Epilepsy, epileptic seizure-seizure: causes, treatment

Epilepsy- "epilepsy", Occurs in children and adults. In Greek, the word means "fall suddenly". The disease manifests itself periodically recurring large seizures with loss of consciousness or very brief (seconds) loss of consciousness.

In some cases, with epilepsy, there is a decrease in intelligence, changes in character (the so-called "epileptic character") and mental disorders can gradually develop.

Today we will consider the causes, symptoms, signs and treatment of epilepsy in a child and an adult with official medications, medicines and folk remedies at home. How to provide first aid for an epileptic seizure-seizure you can read here: Seizures in children, adults: treatment, first aid, what to do with cramps.

Epilepsy: causes, symptoms, signs

The clinical picture of the disease is very diverse. All the painful manifestations can be divided into four main groups:

1. seizures,
2. disorders of consciousness,
3. mood disorders,
4. epileptic personality changes with a significant decrease in intelligence.

Today, the specific cause of the onset of epilepsy has not been clarified. The disease is not always inherited, although 40 of those suffering from epilepsy out of 100 have this disease in their pedigree.

Epileptic seizures have varieties, the severity of each species is different.

When a seizure occurs due to disorders of one part of the brain, it is calledpartial. If the whole brain suffers, the attack is calledgeneralized. There are mixed types of seizures.

The causes of epilepsy can be the following:

1. brain abscess;
2. diseases of the viral type;
3. stroke;
4. meningitis;
5. hereditary predisposition.
6. lack of oxygen and blood supply at the time of birth;
7. pathological changes in the structure of the brain;
8. defeat of the brain with cancerous tumors;
9. craniocerebral trauma;

Epileptic seizures in children occur due to convulsions of the mother during pregnancy. They form pathological changes in children in the womb of the mother:

1. Epilepsy in children with cerebral hemorrhages;
2. hypoglycemia in newborns;
3. severe form of hypoxia;
4. chronic form of epilepsy.

The main causes of epilepsy in the child are:

1. meningitis;
2. toxicoses;
3. thrombosis;
4. hypoxia;
5. embolism;
6. encephalitis;
7. concussion of the brain.

It provokes the development of seizures in adults:

1. trauma of the brain tissue - bruises, concussion;
2. infection in the brain - rabies, tetanus, meningitis, encephalitis, abscesses;
3. organic pathology of the head zone - cyst, tumor;
4. reception of certain drugs - antibiotics, axiomatics, antimalarial drugs;
5. pathological changes in cerebral circulation - stroke; multiple sclerosis;
6. pathology of brain tissue of an innate character;
7. antiphospholipid syndrome;
8. lead poisoning or strychnine;
9. arteriosclerosis of blood vessels;
10. drug addict;
11. a sharp rejection of sedatives and hypnotics, alcoholic beverages.

Symptoms of epilepsy in children and adults depend on the form of the attack. Distinguish:

1. partial seizures;
2. complex partial;
3. tonic-clonic seizures;
4. absence.

Code of epilepsy for the ICD 10 in detail: G40

Excluded:

1. Landau-Kleffner syndrome (F80.3),
2. convulsive seizure of the BDU (R56.8),
3. epileptic status (G41.),
4. Todd's paralysis (G83.8).

G40.0: Localized (focal) (partial) idiopathic epilepsy and epileptic syndromes with convulsive seizures with a focal start.

1. Benign epilepsy with peaks on the EEG in the central temporal region.
2. Children's epilepsy with paroxysmal activity or EEG in the occipital region.

G40.1: Localized (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures.

1. Attacks without a change in consciousness.
2. Simple partial seizures, turning into secondary generalized seizures.

G40.2: Localized (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures.

1. Attacks with a consciousness, often with an epileptic automatism.
2. Complex partial seizures, resulting in secondary generalized seizures.

G40.3: Generalized idiopathic epilepsy and epileptic syndromes.

1. Benign (s): myoclonic epilepsy of early childhood; neonatal convulsions (family).
2. Children's epileptic absences [picnolepsy].
3. Epilepsy with large convulsive seizures [grand mal] on awakening Juvenile: absense-epilepsy, myoclonic epilepsy [impulsive small fit, petit mal].
4. Nonspecific epileptic seizures: atonic, clonic, myoclonic, tonic, tonic-clonic.

G40.4: Other types of generalized epilepsy and epileptic syndromes.

1. Epilepsy with: myoclonic absences, myoclonic-astatic seizures.
2. Children's spasms.
3. The Lennox-Gastaut syndrome.
4. Salaamov tick.
5. Symptomatic early myoclonic encephalopathy West syndrome.

