Update: February 2019
Epilepsy, or “epilepsy” – a chronic disease of the nervous
systems with brain damage characterized by
pathological predisposition to convulsive seizures with
loss of consciousness. Withчина возникновения такого недуга может быть
различной: injuries heads, образования и структурные изменения в
brain, prenatal complications, hereditary predisposition
etc. The disease may be primary – self
(idiopathic, cryptogenic), and secondary (symptomatic) –
testifies to the pathologies of the brain. According to statistics in
75% of cases of epilepsy incidence, its manifestations appear in
childhood – age from birth to 18-20 years. With установлении
diagnosis of epilepsy, symptoms of the disease can occur
in different ways, depending on the cause of the disease.
Withступы эпилепсии – это результат гиперсинхронного разряда в
a group of nerve cells in the brain. Sick brain manifests
increased convulsive readiness due to the peculiarities of exchange
processes. However, the principle of development
an attack. Hereditary predisposition to
epileptic seizures, infections have a negative effect on
condition of the nervous system, traumatic brain injury at any age
may cause recurrent seizures.
Epilepsy in children
Children are highly sensitive to changes in external and internal
факторов, поэтому даже жар может вызвать приступ epilepsy. In children
symptoms of the disease occur three times more often than in adults.
The main cause of epilepsy are prenatal and perinatal
- trauma at birth,
- hypoxia (oxygen starvation of the brain),
- infectious diseases in the period of embryonic development
(toxoplasmosis during pregnancy, cytomegaly, rubella).
After the first attack, the risk of subsequent convulsive
seizures is 23-71%. Very important in the occurrence of the first
Signs to see a doctor. Lack of treatment in 40-50% of cases
provokes repeated seizures occurring within two years.
In addition, there is always the risk of death.
Frequent convulsive seizures in childhood can become
причиной развития epilepsy. Even heat can
provoke seizures. During an attack, a stop occurs.
respiration, brain hypoxia occurs – a common cause
Typically, an attack of epilepsy in children has the following
- Loss of consciousness
- Full body muscle convulsions
- Involuntary urination or defecation
- Muscle strain (straightening legs, flexing arms)
- The chaotic movement of certain parts of the body (twitching
limbs, lip wrinkling, rolling eyes)
In addition to the typical manifestation of childhood epilepsy in the form of convulsive
seizures are separately allocated absansy, atonic seizures, children
spasm and juvenile myoclonic seizures.
With абсансах как ребенок, так и взрослый не падает. Convulsions
are missing. Without changing position, the patient freezes for several
seconds, the look is detached, there is no reaction to
anything. The duration of the abscess – from a few seconds to
half a minute.
The absence of epilepsy in girls occurs more often (twice),
rather than boys, and manifests itself, as a rule, in 6-7 years. As
maturation attacks disappear, or take another form.
Atonic seizures: a sick child loses consciousness sharply with
полным расслаблением всего body. Characterized by strong weakness and
lethargy. A sudden fall is often accompanied by injuries and bruises.
Withзнаки атонических приступов очень сходны с обмороком.
Children’s infantile spasm manifests itself as follows:
suddenly the child brings his hands to his chest, leans forward
(head or whole body) and straightens the legs. Frequent manifestation observed
childhood cramps in the morning immediately after waking up. Most
often suffer from such attacks children under the age of 3 years.
Juvenile myoclonic seizures are characteristic of adolescent
age (13-15 years) and manifest as sudden involuntary
jerking of limbs (one or two arms, legs) for an hour
before waking up.
Facts about the disease:
- Every year, 5-10 cases of epilepsy are recorded.
per 100 of the population.
- Epilepsy is more common in men than in women.
- High rates of morbidity in early childhood and in individuals
over 65 years old.
- A low standard of living is considered the determining factor in the development
- In 40% of patients, no additional intellectual
behavioral, neurological disorders.
- 30% of patients suffer from epilepsy for life.
- On average, epilepsy lasts 10 years, in 50% of patients the period
seizures last no more than 2 years.
- Mortality in 30% of patients with epilepsy
непосредственно связана с приступом, также нередко бывают
deaths during sleep.
