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The classification of partial epilepsy is based on identifying an area in the brain with increased activity during an attack. By the way, the picture of a particular seizure will largely be determined by the location of the focus of pathological excitability of neurons.

Possible localization of the outbreak:

1. Temporal. This is the most common type of partial epilepsy (about 50% of all cases of the disease are provoked by the pathological activity of neurons in the temporal zone).
2. Frontal. It deservedly ranks second in frequency of cases (24-27%).
3. Occipital(about 10% of all patients with this form of epilepsy).
4. Parietal. Occurs least frequently (1%).

How to determine the exact location of the outbreak? Now this is very easy to do. An EEG will help ().

Diagnosis is most often carried out during the period when the patient is at rest or asleep (). But the most accurate result is given by an EEG directly during the next attack. It is almost impossible to wait for it. Therefore, an attack is provoked by the introduction of special drugs.

Types of attacks and their symptoms

Partial epilepsy in each patient manifests itself in purely individual attacks. But there is an accepted classification of their main types. In simple partial attacks, the patient’s consciousness is retained completely or partially. This condition has different forms of manifestation:

• one can observe not very intense contractions of the muscles of the legs, arms, facial muscles, the patient feels numbness, tingling, so-called “goosebumps” on his skin;
• the patient turns his eyes, head, and sometimes his entire body in a certain direction;
• there is drooling;
• the patient performs chewing movements and grimaces;
• the speech process stops;
• pain appears in the epigastric area, heartburn, heaviness, peristalsis increases, flatulence appears;
• hallucinations may be observed: gustatory, olfactory, visual.

About a third of patients experience complex partial seizures, in which the person loses consciousness. Such patients are often fully aware of what is happening, but are not able to speak or answer the questions posed.

Often after another attack the patient experiences amnesia. He forgets everything that happened.

It often happens that epilepsy begins with a partial form, and then both hemispheres of the brain suffer. This becomes the cause of the development of a secondary seizure, generalized. It often makes itself felt in the form of severe cramps.

Symptoms of complex partial seizures:

1. The patient appears severe anxiety, fear of death.
2. He concentrates on events that have happened or words heard, experiences strong feelings because of them.
3. The patient begins to perceive a completely familiar environment as unfamiliar to him. Or maybe, on the contrary, pursue a feeling "deja vu".
4. The patient perceives what is happening as something unreal. He may perceive himself as the hero of a book, a movie he has seen, or even observes himself as if from the outside.
5. Automatisms. These are certain obsessive movements. What specific movement a patient will experience depends on which area of ​​his brain is affected.
6. In the short periods between seizures, a person at the initial stage of development of partial epilepsy feels quite normal. But over time, symptoms of brain hypoxia or underlying pathology become more and more apparent. Sclerosis appears, personality changes, dementia (dementia) is observed.

Let us consider the manifestation of each type of disease in more detail.

Damage to the frontal lobes of the brain

Partial epilepsy in the frontal lobes has characteristic symptoms:

• simple seizures;
• complex seizures;
• secondary generalized paroxysms;
• a combination of these attacks.

Seizures last for 30-60 seconds and are often repeated. You can observe their seriality. They often happen at night. In 50% of patients, the seizure begins without an aura before it begins.

Frontal lobe epilepsy has its own characteristics:

• seizures are quite short-lived (up to 1 minute);
• after the end of complex attacks there is a minimum of confusion;
• secondary attacks occur very quickly;
• motor disturbances can often be observed (uncharacteristic automatic gestures, trampling in one place);
• at the beginning of a seizure, automatisms are very common;
• the patient often falls.

Forms of frontal lobe epilepsy:

1. Motor. It manifests itself in the form of convulsions in the limbs, an aura before an attack, Todd's paralysis may occur, and secondary generalization often occurs.
2. Anterior (frontopolar). It manifests itself in the form of painful memories, the sense of time changes, thoughts come flooding in, and memory lapses often occur.
3. Cingular. Characterized by hyperemia of the facial area, increased motor skills, blinking, and a state of passion.
4. Dorsolateral. The patient turns his eyes, head and even torso in one direction, loses the ability to speak during the attack, and secondary generalization often occurs.
5. Orbitofrontal.
6. Opercular.
7. Additional motor area.

Temporal form of the disorder

Temporal partial epilepsy manifests itself in the following seizures:

• simple;
• complex;
• secondary generalized;
• their combinations.

Very often, with the temporal form, complex partial seizures with automatisms and upset consciousness are observed.

Very often, before attacks in the case of the temporal form, the patient feels an aura:

Types of temporal lobe epilepsy:

1. Paleocortical. The patient may freeze with a completely motionless face, his eyes remain wide open, directed at one point. There is a feeling that he is simply “staring” at something. Consciousness may turn off, but motor activity may remain. For example, the patient may be fiddling with his buttons on his clothes. Often the patient can simply fall without the appearance of convulsions (temporal syncope).
2. Lateral. During seizures, speech, vision, and hearing are impaired, and auditory and visual hallucinations appear.

Patients with occipital epilepsy suffer from visual hallucinations, impaired visual field, discomfort in the eyeballs, curvature (deviation) of the neck, and they experience frequent blinking.

Complex of therapeutic measures

Partial epilepsy is an incurable disease. The essence of treatment is to reduce attacks. To achieve remission, antiepileptic drugs are prescribed (Carbamazepine (a standard drug for all possible forms of epilepsy), Lamictal, Depakine, Topiramate).

To get maximum results, the doctor can combine drugs. If drug treatment does not work, perform.

Surgery is resorted to only if all conservative treatment methods have failed and the patient suffers from frequent seizures.

A craniotomy is performed in the area that caused the epilepsy. The neurosurgeon carefully excises everything that irritates the cerebral cortex - membranes that are changed by scars, exostoses. This operation is called meningoencephalolysis.

The Horsley procedure is performed less frequently. Her technique was developed by the English neurosurgeon Horsley back in 1886. In this case, the affected cortical centers are scooped out.

If partial seizures of epilepsy are provoked precisely by scars on the substance or membranes of the brain, then the results of such an operation do not bring the desired result.

When the irritating effect of scarring on the brain is eliminated, seizures may stop for a while. But very quickly, scars form again in the area of ​​the operation, and they are even more massive than the previous ones.

After Horsley's operation, monoparalysis of the limb from which the motor centers were removed may occur. At the same time, the seizures stop. Over time, the paralysis passes and is replaced by .

The patient always has some weakness in this limb. Most often, seizures reappear over time. Therefore, surgery is not the first choice for partial epilepsy. Conservative treatment is preferable.

The essence of prevention of all types of epilepsy is as follows:

• should be avoided;
• intoxication should be avoided;
• it is necessary to treat infectious diseases in a timely manner;
• You should not have children if both parents suffer from epilepsy (this greatly increases the risk of developing diseases in their children).

Partial epilepsy is a disorder of the conduction of nerve impulses in the brain; attacks can vary in intensity. Pathogenesis is determined by problems in neural connections in the head. Given the generalized form of this disorder, partial epilepsy is caused by damage to certain parts of the nervous system.

The classification of this disorder depends on the location of the inflammatory foci in which abnormal neuronal bioelectrical activity occurs. Partial seizures are divided according to symptoms as follows:

• Temporal. Refers to the most common forms of the disease. It accounts for up to half of the examples of this disease.
• Frontal is in 2nd place in terms of frequency of occurrence. partial poultices are diagnosed in 25% of patients.
• Occipital About 10% of people are affected by the form.
• Parietal appears in 1% of patients.

It will be possible to identify the localization of the source of the disorder using an EEG. The diagnostic procedure is carried out in a calm state during sleep. The most significant for diagnosis is the elimination of EEG readings when an attack occurs. It won't be possible to hold her. To simulate an attack, the patient is given special medications.

Causes

Many doctors believe that partial epilepsy is considered a multifocal disorder in most examples. Their main reason is considered to be genetic predisposition.

The following conditions can cause the onset of the disease and intensify attacks and develop into an independent pathology: benign neoplasms, hematomas, aneurysms, malformations, ischepia, and other problems with the blood supply to the brain, neuroinfections, congenital defects of the nervous system, head injuries.

Under the influence of such factors, a set of neurons in a specific lobe of the brain generates impulses of painful intensity. Consistently, such a process can affect nearby cells, and an epileptic seizure begins.

Symptoms

The clinical picture among patients does not differ significantly. But partial seizures can be classified. During simple attacks the patient remains conscious. This condition can manifest itself as follows:

• Weak contractions of muscle tissue on the face and limbs, a feeling of tingling, numbness, and goose bumps occurs.
• The eyes turn with the head in the same direction.
• Intense salivation.
• The patient makes faces.

• Involuntary chewing movements occur.
• Speech defects.
• Disorders in the epigastric region, a feeling of heaviness in the abdomen, heartburn, intense peristalsis, flatulence.
• Hallucinations due to defects in the organs of vision, hearing, and smell.

Severe partial seizures occur in approximately 35-45% of the population. At the same time, consciousness is lost. The patient is aware of what is happening, but cannot respond to the appeal to him. When the attack ends, amnesia occurs and the patient does not remember the events that occurred.

Often there is a focal activation of the disorder, mirrored in the second hemisphere. In such a situation, a secondary generalized attack appears as convulsions.

