Jacksonian epilepsy is a type of underlying disease. It was first discovered in 1927 by Dr. Brava. It was then carefully studied and described by the English doctor Jackson. Therefore, it received the name by the name of the doctor. This type of epilepsy is not considered dangerous, since it does not lead to death.
Medical history
For the first time, Jackson's epilepsy was briefly described in 1827 by the French physician Brave. In 1863, an Englishman, a neurologist Jackson, took seriously 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 have become the basis for studying the functions of various zones.
What it is?
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. In this case, a clear consciousness is maintained. Seizures spread in a certain sequence throughout the body, which leads to a secondary epiproteus.
Causes of the disease
One of the nervous diseases is Jackson's 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 more often occurs due to organic pathology. Its appearance at any age indicates damage to the brain.
Symptoms of the disease
Jacksonian epilepsy, the symptoms of which are variable in nature, appear in the form of seizures and seizures. Common features - they occur locally, in separate areas of the body. Most often appear on the face or in the hands. Then spread throughout the body. Thanks to this development, the symptoms were called the Jackson 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, projection onto the cerebral cortex of the central gyrus. Attacks occur when a person is fully conscious. For example, if a cramp begins 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. An attack passes in the same order in which it spread.
At the same time, it is noted that once convulsions in a certain part of the body begin in the same place. 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 twitches begin to spread up the arm to the shoulder, then from the hip down. Less commonly, cramps start from the first toe. In this case, they spread first upward on it, then on the hand and face. Seizures cease suddenly, just as they begin.
With sensory jackson, excitation of the central cerebral gyrus also occurs. Propagation is similar to motor appearance. The difference lies in the loss of sensitivity. Its violation occurs. Sometimes convulsions that occur in one place, hardly extend further. This attack is considered simple. At the same time, a person does not lose consciousness.
This happens during the Jackson march. Consciousness is not always lost, but in most cases. Especially if the cramps suddenly change sides. If an epileptic status develops, then the seizure is localized only in the facial muscles, affecting the muscles of one limb, or convulsions begin to appear one after another.
What to do when seizures occur?
Jacksonian epilepsy in most cases occurs with the manifestation of simple attacks that start from a certain permanent place. You can try to stop the spread of seizures by holding a twitching limb. But this option is possible only in the initial stage of the disease. With its further progression, convulsions begin to emerge from a local point, gradually spreading throughout the body. Therefore, stopping them with the help of retention is no longer possible.
Seizure progression
With the progression of Jacksonian epilepsy after an attack, the 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, motor aphasia may begin . Sometimes cramps turn into transient paralysis of the legs or arms. During seizures, other neurological symptoms are also observed . They depend on the presence of major diseases in humans.
Diagnosis of the disease
It is not difficult to establish the presence of Jacksonian epilepsy. It is more difficult to determine the cause of its occurrence, that is, the underlying disease, which caused the occurrence of convulsive attacks. Therefore, a neurological examination is carried out, and an analysis of the mental state of the patient is done. Jacksonian epilepsy needs to be separated from similar diseases. Therefore, a psychiatrist, a neurologist and a neurologist participate in the examination.
In the period between attacks, electroencephalography registers focal discharges of epi-activity, which are provoked by sound and light stimuli. But according to the causative disease, the underlying rhythm can be changed. Using EEG video monitoring, a complete picture of ictal EEG is obtained.
The best diagnostic method is considered to be an MRI of the brain. If there are contraindications to its use, then CT is used. These methods allow you to identify or exclude a brain tumor, abscess, encephalitis, etc.
Jacksonian epilepsy: treatment
Reviews indicate that seizures after therapy almost completely disappear. The mood of the patient to recover is also important. Treatment of Jackson's 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, stopping epilepsy is impossible.
During anticonvulsant therapy, medication complexes are prescribed (Benzonal, Hexamethadine, etc.), which the patient should drink throughout his life. At the same time, the patient is prescribed dehydration drugs ("Hypothiazide", "Diacarb" or "Lasix") and absorbable ("Aloe", "Lidase").
Jackson's epilepsy, the treatment of which has begun, requires the advice of a neurosurgeon if the disease is caused by a cyst, arteriovenous malformation, or tumor. In this case, surgical intervention is required. But even after the operation, during which the organic cause of Jackson's epilepsy is removed, often the seizures persist for a long time.
In this case, the possibility of surgical treatment is considered. Dissections of adhesions and removal of scar-modified membranes are ineffective. After such operations, the attacks stopped only for a while. A more effective treatment is focal resection. During the operation, areas of the cerebral cortex that are responsible for epiactivity are removed.
But after such surgery, paralysis of the extremities occurs, the motor zones of which were excised. 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
Jacksonian epilepsy prognosis is reassuring. The disease is treatable. There is no development of additional complications in the form of mental or functional abnormalities. This type of epilepsy does not apply to life-threatening or dangerous diseases. Nevertheless, the disease is very unpleasant due to constant convulsive attacks and periodic loss of consciousness. And also due to the loss of certain body functions. But with timely access to a doctor, the number of seizures is significantly reduced. Treatment lasts at least a year.