Epilepsy in adults
Epileptic seizures that appeared after twenty years, as
usually have a symptomatic form. Withчинами эпилепсии могут
be the following (for more details, see the causes of epilepsy):
- injuries heads
- aneurysm (see cerebral vascular aneurysm)
- stroke (see left and right stroke)
- brain abscess
- meningitis, encephalitis (see the first signs of meningitis)
- or inflammatory granulomas
Symptoms of epilepsy in adults manifest in various forms.
seizures. When the epileptic focus is clearly
certain parts of the brain (frontal, parietal, temporal, occipital
epilepsy), these seizures are called focal or
partial Pathological changes in bioelectric activity
whole brain provokes generalized epileptic seizures.
The classification of generalized seizures: absences,
tonic-clonic, myoclonic, clonic, tonic,
Most typical of the disease is a large epileptic
an attack that starts suddenly and is not caused by changes in external
- The appearance of the aura (unusual sensations of a different nature) on
a few seconds indicates the beginning of a seizure.
- A person falls unconscious with a characteristic
a loud cry that is due to spasm of the glottis and
contraction of the muscles of the diaphragm.
- Breathing stops.
- Tonic convulsions begin (15-20 seconds): muscles are tense,
body and limbs stretched out, head thrown back.
- On a neck veins swell, jaws are linked, the face of the patient
- Next comes the clonic phase (2-3 minutes), manifested
jerky convulsions of the whole body.
- Marked language sinking, accumulation of saliva and hoarse
- Then cyanosis slowly disappears and foam is released from the mouth (often
with blood – from biting the tongue).
- The cramps subside and relaxation begins.
- At the end of the attack, the pupils of the patient are dilated, he is no matter what
does not react.
- Involuntary urination is often observed.
- After a few minutes consciousness returns, appears
feeling of weakness, lethargy, drowsiness. O fit man nothing
does not remember.
Before an attack, precursors appear in 1-2 days: headache
pain, feeling unwell, irritability.
In the case when the seizures are prolonged, one after another
to others and the person does not regain consciousness, there is a so-called
The most common cause of focal seizures are
tumors в височной доле — височная эпилепсия, признаки которой
start with a vegetative aura:
- abdominal pain, heart
- labored breathing
Consciousness of the patient changes: thoughts lose touch with
previous actions, common interests and real
surrounding environment. Man is unpredictable, his personality
as if changing.
An attack of temporal epilepsy can last several minutes.
or to be long (lasts for hours, days), which is often
lead to severe personality changes.
Epilepsy is one of the most common neurological
diseases. It occurs 10 times more often in multiple sclerosis and in
100 times more common motor neuron disease (lateral
Objectives of conservative treatment of epilepsy
Usually epilepsy is treated with a conservative method or
surgically. It is also possible folk treatment of epilepsy,
based on the use of leaves, roots, grass seed, their infusions,
decoctions, fees, bee products, etc.
Research has proven: epilepsy in 50-80% is curable. Right
Selected drug treatment allows you to achieve resistant
remission. Newly diagnosed epilepsy followed
treatment after the first course of therapy in 60% of cases no longer
disturbed patients, or retreated by 2-5 years.
The conservative method of treating a disease implies
antiepileptic drugs. Tasks of therapy:
- Proper differential diagnosis of the form of epilepsy and
seizures, which determines the adequate selection of medicines.
- Identifying the cause of epilepsy (symptomatic form) –
exclusion of a structural defect of the brain (tumor,
- Elimination of factors that provoke seizures (alcohol,
overstrain, hyperthermia, lack of sleep).
- Relief of seizure or status epilepticus. it
performed by taking anticonvulsants (one or
complex) and first aid in the event of a seizure.
It is obligatory to control the airway and prevent
biting the tongue, protecting the patient from possible injuries.
Drug treatment of epilepsy
Seizure control can be achieved with medication.
epilepsy. To do this:
- Medications taken strictly prescribed by the doctor.
- Seek advice from a doctor if the patient wants to change
prescribed antiepileptic drug for generic
- Do not stop taking the medication yourself.
- Notify the doctor about the disappearance or occurrence of depression,
unusual mood swings and common changes
Half of the patients with emergency diagnosis of the disease live without
seizures, taking one first prescribed drug to treat
Therapy begins with the appointment of a small dose.
antiepileptic drug. Recommended to conduct
monotherapy (treatment with one drug). If the seizures do not disappear and
the patient’s condition does not stabilize, the dose is gradually increased
to achieve positive dynamics.