Complex attacks are characterized by the following symptoms:

• Negative emotions, fear of death, and anxiety arise.
• Feelings or focus on events that have happened.
• When the patient is in a normal environment, there is a feeling as if he is in an unfamiliar place.
• A feeling of unreality of current events. The patient observes himself from the outside and can identify with the characters of the works or films he has read.
• Automatisms of behavior and some movements appear, the nature of which is determined by the affected area.

During the periods between attacks in the first stages of the disease, the patient will feel well. Over time, signs of the underlying disease or brain hypoxia develop. A sclerotic process occurs, behavior changes, and...

Treatment

Partial seizures are complex. The main task of doctors is to reduce their number and achieve remission. In this case, the following are most often used: Carbamazeline (the medicine is the standard in the treatment of partial seizures. Use is carried out with a minimum dosage, after which, if necessary, the amount of medicine is increased), Depakine, Lamotrigine, Toliramate.

Often, combinations of several antiepileptic drugs are used to obtain good results. But recently, this tactic has been used infrequently due to the high likelihood of side effects.

Approximately 1/3 of patients do not experience any effect from the use of drugs, so surgery has to be performed.

When is surgery necessary?

The main goal of surgical intervention is to reduce the frequency of attacks. Surgery is considered a last resort, but is effective. This is a difficult neurosurgical procedure.

Before the meeting of doctors identifies the source of the epileptic disorder through surgery, the patient will have to undergo a preoperative examination.

Surgical treatment of epilepsy is performed in the following situations:

• Antiepileptic drug therapy does not give the desired result or the patient’s condition worsens.
• Drug treatment is effective. However, poor tolerance of the components provokes side effects.
• Epilepsy attacks are detected only in a few segments of the brain. Additional examinations make it possible to determine how restrictive areas cause seizures. When surgery occurs, such pieces of the brain are removed.
• Atonic attacks occur, the patient falls without convulsions.
• Secondary generalization of partial symptoms occurs.

In 20% of patients with partial epilepsy, treatment is possible only with surgery. The postoperative period is of great importance, therefore it is always accompanied by serious supervision by a doctor. If the patient has non-geralized symptoms, epilepsy therapy is not carried out. Methods are determined taking into account the signs of partial epilepsy and the location of the abnormal bioelectrical activity of neurons.

How do you prepare for surgery?

If epilepsy needs to be treated, the patient will have to follow the following precautions before surgery:

• Avoid interaction with factors that provoke partial seizures.
• Follow the course of treatment with tablets.
• Do not eat or drink 8 hours before the procedure.
• Get some sleep.
• Sometimes premedication is given.

Lobectomy

During the procedure, the hemispheres are divided into 4 sections: occipital, frontal, temporal, parietal. If the epileptic focus is in the temporal lobe, it must be removed during surgery. The lesion is located in the frontal and mesial region. If it is necessary to remove a fragment of brain tissue not in the temporal lobe, extratemporal resection is performed.

Lobectomy is a common method of treating episyndrome. This type of surgery. In most examples, the initial seizure frequency is reduced by 95%.

Temporal resection is an open operation. To carry out this procedure, an operating microscope is used. The doctor opens the skull, removes the meninges, and removes the inflamed area. This method of combating pathology increases the chances of successfully preventing attacks by up to 80%. If no complications are observed, the patient is discharged.

Elimination of pathological formation

Lesionectomy is based on the elimination of isolated fragments of neural networks damaged as a result of injury or some disease. For the first 24 hours the patient is in the intensive care ward. Further postoperative follow-up arises in neurosurgery. In most situations, the signs of lesinectomy are eliminated and the patient leaves the hospital within a week.

Callosotomy

This involves cutting the corpus callosum. The procedure prevents abnormal bioelectrical impulses from spreading to other areas of the brain. During the operation, nerve connections with several hemispheres are fragmented or completely severed.

This method of surgical intervention prevents the expansion of epileptogenic neoplasms and eliminates the intensity of attacks. The indication for this procedure is a complex, poorly controlled form of seizures in which convulsions occur, which ultimately cause injury or falls.

Hemispherectomy

Hemispherectomy is a radical surgical procedure that removes the hemisphere of the brain. Similar procedures are performed for complex forms of epilepsy. This is necessary if the patient has more than 10 attacks per day. When the two hemispheres separate, several anatomically significant fragments remain.

This procedure is performed for patients under 13 years of age in a situation where one of the hemispheres is working with defects. If surgery is performed at this age, the chances of a favorable outcome increase. The patient is sent home after 10 days.

How is the vagus nerve stimulated?

The operation is performed when the patient has multiple foci of epilepsy distributed throughout the entire cortex. During the operation, the neurosurgeon inserts a device under the skin that stimulates the vagus nerve.

Implantation of stimulators combined with the vagus nerves. 50% of the operations performed reduce seizure activity and make seizures weaker.

Forecast

When a patient is treated for simple partial seizures, the prognosis can vary. Often epilepsy is effectively treated or eliminated without intervention, sometimes it is necessary to monitor the patient's condition therapeutically.

Most forms of the disease are safe for the life and well-being of the carriers, excluding the possibility of accidents such as a fall, the initial stage of a seizure, or during swimming, while driving a vehicle, etc. Patients quickly learn to cope with their illness and avoid interaction with provoking factors or difficult situations.

The forecast always depends on the following factors:

• Location of abnormal bioelectrical activity of neurons.
• Limits of seizure activity.
• Reasons for appearance.
• The nature of transformations in the nervous system.
• Associated disorders.
• Types of seizures and features of their course.
• Age category of the patient.
• A type of epilepsy.
• There are other points that determine the condition of patients.

Seizures caused by severe brain damage are rare. They can cause complex organ dysfunction, changes in consciousness, loss of relationship with the environment or paralysis of the arms, etc.

Conclusion

Partial epilepsy refers to a problem with the passage of nerve impulses in the head. Symptoms may appear in different ways. The pathogenesis of this disease is the deterioration of neural communication in the nervous system.

Today, international standards for the treatment of epilepsy are being developed, which require compliance to improve the effectiveness of treatment and the patient’s standard of living. Procedures are allowed to begin only after the diagnosis has been reliably determined. There are 2 main categories of neurological disorders: the epileptic variety and the non-epileptic variety.

Prescription of therapy is justified only in the treatment of pathology. Doctors say that treatment is necessary after the first seizures.

Epilepsy is considered a polyetiological disease, since there are many different causes of its occurrence. The lesion may affect the entire brain or individual parts of it.

Partial seizures occur in the presence of psychoneurological diseases, characterized by high electrical activity of neurons and a prolonged course of the disease.

Features of the disease

Partial epileptic seizures can occur at any age. This occurs due to the fact that structural changes lead to disturbances in the psychoneurotic status of a person. There is also a decrease in intelligence.

Partial seizure in epilepsy is a neurological diagnosis that indicates the chronic course of brain diseases. The main feature is the occurrence of convulsions of varying strength, shape, as well as the nature of the course.

Main classification

Partial seizures are characterized by the fact that they affect only a certain part of the brain. They are divided into simple and complex. Simple ones, in turn, are divided into sensory and vegetative.

Sensory hallucinations are mainly accompanied by hallucinations, which can be:

• auditory;
• visual;
• taste.

It all depends on the location of the lesion in certain parts of the brain. In addition, there is a feeling of numbness in a certain part of the body.

Autonomic partial seizures occur when the temporal region is damaged. Among their main manifestations it should be noted:

• rapid heartbeat;
• heavy sweating;
• fear and depression.

Complex partials are characterized by a slight impairment of consciousness. The lesion extends to areas responsible for attention and consciousness. The main symptom of this disorder is stupor. In this case, a person literally freezes in one place; in addition, he can make various involuntary movements. When he regains consciousness, he does not understand what is happening to him during the attack.

Over time, partial seizures may develop into generalized seizures. They form completely suddenly, since both hemispheres are affected simultaneously. With this form of the disease, examination will not reveal foci of pathological activity.

Simple seizures

This form is characterized by the fact that a person’s consciousness remains normal. Simple partial seizures are divided into several types, namely:

• motor;
• sensory;
• vegetative.

Motor seizures are characterized by simple muscle contractions and limb spasms. This may be accompanied by involuntary turns of the head and torso. Chewing movements worsen and speech stops.

Sensory seizures are characterized by numbness in the limbs or half of the body. If the occipital region is affected, there may be visual hallucinations. In addition, unusual taste sensations may appear.

Vegetative seizures are characterized by the occurrence of unpleasant sensations, salivation, the release of gases, and a feeling of tightness in the stomach.

Complex seizures

Such violations occur quite often. They are characterized by much more pronounced symptoms. Complex partial seizures are characterized by a change in consciousness and the inability to make contact with the patient. In addition, spatial disorientation and confusion may occur.

The person is aware of the course of the attack, but at the same time cannot do anything, does not react to anything, or makes all movements involuntarily. The duration of such an attack is 2-3 minutes.

This condition is characterized by the following symptoms:

• rubbing hands;
• involuntary licking of lips;
• fear;
• repetition of words or sounds;
• a person moves to different distances.

There may also be complex seizures with secondary generalization. The patient fully retains all memories of the onset of the attack right up to the moment of loss of consciousness.

