With epilepsy, metabolic processes in the patient's brain are disturbed, and this leads to epileptic seizures. Seizures are divided into generalized and partial. They differ in clinic and mechanism of development. An attack occurs when pathological excitation in the brain dominates the processes of inhibition. A generalized epileptic seizure differs from a partial seizure by the presence of an abnormal process in both hemispheres. With partial seizures, the focus of excitation is formed in only one area of the brain, spreading to neighboring tissues. Treatment of the disease depends on the type and nature of the attack.
What is epilepsy?
Partial - this is a type of epilepsy in which a specific part of the brain is damaged, neurons give pathological signals with impaired intensity and spread to all abnormal cells. The result is an attack. The classification of partial epilepsy according to the location of the affected focus is as follows:
- temporal - isone of the most common types of epilepsy, it is detected in almost half of all patients who turn to the doctor;
- frontal - observed in a third of patients;
- occipital - accounts for only 10% of cases;
- parietal - rare and occurs in less than 1% of patients.
The peculiarity of partial epilepsy is that the disease is formed in a separate part of the brain, all other parts of it remain intact. Most often, partial epilepsy occurs in children due to intrauterine anomalies in the development of the fetus or born after prolonged oxygen starvation as a result of difficult childbirth. In adults, epilepsy can occur as a secondary ailment after previous illnesses or brain injuries. In this case, epilepsy is called symptomatic.
Causes of disease
Symptomatic epilepsy develops as a result of acquired or congenital diseases. It occurs for the following reasons:
- hematomas;
- stroke;
- malignant and benign neoplasms;
- circulatory disorders in the cerebral cortex;
- staphylococcal, streptococcal and meningococcal infections;
- abscess;
- herpes virus;
- encephalitis and meningitis;
- postpartum trauma;
- congenital pathological changes;
- body's response to long-term medication;
- traumatic brain injury.
In addition, epilepsy cancontribute to the violation of metabolic processes in the body, various endocrine diseases, syphilis, tuberculosis, rubella measles, prolonged use of alcoholic beverages and drugs. Can provoke the disease:
- wrong lifestyle;
- abnormal pregnancy;
- highly stressful situation.
Symptoms of partial epilepsy
The symptoms of partial seizures depend on the area of the brain affected. It is expressed as follows:
- Temporal – this lobe of the brain is responsible for emotional processes. The patient may experience anxiety, euphoria, or anger. There is a violation of the perception of sound, memory is distorted. The individual hears music or certain sounds. He is able to recall events long forgotten.
- Frontal - controls motor processes. During a partial seizure, the patient makes stereotypical movements of the tongue or lips. His limbs involuntarily twitch, his hands and fingers move. Facial expression changes, eyeballs move from side to side.
- Occipital - it processes visual signals. The patient during an attack sees colored spots, flies appear before his eyes, flashing lights appear. In addition, he may not see some of the objects and phenomena, they simply disappear from the field of view. After a partial seizure, the patient is tormented by severe headaches resembling a migraine.
- Parietal - Causes sensory seizures. A person feels warm, cold in some part of the bodyor tingling. Often there is a feeling that a part of the patient's body is separated or increases in size.
Sometimes, after partial epilepsy, generalized epilepsy can immediately begin. The patient develops convulsions, paralysis occurs, muscle tone is lost.
Diagnosis of disease
To make a diagnosis, the doctor performs the following activities:
- Listens to the story of a witness who was present when the victim had a fit. The patient himself with complex partial convulsions often does not remember the attack. In simple cases, the patient can talk about how he/she feels during the seizure.
- Neurological examination in progress. The patient is checked for coordination of movements, performing a finger-to-nose test, questions are asked to test intelligence, and simple logical problems are solved.
- MRI is necessary for the diagnosis of epilepsy with congenital pathologies of the structure and various brain tumors, cystic formations, diseases of the head vessels, multiple sclerosis.
- EEG (electroencephalogram) - determine the location of the focus and the form of epilepsy. In some cases, the examination is carried out several times.
Taking into account all the data that were obtained during the study, as well as the causes and symptoms of partial epilepsy, the doctor builds the tactics of treating the patient.
Therapy of disease
In the treatment of symptomatic epilepsy, an integrated approach is used. To do this, spend:
- timely and accurate diagnosis of the disease;
- monotherapy - one effective drug is used;
- Experienced way of drug selection;
- the dose of the drug is increased until the symptoms of the disease disappear;
- selection of another drug in the absence of effect.
Treatment of partial epilepsy is then discontinued, signs and symptoms cease to appear for a long period of time. Therapy is carried out on an outpatient or inpatient basis, depending on the severity of the symptoms. In treatment, the following goals are pursued:
- prevent new attacks;
- reduce the duration and frequency of seizures;
- reduce the side effects of drugs;
- get drug withdrawal.
Used for treatment:
- nootropics - affect the nerve impulse of the brain;
- anticonvulsants - reduce the duration of the attack;
- psychotropic drugs - neutralize the effects of neurological disorders.
In some cases, long-term medication does not give a positive effect, then surgery is performed. It is shown at:
- tumors;
- cysts;
- abscess;
- hemorrhage;
- aneurysm.
With the help of the operation, a section is made that connects both hemispheres, cysts, tumors are removed, sometimes one of the hemispheres is removed. The prognosis of surgery is positive, most patients get rid of the symptoms of focalepilepsy.
What are partial seizures?