When partial seizures are used:
- carbamazepine: Finlepsin (50 tab. 260 rub), carbamazepine (50
tab. 40 руб), Зептол, Тимонил, Тегретол (tab. 300-400 руб),
- valproates: Konvuleks (syrup 130 rubles, drops 180 rubles),
Конвулекс Ретард (tab. 300-600 руб.) Депакин Хроно (tab. 30 pieces
580 руб.), Энкорат-Хроно (tab. 130 руб.), Вальпарин Ретард (tab.
30 pieces 380 rubles, 100 pcs. 600-900 rubles).
- Phenytoin: Difenin (price 50 rubles).
- Phenobarbital: Luminal
Carbamazepine and valproate are first-line drugs. Phenytoin and
Phenobarbital have many side effects, and apply
Daily dose of carbamazepine – 600-1200 mg, valproate –
1000-2500 mg, which is taken in equal parts in 2-3 doses.
Convenient prolonged drugs are convenient to use.
forms that take 1-2 times a day. it Депакин Хроно,
Tegretol – HRC, Finlepsin Retard.
For generalized seizures, valproate and
carbamazepine. Idiopathic generalized epilepsy is treated
valproate With абсансах используют itсуксимид. Carbamazepine and
phenytoin with myoclonic seizures are not effective.
In recent years, often use new antiepileptic
drugs – Lamotrigine and Tiagabin, which in practice showed
Termination of treatment may be considered in the absence of
epileptic seizures for five years and based on
gradually reducing the dose of drugs to cancel.
Treatment of a patient with epileptic status is carried out with
using sibazon (Seduxen, Diazepam), which is administered slowly
intravenously (2 ml of 10 mg of the drug is dissolved in 20 ml of 40%
glucose). Re-introduction is possible after 10-15 minutes. With
inefficiencies of sibazon use Hexenal, phenytoin, thiopental
sodium (1 g of the drug dissolved in saline is administered in the form of 1-5%
solution). After the introduction of 5-10 ml of the drug make minute pauses
in order to avoid respiratory depression and hemodynamics.
Inhalation anesthesia nitrous oxide with oxygen (2: 1)
It is advisable to use with the ineffectiveness of intravenous
drug administration and is prohibited to use for patients in a coma, with
collapse and respiratory disorders.
Surgical operation is indicated in the case of focal epilepsy
symptomatic origin caused by a tumor, aneurysm,
abscess or other structural changes in the brain.
The procedure is often performed under local anesthesia to
monitor the patient’s condition and avoid damage
functionally important areas of the brain (speech, motor
Often, surgery is performed to remove the temporal
epilepsy. There may be a resection of the temporal lobe, or more
gentle method – selective removal of the hippocampus and amygdala
body. In 70-90% of cases after surgery, epilepsy attacks
In some cases, with the underdevelopment of one of the hemispheres of the brain in
children and hemiplegia may be shown removing the affected
whole hemisphere (hemispherectomy).
In the case of diagnosis of primary idiopathic epilepsy may
apply the intersection of the corpus callosum (callesotomy) to
sever inter-hemisphere relations and prevent generalization
Treatment of epilepsy by folk methods
Epilepsy may be treated as adjunctive therapy.
folk remedies. Eating cooked home folk
potions help reduce the severity and frequency of attacks,
enhances the effect of anticonvulsants, strengthens the body as a whole.
Folk recipes for epilepsy:
- Collection: lavender flowers, peppermint, valerian roots and primroses.
Mixed components need to pour 1 cup boiling water and insist
15 minutes, then strain. Withнимают народное лекарство трижды в
a day half an hour before meals, one glass each.
- Infusion water: fresh grass motherwort (100 g) poured 500
ml of boiling water and infused for two hours. Strained cooked
the infusion is taken in equal parts four times a day before
- Infusion of alcohol: dried leaves of white mistletoe pour 96%
alcohol (1: 1) and insist a week in a dark place. Withнимают
infusion in the morning four drops in 10 days. Then do
break 10 days and repeat the course.
Treatment of this disease should be strictly supervised.
the doctor. If the patient preferred folk methods as
primary therapy, it is important to control the course of the disease. When
the nature of the attacks changed (increased, became longer)
when increasing severity of seizures need to urgently turn to
to the neuropathologist.
It is important to remember: epilepsy is an insidious disease that
leaves a mark on the life of the patient, limits the possibilities
choice of profession makes it difficult to establish personal
relationship, and sometimes even creates a danger to others.
Epilepsy is treated. Timely diagnosis and adequate treatment
will help to cope with a disease.