Causes

The causes of partial epileptic seizures are not yet fully known. However, there are certain provoking factors, in particular such as:

• genetic predisposition;
• neoplasms in the brain;
• traumatic brain injuries;
• developmental defects;
• cysts;
• alcohol addiction;
• emotional shock;
• drug addiction.

Often the underlying cause remains unidentified. The disease can occur in a person at any age, but teenagers and the elderly are at particular risk. For some, epilepsy is not very severe and may not manifest itself throughout life.

Causes in children

Partial motor seizures can occur at any age in both infants and adolescents. Among the main reasons it is necessary to highlight the following:

• injuries received during childbirth;
• intrauterine negative factors;
• cerebral hemorrhages;
• chromosomal pathologies;
• brain damage and injury.

It is worth noting that with timely treatment, the prognosis is quite favorable. By about 16 years of age, you can completely get rid of the disease. Treatment of children is carried out through surgery, medication or a special diet. Proper nutrition will allow you to get the desired result and get rid of the disease much faster.

In some cases, epileptic seizures appear during the first 3 months of a child's life. The symptoms are similar to cerebral palsy. Seizures are mainly caused by various genetic defects. The disease can lead to dangerous developmental defects. It is worth noting that many children suffering from this disease die.

Main symptoms

Symptoms of partial seizures in all patients are purely individual. The simple form is characterized by the fact that it occurs with preservation of consciousness. This form of the disease mainly manifests itself in the form of:

• unnatural muscle contractions;
• simultaneous turning of the eyes and head in one direction;
• chewing movements, grimaces, drooling;
• stopping speech;
• feeling of heaviness in the stomach, heartburn, flatulence;
• olfactory, visual and gustatory hallucinations.

Complex attacks occur in approximately 35-45% of affected people. They are predominantly accompanied by complete loss of consciousness. A person understands exactly what is happening to him, but at the same time he is simply not able to respond to someone addressing him. At the end of the attack, complete amnesia is generally observed, and then the person does not remember what exactly happened to him.

Often, the resulting focal pathological activity covers both hemispheres of the brain at once. In this case, a generalized seizure begins to develop, which often manifests itself in the form of a convulsion. Complex forms of the disease manifest themselves as:

• the emergence of negative emotions in the form of severe anxiety and fear of death;
• experiencing or concentrating on events that have already happened;
• feelings of unreality of what is happening;
• emergence of automatism.

Being in a familiar environment, a person may perceive it as unfamiliar, which causes a feeling of panic. The patient can observe himself as if from the outside and identify with the characters of recently read books or watched films. He can also constantly repeat monotonous movements, the nature of which is determined by the area of ​​brain damage.

In the period between attacks at the initial stage of the disorder, a person may feel quite normal. However, after some time, symptoms begin to progress and brain hypoxia may occur. This is accompanied by the appearance of sclerosis, headaches, and personality changes.

If partial convulsive seizures occur very often, then you must know how to provide first aid to a person. If an attack occurs, you must:

• make sure that it is really epilepsy;
• place the person on a flat surface;
• turn the patient's head to the side to avoid suffocation;
• do not move a person or do so if there is danger for him.

You should not try to control the convulsions, and it is strictly forbidden to perform artificial respiration or chest compressions. After the end of the attack, you need to give the person the opportunity to come to his senses and urgently call an ambulance and hospitalize the patient in a hospital. It is imperative to provide timely assistance to the victim, since such seizures can lead to the death of the patient.

To make a diagnosis of complex partial seizures, the neurologist prescribes a thorough examination, which necessarily includes:

• taking anamnesis;
• carrying out an inspection;
• conducting ECG and MRI;
• study of the fundus;
• conversation with a psychiatrist.

To detect damage to the subarachnoid region, asymmetry or deformation of the ventricles of the brain, pneumoencephalography is indicated. Seizures of partial epilepsy must be differentiated from other forms of the disorder or severe disease. That is why the doctor may prescribe additional research techniques that will help make a more accurate diagnosis.

Feature of treatment

Treatment of partial seizures must begin with a comprehensive diagnosis and identification of the causes that provoked the attack. This is required to eliminate and completely stop epileptic seizures, as well as to minimize side effects.

It is worth noting that if the disease occurs in adulthood, it cannot be cured. In this case, the essence of therapy is to reduce attacks. To achieve stable remission, antiepileptic drugs are prescribed, in particular, such as:

• "Lamictal".
• "Carbamazepine".
• "Topiramate".
• "Depakine."

To get the best possible result, your doctor may prescribe combination medications. If drug therapy does not bring the required result, then neurosurgical surgery is indicated. Surgical intervention is resorted to if conservative treatment methods do not bring the required result, and the patient suffers from frequent seizures.

When performing meningoencephalolysis, craniotomy is performed in the area that caused the epilepsy. The neurosurgeon very carefully excises everything that irritates the cerebral cortex, namely the membrane, which is changed by scar tissue, and exostoses are also removed.

Horsley surgery is sometimes performed. Her technique was developed by an English neurosurgeon. In this case, the affected cortical centers are removed. If attacks provoke the formation of scar tissue on the membranes of the brain, then such an operation will not produce any results.

After eliminating the irritating effect of scars on the brain, the seizures will stop for a while, but very quickly scars will form again in the area of ​​the operation, which will be much larger than the previous ones. After Horsley's operation, monoparalysis of the limb whose motor centers were removed may occur. In this case, the seizures immediately stop. Over time, the paralysis goes away on its own and is replaced by monoparesis.

The patient permanently retains some weakness in this limb. Often, over time, seizures reappear, which is why surgery is prescribed as a last resort. Doctors prefer to initially carry out conservative treatment.

For minor epilepsy that is not provoked by serious pathologies, treatment is possible by eliminating irritants using osteopathic techniques. For this purpose, massage or acupuncture treatment is indicated. Physiotherapeutic techniques and adherence to a special diet also provide good results.

It is worth noting that the disease manifests itself much weaker and less frequently in the absence of stress, normal nutrition, and adherence to a daily routine. It is also important to give up bad habits that are strong provoking factors.

Forecast

The prognosis of epilepsy can be very different. Often the disease is treated quite effectively or goes away on its own. If the disease occurs in older people or has a complex course, the patient is under the supervision of a doctor throughout his life and must take special medications.

Most types of epilepsy are completely safe for human life and health, but during attacks the possibility of accidents must be excluded. Patients learn to live with the disease, avoid dangerous situations and provoking factors.

Epilepsy is very rare and is associated with severe brain damage, which can cause dangerous damage to internal organs, changes in consciousness, loss of connection with the outside world, or paralysis. During the course of the disease, the prognosis depends on many different factors, namely:

• area of ​​focus of convulsive activity and its intensity;
• causes;
• presence of concomitant diseases;
• patient's age;
• the nature and level of changes in the brain;
• reaction to drugs;
• type of epilepsy.

Only a qualified specialist can give an accurate prognosis, therefore it is strictly forbidden to self-medicate. It is important to immediately consult a doctor when the first signs of illness appear.

Prevention

Prevention of any type of epilepsy is to maintain a healthy lifestyle. To prevent frequent recurrence of seizures, you need to completely give up smoking, drinking alcohol, and caffeine-containing drinks. It is strictly forbidden to overeat, and you should also avoid exposure to harmful, provoking factors.

It is important to strictly adhere to a certain daily routine, as well as follow a special diet. In order to prevent the occurrence of partial seizures after head injuries and operations, a course of antiepileptic drugs is prescribed.

And only a third of these patients experience recurrent seizures, which allows a diagnosis of epilepsy.

A seizure is a separate episode, and epilepsy is a disease. Accordingly, any seizure cannot be called epilepsy. In epilepsy, seizures are spontaneous and recurrent.

Causes

A seizure is a sign of increased neurogenic activity. This circumstance can provoke various diseases and conditions.

Causes leading to seizures:

1. Genetic disorders lead to the development of primary epilepsy.
2. Perinatal disorders - effects on the fetus of infectious agents, medications, hypoxia. Traumatic and asphyxial lesions during childbirth.
3. Infectious lesions of the brain (meningitis, encephalitis).
4. Effect of toxic substances (lead, mercury, ethanol, strychnine, carbon monoxide, alcohol).
5. Withdrawal syndrome.
6. Eclampsia.
7. Taking medications (aminazine, indomethacin, ceftazidime, penicillin, lidocaine, isoniazid).
8. Traumatic brain injury.
9. Cerebrovascular accidents (stroke, subarachnoid hemorrhage, and acute hypertensive encephalopathy).
10. Metabolic disorders: electrolyte disturbances (eg, hyponatremia, hypocalcemia, overhydration, dehydration); disturbances of carbohydrate (hypoglycemia) and amino acid metabolism (with phenylketonuria).
11. Brain tumors.
12. Hereditary diseases (for example, neurofibromatosis).
13. Fever.
14. Degenerative brain diseases.
15. Other reasons.

Certain causes of seizures are typical for certain age groups.

Types of seizures

In medicine, attempts have been made repeatedly to create the most appropriate classification of seizures. All types of seizures can be divided into two groups:

Partial seizures are triggered by the firing of neurons in a specific area of ​​the cerebral cortex. Generalized seizures are caused by hyperactivity of a large area of ​​the brain.

Partial seizures

Partial seizures are called simple if they are not accompanied by impaired consciousness and complex if they are present.

