Epilepsy - is a brain disorder characterized by recurrent attacks of motor disorders, sensory, cognitive or mental functions resulting from excessive neuronal discharges in the cerebral cortex brain.
Only repeated attacks are the basis for diagnosis. Febrile convulsions and convulsions arising from acute cerebral diseases (e.g., encephalitis, Stroke, acute ischemic stroke and so on.) Are not epilepsy.
types of epilepsy
Absence epilepsy
Absence seizures - a kind of generalized nonconvulsive seizures, characterized by high frequency and short duration with Shutdown of consciousness and the presence of a particular EEG pattern. Absence seizures - one of the most common types of seizures in children and adolescents.
The debut of absence seizures in children is observed from 2 to 9 years of age and the prevalence of sex girls.
Clinically absences characterized by a sudden short-off (or a significant decrease in the level) of consciousness with no or minimal motor impairment. The duration of absences varies from 2-3 to 30, with an average of 5-15 seconds. Absences characteristic feature is the high frequency, reaching tens and hundreds of attacks per day.
In principle, the separation of absences on both simple and complex. Simple absence seizures are characterized by the cessation of all activity, "hardening", "sinking" of patients Fixed "missing" look confused gipomimichnym expression. Simple absences constitute only 20%.
More characteristic of complex absence seizures that occur with a minimum motor component (rhythmic stretching the lips like a "golden fish ", rhythmic twitching of the nose, in some patients during the attack is marked once flinching or more short weak twitch muscles of the shoulder girdle and / or hands, the deviation of the head and sometimes torso posteriorly diverting eyeballs upwards or side).
Factors provoking more frequent absences are sleep disturbance, Bright light, menstruation, intense mental activity or, conversely, relaxed, passive state.
Generalized seizures - the most dramatic manifestation of epilepsy. Clinically characterized by the sudden (without aura) shutdown of consciousness with a fall convulsions institution eyeballs, dilated pupils. First, there is a brief tonic phase, passing in the longer clonic followed postpristupnym stunning.
Duration of seizures is from 30 seconds to 10 minutes (median 3 minutes). The frequency of attacks is low - from the individual in the year to 1 per month, with no tendency for mass flow and status. Characterized by the association of the majority of attacks to the period of awakening and rarely sleep. The most important predisposing factor - sleep disturbances and sudden violent awakening. Perhaps more frequent attacks in perimenstrualnogo period.
West syndrome
Debut syndrome Vesta notes on G-8 months of age. Seizures are often flexion in nature (lightning, "bows" to curl).
On electroencephalogram - gipoaritmiya, generalized irregular sharp slow waves with the registration of multifocal lesions. In the neurological status - changes in muscle tone, high asymmetric reflexes. Often formed symptom of cerebral palsy. In 90% of defined retardation. 30% of children die within the first three years of life as the basis for this disease are gross defects in brain development.
In 15-30% of cases may be a cause of seizures or tuberous sclerosis metabolic disorders, i.e. genetic defect.
epilepsy treatment
It has now been developed to generally accepted international standards for the treatment of epilepsy, which must be followed to improve the efficiency of the treatment and improving the quality of life of patients.
Therapy can be started only after the establishment of an accurate diagnosis. According to the majority of neurologists, treatment should be initiated after repeated attacks. A single paroxysm may be "random", due to fever, overheating, intoxication, metabolic disorders and treat epilepsy.
Antiepileptic drugs are prescribed in strict compliance with the form of the disease and the nature of the attacks. epilepsy treatment success depends on the accuracy of diagnosis Syndromological.
Receiving drugs since taking low dose with a gradual increase until the therapeutic efficacy or occurrence of the first signs of side effects. In this determining are clinical efficacy and tolerability of the drug, not the content of his blood.
In case of failure of one drug, he must gradually be replaced by another, effective for this form of epilepsy.
Antiepileptic drugs may be canceled after 2.5-4 years the total absence seizures. The clinical criteria (absence seizures) is the primary criterion for discontinuation.
Among basic drugs may be mentioned: ACTH (ACTH), acetazolamide, benzobarbital, bromides, valproic acid (high salt), vigabatrin, gabapentin, diazepam, carbamazepine, clonazepam, lamotrigine, midazolam, nitrazepam, primidone, tiagabine, topiramate, phenytoin (diphenylhydantoin), phenobarbital, ethosuximide et al.
The most common anti-epileptic drugs in Russia are:
- valproic acid (Depakinum, chrono-Depakinum, konvulsofin, Konvuleks et al.),
- carbamazepine (Finlepsinum, Finlepsinum retard, Tegretol, Tegretol CR et al.),
- phenobarbital (Luminal, glyuferal, paglyuferal et al.).
The first two drugs are available in both traditional and a prolonged ( "chrono") forms application which reduces the number of intakes of drugs and avoid many of the side effects associated with their using.
Diazepam (seduksen) and midazolam (dormicum) are the primary agents for the treatment of all forms of status epilepticus.