G40.5: Special epileptic syndromes

1. Epilepsy partial continuous [Kozhevnikova].
2. Epileptic seizures associated with: alcohol consumption, the use of drugs, hormonal changes, sleep deprivation, the impact of stress factors.

If necessary, an additional code of external causes (class XX) is used to identify the drug.

G40.6: Grand mal seizures, unspecified (with or without small seizures [petit mal]).

G40.7: Small seizures [petit mal], unspecified without seizures. Grand mal.

G40.8: Other specified forms of epilepsy.

Epilepsy and epileptic syndromes, not defined as focal or generalized.

G40.9: Epilepsy, unspecified.

Epileptic: convulsions of the BDU, attacks of the BDU, seizures of the BDU.

A source:http://mkb-10.com/index.php?pid=5132

A seizure of epilepsy

Large epileptic seizure: seizure: symptoms

Most often occurs suddenly and without any apparent reason.

The patient just loses consciousness and falls. Sometimes before the onset of a fit, some patients note the appearance of so-called harbingers of the attack - "aura". These can include visual and olfactory hallucinations, when the patient begins to clearly feel some odors that really do not exist, or see what others do not see.

The fall of the patient can be explained by the fact that almost all the muscles of his body are sharply tonic, and usually uneven, and the patient falls more often forward or sideways.

Often the fall is accompanied by a cry. Tonic convulsions begin. Hands and legs are stretched in a state of sharp muscle tension, muscles of the trunk are sharply reduced. After 30-40 seconds, tonic convulsions are replaced by clonic (rhythmic contractions of the muscles), the face becomes pale, then acquires a cyanotic shade, the pupils dilate. The patient usually does not react to any stimuli. A foam appears from the mouth, often colored with blood (because of the biting of the tongue or the inner surface of the cheeks). Sometimes there is involuntary urination or defecation. The seizure usually lasts 3-5 minutes. After him, the patient is most often immersed in deep sleep.

Most often, patients do not remember about their seizure and only on a bitten tongue, bruises, traces of urine on linen guess about it.

In some patients, seizures are more frequent during the day, others - at night. The frequency of seizures is also different, from one to two a month to several a day.

Small epileptic seizures: an attack, symptoms

Characterized by a temporary loss of consciousness (one or two seconds) without falling to the floor and seizures. With small seizures, others can notice only the absent facial expression in the patient or a short break in the actions that he performs.

With this kind of epilepsy, the patient's face suddenly turns pale, becomes empty and malo-meaningful, the look is fixed immovably in space.

In some types of epilepsy, seizures are so frequent that patients do not have time to regain consciousness. This condition is called epileptic status and often leads to death.

After a fit, some patients have a condition in which they can not remember the names of some household items, the names of relatives. This condition is called oligophasia and usually passes through 1-2 hours.

Other symptoms and signs of epilepsy

Mood disorders (dysphoria)

When epilepsy is expressed in the sudden appearance of anguish, unreasonable anger, sometimes - gaiety. States of this kind suddenly appear and suddenly end. Their duration can range from several hours to several days. With a depressed mood, patients do not feel anguish, but irritability. They are spiteful, begin to objectlessly find fault with others, overcome them with useless requests and complaints, can be aggressive.

Mental disorders

With epilepsy manifested changes in the whole structure of the personality of a sick person, as well as various psychoemotional states.

Personality changes

Characterized by irritability, captiousness, a tendency to quarrel, flashes of rage accompanied by sometimes dangerous aggressive actions.

Along with these traits, there can be diametrically opposed qualities of character - fearfulness, a tendency to self-abasement, exaggerated courtesy, reaching up to sugaryness, exaggerated respect and affection in treatment. The mood of patients is subject to frequent changes: from gloomy-irritable to highly-careless. Also, the intellectual abilities of epileptic patients are also variable. They complain about the retardation of thoughts, the inability to focus on something, the decrease in efficiency. Other patients may be, on the contrary, overly active, talkative and fussy.

Intermittency of mental phenomena in the sphere of mood and mental abilities is one of the most important features in the character of patients with epilepsy. They are characterized by poverty of speech, frequent repetition of what has already been said, the use of pattern phrases and phrases, diminutive words and definitions.

Often speech of patients with epilepsy is singing. They pay special attention to their "I". Therefore, in the foreground of their interests and sayings are their own experiences, their own disease, their own interests.

Patients with epilepsy are always supporters of truth, justice, order, especially when it concerns everyday trifles. Their love of treatment, their belief in the possibility of recovery, their optimistic attitude towards the future are characteristic.

