medicalx - Epilepsy

Epilepsy

What is epilepsy?

Epilepsy is one of the most frequent neurological diseases. It is a disease in which the result of a sudden irregular activity of brain cells (neurons) develops seizures. These outward show in different ways, depending on where in the brain has been irregular activity of brain cells. If a seizure occurs only once, this does not mean that a person has epilepsy. Epilepsy is characterized by the repeated seizures.

Epileptic attack
Epileptic seizure is one of the symptoms of epilepsy, which caused an outbreak of abnormal electrical impulses in the brain. Depending on the location of an outbreak of momentum there are two basic groups of seizures: generalized and partial.

    * Generalised seizures: they are characterized by abnormal electrical outbreak cover the entire cerebral cortex. With this kind of attacks the patient loses consciousness (and only for a few seconds) may occur muscle spasms (contractions and toes) and disturbance of muscle tone (sudden falls).
    * Partial seizures: an abnormal electrical outbreaks are limited only to a specific area of the cortex (epileptično focus). For this type of attack is significant that may take place without disruption or partial disruption of consciousness (the person is confused) There may be muscle cramps and sensory disturbances (type, smell, hearing, vision). If the abnormal electrical outbreak of a particular area of the cortex and then spreads to the entire cerebral cortex, we are talking about secondary generalized attack.

More info here How common is epilepsy?

In developed countries, epilepsy occurs in 1% of the population. In the world supposed to have 40 million people, of which 6 million Europeans. It is estimated that today in Slovenia about 20,000 patients with epilepsy a year by the newly diagnosed around the 1000th Epilepsy can occur at any age, incidence in males and females is the same. Most often suffer from epilepsy, young people, with more than half of patients develop the disease before 18 years of age. The disease also commonly occurs after the 60th age.
What causes epilepsy?

Causes of epilepsy Sat wide variety, the proportion of causes in different stages of life to another. Epilepsy can occur as a result of damage of brain tissue caused by abnormal brain development or due to brain inflammation, brain injury (at birth, in a car accident), stroke, poisoning, excessive drinking or taking drugs (or both) of tumors. Epilepsy can also trigger a long-term prevention of sleep, hypoglycemia (low blood sugar), longer or stronger physical effort, lack of oxygen supply to the brain. For the emergence of epilepsy could be important as genetics. However, the inheritance is very complex and varied, so that epilepsy is rarely transmitted from parents to children. In many patients may be the cause of disease remains unexplained.
Epilepsy Treatment

Treatment of epilepsy is essential as seizures more or less damaged brain, in addition to the attacks also cause accidents (such as injuries due to falls, traffic accidents, drowning). In the treatment play a key role used to treat epilepsy or antiepileptic drugs. Other treatment options include surgery, vagusno stimulation (the use of devices similar in size to a heart spodbujevalniku that stimulates nerve vagusni) and ketogeno diet (a special food regime, based on a high body fat and the introduction of the necessary protein to the exclusion of carbohydrates).
Treatment with drugs - antiepileptic drugs

Medicines to treat epilepsy or antiepileptic drugs work by preventing the occurrence of epileptic seizures, therefore, the patient must be taken regularly. There is evidence that treatment with drugs effective in 60 to 75 percent of patients. For the treatment of epilepsy is now available for several drugs. Treatment with them can be independent, which means that the patient is only a single agent, but may be combined, which means that the patient takes two or more drugs simultaneously. Choice of drug depends on the type of seizure and investigations carried out by a specialist doctor (neurologist). In addition to efficacy (prevention of occurrence of epileptic seizures) is very important how the drug affects the quality of life of the patient. It is particularly important, how often the medicine is being assessed, what are the side effects of medicines, whether prescribed medication a patient administered with other drugs ...
Today there are two basic groups of antiepileptic drugs:

    * Older antiepileptic drugs, are drugs that have been in use for several decades. It is an effective medicine, which have many adverse effects, including those that occur after prolonged use. In addition, they can influence the way other drugs (they have interactions with other drugs) that are concomitant.
    * Newer antiepileptic drugs available to treat the last 15 years. Their advantage is that the efficiency comparable with that of older drugs, while causing fewer side effects and fewer interactions with other drugs.

Choosing antiepileptic drugs

The type and dose of the medical doctor for every individual basis, taking into account the age, body weight, an individual's response to drugs, side effects and possible interactions with drugs that the patient is already taking. Special attention, mainly because of side effects is needed in selecting antiepileptic drugs for children and youth, girls and women and the elderly.

More info here     * Among children and adolescents is particularly important to successful antiepileptic does not cause sedation (sleepiness, fatigue), does not adversely affect cognitive function (attention, perception, memory, acquisition of), behavior and body weight.
    * In girls and women is important that antiepileptic drugs have no effect on the menstrual cycle and fertility. It is known that some antiepileptic drugs can cause irregular menstrual cycles, polycystic ovaries, which can lead to reduced fertility in women. It can also reduce the efficacy of some antiepileptic drugs pill, increased body weight and cause cosmetic changes (acne, thinning or hair loss, ...). Long-term use of certain anti-epileptic drugs may occur osteoporosis (bone loss). Special care should be given to women during pregnancy, it can take anti-epileptic drugs during pregnancy causes disturbances in the development of the child. This is one of the undesirable properties of drugs, which is not unique to AEDs, but also for certain other medicines.
    * In elderly patients may be problematic side effects of antiepileptic drugs mainly sedation, adverse effects on cognitive function and changes in body weight. Due to time other diseases usually elderly patients taking other medications, so it is important that the selected antiepileptic no effect on the functioning of these drugs,. this impact is minimized. For better participation in treatment is also important that treatment with selected antiepileptikom as simple as possible (once or twice daily dosing).

Can medication be interrupted?

After several year period (two or more years) with no attack, the doctor may, after discussion with the patient decides to phase out therapy. The decision to terminate depends on many factors, most important is certainly a form of epilepsy. It is also often depends on the patient himself, or he will want to stop treatment or to the interest of safety will continue to take minimum doses. If the physician in collaboration with the patient decides to discontinue the drug, it must be this gradual (very slow, several months) and caution. The possibility of recurrence of seizures after discontinuation of treatment is between 11 to 41%, the highest in the first year after discontinuation. If seizures recur, it is necessary to reintroduce the medication. Many patients decide for safety of life taking anti-epileptic drugs.
What happens if there is a seizure?

Each of us may be in a situation that the person next to us experienced seizures. How to deal? Aid depends on the type and length of seizure. Most seizures do not usually require any special intervention. First aid is definitely needed in large generalized epileptic attacks (grand Malu) and in specific circumstances (eg when a seizure occurs in water). In these cases, we offer our help and / or medical assistance call.

First aid for a large epileptic attacks (grand Malu):

    * Patient must avoid to hurt in the collapse (remove all dangerous objects)
    * Loosen clothing around his neck (released from the tie, shirt collar unhooked) and belt (belt unfasten the pants)
    * Support his head with a soft and flat object (pillow, bag, twisted clothes)
    * After the termination of an attack should the person loses consciousness, lay in the lateral position of the unconscious,
    * The patient in the mouth should not be given any objects that would prevent you pregriznil tongue, mouth, he does not open by force,
    * Patient during the attack should not be given any fluids in the mouth until it was not recovers consciousness
    * Patients do not keep the attack, seizures no attempt to physically stop
    * Always wait on the ground that the patient comes to consciousness
    * Offer him help or if necessary, call a professional medical help.