Simple partial seizures

They occur without impairment of consciousness. The clinical picture depends on which part of the brain the epileptogenic focus occurs. The following signs may be observed:

• Cramps in the limbs, as well as turning of the head and torso;
• Feelings of crawling on the skin (paresthesia), light flashes before the eyes, changes in the perception of surrounding objects, sensation of an unusual smell or taste, the appearance of false voices, music, noise;
• Mental manifestations in the form of deja vu, derealization, depersonalization;
• Sometimes different muscle groups of one limb are gradually involved in the convulsive process. This condition was called the Jacksonian march.

The duration of such a seizure is only from a couple of seconds to several minutes.

Complex partial seizures

Accompanied by impaired consciousness. A characteristic sign of a seizure is automatism (a person can lick his lips, repeat some sounds or words, rub his palms, walk along the same path, etc.).

The duration of the attack is one to two minutes. After a seizure, there may be a short-term clouding of consciousness. The person does not remember the event that occurred.

Sometimes partial seizures transform into generalized ones.

Generalized seizures

Occurs against the background of loss of consciousness. Neurologists distinguish tonic, clonic and tonic-clonic generalized seizures. Tonic cramps are persistent muscle contractions. Clonic - rhythmic muscle contractions.

Generalized seizures can occur in the form of:

1. Grand mal seizures (tonic-clonic);
2. Absence seizures;
3. Myoclonic seizures;
4. Atonic seizures.

Tonic-clonic seizures

The man suddenly loses consciousness and falls. The tonic phase begins, lasting seconds. Extension of the head, bending of the arms, stretching of the legs, and tension of the torso are observed. Sometimes a kind of scream occurs. The pupils are dilated and do not respond to light stimuli. The skin takes on a bluish tint. Involuntary urination may occur.

Then comes the clonic phase, characterized by rhythmic twitching of the entire body. There is also rolling of the eyes and foaming at the mouth (sometimes bloody if the tongue is bitten). The duration of this phase is one to three minutes.

Sometimes, during a generalized seizure, only clonic or tonic convulsions are observed. After an attack, a person’s consciousness is not restored immediately; drowsiness is noted. The victim does not remember what happened. Muscle pain, abrasions on the body, bite marks on the tongue, and a feeling of weakness can be used to suspect a seizure.

Absence seizures

Absence seizures are also called petit mal seizures. This condition is characterized by a sudden loss of consciousness for just a few seconds. The person becomes silent, freezes, and his gaze is fixed at one point. The pupils are dilated, the eyelids are slightly lowered. Twitching of facial muscles may be observed.

It is typical that a person does not fall during an absence seizure. Since the attack does not last long, it often goes unnoticed by others. After a few seconds, consciousness returns and the person continues to do what he did before the attack. The person is not aware of the event that has occurred.

Myoclonic seizures

These are seizures of short-term symmetrical or asymmetrical contractions of the muscles of the trunk and limbs. Convulsions may be accompanied by a change in consciousness, but due to the short duration of the attack, this fact often goes unnoticed.

Atonic seizures

Characterized by loss of consciousness and decreased muscle tone. Atonic seizures are a faithful companion of children with Lennox-Gastaut syndrome. This pathological condition is formed against the background of various abnormalities in brain development, hypoxic or infectious damage to the brain. The syndrome is characterized by not only atonic, but also tonic seizures with absences. In addition, there is mental retardation, paresis of the limbs, and ataxia.

Status epilepticus

This is a formidable condition, which is characterized by a series of epileptic seizures, between which the person does not regain consciousness. This is an emergency condition that can result in death. Therefore, status epilepticus should be stopped as early as possible.

In most cases, epistatus occurs in people with epilepsy after stopping the use of antiepileptic drugs. However, status epilepticus can also be the initial manifestation of metabolic disorders, cancer, withdrawal syndrome, traumatic brain injury, acute disorders of cerebral blood supply, or infectious brain damage.

Complications of epistatus include:

1. Respiratory disorders (respiratory arrest, neurogenic pulmonary edema, aspiration pneumonia);
2. Hemodynamic disorders (arterial hypertension, arrhythmias, cessation of cardiac activity);
3. Hyperthermia;
4. Vomit;
5. Metabolic disorders.

Convulsive syndrome in children

Convulsive syndrome among children is quite common. Such a high prevalence is associated with imperfect structures of the nervous system. Convulsive syndrome is more common in premature babies.

Febrile seizures

These are convulsions that develop in children aged from six months to five years against a background of body temperature above 38.5 degrees.

You can suspect the onset of a seizure by the baby's wandering gaze. The child stops responding to sounds, moving hands, and objects in front of his eyes.

There are these types of seizures:

• Simple febrile seizures. These are single convulsive seizures (tonic or tonic-clonic), lasting up to fifteen minutes. They do not have partial elements. After the seizure, consciousness was not impaired.
• Complicated febrile seizures. These are longer seizures that follow one another in series. May contain a partial component.

Febrile seizures occur in approximately 3-4% of babies. Only 3% of these children subsequently develop epilepsy. The likelihood of developing the disease is higher if the child has a history of complicated febrile seizures.

Affective-respiratory convulsions

This is a syndrome characterized by episodes of apnea, loss of consciousness, and convulsions. The attack is provoked by strong emotions, such as fear, anger. The baby begins to cry and apnea occurs. The skin becomes cyanotic or purple in color. On average, the apnea period lasts seconds. After which loss of consciousness and a limp body may develop, followed by tonic or tonic-clonic convulsions. Then a reflexive inhalation occurs and the baby comes to his senses.

Spasmophilia

This disease is a consequence of hypocalcemia. A decrease in calcium in the blood is observed in hypoparathyroidism, rickets, and diseases accompanied by excessive vomiting and diarrhea. Spasmophilia is registered among children aged from three months to one and a half years of age.

There are such forms of spasmophilia:

The obvious form of the disease is manifested by tonic spasms of the muscles of the face, hands, feet, and larynx, which transform into generalized tonic spasms.

You can suspect a latent form of the disease based on characteristic signs:

• Trousseau's symptom - muscle spasms of the hand that occur when the neurovascular bundle of the shoulder is compressed;
• Chvostek's sign is a contraction of the muscles of the mouth, nose, and eyelids that occur in response to tapping with a neurological hammer between the corner of the mouth and the zygomatic arch;
• Lyust's symptom is dorsiflexion of the foot with inversion of the leg outward, occurring in response to tapping the peroneal nerve with a hammer;
• Maslov's symptom - when the skin tingles, a short-term holding of breath occurs.

Diagnostics

Diagnosis of convulsive syndrome is based on obtaining the patient's medical history. If it is possible to establish a connection between a specific cause and seizures, then we can talk about a secondary epileptic seizure. If seizures occur spontaneously and recur, epilepsy should be suspected.

An EEG is performed for diagnosis. Recording electroencephalography directly during an attack is not an easy task. Therefore, the diagnostic procedure is carried out after the seizure. Focal or asymmetric slow waves may indicate epilepsy.

Please note: Electroencephalography often remains normal even when the clinical picture of a seizure syndrome does not raise doubts about the presence of epilepsy. Therefore, EEG data cannot play a leading role in determining the diagnosis.

Treatment

Therapy should be focused on eliminating the cause that caused the seizure (removal of the tumor, elimination of the effects of withdrawal syndrome, correction of metabolic disorders, etc.).

During an attack, the person must be placed in a horizontal position and turned on his side. This position will prevent choking on gastric contents. You should place something soft under your head. You can hold the head and body of a person a little, but with moderate force.

note: During a seizure, do not put any objects into the person's mouth. This can lead to injury to teeth, as well as objects getting stuck in the airways.

You cannot leave a person until consciousness is completely restored. If seizures are new or a seizure is characterized by a series of seizures, the person must be hospitalized.

For a seizure lasting more than five minutes, the patient is given oxygen through a mask and ten milligrams of diazepam with glucose is administered over two minutes.

After the first episode of seizures, antiepileptic drugs are usually not prescribed. These medications are prescribed in cases where the patient is given a definitive diagnosis of epilepsy. The choice of medication is based on the type of seizure.

For partial and tonic-clonic seizures, use:

For myoclonic seizures the following is prescribed:

In most cases, the expected effect can be achieved with therapy with one drug. In resistant cases, several drugs are prescribed.

Grigorova Valeria, medical observer

Health, medicine, healthy lifestyle

Partial seizures

Etiology and pathophysiology

Pathological electrical discharges emanating from focal brain lesions cause partial seizures, which can manifest themselves in different ways.

Specific manifestations depend on the location of the damage (pathology of the parietal lobe can cause paresthesia on the opposite limb when walking; with pathology of the temporal lobe, bizarre behavior is observed).

The causes of focal brain damage can be stroke, tumor, infectious process, congenital defects, arteriovenous malformations, trauma.

The disease can begin at any age, since this type of epilepsy is acquired.

Often onset in adults, the cause is usually cerebrovascular pathology or neoplasm.

In adolescents, the most common cause is head injury or an idiopathic form of the disease.

Simple partial seizures are focal sensory or motor disturbances that are not accompanied by loss of consciousness.

During complex partial seizures, a brief loss of consciousness occurs, often in the presence of bizarre sensations or actions (eg, dreams, automaticity, olfactory hallucinations, chewing or swallowing movements); This usually occurs against the background of pathology of the temporal or frontal lobes.

All partial seizures can lead to secondary generalized tonic-clonic seizures.

