Epilepsy. Guidance for patients.

Epilepsy - one of the most widespread diseases of nervous system which cause of the prominent features represents a serious medical and social problem. Among the children's population frequency of epilepsy makes 0,75-1 %, from them of 65 % can live practically without attacks provided that they pass appropriating medical examination and receive appropriate treatment. Epilepsy - disease of the brain, described attacks of infringements of impellent, sensitive, vegetative or cogitative functions. Thus during between attacks the patient can be absolutely normal, nothing differing from other people. It is important to note, that the individual attack yet is not an epilepsy. Only repeated attacks - the basis for an establishment of the diagnosis of epilepsy. At epilepsy attacks also should be spontaneous, i.e. nothing to be provoked; they appear always unexpectedly. The attacks arising at temperature (pyretic spasmes), a fright, at a capture of blood, as a rule, have no attitude to epilepsy.

The reasons of occurrence of an epilepsy depend on age. At children of younger age the most frequent causal factor got epilepsy is oxygen starvation during pregnancy (hypoxia), as well as congenital developmental anomalies of a brain, intra-uterine infections (a toxoplasmosis, a cytomegaly, a roetheln, a herpes, etc.); less often - a patrimonial trauma. There are also forms of epilepsy with hereditary predisposition (for example, youthful myoclonic epilepsy). At these forms the risk of a birth of the sick child if one of parents is sick of epilepsy, is low and makes no more than 8 %. Extremely seldom there are progressing hereditary forms of epilepsy, mainly, in families with close relatives marriage or in the certain ethnic groups (for example, among a Finno-Ugrian population). In these families the risk of a birth of the sick child can be very high and reach 50 %.

Thus, allocate a "symptomatic" epilepsy (when it is possible to find out structural defect of a brain), an autopathic epilepsy (when there is a hereditary predisposition and structural changes in a brain are absent) and a cryptogenic epilepsy (when the reason of disease to reveal it is not possible).

Allocate nidal (franctional, focal, local) attacks, at which spasmes or original sensations (for example, numbness) in the certain parts of a body can be observed; most often - on behalf of or finitenesses, especially in hands. Nidal attacks can be shown also by short attacks of visual, acoustical, olfactory or flavouring hallucinations; short-term sensation of a pain or discomfort in a stomach; inflow of ideas with impossibility to concentrate; sensation «already seen» or «never seen»; attacks of unmotivated fear. The consciousness at these attacks is usually kept (simple fractional attacks), and the patient in details describes the sensations.
Deenergizing consciousness without falling and spasmes (complex fractional attacks) is possible. Thus the patient continues automated to carry out the interrupted action. During this moment can meet automatisms: chewing, stroking bodies, rub palms and so forth thus is made impression, that the person is simply absorbed by the activity. Duration of franctional attacks usually no more than 30 sec. After complex of fractional attacks short-term confusion of consciousness, drowsiness are possible.

Generalized attacks happen convulsive and non-convulsive (absenses). Generalized convulsive tonic-clonic attacks - the most serious, shocking, frightening parents and attacks surrounding type, nearby not the heaviest. Sometimes in some hours or even days up to an attack patients test some phenomena named by harbingers: the general discomfort, alarm, aggression, irritability, a sleeplessness, sweaty, the feeling of heat or a cold, etc. If directly ahead of an attack of the patient feels aura (discomfort in a stomach, visual sensations, unreality surrounding and so forth), and then loses consciousness and falls in spasmes such attack refers to again-generalized.
During aura some patients have time to secure themselves, having called to the aid associates or having reached up to a bed. At primarily-generalized convulsive attacks of the patient does not feel aura; these attacks are especially dangerous the suddenness. Favourite time of their occurrence - the period soon after awakening patients. In the beginning of an attack (a tonic phase) there is a pressure of muscles and shrill shout is often observed. During this phase probably biting language. Short-term respiratory standstill with the subsequent occurrence of cyanosis develops. The clonic phase of an attack further develops: there are rhythmical twitchings muscles, is usual with involving all finitenesses. In the end of clonic phases it is often observed incontience of urine. Spasmes usually stop spontaneously in some minutes (2-5 mins). Then the post attack period comes, described drowsiness, confusion of consciousness, a headache and approach of a dream.

Non-convulsive generalized attacks called by absense. They arise almost exclusively at children's age and an early youth. The child suddenly fades (deenergizing of consciousness) and steadfastly looks in one point; the sight seems absent. Attacks proceed all some 5-20 seconds and often remain not noticed. These attacks are very sensitive to hyperventilation - are provoked by the deep forced breath during 2-3 minutes

Allocate also myoclonic attacks: involuntary reduction of muscles of all body or its parts, for example, hands or a head, thus the patient can reject aside subject matters being hands. These attacks quite often arise in the morning, especially if the patient has not slept. The consciousness at them is kept. Atopic attacks are characterized by sudden full loss of a muscular tone owing to what the patient sharply falls. Convulsive reductions are absent. Children of the first year of a life have a special type of heavy attacks - infantile spasms. The given attacks proceed serially in the form of nods, folding of a trunk, bending of hands and legs. Children with this type of attacks usually lag behind in impellent and mental progress.

Exist about 40 various forms of epilepsy and different types of attacks. The doctor should lead indispensable inspection and precisely diagnose the form of epilepsy and character of attacks. Thus for each form there is certain an antiepileptic preparation and the programme of treatment.