Jacksonian epilepsy is a variation of the underlying disease. It was first discovered in 1927 by Dr. Brave. Then carefully studied and described by the English doctor Jackson. Therefore, it was named after the name of the doctor. This type of epilepsy is not considered dangerous, as it does not lead to death.
Case history
For the first time, Jacksonian epilepsy was briefly described in 1827 by the French physician Bravais. In 1863, an Englishman, a neurologist Jackson, seriously took up the study of the disease. He compared seizures with a focus of epiactivity in different parts of the cortex of the center of the brain. And these studies became the basis for studying the functions of various zones.
What is this?
Jacksonian epilepsy is characterized by sensory, motor or mixed seizures. In this case, epileptiform excitation first appears in the central gyrus of the brain or its cortex. Most often, seizures and convulsions begin locally. At the same time, a clear consciousness is preserved. Seizures spread tosequence throughout the body, resulting in a secondary epileptic seizure.
Causes of disease
One of the nervous diseases – Jacksonian epilepsy. The reasons may be different. Among them:
- brain tumor;
- cysticercosis;
- accumulated fluid in the brain;
- cerebral cyst;
- echinococcosis;
- solitary tuberculosis;
- neurosyphilis;
- encephalitis;
- traumatic brain injury;
- chronic arachnoiditis;
- arteriovenous malformations;
- pachymeningitis;
- aneurysms.
Jacksonian epilepsy in children often occurs due to heredity. But this factor is secondary. That is, the disease often occurs due to organic pathology. Its appearance at any age indicates brain damage.
Symptoms of the disease
Jacksonian epilepsy, the symptoms of which are variable, appear in the form of seizures and convulsions. Common features - they occur locally, in certain areas of the body. Most often appear on the face or in the hands. Then they spread throughout the body. Due to this development, the symptoms have been called the Jacksonian march.
Features of the disease
A characteristic feature of Jacksonian epilepsy is its local manifestation in only one part of the body. And the spread of seizures, respectively, the projection on the cerebral cortex of the central gyrus. Seizures occur when a person is fully conscious. For example, if a cramp began in the fingers of the left hand, it begins to spread along the same side of the body - to the shoulder, face and goes to the leg. The attack passes in the same order in which it spread.
At the same time, such a fact is noted that once the convulsions that have arisen in a certain part of the body will begin exactly there. The period between attacks can be different: seconds, minutes or days.
Types of Jacksonian epilepsy
Jacksonian epilepsy can be of three types. Motor motor disease occurs when the cerebral central gyrus is excited. First, cramps appear, which mainly originate in the muscles of the thumb. Then the twitches begin to spread up the arm to the shoulder, then from the hip down. Less often, cramps start from the first toe. In this case, they spread first along it up, then to the arm and face. Seizures stop abruptly, just as they start.
When sensory Jackson is also excitation of the central cerebral gyrus. The distribution is similar to the motor view. The difference lies in the loss of sensitivity. It is being violated. Sometimes seizures that have arisen in one place hardly spread further. This attack is considered simple. At the same time, the person does not lose consciousness.
This is what happens during the Jacksonian march. Consciousness is not always lost, but in most cases. Especially if the convulsions suddenly changeto the other side. If status epilepticus develops, then the attack is localized only in the facial muscles, affecting the muscles of one limb, or convulsions begin to appear one after another.
What to do if you have seizures?
Jackson's epilepsy in most cases occurs with the manifestation of simple seizures that start from a certain permanent place. You can try to stop the spread of seizures by holding the twitching limb. But this option is possible only in the initial stage of the disease. With its further progression, convulsions begin to leave the local point, gradually spreading throughout the body. Therefore, it is no longer possible to stop them with a hold.
Seizure progression
When Jacksonian epilepsy progresses after an attack, a limb often temporarily fails, which served as the starting point for the onset of seizures. The duration and severity of postparoxysmal paresis indicates the onset of the tumor process.
If the focus of the attack is in the dominant cerebral hemisphere, then motor aphasia may begin. Sometimes convulsions turn into transient paralysis of the leg or arm. During attacks, other neurological symptoms are observed. They depend on whether a person has underlying diseases.
Disease diagnosis
Establishing the presence of Jacksonian epilepsy is easy. It is more difficult to determine the cause of its occurrence, that is, the maindisease that caused the onset of convulsive seizures. Therefore, a neurological examination is carried out, and an analysis of the mental state of the patient is made. Jacksonian epilepsy must be separated from similar diseases. Therefore, a psychiatrist, a neuropathologist and a neurologist take part in the examination.
In the period between attacks, electroencephalography registers focal discharges of epiactivity, which are provoked by sound and light stimuli. But according to the causative disease, the basic rhythm can be changed. With the help of EEG video monitoring, a complete picture of the ictal EEG is obtained.
The best diagnostic method is MRI of the brain. If there are contraindications to its use, then CT is used. These methods can detect or exclude a brain tumor, abscess, encephalitis, etc.
Jacksonian epilepsy treatment
Reviews indicate that seizures after therapy almost completely disappear. The patient's attitude towards recovery is also important. Treatment of Jacksonian epilepsy is mainly aimed at eliminating the underlying disease, which was the cause of the seizures. And the second component of therapy is anticolvusant. Without it, the relief of epilepsy is impossible.
During anticonvulsant therapy, complexes of medicines (“Benzonal”, “Hexamethadine”, etc.) are prescribed, which the patient must drink throughout his life. At the same time, the patient is prescribed dehydration drugs (Hypothiazid, Diakarb or Lasix) and absorbable drugs (Aloe,"Lidaza").
Jacksonian epilepsy, for which treatment has begun, requires a consultation with a neurosurgeon if the disease is caused by a cyst, arteriovenous malformation, or tumor. In this case, surgery will be required. But even after surgery, during which the organic cause of Jacksonian epilepsy is removed, seizures often persist for a long time.
In this case, the possibility of surgical treatment is considered. Dissection of adhesions and removal of scar-changed membranes are ineffective. After such operations, the seizures stopped only for a while. A more effective method of treatment is focal resection. During the operation, parts of the cerebral cortex that are responsible for epiactivity are removed.
But after such a surgical intervention, paralysis of the limbs occurs, the motor zones of which were cut out. Over time, the muscles begin to recover, but not to the full extent. And partial immobility remains for life. And there is no guarantee that the attacks will not start again. The reason for this is the occurrence of cicatricial changes after the operation.
Forecast
Jackson's epilepsy has a comforting prognosis. The disease responds well to treatment. There is no development of additional complications in the form of mental or functional abnormalities. This type of epilepsy is not a life-threatening or dangerous disease. But still, the disease is very unpleasant due to constant convulsive seizures and periodic loss of consciousness. And also because ofloss of some bodily functions. But with timely access to a doctor, the number of seizures is significantly reduced. Treatment lasts at least a year.
