Epilepsy in Adults

Seizure Disorder—Adult (Epilepsy—Adult)

Description of epilepsy in adults

Seizures occur in the presence of certain types of abnormal electrical activity in the brain. During the seizure the patient may:

• Lose consciousness;
• Watch space (as through items);
• Having seizures (abnormal muscle twitching);
• Have violation feelings or emotions.

If seizures occur quite frequently, and they are not associated with disease or other triggers, it is believed that patients with epilepsy. Seizures can be classified on the part of the brain, to which they affect, and types of symptoms caused by. One of the common ways – seizure classification into two groups:

• Primary generalized epilepsy – are not the center of origin konkrektnogo;
• Partial (Focal) epilepsy – attack begins in certain areas of the brain. Usually occurs when damaged nerve cells in a specific area of ​​one of the hemispheres of the brain.

Causes of epilepsy in adults

Seizures causing brain dysfunction. But for many people the exact cause of seizures is often impossible to establish. Some known causes of seizures include:

• Newborns:
  • Congenital malformations of the brain (at birth);
  • Birth injuries, that limit the supply of oxygen to the brain;
  • Metabolic disorders;
  • The consumption of drugs the mother;
  • Infection;
• Babies:
  • Febrile seizures – caused by the presence of a child's fever;
  • Brain tumors in children;
  • Infection (encephalitis, brain abscess);
• Children and Adults:
  • Congenital diseases;
  • Genetic causes;
  • Head injury – common cause sulorog (eg, concussion, skull fracture, bleeding within the skull, anoxia due to the partial drowning);
  • Infection – eg, encephalitis, brain abscess;
  • Stroke;
  • Encephaloma;
• Elderly:
  • Stroke;
  • Trauma;
  • Encephaloma;
  • Degenerative diseases (eg, Alzheimer's disease).

Risk factors for epilepsy in adults

Factors , that may increase the likelihood of developing convulsions or epilepsy include:

• Previous brain injury – epilepsy usually develops within one year of the injury;
• Previous brain infection;
• Abnormalities of the blood vessels of the brain;
• Encephaloma;
• History of stroke;
• History febrilnyh convulsing;
• The use of certain drugs or drug use;
• Stopping drugs, drugs or alcohol;
• Drug Overdose;
• Exposure to toxins (such as arsenic, lead or carbon monoxide);
• A family history of epilepsy;
• Alzheimer's Disease;
• Toxemia during pregnancy;
• Chemical violations (reduction or excess sodium or glucose in the blood, low blood calcium);
• Hepatic or renal failure;
• High blood pressure, difficult to treat;
• Chronic diseases (eg, lupus, polyarteritis nodosa, porphyria, drepanocytemia, Whipple's disease);
• Syphilis;
• Cysticercosis (infection, caused by swine tapeworm).

If you already have epilepsy, may increase the likelihood of attack by the following factors:

• Lack of sleep;
• Alcohol;
• Hormonal changes (eg, occurring during the menstrual cycle);
• Stress;
• Flashing lights, especially strobe lights;
• The use of some drugs;
• Skip receiving antiepileptic drugs.

Symptoms of epilepsy in adults

There are many types of seizures with different symptoms, such as:

• Aura (a symptom of epilepsy) – It occurs in early attack, It may include a feeling of strange smells or sounds, visual symptoms, or abnormal sensations in the stomach;
• Changing the size of the pupils;
• Loss of consciousness;
• Repeated twitching of one limb;
• Uncontrolled seizures with muscle twitching all over my body;
• Rubbing his hands;
• Smacking lips;
• Shuffling clothes;
• Unusual perception of smell, sound or taste;
• Loss of control of the bladder or bowel;
• Postiktalnye symptoms – drowsiness , changes in mental status and / or confusion; It may take a few minutes, hours or days;

Symptoms of primary generalized epilepsy include:

• Loss of consciousness, muscle stiffness, uncontrollable twitching of muscles throughout the body;
• Absences – short-term shutdown of consciousness, gaze directed forward, a person stops moving (as it hardens).

Symptoms of partial epilepsy include:

• Complex partial seizures:
  • Can lose contact with reality, absent purposeful activity, there is a series of automatic gestures (eg, smacking lips, hand-wringing or shuffling clothes);
  • Seizures may occur in the form of brief confusion or loss of attentiveness;
  • The patient may feel unusual sounds and smells, there are visual hallucinations;
• Simple partial seizures:
  • It does not entail the loss of contact with reality, or loss of consciousness;
  • Unchecked can move some parts of the body (eg, the patient can shake a hand or foot);
  • It may include unusual odor perception, sound, taste, or unusual emotions.

