Epilepsy in adults: causes and symptoms

Epilepsy is a chronic brain disease that occurs in the form of repeated epileptic seizures that appear spontaneously. Epileptic seizure (epiprip) is a kind of complex of symptoms that occurs in a person as a result of special electrical activity of the brain. This is a rather severe neurological disease, which sometimes carries a life threat. Such a diagnosis requires regular dynamic observation and drug treatment (in most cases). With strict observance of the doctor's recommendations, it is possible to achieve an almost complete absence of epi-seizures. And this means the opportunity to lead a lifestyle of a practically healthy person (or with minimal losses).

In this article, read about why the most common causes of epilepsy in adults, as well as the most recognizable symptoms of this condition.

General information

Epilepsy in adults is a fairly common disease. According to statistics, about 5% of the world's population have suffered an epileptic fit at least once in their life. However, the only fit is not the reason for the diagnosis. With epilepsy, seizures are repeated with a certain periodicity and occur without the influence of any factor from outside. This should be understood as follows: one seizure in life or repeated seizures in response to intoxication or high fever is not epilepsy.

Many of us have seen a situation where a person suddenly loses consciousness, falls to the ground, beats in cramps with the release of foam from the mouth. This variant of epipripade is only a special case, in its clinical manifestations seizures are much more diverse. The seizure itself can be an attack of motor, sensitive, vegetative, mental, visual, auditory, olfactory, taste disorders with or without loss of consciousness. This list of disorders is not observed in everyone who suffers from epilepsy: one patient has only motor manifestations, while the other has only impaired consciousness. The variety of epileptic seizures presents special difficulties in the diagnosis of this disease.

Causes of epilepsy in adults

Epilepsy is a disease that has many causative factors. In a number of cases, they can be established with a certain degree of certainty, sometimes it is impossible. It is more correct to talk about the presence of risk factors for the development of the disease, rather than on immediate causes. So, for example, epilepsy can develop as a result of a craniocerebral trauma, but it is not necessary. Trauma of the brain may not leave after itself the consequences in the form of epipriplets.

Among the risk factors are:

• hereditary predisposition;
• acquired predisposition.

Hereditary predispositionconsists in a special functional state of the neurons, in their propensity to excite and generate an electric pulse. This feature is encoded in genes and transmitted from generation to generation. Under certain conditions (the action of other risk factors) this predisposition is transformed into epilepsy.

Acquired predispositionis a consequence of early illnesses or pathological states of the brain. Among the diseases that can become a background for the development of epilepsy, we can note:

• craniocerebral trauma;
• meningitis, encephalitis;
• acute disorders of cerebral circulation (especially hemorrhage);
• brain tumors;
• toxic brain damage resulting from the use of drugs or alcohol;
• cysts, adhesions, aneurysms of the brain.

Each of these risk factors as a result of complex biochemical and metabolic processes leads to the appearance in the brain of a group of neurons having a low excitation threshold. A group of such neurons forms an epileptic focus. A nerve impulse is generated in the focus, which spreads to surrounding cells, excitation captures more and more new neurons. Clinically, this moment is the appearance of some type of seizure. Depending on the functions of the neurons of the epileptic focus, it can be motor, sensitive, vegetative, mental, etc. phenomenon. As the disease develops, the number of epileptic foci increases, stable links between "excited" neurons are formed, new structures of the brain are involved in the process. This is accompanied by the appearance of a new type of seizures.

In some types of epilepsy, initially a low excitation threshold exists in a large number of neurons of the cerebral cortex (especially this is characteristic of epilepsy with a hereditary predisposition), i.e. the resulting electrical impulse immediately has a diffuse character. Epileptic hearth, in fact, no. Excessive electrical activity of diffuse cells leads to the "capture" of the entire cortex of the brain in the pathological process. And this, in turn, leads to the emergence of a generalized epileptic fit.

Symptoms of epilepsy in adults

The main manifestation of epilepsy in adults is epileptic seizures. In essence, they represent a clinical mapping of the functions of those neurons that are involved in the process of excitation (for example, if the neurons of the epileptic focus are responsible for flexing the hand, then the fit consists in involuntary bending of the hand). The duration of a seizure usually ranges from a few seconds to several minutes.

Epipristupy occur with a certain frequency. The number of seizures in a certain period of time is important. After all, each new epileptic attack is accompanied by damage to neurons, suppression of their metabolism, leads to the appearance of functional disorders between brain cells. And this does not pass without a trace. After a certain period of time, the result of this process is the appearance of symptoms in the inter-attack period: a peculiar behavior is formed, the character changes, thinking worsens. The frequency of seizures is taken into account by the doctor when prescribing treatment, as well as when analyzing the effectiveness of the therapy.