All these symptoms that characterize the epilepsy clinic can be observed in the same patient, but it also happens that only a few of them are found.

In cases where the listed signs are only partially manifested, they speak of an epileptic character. The severity of these signs, accompanied by various changes in memory depth, allows us to speak about the presence of epileptic dementia. The rate of increase in changes in personality and memory depends on many factors, including the duration of the disease itself, the nature of the paroxysmal disorders and their frequency.

Some patients have convulsive seizures in the first place, others have mental disorders, others have mood disorders and, finally, in the fourth, personality changes. It may also be that epileptic seizures appear at the beginning of the disease, and then they disappear, and one or the other symptom of the complexes described above appears.

Epilepsy: treatment and first aid in a child and an adult

In the interictal period, epilepsy is prescribed sedatives:

1. Phenobarbital,
2. Bromine preparations (sodium, potassium, calcium bromine salts or mixtures thereof),
3. Diphenin,
4. Benzonal,
5. Trimethine.

In rare large and small seizures appointsodium borate(2-4 g per day).

The main drug for the treatment of large seizures isPhenobarbital. Its dosage depends on the frequency and severity of seizures.

Adultsusually give 0.05 g Phenobarbital 2-3 times a day, less often prescribed 0.1 g 2-3 times a day, but not more than 0. 5 g per day.Childrenup to 8 years receive a dose of 0.01 to 0.03 (up to 0.1 g per day), depending on the age and frequency of seizures. With this dosage, even a very long application of Phenobarbital does not cause intoxication. Sometimes, with drowsiness to Phenobarbital, add small doses of Caffeine (0.01-0.02 g).

For large seizures,Diphenine. The optimal dose of its 0.1 g at the reception three times a day. Children older than 6 years are prescribed a twice smaller dose (0.03 g).

With a small epilepsy, a good effectTrimetin. The usual daily dose of it forof adults- from 0.9 to 1.2 g, forchildrenup to 2 years - 0,3 g per day, from 2 to 5 years - 0,6 g and over 5-0,9 g.

Patients suffering from epileptic seizures should not use drugs that stimulate the nervous system (aminalon, nootropil).

Anticonvulsants

Acidiprol

Pharmachologic effect:antiepileptic means of a wide spectrum of action.

Indications for use:in adults and children with different types of epilepsy: with various forms of generalized seizures - small (absences), large (convulsive) and polymorphic; with focal seizures (motor, psychomotor, etc.). The drug is most effective at absences (short-term loss of consciousness with complete loss of memory) and pseudoabsances (short-term loss of consciousness without loss of memory).

Dosing and Administration:inside during or immediately after a meal. Begin by taking small doses, gradually increasing them within 1-2 weeks before reaching a therapeutic effect; then select an individual maintenance dose.

Daily dose forof adultsat the beginning of treatment, 0.3-0.6 g (1-2 tablets), then gradually increase it to 0.9-1.5 g. Single dose - 0,3-0,45 g. The highest daily dose is 2.4 g.

The dose forchildrenthey are selected individually depending on the age, the severity of the disease, the therapeutic effect. Usually the daily dose for children is 20-50 mg per 1 kg of body weight, the highest daily dose is 60 mg / kg. Begin treatment with 15 mg / kg, then increase the dose weekly by 5-10 mg / kg until the desired effect is achieved. The daily dose is divided into 2-3 doses. It is convenient for children to prescribe the drug in the form of a liquid dosage form - Acidiprol syrup.

Acediprol can be used alone or in combination with other antiepileptic drugs.

In small forms, epilepsy is usually limited to the use of Acediprol.

Contraindications.The drug is contraindicated for violations of the liver and pancreas, hemorrhagic diathesis (increased bleeding). You should not prescribe the drug in the first 3 months of pregnancy (at a later date prescribed in reduced doses only if other antiepileptic drugs are ineffective). The literature cites data on cases of teratogenic (damaging fetus) effect when using Acediprol during pregnancy. It should also be borne in mind that in breast-feeding women, the drug is excreted with milk.

Benzoamyl

Pharmachologic effect:has anticonvulsant, sedative (calming), hypnotics and hypotensive (lowering blood pressure) properties. Less toxic than Benzonal and Phenobarbital.

Indications for use:epilepsy, mainly with subcortical localization of the focus of excitation, "diencephalic" form of epilepsy, epileptic status in children.

