Epilepsy

Epilepsy (epilepsy) is a very common mental-mental illness. According to many domestic and foreign authors, this rate accounts for about 0.5-0.8% of the population. According to the World Health Organization, epilepsy is a chronic disease, caused by many different causes, characterized by the repetition of episodes due to excessive discharge of brain neurons, Although clinical and subclinical symptoms may vary.

Classification of DK

Taking blood for testing for patients at Hanoi Mental Hospital (Photo: TTO) - Local epileptics: simple local regression, complex local epilepsy and secondary generalization.

- Primary general epileptic seizures: big bout, hypertonic, unconsciousness, atypical unconsciousness, muscle twitching, muscle atony and spasms in children.

- The continuous state of epileptic seizures: epileptic seizures continued continuously, episodes of continuous absence of consciousness and continuous local epilepsy.

- The type of recurrence: sometimes, with epileptic cycles, reflexes (epileptic jerky due to light, epilepsy - senses, music due to DK, reading due to reading).

Clinical symptoms

- Local epilepsy : begins due to activation of nerve cells in a localized area of ​​the cerebral cortex. Clinical symptoms depend on the area of ​​the cortex involved. Injury can be due to birth or postnatal trauma, brain tumors, brain abscesses, brain tumors, cerebrovascular malformations, brain structural abnormalities.

Local epileptic episodes are divided into: simple local epilepsy (no disturbance of consciousness and awareness of the surrounding environment) and complicated local epilepsy (disturbance of consciousness and confusion of cognitive ability) surroundings).

- First-line epilepsy : including major epileptic seizures, unconscious episodes, atypical conscious episodes, minor seizures, muscular atony, contractions in children. This article only mentions the most common. It is a great epilepsy.

- Great epilepsy: most common and known. The attack suddenly occurs, the patient loses consciousness for a short time, appears to contract, convulsions and then coma. Before the attack from a few hours to a few days, the patient may have warning signs such as headache, tinnitus, insomnia, loss of appetite, dizziness, change in personality, become irritable to people Dear.

Warning signs and transient episodes may not occur and sudden seizures occur suddenly. The patient loses consciousness, spasms, suddenly falls down, sometimes accompanied by a moan due to the contraction of the larynx muscles. Due to strong fall, patients can suffer injuries, burns .

When he fell down, the muscles continued at the cramping stage, the limbs of the patients' arms stretched straight, stiffened slightly and raised slightly, their teeth clenched tightly, their tongues were bleeding. The breathing is stopped, the face of the patient is pale and bruised. Rapid pulse, slight increase in blood pressure, pupil at first, later contraction dilate and lose reflexes to light. The spastic stage lasts from 30 seconds to 1 minute.

After the spastic phase, the epileptic phase is followed: the striated muscles contract and stretch very quickly. Due to convulsions of the chest muscles, there is a hiccup and the mouth of a person with saliva, sometimes pink due to the tongue being bitten. The rate of convulsions decreases and then disappears. The duration of seizures lasts from 2-5 minutes. Coma: after a period of seizure of a patient entering a coma, it is possible to see pathological reflexes, loss of light reflection and pupil, hemorrhage under the skin and eyes.

After the attack, the patient woke up, initially having a disturbance in the orientation capacity with the surrounding environment and not remembering what happened, talking about disorder, mental instability. Sometimes the patient does not wake up but turns to a deep sleep, when he wakes up, he feels headache, fatigue, and pain in his whole body. There are cases after epileptic seizures due to large disturbance of consciousness, patients have unexpected behavior.

Epilepsy usually occurs after eating well, drinking plenty of water, drinking alcohol, after being too nervous, tired, stressed, and insomnia. Epilepsy is also often present in hot weather, when patients have menstruation.

The state of continuous seizures

This state is very dangerous for life of patients because of the phenomenon of cerebral edema, acute pulmonary edema, circulatory and respiratory disorders. People with tiredness, rapid pulse, high temperature, low blood pressure, rapid and irregular breathing, have dehydration and electrolyte disorders. The faster the circuit, the higher the temperature, the worse the patient's reaction between the worse the more severe the disease.

The continuous episodes of episodes need immediate emergency treatment. Prognosis is usually relatively good if a large epileptic seizure occurs continuously because the patient stops taking anti-epileptic drugs suddenly. Prognosis is often worse if severe brain injury, brain tumor or meningitis. The mortality rate of epileptic seizures is continuous about 20%.

Causes of epilepsy

All seizures are a result of a combination of genetic factors and acquired factors. Depending on the situation, one of the two factors will prevail.

Acquired factors: prenatal and perinatal factors, these factors are extremely rich. The role of perinatal and puerperal factors has been much reduced compared to the role of prenatal factor, due to obstetric and obstetric advances.

Central nervous system infections can cause episodes or episodes later in any age in life.

Skull injury: from ancient civilization, a known injury to the skull due to brain damage can develop later into seizures.

Brain tumors: rare in children and adolescents, epileptic seizures due to tumors account for 10 to 15% of adults and elderly people.

Cerebrovascular diseases: the scars causing epilepsy in the cerebral cortex and sequelae of cerebral vascular accident are one of the most common causes of epilepsy in the elderly.

Drug poisoning and metabolic factors: Most of these factors often cause separate episodes, associated with a condition that causes temporary seizures.

Treatment

Epilepsy should be treated as soon as possible to completely control the attack, avoiding adverse effects such as dementia and personality changes as well as preventing continuous DK status. Today, comprehensive treatment by means of medicine, surgery, diet, living, rehabilitation . has brought many good results.

Drug treatment: The most common and simple form of treatment. Recently, this method of treatment has had many important changes because of further clinical and subclinical analysis that makes the classification of epilepsy into many different forms able to respond well to each drug. certain.

Advances in the pharmacokinetic field of anti-epileptic drugs allow for more rational and safe use of these drugs. The measurement of serum drug concentrations, the understanding of interactions between anti-epileptic drugs, the effects between them and other drugs help physicians to monitor and evaluate as well as avoid ears. turn in treatment. The principle is to use the first monotherapy (one drug) with small incremental doses, if no new results are replaced or the combination of drugs.