According to the incidence of seizures are divided into:

• rare - no more than once a month;
• average frequency - from 2 to 4 per month;
• frequent - more than 4 per month.

Another important point is the division of epileptic seizures into focal (partial, local) and generalized. Partial seizures occur when one of the hemispheres of the brain has epileptic focus (this can be detected during electroencephalography). Generalized seizures appear as a result of diffuse electrical activity of both halves of the brain (which is also confirmed by an electroencephalogram). Each group of seizures has its own clinical features. Typically, one patient has the same type of seizures, i.e. identical to each other (only motor or sensitive, etc.). As the disease progresses, it is possible to layer new seizures into old ones.

Partial epimetails

This type of epileptic seizures can occur with a violation of consciousness and without it. If loss of consciousness does not occur, the patient remembers his feelings at the time of the attack, then such an attack is called a simple partial. The attack itself can be different:

• motor (motor) - muscle twitching in small parts of the body: in the hands, feet, face, abdomen, etc. it there can be a turn of the eyes and the head of a rhythmic character, shouting out individual words or sounds (contraction of the muscles of the larynx). Twitchings occur suddenly and are not subject to strong-willed control. A situation is possible when the contraction appearing in one group of muscles extends to the entire body half, and then to the other. This causes loss of consciousness. Such seizures are called motor attacks with a march (Jacksonian) with secondary generalization;
• sensitive (sensory) - a burning sensation, an electric current, a tingling sensation in different parts of the body. The same type of epipripadkov include the appearance of sparks before the eyes, sound (noise, banging, ringing) in the ears, smells and taste sensations. Sensory seizures can also be accompanied by a march followed by generalization and loss of consciousness;
• vegetative-visceral - the appearance of an unpleasant sensation of emptiness, discomfort in the upper abdomen, displacement of internal organs relative to each other friend and so on. In addition, there may be increased salivation, increased blood pressure, palpitations, redness of the face, thirst;
• mental - a sudden violation of memory, thinking, mood. This can be expressed in the form of a sharply evoked sense of fear or happiness, a feeling of "already seen" or "already heard" while staying in a completely unfamiliar setting. "Strangeness" in behavior: sudden disregard of loved ones (for a few seconds, with a subsequent return to the topic of conversation, as if nothing did not happen), the loss of orientation in his own apartment, the feeling of "unreal" conditions - this is all mental partial seizures. Illusions and hallucinations may appear: the hand or leg looks to the patient too large, or superfluous, or immobilized; there are smells, see lightning, etc. Since the patient's mind is not disturbed, after an attack he can tell about his unusual sensations.

Partial seizures can be complicated. This means that they proceed with loss of consciousness. In this case, the patient should not necessarily fall. Just the very moment of the attack is "erased" from the memory of the patient. At the end of the seizure and the return of consciousness, a person can not understand what happened, what he just said, what he did. And completely does not remember the epipresent itself. How can it look from the outside? The person suddenly freezes and does not react to any stimuli, makes chewing or swallowing (sucking, etc.) movements, repeats the same phrase, shows some gesture, etc. I repeat - there is no reaction to others, since consciousness is lost. There is a special kind of complex partial seizures that can last for hours and even days. Patients in this state can give the impression of a thoughtful person, but they make the right acts (crossing the road to green light, dressing, eating, etc.), as if "lead a second life." Perhaps, sleepwalking also has an epileptic beginning.

All kinds of partial seizures may result in secondary generalization, i.e. involving the entire brain with loss of consciousness and general convulsive twitching. In such cases, the motor, sensory, vegetative and mental symptoms described above become a so-called aura. Aura occurs before the generalized epiprip for several seconds, sometimes minutes. Since the seizures are the same, and the sensation of the aura is remembered by the patient, then in the future, when an aura occurs, a person may have time to lie down (preferably on something soft), so that if you lose consciousness, do not cause yourself a trauma, leave a dangerous place (for example, an escalator, a carriageway). To prevent an attack the patient can not.