Dosing and Administration:inside after eating. Doses forof adults- 0,05-0,2 g (up to 0,3 g) 2-3 times a day, forchildrendepending on the age - from 0.05 to 0.1 g 3 times a day. Benzobamyl can be used in combination with dehydration (dehydrating), anti-inflammatory and desensitizing (preventive or inhibitory allergic reactions) therapy. In case of accustoming (weakening or lack of effect with prolonged repeated use), benzobamyl can be temporarily combined with equivalent doses of Phenobarbital and Benzonal with subsequent replacement by Benzobamyl.

Contraindications:kidney and liver damage with violation of their functions, cardiac decompensation.

Form of issue:tablets of 0.1 grams per pack of 100 pieces.

Storage conditions:List B. In a tightly closed container.

Benzonal

Pharmachologic effect -has a pronounced anticonvulsant effect; unlike Phenobarbital does not give a hypnotic effect.

Indications for use:convulsive forms of epilepsy, including tannerial epilepsy, focal and Jackson seizures.

Dosing and Administration:inside. Single dose forof adults- 0,1-0,2 g, daily - 0,8 g, forchildrendepending on the age - a single 0,025-0,1 g, daily - 0,1-0,4 g. Individually set the most effective and tolerated dose of the drug. Can be used in conjunction with other anticonvulsants.

Side effect:drowsiness, ataxia (violation of coordination of movements), nystagmus (involuntary rhythmic movements of the eyeballs), dysarthria (speech disorder).

Hexamidine

Pharmachologic effect:has a pronounced anticonvulsant effect, by pharmacological activity is close to Phenobarbital, but does not have a pronounced hypnotic effect.

Indications for use:epilepsy of various genesis (origin), mainly large convulsive seizures. In the treatment of patients with polymorphic (diverse) epileptic symptoms are used in conjunction with other anticonvulsant drugs.

Dosing and Administration:inside 0.125 g in 1-2 doses, then the daily dose is raised to 0.5-1.5 g. Higher doses forof adults: single - 0.75 g, daily - 2 g.

Side effect:itching, skin rashes, mild drowsiness, dizziness, headache, ataxia (impaired coordination of movements), nausea; long-term treatment of anemia (a decrease in the number of red blood cells in the blood), leukopenia (a decrease in the level of leukocytes in the blood), lymphocytosis (an increase in the number of lymphocytes in the blood).

Diphenine

Pharmachologic effect:has a pronounced anticonvulsant effect; hypnotic effect almost does not cause.

Indications for use:epilepsy, mainly large convulsive seizures. Diphenin is effective in some forms of cardiac arrhythmias, especially in arrhythmias caused by an overdose of cardiac glycosides.

Dosing and Administration:inside after eating half the tablets 2-3 times a day. If necessary, the daily dose is increased to 3-4 tablets. The highest daily dose forof adults- 8 tablets.

Side effect:tremor (hand trembling), ataxia (disruption of coordination of movements), dysarthria (speech disorder), nystagmus (involuntary movements of the eyeballs), eye pain, increased irritability, skin rashes, sometimes fever, gastrointestinal disorders, leukocytosis leukocytes in the blood), megaloblastic anemia.

Carbamazepine

Pharmachologic effect:has a pronounced anticonvulsant (antiepileptic) and moderately antidepressant and normotimic (mood-improving) effect.

Indications for use:with psychomotor epilepsy, large seizures, mixed forms (mainly when combining large seizures with psychomotor manifestations), local forms (posttraumatic and postencephalitic origin). With small seizures is not effective enough.

Dosing and Administration:inside (during eating)adults, starting with 0.1 g (half a tablet) 2-3 times a day, gradually increasing the dose to 0.8-1.2 g (4-6 tablets) per day.

The average daily dose forchildrenis 20 mg per 1 kg of body weight, i.e., on average, under 1 year of age - from 0.1 to 0.2 g per day; from 1 year to 5 years - 0.2-0.4 g; from 5 to 10 years -0.4-0.6 g; from 10 to 15 years - 0.6-1 g per day.

You can prescribe carbamazepine in combination with other antiepileptic drugs.

Just as with the use of other antiepileptic drugs, the transition to carbamazepine treatment should be gradual, with a decrease in the dose of the previous drug. Stop treatment with carbamazepine, too, should be gradual.

There are data on the effectiveness of the drug in a number of cases in patients with various hyperkinesis (violent automatic movements due to involuntary muscle contraction). The initial dose of 0.1 g gradually (after 4-5 days) was increased to 0.4-1.2 g per day. After 3-4 weeks. reduced the dose to 0.1-0.2 g per day, then in the same doses prescribed daily or every other day for 1-2 weeks.

