Description of epilepsy

Epilepsy is a disease characterized by recurrent seizures. An epileptic seizure is caused by a sudden onset of an imbalance between excitatory (stimulating) and inhibitory (damping) systems in the brain, this imbalance leads to a predominance of stimulating mechanisms and manifested seizure.

Seizures are divided into clinical and subclinical. Clinical seizuremay exhibit impaired consciousness, mobility, sensation, skin sensation, changes in sensory function and altered mental manifestations.

Subclinical seizures following clinical signs does not, it can only detect EEG (electroencephalogram – examination of brain electrical activity), which show altered activity.

Furthermore, we can divide in terms of seizures to their origin onsymptomatic and idiopathic. Symptomatic seizures result from structural damage of the central nervous system. In idiopathic seizures no damage or origin of the formation to the currently available diagnostic methods can not detect.


epidemiology of epilepsy

Studies show that epilepsy affects all ethnic race. The incidence in the population is about 1.3 to 3.1%. Men tend to suffer 2.5 times more often than women, and children around 4 times more often compared with adults. Approximately 60% of patients the disease disappears during adolescence and these patients can be considered cured. Conversely, however, they may panic during puberty arise and persist to adulthood. Other age limit for the increased incidence of epilepsy is 60 years old.


Risk factors for epilepsy

The cause of epileptic seizure is thus an imbalance between stimulating and damping processes in the central nervous system leading to a predominance of stimulating component. The main role is played by amino acids. Among the most important excitatory (stimulating) include glutamic acid and aspartic acid. The most important inhibitory (damping) is GABA – gamma amino butyric acid.

Epilepsy can occur at any age. Upon its establishment is covered mainly by three factors: 1. readiness to attack, the second outbreak, which causes seizures, 3rd stimulus as a trigger seizures.

Readiness for an attack is conditioned primarily genetically. Known several tens of thousands of genes that are involved in the generation of epileptic disorders.

Other factors affecting the seizure include internal environment condition and age of the individual.Seizure decreases with increasing age. It is highest in infants and toddlers. For them we encounter so. Febrile seizures (febrile = fever), ie seizures bound to a fever. It is an age-related disorder of consciousness or seizures occurring only at elevated temperature. This type of seizure disorder epilepsy shifts to right, but when it recurs, epilepsy can arise.

Readiness to seizures increases also many environmental factors, the most common include lack of sleep, alcohol, physical exhaustion. An important moment of provocation for some types of epilepsy can be a normal night’s sleep.

The most important factor influencing the formation of a seizure outbreak, bearings, in which nerve cells are damaged, do not correspond to the normal appearance and have also altered function.Such deposits can occur prenatally (before birth) and perinatal (during birth) and postnatal (already born by the individual).

Within prenatal damage apply development disorders, infections and toxic effects. The risk perinatal interventions is the most important cause of inadequate oxygen supply to the brain. In the postnatal period and maturity are the most common causes of damage accidents, brain hemorrhage, stroke (ie. Stroke), infections and tumors.

With the increasing number of insults in the elderly is related to the increased incidence of epilepsy in persons over 60 years of age.

Complaint asserting as a trigger epileptic seizure is only present in some types of epilepsy. These are both internal and external factors which are extraneous most frequently sensations, in particular light (eg. Lights in discos, quick glimpses of the children’s series) and audio. A good example of the internal environment factors in women seizures dependence on the phase of the menstrual cycle, as fever, fatigue, starvation, drugs.


prevention of epilepsy

Prevention is a normal healthy lifestyle. This means a healthy diet, not smoking, drinking alcohol in moderation.


Signs and symptoms of epilepsy

We distinguish a variety of epilepsy differing formation, duration and course of seizures. Basic international classification divides seizures to partial 1st, 2nd generalized and unclassifiable epilepsy third group.

Partial, or partial, localized are further subdivided according to whether it is accompanied by alteration of consciousness or not. Simple partial seizures are not accompanied by a change of consciousness. Affects motor (movement), somatosenozrickými (sensory), vegetative (relating to internal organs) or psychological symptoms. Motor seizures accompany twitching, convulsions andtransient paralysis of the affected muscle groups. Sensory attacks manifested seizure tingling or numbness of the affected parts of the body. Sensory seizures are highly variable and the symptoms depend on the position of the focal point, the epileptic bearings.

The presence of foci in the brain, which is responsible for visual perception, conditional binge vision flashes, or disorder of peripheral vision, visual field failures blindness.

Localization outbreak in another place can lead to auditory or olfactory hallucinations, taste sensations, dizziness, feelings rotation, fits strongly to emotional or psychotic behavior.

Psychological symptoms can lead to different states of unreality and depersonalization, such as the illusion of something already lived, seen, or, conversely, feelings slyšného first experience these sensations.

Partial seizure type are usually preceded by the so-called. Aura. Aura is experienced with individual differences but on the basis of ill will recognize impending attack. Often it prjevuje as complex mental sensations, nervousness, flashes before his eyes or vision problems.

Partial seizures accompanied by loss of consciousness are called complex. They may follow a simple partial seizure, in which case the altered state of consciousness occurs slowly, but is often impaired consciousness expressed early in the bout. Patients are always on the completed bout ofamnesia, does not remember it. Usually it is only for seconds to minutes, rarely appears longer duration. During the seizure respond appropriately to stimuli from the environment.