Focal or partial seizures are characterized by localization in one part of the brain. The location of the focus can be suggested by the symptoms that are present during the attack. They come with and without loss of consciousness. With a simple partial seizure, the individual does not lose consciousness, various emotions and sensations are inherent in him. Suddenly he has a feeling of joy, sadness or anger. He feels various tastes and smells, hears and sees what is not in reality. In a complex partial seizure, the patient changes or completely loses consciousness.
The condition is accompanied by convulsions, convulsive curvature of the lips occurs, frequent blinking begins, he can walk in circles. In this case, the patient continues to perform the same actions that were started before the attack. Sometimes, a particularly difficult attack begins with an aura. These are sensations characteristic of a particular individual: an unpleasant smell or fear. The aura is a warning for the patient about the occurrence of an attack. Therefore, he or his relatives are quite capable of taking certain actions aimed at reducing the likelihood of injury. Each time the attack manifests itself in approximately the same way.
Types of partial seizures
All seizures are divided into:
1. Simple. The patient during these attacks does not lose consciousness. The following paroxysms belong to this group:
- Motor - characterized by muscle cramps, various twitches, body rotations andhead, lack of speech or sounds, chewing movements, lip licking, smacking.
- Sensory - manifested by a tingling sensation, the presence of goosebumps or numbness of some part of the body, a feeling of an unpleasant aftertaste in the mouth, a disgusting smell, impaired vision: flashes before the eyes.
- Vegetative - a change in skin color occurs: redness or blanching, heart palpitations appear, blood pressure and pupil changes.
- Psychic - there is a feeling of fear, speech changes, pictures that were previously heard or seen are reproduced, objects and body parts may seem to be of a completely different shape and size than they really are.
2. Complex. This occurs when a simple partial seizure is accompanied by a disturbance of consciousness. The person is aware that he has had an attack, but cannot make contact with other people. All the events that happen to the patient, he forgets. He has a feeling of unreality of the events taking place.
3. With secondary generalization. Seizures begin with simple or complex partial seizures and progress to generalized seizures that last no more than three minutes. After they are over, the patient usually falls asleep.
Features of simple focal seizures
As noted earlier, with simple partial or focal epileptic seizures, the patient is conscious. Epilepsy attacks last no more than five minutes. They are characterized by the followingsymptoms:
- Rhythmic convulsive muscle contractions with varying intensity. Spread to the upper and lower limbs, as well as the face.
- Violation of the functions of the respiratory system.
- Blue lips.
- Profuse salivation.
In addition, vegetative signs are inherent in seizures:
- rapid heartbeat;
- heavy sweating;
- feeling of a lump in the throat;
- depression, anxiety or drowsiness.
Simple seizures are accompanied by sensory reflexes: auditory, gustatory and visual hallucinations occur, sudden numbness of body parts occurs.
Features of complex symptomatic seizures
Complex ones are much more severe than simple attacks. The main syndrome of partial epileptic seizures of a complex type is a violation of the patient's consciousness and the following characteristic features:
- the patient becomes lethargic, inactive, mentally depressed;
- gaze rushes to one point;
- no external stimuli are perceived;
- there is a repetition of the same actions: stroking or marking time;
- no memory of what happened. After an attack, the patient may continue to do what he did before and not notice the attack.
A complex partial seizure can turn into a generalized one, in which the focus of excitation is formed in both hemispheres of the brain.
Seizure classification
More knownthirty types of epileptic seizures, which differ in character. There are two main types of seizures:
- Partial (focal or focal) occur in a limited part of the brain.
- Generalized, or common, covering both hemispheres.
Partial seizures include:
- Simple - consciousness never turns off, accompanied by unpleasant sensations in one part of the body.
- Complex - expressed by motor manifestations, they are accompanied by a change in consciousness.
The following subspecies belong to generalized ones:
- Absences – consciousness is instantly turned off for up to 30 seconds, movement stops abruptly, there is no reaction to external stimuli, eyes may roll, eyelids and facial muscles twitch, then there are no convulsions. The attack occurs up to a hundred times a day. More common in adolescents and children.
- Myoclonic - seizures last a few seconds, manifested by jerky muscle twitches.
- Atonic or akinetic - a sharp loss of tone of the whole body or a separate part of it. In the first case, a person falls, in the second, the head or lower jaw hangs down.
All types of partial and generalized seizures can occur unexpectedly and at any time, sopatients always remember this.
Prevention
There are no specific methods to prevent the development of epilepsy. The disease often occurs spontaneously and is difficult to diagnose during the latent stage of the course. The following recommendations will help reduce the risk of developing the disease:
- clear observance of the daily routine, good sleep and rest;
- timely treatment of brain diseases and infectious diseases;
- thorough treatment of traumatic brain injury;
- abstaining from alcohol and drugs;
- consultation with a geneticist when planning a pregnancy;
- calm lifestyle: if possible, eliminate stressful situations, depression.
The prognosis of the disease is favorable, up to 80% of all patients live a full life and forget about partial seizures if they receive appropriate therapy in a timely manner and follow all the doctor's recommendations. Expectant mothers should pay special attention to their he alth, recently epilepsy often occurs in childhood due to intrauterine anomalies.
Conclusion
Patients suffering from epileptic seizures strive to get good medical care and get rid of seizures in the future. Medicine is able to provide all patients with the necessary drug treatment, with which it is possible to achieve positive dynamics. During the rehabilitation period, it is necessary to follow all the recommendations of the doctor, maintain a proper diet and a he althy lifestyle.
