Now epilepsy is classified as a polyetiological disease, that is, one that can be caused by many different factors. Interestingly, researchers still do not fully understand why some patients suddenly have seizures, sometimes leading to disability. Perhaps that is why the diagnosis of "epilepsy" sounds so frightening for everyone.
The causes, classification, symptoms and methods of treating this disease described in this article will help you better understand what exactly leads to the onset of the disease and how to deal with it.
How disruption of the transmission of electrical impulses affects the development of an epileptic attack
Nerve cells of the human brain - neurons - constantly generate and transmit electrical impulses in a certain size and at a certain speed. But in some cases they suddenly start either spontaneously or under the influence of somethen the factors produce impulses of much greater force.
The main cause of epilepsy, as researchers have found out, is precisely the same erratic and excessive electrical activity of nerve cells. True, in order for a seizure to develop, in addition, it is also necessary to weaken certain brain structures that protect it from excessive overexcitation. These structures include segments of the pons, as well as the caudate and sphenoid nuclei.
What are generalized and partial seizures in epilepsy?
Epilepsy, the causes of which we are considering, at its core, as you already understood, has an excessive electrical activity of brain neurons that causes a discharge. The outcome of this activity can be different:
- discharge stops within the boundaries where it originated;
- discharge spreads to neighboring areas of the brain and, having encountered resistance, disappears;
- the discharge spreads to the entire nervous system, after which it disappears.
In the first two cases there are partial seizures, and in the last - generalized. It always results in loss of consciousness, while partial seizures may not cause this symptom.
By the way, researchers have found that epilepsy develops when a specific part of the brain is damaged, not destroyed. It is the affected, but still viable cells that cause pathological discharges that lead to seizures. Sometimes at the time of the seizurenew damage to cells next to existing ones, and sometimes even far from them, new epileptic foci are formed.
Epilepsy: causes of seizures
The disease can be either independent or be one of the symptoms of an existing disease. Depending on what exactly causes epileptic seizures, doctors distinguish several types of pathology:
- symptomatic (secondary or focal);
- idiopathic (primary, or congenital);
- cryptogenic epilepsy.
Symptomatic causes of the described disease can be called any structural defects of the brain: cysts, tumors, neurological infections, developmental disorders, strokes, as well as drug or alcohol addiction.
The idiopathic cause of epilepsy is the presence of a congenital predisposition to epileptic seizures, which is inherited. Such epilepsy manifests itself already in childhood or early adolescence. At the same time, by the way, the patient does not show damage to the brain structure, but there is an increase in the activity of neurons.
Cryptogenic causes are difficult to determine even after the full range of examinations.
Classification of seizures in the diagnosis of "epilepsy"
The causes of this disease in children and adults directly affect how exactly the attacks in the patient proceed.
When we talk about epilepsy, we think of a loss ofconsciousness and convulsions. But the course of seizures in many cases turns out to be far from established ideas.
Thus, in infancy, propulsive (minor) seizures are most often observed, which are characterized by short-term forward tilts of the head or flexion of the upper body. The cause of epilepsy in this case is usually explained by delays in brain development in the prenatal period.
And in older childhood and adolescence, myoclonic seizures occur, expressed by a sudden short-term twitching of the muscles of the whole body or its individual parts (usually the arms). As a rule, they develop against the background of metabolic or degenerative diseases of the central nervous system, as well as in cases of cerebral hypoxia.
What is a seizure focus and convulsive readiness?
When diagnosed with epilepsy, the causes of an attack depend on the presence of an epileptic focus in the patient's brain and its convulsive readiness.
An epileptic (convulsive) focus appears, as a rule, as a result of brain injuries, intoxication, circulatory disorders, tumors, cysts, etc. All these injuries cause excessive cell irritation and, as a result, convulsive muscle contraction.
Under convulsive readiness is meant the probability of occurrence in the cerebral cortex of pathological excitation in excess of the level at which the anticonvulsant system of the body functions. By the way, she might behigh and low.
High and low convulsive readiness
With high convulsive readiness, even a slight irritation of the convulsive focus is the cause of epilepsy in the form of an extended attack. And sometimes such readiness is so high that it leads to short-term blackouts of consciousness even without the presence of a convulsive focus. In these cases, we are talking about seizures called absences (a short-term freezing of a person in one position with a blackout).
If there is no convulsive readiness in the presence of an epileptic focus, so-called partial seizures occur. They are not accompanied by blackouts.
The occurrence of increased convulsive readiness often lies in intrauterine hypoxia of the brain or a person's hereditary predisposition to the development of epilepsy.
Features of the disease in children
Idiopathic epilepsy is most common in childhood. The causes of this type of disease in children are usually quite difficult to establish, since the diagnosis itself is almost impossible to determine at first.
After all, epileptic seizures in children can hide under unclear pain attacks, umbilical colic, fainting or acetonemic vomiting caused by the accumulation of acetone and other ketone bodies in the blood. At the same time, sleepwalking, enuresis, syncope, and conversion seizures will be perceived by others as signs of epilepsy.
Most common in childrenage is absence epilepsy. The reasons for its occurrence are attributed to hereditary predisposition. Seizures look like the patient freezes in place for a few seconds at the time of the game or conversation. Sometimes they are accompanied by small clonic twitches of the muscles of the eyelids or the entire face. After an attack, the child does not remember anything, continues the interrupted lesson. These conditions respond well to treatment.
Features of epilepsy in adolescents
At puberty (from 11 to 16 years old), myoclonic epilepsy can develop. The causes of this disease in adolescents are sometimes associated with a general restructuring of the body and hormonal instability.
Seizures of this form of epilepsy are characterized by symmetrical muscle contraction. Most often, these are the extensor muscles of the arms or legs. The patient at the same time suddenly feels a "blow under the knee", from which he is forced to squat or even fall. With the contraction of the muscles of the hands, he can unexpectedly drop or throw far objects that he was holding. These attacks, as a rule, pass with the preservation of consciousness and are most often provoked by sleep disturbance or sudden awakening. This form of the disease responds well to therapy.
Basic principles of treatment
Epilepsy, the causes and treatment of which we consider in the article, is a special disease, and its therapy requires adherence to certain rules.
The main one is that the treatment of the disease is carried out with one anticonvulsant (anticonvulsantdrug) - this method is called monotherapy. And only in rare cases, several drugs are selected for the patient. The drug should be taken regularly and for a long time.
Only a neurologist can choose the right anticonvulsant, since there are no medicines that are equally effective for the whole variety of epileptic seizures.
The basis for the treatment of the described pathology is currently the drugs "Carbamazepine" ("Finlepsin", "Tegretol"), as well as "Depakin" and "Depakin Chrono". Their dose should be calculated by the doctor personally for each patient, because an incorrectly selected dosage of drugs can lead to an increase in seizures and a deterioration in the general condition of the patient (this phenomenon is called "epilepsy aggravation").
Is the disease treated?
Thanks to advances in pharmacology, 75% of epilepsy cases can be controlled with a single anticonvulsant. But there is also a so-called catastrophic epilepsy that is resistant to such therapy. The causes of the named resistance to prescribed drugs in adults and children may lie in the presence of structural defects in the patient's brain. Such forms of the disease are currently successfully treated with neurosurgical intervention.