Once again there during the seizure dependence on the localization of epileptic focus. Symptoms include automatic movements such as smacking, swallowing more complex tasks. Physical symptoms may also be accompanied by emotions, laughter, fear and aggressive behavior.

Other times they appear unusual to bizarre physical acts that resemble such as swimming or cycling.

Generalized seizures are from the outset accompanied by coma and bilateral motion speeches.According to the kinetic expressions are divided into: 1. tonic, clonic 2nd, 3rd tonic – clonic, atonic 4th, 5th absence.

Tonic seizures are characterized by a large muscle contractions, convulsions. The primarily affected muscle groups include the muscles of the torso, thighs and arms. Convulsions may also be accompanied by breathing pauses. Everything usually subsides within tens of seconds.

Clonic seizures are more accurately called myoclonic where myoclonus is a muscle twitch. These twitches are involuntary. Origin twitch may be epileptic, sometimes with epilepsy do not have anything in common, differentiating us serve EEG.

The most common form of generalized seizures are tonic – clonic. Period of several hours or days before the onset of a seizure is called prodromal stage. These are headaches, mood changes, nervousness, irritability, impulsiveness like. It may also follow aura. Own bout is manifested firstsudden loss of consciousness and fall, changing the position of the eyeballs and loss of pupil response to light exposure. Following tonic spasms of all muscles. Since the body predominate extensor (tensioners) group of flexors (flexor) and the patient has stretched limbs and head with the spine in the upright position, this position is called opsitotonus.

Also affected is the breathing muscles, which in the initial stage may cause spasm strong exhaleaccompanied by a characteristic cry. Following stops breathing and cyanosis of the face. Seizures are affected chewing muscles, which leads to injuries to lips and tongue.

Gradually developing clonic phase. When it appear twitching, muscle groups are affected on both sides of the body at the same time. Intensity jerks increases, the frequency decreases. When releasing the sphincter of the bladder and rectum occurs urination and broken.

In the last phase wears off all manifestations cramps and twitches and normalized breathing.Impairment of consciousness turns into a deep sleep. Upon awakening, confusion persists, the patient is experiencing severe headaches and muscle pain vast nelokalizovatelnou.

Atonic seizures are accompanied by a loss of muscle tone, diminishing of muscle. It may be only a particular group of muscles, such as muscle relaxation of the neck is in decline in the head, or total involvement, in which case there is a sudden falls. Due to the immediate loss of consciousness and the very rapid onset of an attack in great danger of accidents. Additionally, this type of attack is most common in children.

Absence is also a type of epileptic seizure characteristic of childhood. It takes only 5 to 10 seconds. The child stares stiffly, interrupt activity (game, writing, reading …), which subsided after the attack, without the loss realized proceeds. During a fit individual is responding to salutation. May be present discoloration of the face, head drop, eye curl upwards. Hand-held objects fall to the ground.

For unclassifiable seizures are considered such seizures are not eligible for inclusion in one of the groups according to specific criteria and or they do not have enough data dipozici.

A very serious condition is called. Status epilepticus. This concept is called crowding epileptic seizures. Individual seizures lasting 2-3 minutes, well together without a transition returning consciousness. All this takes longer than 30 minutes. It is a very serious life-threatening condition. It requires immediate treatment and hospitalization. Status epilepticus may occur as the first manifestation of an epileptic disorder, but are more likely to in the course of which the most important factor causing the omission of treatment.


treatment of epilepsy

Epilepsy treatment must be prescribed judiciously. Rare epileptic seizure does not mean that an individual suffers from epilepsy. It may be the response of the organism to extreme conditions (lack of sleep, alcohol, physical exhaustion). Prior to initiation of the treatment is necessary to consider the circumstances under which the seizure occurred and consider finding on EEG.

Current trends are not recommended to deploy treatment as prevention. The probability of the first seizure recurrence is 40% for second attack 90%. Therefore, the prevailing view is that antiepileptic treatment should be deployed only in the case of recurring seizures.

When drug use must be respected several principles. By the patient are: cooperation, regular use of medications according to the doctor’s advice and absolute omission alcohol. The patient must follow a regular sleep habits and avoid sleeping during the day. It must not work on shifts, which means a ban on night services.

The doctor initially deploy the drug of choice, most effective, proven. If does not work, comes the second drug of choice. Fails – if even one selects the combination of different drugs with regard to side effects. An important part of treatment is to determine levels of anti-epileptic drugs in the blood. It is especially used for prevention of overdose these drugs.

When inefficiency drugs is recommended in certain cases surgical treatment. Failure drug therapy means two years is not improving persistent recurrent seizures despite trying all available appropriate medical treatment.


complications of epilepsy

Complications of the disease include the previously mentioned injuries and status epilepticus.

Another complication may be a drug overdose, manifested depression, problems with posture and gait, imbalance, impaired blood formation and adverse effects on the liver. Is particularly affected the quality of life of patients with epilepsy.

From the perspective of patients, the most severe problems limiting career choices, driving license ban, hindering the selection of a partner, limiting social opportunities for women afraid of pregnancy.Nearly half of patients are more tired and complaining of reduced attention as a result of side effects.

Other names: epilepsy, falling sickness, partial epilepsy, generalized seizure, absence, status epilepticus, grand mal, petit mal

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