Side effect: the drug is usually well tolerated. In some cases, loss of appetite, nausea, rarely - vomiting, headache, drowsiness, ataxia (violation of coordination of movements), disruption of accommodation (visual impairment).. Reduction or disappearance of side effects occurs with a temporary discontinuation of the drug or a decrease in dose. There are also data on allergic reactions, leukopenia (a decrease in the level of leukocytes in the blood), thrombocytopenia (a decrease in the number of platelets in the blood), agranulocytosis (a sharp decrease in granulocytes in the blood), hepatitis (inflammation of the liver tissue), skin reactions, exfoliative dermatitis (skin inflammation) When these reactions appear, the drug is stopped.

It should be considered the possibility of the emergence of mental disorders in patients with epilepsy, treated with carbamazepine.

Metindion

Pharmachologic effect:An anticonvulsant that does not depress the central nervous system, reduces affective (emotional) stress, improves mood.

Indications for use:epilepsy, especially with temporal form and epilepsy of traumatic genesis (origin).

Dosing and Administration:inside (after eating)adultsfor 0.25 g per reception. With epilepsy with frequent seizures 6 times a day at intervals of 1½-2 hours. (daily dose of 1.5 g). With rare seizures in the same single dose of 4-5 times a day (1-1.25 g per day). At seizures at night or in the morning additionally appoint 0,05-0,1 g of Phenobarbital or 0.1-0.2 g of Benzonal. In psychopathological disorders in patients with epilepsy 0.25 g 4 times a day. If necessary, treatment with methindione is combined with Phenobarbital, Seduxen, and Eunotin.

Contraindications:marked anxiety, tension.

Folk remedies for the treatment of epilepsy at home

Treatment for epilepsy in the home is done only under supervision and with the advice of the doctor in charge!

Peony evading(marjin root).Tincturecook this way: 1 tablespoon finely chopped peony roots, pour 3 cups of boiling water, leave for 30 minutes in a tightly closed container. Take 1 tablespoon 30 minutes before meals 3 times a day. When preparing the infusion, you can also use the root and grass of the peony in equal parts.

Woolly panther. In folk medicine, the aerial part of the plant is used during flowering. When epilepsy is used as an anesthetic and sedative. Liquid extract, tincture, broth have a calming effect on the central nervous system, contribute to the rapid removal of toxic substances from the body. Preparation: 2 teaspoons of herbs (fresh or dried) pour a glass of boiling water, boil on low heat for 5 minutes, cool, strain. Take a tablespoon 3 times daily before meals.

Motherworts common. Bulgarian pharmacologists recommend Leonurus as an additional remedy for cramps, in particular with epilepsy.

1. 2 parts, or 2 tbsp. spoon, crushed raw materials (aboveground blooming part), pour 200 ml of cold boiled water and soak for 8 hours. Dose take during the day.
2. 2 tbsp. Spoon the crushed raw material for 2 hours in 500 ml of boiling water. Cooked infusion drink on a glass 4 times a day before eating.

Blue Cyanosis(brane-grass, odolen-grass, Greek valerian). Roots, rhizomes, grass are used for insomnia, epilepsy, fright, as soothing. 3-6 g of crushed rhizomes pour a glass of boiling water and boil for 30 minutes, cool, strain. Drink 1 tbsp. spoon 3-5 times a day after meals.

Periwinkle(pearled leaf, apple apple tree). In epilepsy, leaves and flowers of the plant are used in the form of infusion, tea, decoction. 1 tbsp. Spoon a dry herb pour a glass of boiling water, insist for two hours, strain. Take 2 tbsp. spoon 3 times a day.

Cleavers. In Bulgarian folk medicine, epilepsy uses the juice of the fresh grass of the bed. One of the recipes: 2 teaspoons of bedstraw lingerie pour 2 cups of boiling water. When the infusion cools down, strain. Drink the medicine during the day.

Tansy. 10 flower baskets tansy pour one cup of boiling water, insist 1 hour, strain. Drink 1 tablespoon three times a day.

Chernobylnik(Artemisia vulgaris). One teaspoon of chopped dry herbs pour a glass of boiling water, cool, drain. Drink one third of a glass three times a day. Or so: 1 tablespoon chopped roots, pour 0.5 liters of kvass, boil on low heat for 10 minutes, strain. Drink half the glass morning and afternoon, at night - only 1 glass a day.

It is said that many people suffering from epilepsy get rid of it if they completely switch to vegetarian food. Full hunger - 2-3 days every two weeks.

Little help to the epileptic: when the attack begins, put the left hand of the epileptic on the floor and squeeze the little finger of the left hand. The attack ends quickly.

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Source: O.G.G.G. N. Official and traditional medicine. The most detailed encyclopedia. - Moscow: Publishing house Eksmo, 2012.