Transient global amnesia.

Simple partial seizures are not accompanied by loss of consciousness.

They are classified according to clinical manifestations, including: focal motor seizures, focal sensory seizures, and seizures accompanied by mental disturbances.

Mental disorders: deja vu (from the French “already seen”), jamais vu (from the French “never seen”), depersonalization, a feeling of the unreality of what is happening.

Often progress to complex partial seizures.

During complex partial seizures, a short-term loss of consciousness occurs (30-90 s), followed by a post-convulsive period lasting 1-5 minutes.

Automatism - aimless actions (pinching clothes, smacking lips, swallowing movements).

The diagnosis is often made based on a witness's account.

With complex partial seizures, the patient does not remember the attack; The witness describes the patient's gaze into nowhere and minor manifestations of automatism.

Simple partial seizures are self-described by the patient, noting focal jerking of a limb, focal sensory disturbances occurring most often on one side of the body or one limb, or mental symptoms such as deja vu.

The EEG often shows focal abnormalities, including focal slow or spiky wave discharges.

Multiple EEG monitoring may be required.

In unclear cases, long-term video monitoring of the patient may be required to record an attack.

MRI allows you to determine focal pathology.

There are many drug therapy options, including phenytoin, carbamazepine, oxcarbazepine, phenobarbital, primidone, zonisamide, topiramate, lamotrigine, tiagabine, and levetiracetam.

The choice of drug is most often determined by possible side effects and additional data (for example, the likelihood of pregnancy, drug interactions, age and gender of the patient).

It is necessary to periodically monitor the level of the drug in the blood, the results of a clinical blood test, platelets and liver function tests.

If drug therapy is ineffective, other treatment methods are used: surgical removal of the focus of seizure activity or installation of a vagus nerve stimulator.

Simple and complex partial seizures very often recur; these variants of seizures are often refractory to drug therapy, even combined.

Remission is possible, but it is difficult to predict how often disease-free periods will occur; the likelihood of remission is higher in patients with a rapid response to drug therapy and minor changes in the EEG. The prognosis also depends on the etiology of the seizures, with more severe injuries and strokes being accompanied by more resistant seizures.

For refractory seizures, surgical treatment improves the results of drug therapy in 50% of cases.

What are cramps?

Statistics show that seizures happen to every person at least once. You should worry if such a phenomenon goes into the system.

The concept of convulsive syndrome is defined as a pathological condition characterized by unaccountable contractions of the muscular system. In this case, cramps can appear in one specific place or spread to an entire muscle group.

There are many reasons for this disease. There are specific medications for each case.

The main thing is to carry out the correct diagnosis. And only a qualified doctor can prescribe adequate treatment.

There are several types of seizures:

• tonic-clonic convulsions;
• myoclonic contractions;
• partial seizures.

Tonic-clonic seizures are manifested by loss of consciousness:

Children and adolescents may experience myoclonic contractions. The process involves the entire muscle or only a certain group of muscles. For example, the muscles of the fingers or face. Many seizures can cause a child to fall, resulting in injury.

Convulsions of clonic origin without loss of consciousness are called partial. The process can involve the muscles of the face, feet and other parts of the body.

Many people confuse calf muscle spasms during sleep with cramps. This phenomenon is called myoclonus. Often accompanied by contractions of the thigh muscles.

Myoclonic states occur as a result of calcium deficiency, as well as due to the influence of low temperatures.

During sports training, painful contractions occur due to insufficient warm-up, loss of fluid and excessive increase in loads.

Causes

The following causes of seizures in different age groups of the population can be identified:

• the occurrence of various neuroinfectious diseases, for example, meningitis or encephalitis;
• deviations in the development of brain activity;
• hypoxia;
• lack of calcium, glucose and magnesium in the blood;
• the occurrence of gestosis during pregnancy;
• severe intoxication;
• severe forms of dehydration;
• complex diseases of the nervous system;
• high fever and respiratory infectious diseases;
• birth injuries in newborns;
• pathologies of metabolic processes;
• epilepsy;
• various brain tumors;
• traumatic brain injuries.

Even bright light and loud noise can trigger seizures. Hereditary factors also play an important role.

If your hands cramp

Most often, hand cramps appear in people who work a lot at the computer.

Reductions can be caused by the following reasons:

• state of stress;
• poor blood supply to the upper extremities;
• excessive sports activities;
• hypothermia;
• lack of calcium;
• various poisonings.

Coffee lovers should remember that this drink contributes to a significant leaching of calcium from the body, which can also cause cramps.

The following manipulations can help with this problem:

To prevent such conditions, you need to follow simple rules:

1. Consume foods rich in potassium and calcium.
2. Avoid extreme cooling.
3. Warm baths with the addition of essential oils have a beneficial effect.

Diseases and consequences

The manifestations of convulsive syndrome are due to the diseases that caused them.

In some cases, seizures can even cause death. This is due to associated complications. For example, cardiac arrest, spinal fracture, arrhythmia or various injuries.

Normal muscle spasms are not dangerous.

Convulsive phenomena occur as a result of disorders of the central nervous system, which can occur due to neurological and infectious diseases, toxic processes, disorders of water-salt metabolism or hysteria.

Seizures occur in the following diseases:

First, the tonic phase occurs, and then the clonic phase:

• consciousness turns off, the face turns pale and breathing stops;
• the body is tense, the head is pulled back, the eyes do not react to light;
• alternating tension and relaxation of the muscles occurs, foam is released from the mouth;
• convulsions decrease and stop, the patient can fall asleep.

Frequent seizures lead to the death of brain cells, and personality changes may also occur.

It is worth remembering that during such attacks the patient should be protected from bruises, and it is also not recommended to insert plastic or metal objects into the mouth to prevent bites.

The disease has the following manifestations:

• contraction of masticatory muscles;
• then convulsions cover all parts of the body, starting with the head;
• holding your breath;
• the patient bends in an arch.

The following consequences appear:

• temperature increase;
• contraction of the respiratory muscles at the sight of water;
• Tonic convulsions and spasms of the swallowing muscles occur;
• hallucinations;
• salivation.

What to do if you have seizures

Treatment of seizures occurs in two stages. First, the attack is stopped, and then treatment is given to the underlying cause.

Drug treatment should be carried out only as prescribed by a doctor. Medicines are often prescribed in the presence of a generalized or partial epileptic seizure.

Medicines for stopping an attack of epileptic convulsions

Convulsions

Cramps are involuntary, uncontrollable muscle contractions, manifested either as a series of contractions and relaxations, or as a period of tension. Depending on the number of muscles involved, localized and generalized types are distinguished.

Convulsions appear suddenly, are paroxysmal or constant. Almost any type of seizures indicates pathological excitation of neurons in the cortex or subcortical structures of the brain.

If you experience prolonged, severe or frequent cramps that affect your well-being, you should immediately consult a doctor. Seizures are a symptom of many diseases, some of which can lead to loss of health, disability and death. Therefore, if you complain of seizures, treatment should begin immediately.

Classification of seizures

Types of seizures

Depending on the type and duration of seizures, they are divided into several types.

Tonic convulsions

Tonic convulsions are a consequence of neural excitation in the subcortical structures of the brain. Long-term muscle contractions hold part or all of the body in a certain position. Tonic convulsions begin gradually and can last quite a long time.

The attack may be accompanied by loss of consciousness, apnea (stopping breathing), and may be replaced by a clonic type.

The tonic type often indicates the presence of diseases caused by infections, traumatic brain injuries, epilepsy, poisoning and intoxication of the body. It can develop as a result of dehydration of the body and be a symptom of a hysterical attack.

The classic picture of a strong tonic attack is opisthotonus in tetanus. The reclining body arches, resting on the heels and the back of the head.

The cause of tonic seizures must be determined by a doctor. The first choice specialist for this type is most often a neurologist.

Clonic seizures

Almost every person is familiar with clonic convulsions. Rhythmic tensions and contractions limited to one muscle or affecting several groups (for example, limbs and face), these spasms are provoked by stimulation of the cerebral cortex.

Localized clonic seizures are divided into focal and multifocal (several separate muscles at the same time). Generalized clonic convulsions are accompanied by loss or impairment of consciousness, changes in breathing rhythm, hypoxia (and, as a result, cyanosis).

The cause may be vitamin and mineral deficiency, fatigue, dehydration, hypertension, stress, as well as serious diseases associated with high intracranial pressure and circulatory disorders in the brain. Among the diseases accompanied by clonic convulsive seizures are epilepsy, abscesses, brain tumors, consequences of head injury, and eclampsia.

Tonic-clonic seizures

A classic illustration of two types of seizures replacing each other in a convulsive attack is an epileptic seizure.

A tonic-clonic seizure starts from the tonic stage against the background of a sudden loss of consciousness. The tension of the skeletal muscles of the body lasts up to several tens of seconds. The tonic phase is followed by a phase of generalized clonic convulsions, about 40 seconds. The muscles of the body tense and relax alternately, convulsions are replaced by relaxation. During the clonic stage, breathing resumes and cyanosis decreases.

A tonic-clonic seizure is accompanied by rolling of the eyeballs with white stripes of the sclera, copious salivation, and blood when biting the tongue. The final stage is a comatose state, followed by sleep or short-term episodes of confusion. A severe course of coma is possible, leading to death or a new series of attacks.

