and coordination of movements;
- working with the diaphragm with special breathing exercises;
- strengthening the skeleton.
Prevention and treatment of epilepsy: physical therapy
All actions are carried out in a different rhythm, which is selected individually.
For patients with the initial stages of epilepsy or in remission, doctors allow training on simulators. The priority is walking and easy running at a calm pace. The result of such training is the harmonization of brain function due to the rhythm of breathing.
If you don’t have time for the gym, then on the street everyone can definitely walk at a speed of 50-70 steps in one minute. When walking this way, you need to breathe through your nose.
Water exercises should only be done with an instructor who will be prepared in advance for possible attacks in the water.
Prevention and treatment of epilepsy: physical therapy
Before engaging in any activity, talk to your healthcare provider to see if you can participate in a particular activity.
Prevention
Let's list the preventive measures. Firstly, the constant use of anti-consultants. Secondly, maintaining a sleep schedule. Thirdly, you should not drink alcohol. If the EEG shows a high level of photosensitivity, you need to watch less TV and work at the computer, and you should not wear sunglasses. Prevention of stress and nervous overload.
Symptomatic or secondary epilepsy is considered a form of chronic disorder and is characterized by the occurrence of a variety of seizures. The disease can manifest itself against the background or after damage to brain structures, with problems with metabolism in neurons.
Precursors of epilepsy in newborns
Epilepsy of intermittent nature. This form of the disease is more often found among newborns. When their attacks are not localized throughout the body, but only in certain areas, constantly changing their location. For example, if you observe such a child, you can notice how his convulsions move from one limb to another or even move to the opposite side of the body.
If, during normal seizures, foam is released from the mouth, the patient bites his tongue, and then he experiences a state of sleep. In newborns they are often absent, but the following symptoms are observed:
- The baby has a high body temperature.
- After the attack there is weakness on the right or left side of his body, lasting for several days.
- The child becomes more irritable, has headaches, and loses interest in food.
