Introduction to epilepsy

Introduction:

epilepsyIt is a disease caused by a variety of causes of paroxysmal abnormalities in the brain neuron group, such as paroxysmal movement, sensation, consciousness, mental and autonomic dysfunction.

Cause:

There are many reasons for epilepsy, especially in the cerebral cortex. It is generally considered to be related to the following four factors:

1. Genetic factors. Epilepsy is prevalent in a family of patients with a history of epilepsy or a congenital central nervous system or cardiac malformation.

2. Brain damage and brain damage. Embryonic dysplasia caused by viral infection, radiation exposure or other causes during embryonic development can cause epilepsy; birth injury is also a major cause of epilepsy in fetal production; craniocerebral trauma can also cause epilepsy.

3, other diseases of the brain. Brain tumors, cerebrovascular diseases, intracranial infections, etc.

4, environmental factors; male patients are slightly more than female patients, the incidence rate in rural areas is higher than the city, and fever, mental stimulation and so on are also the cause of epilepsy.

symptom:

According to the type of clinical attack:

1. Whole body rigidity - clonic seizures (big seizures): Sudden loss of consciousness, followed by acupuncture and convulsions. Often accompanied by screaming, complexion bruising, urinary incontinence, tongue bite, foaming or foaming at the mouth, dilated pupils. After a tens of seconds or minutes, the seizure naturally stops and enters a state of drowsiness. After waking up, there is a short period of dizziness, irritability, and fatigue, which cannot be recalled during the attack. If the episode continues, those who have been in a coma state say that the episode is a persistent state and often endangers life.

2. Absence of seizures (small episodes): Sudden interruption of mental activity, loss of consciousness, may be associated with myoclonus or autopsy. A seizure of a few seconds to more than ten seconds. EEG appears 3 times / sec slow or sharp slow wave synthesis.

3. Simple partial seizures: a local or one-sided limb's rigidity, clonic seizures, or paresthesia episodes, which lasts for a short time and has a clear consciousness. If the range of attack extends to other limbs or the whole body along the movement, it can be associated with loss of consciousness. It is called Jack. After the attack, the affected limb may have temporary paralysis, called Todd paralysis.

4. Complex partial seizures (psychomotor episodes): psychosensory, psychomotor, and mixed seizures. There are varying degrees of disturbance of consciousness and obvious mental, sensory, emotional and psychomotor disorders. There may be autopsy symptoms such as snoring and night snoring. Sometimes, under the control of hallucinations and delusions, violent acts such as wounding and self-injury can occur.

5. Autonomic seizures (diencephalic): may have headache type, abdominal pain type, limb pain type, syncope type or cardiovascular attack.

6. Patients with no clear cause are primary epilepsy, secondary to intracranial tumors, trauma, infection, parasitic diseases, cerebrovascular disease, systemic metabolic diseases, etc. are caused by secondary epilepsy.

diagnosis:

Should be identified with syncope, pseudo seizures, narcolepsy, hypoglycemia. According to EEG, medical history, symptoms and signs are not difficult to identify.

complication:

Often complicated with acute renal failure, acute promyelocytic leukemia, depression

treatment:

First, drug treatment:

1. Choose safe, effective, inexpensive, and easy-to-purchase drugs based on the type of seizure.

1 major seizure selectionPhenobarbital90-300mg/d.Sodium valproate 0.6-1.2/d, carbamazepine 600-1200mg/d, etc.

2 complex partial seizures: phenytoin 0.2-0.6 / d, carbamazepine 0.2-1.2 / d.

3 absence of seizures: clonazepam 5-25mg / d, stability 7.5-40 mg / d.

4 status of epilepsy: preferred stability of 10-20mg / time intravenous injection.

2. The dose of the drug starts from the low limit of the usual dose, and gradually increases to the ideal control of the seizure without serious side effects.

3. The number of doses should be determined according to the characteristics of the drug and the characteristics of the attack.

4. Generally, it is not free to change or interrupt. After seizures are completely controlled for 2-3 years, and the EEG is normal, the drug can be gradually reduced.

5. Regular drug concentration monitoring should be carried out to adjust the drug dosage in a timely manner.

Second, for the definition of the cause of epilepsy, in addition to effective control of the attack must actively treat the primary disease.

Third, refractory epilepsy, which is ineffective for medical treatment, is feasible stereotactic surgery to destroy the relevant areas of brain and seizures, anterior corpus callosum or chronic cerebellar stimulation.

Fourth, the treatment of generalized tonic-clonic seizures

1. Active and effective control of convulsions:

1 stability, adult 10-20mg, children 0.25-1mg/kg, slow intravenous injection to convulsion stop. Subsequently, 20-40 mg was added to the glucose solution for intravenous infusion at a rate of 10-20 mg per hour for 10-20 hours, and the total daily amount did not exceed 120 mg.

2 0.5 mg of sodium pentobarbital in adults was dissolved in 10 ml of water for injection and slowly intravenously injected at a rate of 50-100 mg/min until the seizure stopped. Pay attention to changes in respiratory heartbeat during injection. Nasal feeding or oral antiepileptic drugs should be continued after seizure control.

2. Treatment of complications: keep the airway open, diuretic dehydration to reduce brain edema, correct acidosis and so on.

prevention:

Precautions:

l, patients with epilepsy can not suddenly reduce or stop taking anti-disease drugs, so as not to cause epilepsy state.

2. Overcome inferiority and fear, and avoid fatigue and tension.

3, strengthen physical exercise, regular living, avoid alcohol and other stimulating food.

4. It is strictly forbidden to drive, swim, and go out alone at night. If there is a warning sign, you should immediately fall down and avoid falling.