Most often, tonic-clonic seizures indicate epilepsy, traumatic brain injury, cerebral edema due to encephalopathy and eclampsia. They can also occur at high temperatures (febrile convulsions), chronic poisoning with carbon monoxide, lead, alcohol (without loss of consciousness). In eclampsia, a tonic-clonic attack is accompanied by a rapid, full pulse, high blood pressure, and increased tendon reflexes.

Myoclonic spasms

A type of clonic spasms, rhythmic or arrhythmic twitching of one or more muscles of the body, myoclonic spasms are divided into benign (physiological) and pathological.

Physiological myoclonus includes hiccups (the reaction of the muscle fibers of the diaphragm and larynx to irritation of the vagus nerve), shuddering when frightened, accompanied by vegetative manifestations, and twitching when falling asleep and during sleep. In children of the first year of life, myoclonus can also accompany periods of wakefulness and must be differentiated from pathological convulsions, tremor, and trembling.

If myoclonus manifests itself as a response to an irritant, does not cause much discomfort, and does not cause a deterioration in the physiological and psychological state, then there is nothing to worry about.

When myoclonic convulsions progress, affect your well-being, and the connection with the stimulus cannot be traced, you should urgently consult a doctor. Most likely, such phenomena are caused by a disruption of the central nervous system and indicate the presence of a disease.

Pathological myoclonus manifests itself as rhythmic twitching of the whole body (in the generalized form), convulsive flexion of the limbs, trembling of individual parts of the body. If myoclonus affects the muscles of the tongue and palate, the functioning of the speech apparatus, chewing and swallowing processes are disrupted, speech becomes unintelligible, and food in the mouth is not processed properly.

Another difference between physiological and pathological myoclonus is the presence of seizures during sleep. Myoclonus, which is a symptom of diseases, usually manifests itself as convulsions during wakefulness, intensifying with physical activity or stress.

Predisposition to myoclonus can be genetically determined, reaching a peak of manifestations in adolescence.

Seizures

A seizure is a reaction of the body muscles to a sudden increase in neurogenic activity in the brain. Depending on the part of the brain involved, partial seizures (localized in specific muscles or limbs) and generalized seizures involving the whole body are divided.

Some seizures are so weak that they go unnoticed by both others and the person himself. According to research, 2% of people experience at least one seizure during their lifetime.

Partial seizures

Partial seizures are triggered by abnormal activity of an isolated group of neurons and are localized in a separate group of muscles or parts of the body. In this case, the location of the areas that control muscles in the brain has an influence, and not the proximity of the body parts involved in seizures. For example, cramps in the fingers or hand may be accompanied by contractions of the facial muscles.

Sometimes cramps that begin locally in a part of a limb, such as a foot, spread to the entire limb. This phenomenon is called the “Jacksonian March.”

Partial convulsive seizures are divided into simple (without impairment of consciousness, the person adequately perceives and reacts to what is happening) and complex (with impairment of consciousness and unconscious behavior). If a person is having a seizure and cannot fulfill a simple request (reach out, sit down), the condition is described as a complex seizure.

The complex type is characterized by the phenomenon of automatism: repetition of the same words, movements, walking in circles. The duration of the state is a couple of minutes. After the attack ends, the person may lose consciousness and almost never remember what happened.

Simple partial seizures can develop into complex and secondary generalized ones (with Kozhevnikov epilepsy)

Generalized convulsive seizures - when “the whole body cramps.”

Generalized seizures include tonic-clonic and myoclonic seizures. Such seizures are characterized by the involvement of many muscles in the process, a sensation of “the whole body cramping.”

Occasionally, a tonic-clonic seizure is accompanied by only tonic or only clonic convulsions. At the end of the attack, drowsiness or coma occurs, consciousness is not restored immediately. Often, an attack that took place without witnesses can only be guessed by a feeling of weakness, abrasions, wounds on the tongue, muscle pain from cramps and blows.

A myoclonic seizure is a very short-term attack of rhythmic or chaotic muscle contractions, sometimes accompanied by clouding of consciousness, but the duration of the seizure is so short that the change in consciousness is practically not noticed by either the person or others.

Common types of seizures

Some convulsive manifestations occur quite often and are in the nature of a symptom of a temporary painful condition. In other cases, seizures can accompany a person throughout his life. Depending on the cause of the seizures, the type of seizure, the age and status of the person, specialists choose the type of therapy. However, when there are complaints of seizures, treatment and therapy are always aimed not at the symptom, but at the underlying disease.

Febrile seizures

Two and a half millennia ago, in his treatise “On the Sacred Disease,” Hippocrates described febrile convulsions as a symptom most often found in children under 7 years of age. Modern research confirms that convulsions due to hyperthermia develop mainly in children aged six months to five years. Febrile seizures in adults are quite rare and are caused not only by an increase in body temperature.

Febrile seizures in a child

Peak febrile seizures occur between 18 and 22 months of age. Boys are more likely than girls to have seizures due to high fever. In different regions of the world, the prevalence of the phenomenon is statistically heterogeneous. On average, seizures at fever occur in 2-5% of children of the corresponding age group. In closed populations and on islands, this figure reaches 14%, which confirms the presence of a genetic predisposition.

It is important to distinguish true febrile seizures in children from a combination of high fever and illness that causes seizures. Convulsions at fever can either be caused by hyperthermia or be febrile-provoked seizures, symptoms of some forms of epilepsy.

Convulsions during fever in children are usually divided into simple and atypical.

The simple form accounts for ¾ of all febrile seizures and is typical for children from 6 months to 5 years of age from families with a hereditary tendency to febrile seizures or cases of epilepsy. Simple (typical) convulsions at fever last less than 15 minutes (usually 1-3 minutes), with isolated episodes against the background of fever; partial components are not observed. The attacks stop on their own, and with antipyretic drugs they do not appear against the background of a decrease in body temperature.

Examinations of the child do not reveal neurological symptoms or EEG abnormalities, with rare minor exceptions.

Complicated febrile seizures (atypical) are characterized by several series of seizures following one after another. They develop before the age of one year, and also after five years. Subsequent spontaneous remission may be replaced by afebrile (temperature-independent) psychomotor seizures and temporal lobe epilepsy in children over 9 years of age.

Only 3% of all febrile seizures subsequently develop into epilepsy. However, in the presence of even a single attack, examination by a doctor is necessary to diagnose and prevent subsequent diseases.

Seizures with fever in adults

As a rule, adults do not suffer from febrile seizures. If a high body temperature is accompanied by a seizure, urgent consultation with a specialist is necessary to determine the true cause. Convulsions during fever in adults may indicate neuroinfections, poisoning and other diseases. Differentiating febrile seizures from convulsive conditions caused by other causes helps to make a correct diagnosis, maintain health and prevent serious complications from developing.

Cramps during pregnancy

Cramps during pregnancy can develop due to physiological stress on the body, be a consequence of the pathological course of pregnancy, and also be a symptom of concomitant diseases not related to bearing a child.

One of the common phenomena during pregnancy is calf muscle cramps caused by vitamin and mineral deficiency. Often the second and third trimester are accompanied by painful spasms of the calf muscles in pregnant women.

The most common cause is low levels of potassium, calcium and magnesium in the blood, causing pain and muscle cramps both day and night. A growing fetus requires an increase in nutrients. Often, a lack of magnesium occurs not as a result of a lack of this element in food or in vitamin preparations, but as a result of poor absorption against the background of low calcium in the blood. It must be remembered that the absorption of magnesium and calcium by the body is a balanced process; with a low content of one element, the second is poorly absorbed.

Such conditions are normalized by introducing into the diet foods rich in essential minerals, medications or supplement complexes for pregnant women.

Eclampsia (ancient Greek - outbreak) of pregnant women is a dangerous condition for both the baby and the expectant mother. The condition is characterized by edema and high blood pressure and refers to late toxicosis of pregnancy, manifesting itself in the third trimester.

Developing during pregnancy, eclampsia can manifest itself during pregnancy, during childbirth or in the postpartum period.

Eclamptic seizures are classified as tonic-clonic seizures, starting with loss of consciousness. Precursors to a seizure can be headaches, swelling, and nephropathic manifestations. During the process, fibrillary contractions of the facial muscles (10-30 seconds) are replaced by tonic convulsions with cyanosis, breathing problems, and the eyes roll back. The duration of tonic convulsions is up to 20 seconds.

The tonic stage is replaced by a clonic stage, with contractions and relaxations of the muscles of the body and limbs (1 -1.5 minutes). Often drooling, foaming with blood from the mouth, bruises, fractures.

An eclamptic seizure most often ends in coma. During or after an eclamptic attack, death is possible due to cerebral hemorrhage, asphyxia, and pulmonary edema. During the process, the child experiences acute hypoxia, which also has an extremely negative effect on his condition.

After a successful exit from a coma, the development of aspiration pneumonia and hepatic renal failure is possible.

Eclampsia is a serious disease in pregnant women. Its occurrence cannot be predicted, although factors contributing to the development of eclampsia include genetic predisposition, heredity, the presence of pre-eclamptic episodes in previous pregnancies, multiple births, obesity, diabetes, kidney and cardiovascular diseases. Also at risk are expectant mothers over 40 years of age, especially with their first pregnancy, as well as a gap between bearing children of more than 10 years.

