Abscess epilepsy is a special type of disease that is characterized by specific seizures without seizures. Most often, such a pathology is recorded in children, although its manifestation in later adulthood is also possible.
Of course, many parents today are interested in additional information. Why does childhood abscess epilepsy develop? What are some warning signs? How do seizures occur, and what provokes them? What are the prognoses for patients? The answers to these questions will be presented later in the article.
general information
Abscess epilepsy is a specific idiopathic form of this pathology, which in most cases affects young children. The disease is accompanied by absences - seizures, which are characterized by a short-term shutdown of consciousness without the appearance of a convulsive syndrome.
According to statistics, the abscess form of the disease is 20% of all cases of childhood epilepsy. The first symptoms appear between the ages of 2 and 8 years, and girls are more prone to this.
By the way, such attacks were first described by Tisoot in 1789, but pathology was isolated in a separate nosological form only in 1989.
Abscess epilepsy: causes
The described disease, unfortunately, is recorded quite often. So why does abscess epilepsy develop in children? The causes, as a rule, lie in congenital structural defects of the brain. Risk factors also include damage to already formed neurons in the late stages of fetal development. The likelihood of developing this form of epilepsy increases with congenital pathologies such as hydrocephalus and microcephaly.
Do not ignore the genetic factor. Scientists have proven that heredity plays an important role. Congenital instability of regulation of the processes of excitation and inhibition in the structures of the cerebral cortex is also of importance.
Harbingers of the attack: what to look for?
Abscess epilepsy, as a rule, begins suddenly, against the background of complete health and well-being. Attacks begin spontaneously, they are rarely preceded by any symptoms.
Nevertheless, in some cases, patients note the presence of precursors. So, immediately before the onset of an attack, they experience headache and nausea, as well as a rapid heartbeat and increased sweating. Some parents note that before the abscess, the child begins to behave inappropriately - there is aggression or panic. Perhaps the appearance of taste, sound and auditory hallucinations.
What does an attack look like in a child? Key features
What are the features of abscess epilepsy? Symptoms of this ailment are quite characteristic, although they are not always able to be noticed on time:
- An attack starts unexpectedly and ends just as suddenly. During a simple abscess, the child freezes. Outwardly, it looks as if the patient was thinking about something, but he does not react to speech or other stimuli. In most cases, the attack lasts about 10-15 seconds. At the end of the abscess, the patient does not remember anything that happened during this period. After paroxysm, there is no weakness or drowsiness.
- The so-called complex abscess is also possible, to the symptoms of which a tonic component can be added. For example, a patient drops something from his hands, his head throws back, his eyes roll back. Sometimes automatisms are also added to the list of symptoms, for example, smacking, stroking hands, repeating individual sounds during an attack.
- With an unfavorable course of the disease, the attack is longer, and after it there is drowsiness, severe weakness.
It is worth noting that with this form of epilepsy, paroxysms are repeated often, sometimes up to several hundred times a day, and most often in the daytime (when the patient is conscious).
Epilepsy in adolescence
It is immediately worth noting that juvenile abscess epilepsy is accompanied by more severe symptoms. As a rule, the first symptoms begin to appear at about 10-12 years old.
Attacks are repeated from 5 to 70 times a day. During absences, the child freezes, his eyes become empty, and there is no reaction. Memories of what happened to the patient are not saved. The attack can last from 3 seconds to several minutes. By the way, at this age, the classic convulsive syndrome often joins the manifestations of this form of epilepsy.
In more severe cases in a teenager, you may notice myoclonus of the veins - uncontrolled rapid blinking. If a school-age child suddenly becomes distracted, inattentive, forgetful, then it is worth watching him more closely and, if necessary, consult an experienced neurologist.
Absences in adult patients
Abscess epilepsy in adults is rare and is usually associated with a lack of adequate treatment in childhood or adolescence.
In this case, absences are characterized by a shorter duration, although seizures can be repeated many times a day. Myoclonia of the eyelids and seizures are absent. Nevertheless, human consciousness is turned off, and activity is suspended. That is why patients with such a diagnosis should not be allowed to drive vehicles, swim unaccompanied, work with complex dangerous mechanisms, as sometimes even a second attack can lead to injuries and even death (for example, if a person is driving a car at that moment).
What can trigger an attack?
As already noted, abscess epilepsy is associated with genetic and congenital disorders. Nevertheless, the appearance of the first attack in a patient, as a rule, is associated with certain conditions:
- severe stress;
- significant physical and / or mental stress;
- change of place of residence, climate, living conditions, as this is due to a violation of the adaptive mechanisms of the patient’s nervous system;
- previous injuries, serious illnesses, intoxications, operations;
- metabolic disorders, progressive somatic diseases, pathologies of the endocrine system.
In the future, seizures appear more often, and this may be due to the impact of certain risk factors:
- bright light, its flickering (for example, New Year's garlands, bright luminous signs);
- large visual loads (long reading, watching cartoons, computer games);
- strong mental and physical strain;
- sleep disturbance (its excess or lack);
- sudden changes in temperature, atmospheric pressure, air humidity.
Diagnostic measures
This pathology is accompanied by very characteristic symptoms, so its diagnosis is rarely fraught with difficulties. The task of the pediatrician and pediatric neurologist is to collect as much information as possible about the symptoms, the presence of genetic or congenital abnormalities, etc. Since paroxysms often recur, often the doctor can personally observe them at the examination.
An obligatory part of the diagnosis is electroencephalography. It is worth noting that a few years ago this survey was considered a kind of “gold standard”. Nevertheless, during research and statistics collection, it was proved that against the background of abscess epilepsy, characteristic changes in the electroencephalogram may be absent, however, this is very rare.
Additional examinations, such as computed tomography or magnetic resonance imaging, are optional for diagnosis. Nevertheless, they are carried out if there is a need to exclude the possibility of somatic epilepsy (seizures in such cases are associated with the growth of a cyst or tumor, tuberculous damage to the brain, encephalitis and other lesions of the nervous system).
Abscess Epilepsy: Treatment
In the presence of any alarming symptoms, it is important to consult a specialist in time. After diagnosis, the doctor selects the appropriate treatment regimen. It is worth noting that therapy should be carried out under the strict supervision of an experienced neurologist or epileptologist.
As a rule, patients are prescribed succinimides (for example, Ethosuximide). In most cases, monotherapy is enough. If there are tonic-clonic paroxysms, then the doctor may decide to use drugs containing valproic acid (Valparin, Depakin, Depakin-chrono, etc.).
Of course, for the child you need to create a favorable environment - you need to avoid stress, carefully draw up a regimen of work and rest, monitor the quality and duration of sleep, eat right.
Discontinuation of the drug is recommended only after three years of persistent remission. If during this time attacks do not appear, then you can stop taking medications. It is also worth noting that during therapy, barbiturates and drugs from the group of carboxyamide derivatives cannot be taken, since in this case the likelihood of behavioral and cognitive disorders increases.
Predictions for Patients
This pathology is benign. In approximately 80% of cases, stable remission can be achieved (provided that the small patient received timely help and underwent an adequate course of therapy).
Occasionally, seizures appear again in adulthood. In such cases, patients are prescribed appropriate therapy. People with a similar diagnosis should follow certain safety rules. Until the attacks disappear completely, they are not given rights, they are not allowed to work with potentially dangerous mechanisms, etc.
By the way, small patients with the described diagnosis develop quite normally - cases of delays in physical or mental development are recorded, but very rarely and only with a pronounced malignant course of the disease. Nevertheless, due to repeated attacks, the child experiences difficulty concentrating, becomes distracted, which affects his school performance.