Now epilepsy is classified as polyetiological diseases, that is, those that can be caused by many different factors. Interestingly, researchers are still not completely clear why some patients suddenly have seizures, sometimes leading to disability. This is probably why the diagnosis of epilepsy sounds so frightening for everyone.
The causes, classification, symptoms and methods of treating this ailment described in this article will help to better understand what exactly leads to the onset of the disease and how to deal with it.
How a violation of the transmission of electrical impulses affects the development of an epilepsy
The nerve cells of the human brain - neurons - constantly generate and transmit electrical impulses in certain sizes and at a certain speed. But in some cases, they suddenly begin either spontaneously or under the influence of some factors to produce impulses of much greater force.
The main reason for the occurrence of epilepsy, as the researchers found out, is precisely this very random 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. Such structures include segments of the Varolian bridge, as well as the caudate and wedge-shaped nucleus.
What are generalized and partial seizures of epilepsy?
Epilepsy, the causes of which we are considering, basically, as you already understood, has excessive electrical activity of brain neurons that causes discharge. The outcome of this activity may be different:
- the discharge ceases within the boundaries where it arose;
- the discharge spreads to neighboring parts of the brain and, having met resistance, disappears;
- the discharge spreads over the entire nervous system, after which it disappears.
In the first two cases, partial seizures occur , and in the last - generalized. It always leads to loss of consciousness, while partial seizures may not cause this symptom.
By the way, the researchers found that epilepsy develops with damage, and not with the destruction of a certain part of the brain. It is the injured, but still viable cells that cause pathological discharges, which lead to the appearance of seizures. Sometimes at the time of the seizure, new damage to the cells occurs next to the existing ones, and sometimes even in the distance 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 ailment. 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. In this case, by the way, the patient does not show damage to the structure of the brain, but an increase in the activity of neurons is noted.
Cryptogenic causes are difficult to determine even after the entire spectrum of examinations.
Classification of seizures with a diagnosis of epilepsy
The causes of this disease in children and adults directly affect how the patient’s seizures occur.
Speaking of epilepsy, we imagine a seizure with loss of consciousness and convulsions. But the course of seizures in many cases is far from established beliefs.
So, in infancy, propulsive (minor) seizures are most often observed, which are characterized by short-term bending of the head forward or flexion of the upper body. The cause of epilepsy in this case is explained, as a rule, by delays in the development of the brain in the prenatal period.
And in older childhood and adolescence, there are myoclonic seizures, expressed by sudden short-term twitching of the muscles of the whole body or its individual parts (usually hands). 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 convulsive focus and convulsive readiness?
With the diagnosis of epilepsy, the causes of the attack depend on the presence of an epileptic focus in the patient’s brain and its seizure 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 irritation of cells and, as a result, convulsive muscle contraction.
Convulsive readiness refers to the likelihood of pathological arousal in the cerebral cortex beyond the level at which the anticonvulsant system of the body functions. By the way, it can turn out to be both high 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 a developed attack. And sometimes this readiness is so high that it leads to short-term blackouts, even without a convulsive focus. In these cases, we are talking about seizures called absences (short-term freezing of a person in one pose with a turn-off of consciousness).
If convulsive readiness is absent in the presence of an epileptic focus, so-called partial seizures occur. They are not accompanied by a loss of consciousness.
The occurrence of increased convulsive readiness often lies in intrauterine hypoxia of the brain or a hereditary predisposition of a person to the development of epilepsy.
Features of the disease in children
In childhood, idiopathic epilepsy is most common. The causes of this type of disease in children are usually quite difficult to establish, since the diagnosis itself is initially almost impossible to determine.
After all, epileptic seizures in children can hide under vague 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, walking in a dream, enuresis, syncope, as well as conversion seizures will be perceived by others as signs of epilepsy.
The most common in childhood is abscess epilepsy. The causes of its occurrence are attributed to a hereditary predisposition. Attacks look like a patient fading in place for a few seconds at the time of a game or conversation. Sometimes they are accompanied by small clonic twitches of the muscles of the eyelids or the entire face. After the attack, the child does not remember anything, continues the interrupted lesson. These conditions respond well to treatment.
Features of epilepsy in adolescents
In the puberty period (from 11 to 16 years), myoclonic epilepsy can develop. The causes of this disease in adolescents are sometimes associated with a general restructuring of the body and instability of the hormonal background.
Attacks of this form of epilepsy are characterized by symmetrical muscle contraction. Most often these are extensor muscles of the arms or legs. At the same time, the patient suddenly feels a “blow under the knee”, from which he is forced to squat or even fall. When contracting the muscles of the hands, he may suddenly drop or throw away objects that he held far. 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.
The basic principles of treatment
Epilepsy, the causes and treatment of which we consider in the article, is a special disease, and its treatment requires compliance with certain rules.
The main one is that the treatment of the disease is carried out by one anticonvulsant (anticonvulsant drug) - this is called monotherapy. And only in rare cases, the patient selected several drugs. Taking the drug should be regular and long.
Only a neuropathologist can correctly choose an anticonvulsant, since there are no medications that are equally effective for the entire variety of epileptic seizures.
Currently, the basis for the treatment of the described pathology is the carbamazepine preparations (Finlepsin, Tegretol), as well as Depakin and Depakin Chrono. Their dose should be calculated by the doctor personally for each patient, because an improperly selected dosage of drugs can lead to more frequent seizures and worsen the general condition of the patient (this phenomenon is called "epilepsy aggravation").
Is the disease treated?
Thanks to the development of pharmacology, 75% of cases of epilepsy can be controlled by the frequency of seizures using one anticonvulsant. But there is so-called catastrophic epilepsy that is resistant to such therapy. The causes of the appearance of 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 today are successfully treated with neurosurgical intervention.