Timely diagnosis of eclampsia will help reduce the chances of an attack. With the threatening development of eclampsia, early delivery with mandatory monitoring in the postpartum period is strongly recommended.

Differentiating the phenomenon of convulsions during pregnancy, caused by pathologies of gestation, from other convulsive seizures is important when choosing therapy. Pre-pregnancy examination, family history collection, and genetic consultation are the key to successful preventive measures to prevent conditions that threaten the lives of mother and baby.

Cramps after exercise

Cramps after physical activity occur as a result of overexertion of the body, which has a disease that manifests itself as convulsive attacks, or manifests itself as a reaction to a decrease in the level of electrolytes (magnesium, calcium) in the blood.

With some diseases, poisonings, and infections, areas of the brain may function unstable, causing convulsive phenomena. In such cases, the prevention and treatment of seizures will be the treatment of the underlying disease.

Calf muscle cramps

If a person is healthy, cramps after physical activity may manifest themselves as muscle spasms. Starting in the calf muscle, the spasm can spread to the foot and thigh area. Neither beginners nor professional athletes are immune from such manifestations.

Cramps in the calf muscles most often accompany sports such as running, walking, jumping, and swimming. The cause of spasms, often called cramps (sometimes the word crampy is used, a translation from the English word cramp - spasm), can be either a hereditary predisposition or the consequences of diseases and temporary conditions of the body.

Factors that cause calf muscle cramps include:

• dehydration. The most common reason when playing sports, caused by profuse sweating, loss of moisture when breathing through the mouth, failure to maintain the body's water balance;
• discrepancy in consumption and absorption of minerals (potassium, magnesium);
• iron deficiency or vitamin E deficiency.

Myoclonus that occurs during physical activity is also distinguished. Sudden single or serial contractions or convulsions during training or physical activity that do not cause severe pain are called benign myoclonic spasms. Such attacks go away on their own and do not require medical intervention.

Cramps while moving

Maintaining a healthy lifestyle, following a diet, a proper training, work and rest regime will help to avoid such phenomena as cramps during movement caused by water-salt imbalances, stress, and lack of microelements. It is also necessary to remember the importance of warming up before training and replenishing water and minerals.

Muscle cramps - how to treat?

For complaints of seizures, treatment is carried out by restoring the water-salt balance, massage, and maintaining a healthy lifestyle. It helps to introduce foods rich in potassium, magnesium, and calcium into the diet: cottage cheese, cheeses, bananas, sauerkraut, legumes.

Self-massage, pinching the shin, pulling the foot or big toe towards you helps with painful spasms. In cases of severe spasms, physiotherapy and acupuncture are also prescribed. If you experience prolonged, painful, unusual sensations of muscle cramps after training, you should consult a doctor.

If you are aware of the presence of a disease that manifests itself as seizures, then avoiding seizures during movement can only be done by treating the underlying cause of the seizures.

Seizures as a symptom of body diseases

True seizures are caused by excitation of neurons in the cortex or subcortical structures of the brain. Therefore, any convulsive phenomenon should cause close attention to the person’s health and a visit to the doctor.

Seizures in a child

Convulsions in a child must be distinguished from tremor or trembling - frequent physiological manifestations of the immaturity of the nervous system of children. Warning manifestations include both myoclonus and seizures at fever in newborns. These manifestations may indicate serious illnesses, developmental disorders, and infections.

Sometimes a child’s seizures may go unnoticed due to the short duration of the attack and the inability of children to describe how they feel. Any deviation from normal behavior and reactions should be noted for consultation with a pediatrician.

Seizures in adults

Convulsions in adults occur both in chronic diseases and in temporary pathological, painful or physiological conditions. Depending on the etiology of the phenomenon, different specialists deal with the symptom.

It is often believed that seizures are the fate of patients with epilepsy. However, there are many causes of seizures in adults, including infections transmitted by ticks, carbon monoxide poisoning, or excess alcohol (including one drink). Some seizures are signs of serious illnesses that can lead to health problems or death. If you have frequent, painful cramps or seizures, you should immediately contact the clinic.

Cramps due to stress

Convulsions during stress are usually a manifestation of unstable functioning of brain structures. Such a symptom may indicate the presence of a disease or infection that has worsened due to stressful experiences, and require immediate medical intervention.

Conditionally harmless cramps during stress can be considered cramps - cramps of the calf muscles. Most often they arise due to the body’s high consumption of magnesium during nervous stress, as well as non-compliance with the diet during stressful conditions. A large amount of black coffee, a companion to tense situations, also helps to “wash out” beneficial minerals from the body and can lead to neuroticism and muscle spasms.

Seizures: causes and treatment

The causes of true seizures are rooted in the excitation of neurons in the cortex and subcortical structures of the brain. Most often, when talking about cramps, they mean muscle spasms, not seizures. Treatment of true seizures depends on the etiology of the disease causing the seizures.

Why do muscles cramp?

Most often, muscles cramp due to dehydration or lack of magnesium in the body. Such spasms do not belong to true convulsions, and appear as a separate symptom against the background of physical exertion, stress, during pregnancy and other conditions that cause a violation of the water-salt balance. These may also include frequent visits to the bathhouse, frequent consumption of alcohol, coffee, and diuretics.

If the muscles cramp repeatedly, the attack is prolonged, accompanied by neurological symptoms, fever, breathing problems, and consciousness, it is necessary to urgently consult a specialist. A similar picture accompanies both dysfunctions of the body and diseases that can lead to death without immediate medical intervention.

Cramps at night or myoclonus?

Cramps at night are often a manifestation of myoclonus. Repeated or single twitching of muscles in the limbs occurs at the border of wakefulness and sleep and is called benign myoclonus. Unlike pathological myoclonus, such attacks do not require treatment and are provoked by physical or mental stress during the day.

In children, such convulsions at night appear as a response to a large number of impressions or high physical activity.

Sometimes nocturnal tonic cramps are the result of an awkward position of the limb, accompanied by muscle strain. Most often, such cramps at night disturb the sleep of older people, but they can interfere with sleep at any age.

Painful spasms at rest are usually provoked by metabolic disorders, lack of minerals and salts and dehydration of the body. This is why cramps at night often indicate poor nutritional habits.

Why do cramps happen when swimming?

Swimming is a strain for the whole body. Most often, cramps occur when swimming as a response to physical activity or due to a violation of the water-salt balance (which is especially typical for scuba diving, when breathing through the mouth causes loss of moisture through the mucous membrane).

The second reason why cramps often occur during swimming is stretching of the leg muscles during unusual movements.

The most typical leg cramps during swimming are localized tonic.

Leg cramps while swimming

Leg cramps during swimming are provoked by physical activity and changes in temperature. Most often it cramps the calf muscles. The spasm itself is not dangerous, but fear and pain from cramps in the legs can lead to panic and drowning.

To relieve the spasm, you need to calm down, pull your big toe towards you, and, if necessary, perform a series of pinches on the cramped muscle.

Finger cramps

Finger cramps can develop in professional musicians and dancers, and also occur with little stress on the limbs. The main causes of finger cramps:

As therapeutic and preventive measures, physiotherapy is used to restore blood supply, including self-massage, a gentle exercise regimen and calcium supplements are prescribed. Such therapy can reduce the frequency and have a preventive effect.

Seizures: treatment with drugs

The drugs used in the drug therapy of convulsive conditions depend on the etiology of the underlying disease. Anticonvulsants are often used to relieve seizures and subsequently prevent them. However, for seizure events, drug treatment is primarily aimed at treating the disease or condition causing the symptom.

Severe cramps: causes and diagnosis

All severe convulsions, regardless of the frequency of occurrence, are caused by a factor requiring medical intervention.

When complaining of seizures, the cause is determined and treatment is carried out by various specialists. In order to correctly formulate a picture of the phenomenon and help in determining the diagnosis, when contacting a specialist, you need to have answers to the following questions:

• duration of a convulsive attack, start and end time;
• what preceded severe cramps: stress, pain, strange sounds, sensations, smells;
• the presence of concomitant diseases and physiological conditions: pregnancy, ARVI, physical training;
• was there a loss of consciousness during the attack, were there strong or mild convulsions, what movements were made, what else accompanied the attack;
• how the seizure ended, are there any clear memories of what happened.

Severe cramps are a reason to immediately consult a doctor.

Epileptic convulsions

Epileptic convulsions vary in strength and duration of manifestation. To differentiate convulsive conditions caused by epilepsy from other causes, a patient examination is required.

Contrary to popular belief, epileptic seizures are characterized not only by a picture of a tonic-clonic seizure, but can also occur almost unnoticed by outside observers. Epiactivity of the brain in such cases is recorded during special studies in clinics. If epileptic seizures are suspected, the search for the cause and treatment should be carried out as early as possible.

Convulsions during hysteria

Psychogenic convulsions caused by hysterical states differ from generalized convulsive seizures. Despite the external similarity, convulsions during hysteria do not occur during sleep; they occur more often in a sitting or lying position. There is no change in the facial skin (or there is redness), asynchronous movements, no involuntary urination, rolling eyes, or severe damage to the limbs.

At the end of the attack, no symptoms of confusion are observed (or are demonstrative).

Convulsions in neuroinfections and head injury

Seizures during neuroinfections and traumatic brain injuries are a symptom of impaired brain activity. Seizures can be severe, progress to another series of seizures, and cause severe complications in addition to the underlying disease.