Generalized epileptics

Generalized epipripeds proceed with a violation of consciousness, the patient does not remember anything about the seizure itself. These types of epicas are also divided into several groups, depending on the symptoms that accompany them:

• absences - a special type of seizure, consisting in a sudden loss of consciousness for 2-15 seconds. If this is the only manifestation, then this is a simple absence. A person "freezes" in mid-sentence, and at the end of a seizure, as it were, "turns on" again. If other symptoms join the loss of consciousness, then this is a complex absence. Other symptoms may include: twitching of eyelids, wings of the nose, rolling up the eyes, gesturing, licking lips, falling up hands, quickening of breathing and palpitation, loss of urine, etc. It is very difficult for a doctor to distinguish this type of seizures from complex partial ones. Sometimes the difference between them can be established only with the help of electroencephalography (it will show the diffuse involvement of the entire cortex in absences). The type of seizure must be established, as it depends on what kind of drug will be prescribed for the patient;
• myoclonic - this type of seizure is a massive muscle contraction, twitching, tremors. It can look like swinging hands, squatting, falling on your knees, tipping your head, flinching with shrugging your shoulders, etc .;
• tonic-clonic - the most common type of seizures in epilepsy. A generalized tonic-clonic attack was seen in his life by almost everyone. It can provoke lack of sleep, alcohol consumption, emotional overexcitation. There is a loss of consciousness, the patient falls (sometimes seriously injured at the time of the fall), develops a phase of tonic convulsions, then clonic. Tonic cramps look like a kind of scream (convulsive contraction of the larynx muscles), a reduction in chewing muscles, which leads to biting of the tongue or cheek, arching of the trunk. This phase lasts 15-30 seconds. Then develop clonic convulsions - short-term alternate contractions of flexor muscles and extensors, as if "vibration" of the limbs. This phase lasts 1-2 minutes. The person's face becomes purple-blue, heart rate increases, blood pressure rises, foam from the mouth is released (maybe with blood due to the bite of the tongue or cheek in the previous phase). Gradually, the cramps subsided, noisy breathing appeared, all the muscles of the body relaxed, perhaps the urine was drained, the patient, as it were, "falls asleep." After-sleep sleep lasts from a few seconds to several hours. The sick do not come to the senses immediately. They can not navigate where they are, what time of the day, do not remember what happened, can not immediately give their name and surname. Gradually the memory returns, but the attack in memory is not saved. After the attack, the patient feels broken, complains of headache, muscle pain, drowsiness. Partial seizures with secondary generalization occur in the same form;
• tonic - are like muscle spasms. It looks externally as an extension of the neck, trunk, limbs, lasting 5-30 seconds;
• clonic - quite rare seizures. Similar to tonic-clonic seizures, only without the first phase;
• Atonic (astatic) - represent a sudden loss of muscle tone in some part of the body or in the whole body. It can be a jaw drop and fading in this position for a few seconds, a drop of the head on the chest, a complete fall.

Thus, proceeding from the foregoing, it can be concluded that epithets are not always just convulsions with loss of consciousness.

A condition in which the epileptic seizure lasts more than 30 minutes, or repeated seizures follow one after another so often that in the intervals between them a person does not come to consciousness, is calledstatus epilepticus. This is a very life-threatening complication of epilepsy, requiring resuscitation. Epileptic status can occur with all kinds of seizures: both partial and generalized. Of course, the status of generalized tonic-clonic seizures is the most dangerous for life. In the absence of medical care, the mortality rate is up to 50%. To prevent an epistatus it is possible only adequate treatment of an epilepsy, accurate observance of recommendations of the doctor.

Epilepsy manifests itself in the inter-offensive period. Of course, this becomes visible only after a long existence of the disease and a large number of seizures. For patients with frequent seizures, such symptoms can occur even after a couple of years from the onset of the disease.

During attacks, neurons die, this is subsequently manifested in the form of a so-called epileptic change personality: a person becomes vindictive, vindictive, rude, tactless, picky, pedantic. The sick grumbling for any reason, quarrel with others. The mood becomes gloomy and gloomy for no reason, characterized by increased emotionality, impulsiveness, slowing down thinking ("it became hard to think" - so the others say about the patient). Patients "get hung up" on small things, losing the ability to generalize. Such personality traits lead to a restriction of communication, a deterioration in the quality of life.

Epilepsy is an incurable disease, but this is not a verdict. Correctly established type of seizure helps in diagnosing, and therefore, in the appointment of the right drug (because they vary depending on the variant of epilepsy). The constant intake of antiepileptic drugs in most cases leads to the cessation of epi-seizures. And this allows you to return a person to a normal life. With prolonged absence of seizures on the background of treatment by a doctor (and only a doctor!), The issue of stopping the use of medicines in general can be considered. This should be known to all patients suffering from this ailment.