Diagnosis of epilepsy in adults

The doctor will ask about your symptoms and medical history, and perform a physical examination. Maybe, It requires an additional examination by a neurologist – doctor, who specializes in diseases of the nervous system and brain.

Tests may include the following:

• Blood tests – to find abnormal levels of various substances in the blood;
• Electroencephalogram (EEG) – test, that uses special sensors to evaluate the electrical activity of the brain;
• Magnetic resonance imaging ( MRT) – test, which uses magnetic waves, to make pictures of structures inside the brain;
• Computed tomography of the head (CT) – kind of X-ray inspection, wherein the computer is used , to make pictures of structures inside the head (used in some cases);
• Poyasnichnaya puncture – Selection and analysis of cerebrospinal fluid from the lower back; It can be assigned to search for infection or bleeding;
• Magnetoencephalography (MEG) – measurement of the magnetic field of the brain;
• Positron Emission Tomography (PET ) – test, which shows the activity of certain brain regions;
• Single photon emission computed tomography (SPECT) – test, which allows to study brain blood flow.

The treatment of epilepsy in adults

The goal of epilepsy treatment is:

• Treatment of the underlying cause of seizures (if known);
• Preventing attacks – It can be accomplished using drugs, operations, Special therapies;
• Avoiding factors, that stimulate the occurrence of a seizure.

Protivoэpilepticheskie drugs

There are many medicines, which can be used for the treatment of epilepsy. Some of them:

• Phenytoin;
• Diazepam;
• Lorazepam;
• Carbamazepine;
• Valproic Acid;
• Levetiracetam;
• Gabapentin;
• Phenobarbital;
• Ethosuximide;
• Clonazepam;
• Prymydon;
• Okskarʙazepin;
• Lamotrigine;
• Topiramate;
• Felʙamat;
• Tiagaʙin;
• Zonisamid;
• Pregabalin;
• Lacosamide;
• ACTH (ACTH);
• Vigaʙatrin (approved for use in infants).

These preparations can be administered alone or in combination. Each of these drugs can be side effects. Before taking this medication, consult your doctor.

Operation in the treatment of epilepsy in adults

If the drug does not bring relief, or side effects from taking it are too severe, perhaps, need surgery. Surgery involves the removal of a brain area, which has been identified as a cause of seizures. Surgery is indicated for patients with precisely localized areas of the brain, is the cause of the attack.

Vagus nerve stimulation (RLS) epilepsy in adults

It is implanted in the chest special device, providing electrical stimulation of the vagus nerve. It is not clear the mechanism of its effects, but the procedure is somehow it prevents or reduces the incidence of seizures. The patient still needs to take medication, generally smaller doses than previously.

Ketogenic diet (The ketogenic diet)

This is a very strict diet high in fat and low in carbohydrates and proteins. This diet causes the chemical balance of the body to a state, called ketosis, which reduces the frequency of epileptic seizures. A ketogenic diet is effective for children and less effective in adults.

Changes in physical activity in epilepsy

If you have epilepsy, you can take the following steps, to try to reduce the likelihood of attack:

• Sleep well;
• Avoid excessive alcohol consumption. Alcohol may increase the likelihood of attack;
• Avoid hyperventilation;
• Avoid places with a blinking light or the presence of strobes;
• Wear a medical bracelet. Thus, if you start an attack, People around you will understand, what is happening and be able to take appropriate steps;
• Keep a log of attacks, which record sensations, that occur during a seizure. This will help to determine the possible causes and treatment of epilepsy;
• Take your medicines as directed by your doctor.

Prevention of epilepsy in adults

While there is no way to prevent any type of epilepsy. You can take steps to prevent brain injuries, which may lead to seizures:

• Always wear a helmet when riding a bicycle, roller skates, skateboards or scooters;
• Wear protective headgear, When engaged in contact sports;
• Dive into the water at safe depths;
• In the car, always wear a seat belt;
• Avoid the use of drugs;
• If your child has a high temperature, immediately seek medical advice;
• Get regular prenatal care. If you have high blood pressure during pregnancy, start early treatment;
• If you have a chronic illness, take care of their proper treatment.

If you suffer from very severe epilepsy, Some may be necessary steps to prevent serious injury:

• Depending on your state, should avoid driving;
• You can not swim or bathe alone;
• Do not use on a ladder or projections;
• Avoid active sports.

If you were diagnosed with epilepsy, Follow your doctor's instructions.