Any seizure is a reason to immediately call specialists.

Degenerative diseases as a cause of seizures

Degenerative changes in the spine can also cause seizures known as pathological cramps. Painful spasms occur in the presence of lumbar osteochondrosis and ischalgia.

Therapy for seizures in this case is directly related to the treatment of a degenerative disease that has caused changes in the body.

Seizures are a reason to see a doctor

Physiological convulsions, benign myoclonus, and single spasms, as a rule, do not require medical intervention and go away on their own. However, repeated spasms that cause discomfort, convulsive attacks that affect your well-being, both physical and mental, should be a reason to visit a doctor as soon as possible. Timely diagnosis of the causes of seizures, treatment and prevention of painful conditions is the key to maintaining health and preserving human life.

Cramps are involuntary muscle contractions caused by overactive or irritated neurons. Seizures occur in approximately 2% of adults, and most will have one seizure in their lifetime. And only a third of these patients experience recurrent seizures, which allows a diagnosis of epilepsy.

A seizure is a separate episode, and epilepsy is a disease. Accordingly, any seizure cannot be called epilepsy. In epilepsy, seizures are spontaneous and recurrent.

Causes

A seizure is a sign of increased neurogenic activity. This circumstance can provoke various diseases and conditions.

Certain causes of seizures are typical for certain age groups.

Types of seizures

In medicine, attempts have been made repeatedly to create the most appropriate classification of seizures. All types of seizures can be divided into two groups:

1. Partial;
2. Generalized.

Partial seizures are triggered by the firing of neurons in a specific area of ​​the cerebral cortex. Generalized seizures are caused by hyperactivity of a large area of ​​the brain.

Partial seizures are called simple if they are not accompanied by impaired consciousness and complex if they are present.

Simple partial seizures

They occur without impairment of consciousness. The clinical picture depends on which part of the brain the epileptogenic focus occurs. The following signs may be observed:

• Cramps in the limbs, as well as turning of the head and torso;
• Feelings of crawling on the skin (paresthesia), light flashes before the eyes, changes in the perception of surrounding objects, sensation of an unusual smell or taste, the appearance of false voices, music, noise;
• Mental manifestations in the form of deja vu, derealization, depersonalization;
• Sometimes different muscle groups of one limb are gradually involved in the convulsive process. This condition was called the Jacksonian march.

The duration of such a seizure is only from a couple of seconds to several minutes.

Complex partial seizures

Accompanied by impaired consciousness. A characteristic sign of a seizure is automatism (a person can lick his lips, repeat some sounds or words, rub his palms, walk along the same path, etc.).

The duration of the attack is one to two minutes. After a seizure, there may be a short-term clouding of consciousness. The person does not remember the event that occurred.

Sometimes partial seizures transform into generalized ones.

Generalized seizures

Occurs against the background of loss of consciousness. Neurologists distinguish tonic, clonic and tonic-clonic generalized seizures. Tonic cramps are persistent muscle contractions. Clonic - rhythmic muscle contractions.

Generalized seizures can occur in the form of:

1. Grand mal seizures (tonic-clonic);
2. Absence seizures;
3. Myoclonic seizures;
4. Atonic seizures.

Tonic-clonic seizures

The man suddenly loses consciousness and falls. The tonic phase begins, lasting 10-20 seconds. Extension of the head, bending of the arms, stretching of the legs, and tension of the torso are observed. Sometimes a kind of scream occurs. The pupils are dilated and do not respond to light stimuli. The skin takes on a bluish tint. Involuntary urination may occur.

Then comes the clonic phase, characterized by rhythmic twitching of the entire body. There is also rolling of the eyes and foaming at the mouth (sometimes bloody if the tongue is bitten). The duration of this phase is one to three minutes.

Sometimes, during a generalized seizure, only clonic or tonic convulsions are observed. After an attack, a person’s consciousness is not restored immediately; drowsiness is noted. The victim does not remember what happened. Muscle pain, abrasions on the body, bite marks on the tongue, and a feeling of weakness can be used to suspect a seizure.

Absence seizures

Absence seizures are also called petit mal seizures. This condition is characterized by a sudden loss of consciousness for just a few seconds. The person becomes silent, freezes, and his gaze is fixed at one point. The pupils are dilated, the eyelids are slightly lowered. Twitching of facial muscles may be observed.

It is typical that a person does not fall during an absence seizure. Since the attack does not last long, it often goes unnoticed by others. After a few seconds, consciousness returns and the person continues to do what he did before the attack. The person is not aware of the event that has occurred.

Myoclonic seizures

These are seizures of short-term symmetrical or asymmetrical contractions of the muscles of the trunk and limbs. Convulsions may be accompanied by a change in consciousness, but due to the short duration of the attack, this fact often goes unnoticed.

Characterized by loss of consciousness and decreased muscle tone. Atonic seizures are a faithful companion of children with Lennox-Gastaut syndrome. This pathological condition is formed against the background of various abnormalities in brain development, hypoxic or infectious damage to the brain. The syndrome is characterized by not only atonic, but also tonic seizures with absences. In addition, there is mental retardation, paresis of the limbs, and ataxia.

This is a formidable condition, which is characterized by a series of epileptic seizures, between which the person does not regain consciousness. This is an emergency condition that can result in death. Therefore, status epilepticus should be stopped as early as possible.

In most cases, epistatus occurs in people with epilepsy after stopping the use of antiepileptic drugs. However, status epilepticus can also be the initial manifestation of metabolic disorders, cancer, withdrawal syndrome, traumatic brain injury, acute disorders of cerebral blood supply, or infectious brain damage.

Complications of epistatus include:

1. Respiratory disorders (respiratory arrest, neurogenic pulmonary edema, aspiration pneumonia);
2. Hemodynamic disorders (arterial hypertension, arrhythmias, cessation of cardiac activity);
3. Hyperthermia;
4. Vomit;
5. Metabolic disorders.

Convulsive syndrome in children

Convulsive syndrome among children is quite common. Such a high prevalence is associated with imperfect structures of the nervous system. Convulsive syndrome is more common in premature babies.

These are convulsions that develop in children aged from six months to five years against a background of body temperature above 38.5 degrees.

You can suspect the onset of a seizure by the baby's wandering gaze. The child stops responding to sounds, moving hands, and objects in front of his eyes.

There are these types of seizures:

• Simple febrile seizures. These are single convulsive seizures (tonic or tonic-clonic), lasting up to fifteen minutes. They do not have partial elements. After the seizure, consciousness was not impaired.
• Complicated febrile seizures. These are longer seizures that follow one another in series. May contain a partial component.

Febrile seizures occur in approximately 3-4% of babies. Only 3% of these children subsequently develop epilepsy. The likelihood of developing the disease is higher if the child has a history of complicated febrile seizures.

Affective-respiratory convulsions

This is a syndrome characterized by episodes of apnea, loss of consciousness, and convulsions. The attack is provoked by strong emotions, such as fear, anger. The baby begins to cry and apnea occurs. The skin becomes cyanotic or purple in color. On average, the apnea period lasts 30-60 seconds. After which loss of consciousness and a limp body may develop, followed by tonic or tonic-clonic convulsions. Then a reflexive inhalation occurs and the baby comes to his senses.

Spasmophilia

This disease is a consequence of hypocalcemia. A decrease in calcium in the blood is observed in hypoparathyroidism, rickets, and diseases accompanied by excessive vomiting and diarrhea. Spasmophilia is registered among children aged from three months to one and a half years of age.

There are such forms of spasmophilia:

• Explicit;
• Hidden.

The obvious form of the disease is manifested by tonic spasms of the muscles of the face, hands, feet, and larynx, which transform into generalized tonic spasms.

You can suspect a latent form of the disease based on characteristic signs:

Diagnostics

Diagnosis of convulsive syndrome is based on obtaining the patient's medical history. If it is possible to establish a connection between a specific cause and seizures, then we can talk about a secondary epileptic seizure. If seizures occur spontaneously and recur, epilepsy should be suspected.

An EEG is performed for diagnosis. Recording electroencephalography directly during an attack is not an easy task. Therefore, the diagnostic procedure is carried out after the seizure. Focal or asymmetric slow waves may indicate epilepsy.

Please note: Electroencephalography often remains normal even when the clinical picture of a seizure syndrome does not raise doubts about the presence of epilepsy. Therefore, EEG data cannot play a leading role in determining the diagnosis.

Treatment

Therapy should be focused on eliminating the cause that caused the seizure (removal of the tumor, elimination of the effects of withdrawal syndrome, correction of metabolic disorders, etc.).

During an attack, the person must be placed in a horizontal position and turned on his side. This position will prevent choking on gastric contents. You should place something soft under your head. You can hold the head and body of a person a little, but with moderate force.

note : During a seizure, do not put any objects into the person's mouth. This can lead to injury to teeth, as well as objects getting stuck in the airways.

You cannot leave a person until consciousness is completely restored. If seizures are new or a seizure is characterized by a series of seizures, the person must be hospitalized.

For a seizure lasting more than five minutes, the patient is given oxygen through a mask and ten milligrams of diazepam with glucose is administered over two minutes.

After the first episode of seizures, antiepileptic drugs are usually not prescribed. These medications are prescribed in cases where the patient is given a definitive diagnosis of epilepsy. The choice of medication is based on the type of seizure.