Convulsive disease. Types of seizures. Causes and treatment.

Partial epilepsy is a long-term chronic psychoneurological form of epilepsy in which high electrical activity and damage to nerve cells in one of the areas of the cerebral hemisphere occurs. This disease was first described in 1863 by the English neurologist Jackson, and is therefore sometimes called Jacksonian epilepsy.

Clinical work became the beginning of research in the world neuropathology of cortical epilepsies. At the same time, the study of the localization of the lesion made it possible to further study in more detail the functions of various parts of the cerebral cortex.

Partial epilepsy: what is it?

The most common type of this epilepsy is a convulsive reaction of the body to pathological nerve impulses from a localized focus of the brain. Partial epilepsies are caused by structural changes in part of the cerebral cortex. They are recorded in 80% of epileptic seizures in adults and 60% in children.

In accordance with the localization of the pathology, their manifestations are various types of motor, sensory, autonomic and mental disorders.

During a simple seizure, the epileptic remains conscious, but is unable to control the movements of certain parts of the body or experiences various unusual sensations. During complex paroxysms, a complete or partial loss of consciousness occurs, the patient becomes non-communicative and does not understand the phenomena occurring in his body.

During epileptic seizures, uncontrolled movements are observed, and purposeful actions that have been started often continue. Simple and complex partial changes can result in generalized seizures.

Epileptic changes are short-lived, on average their duration varies from thirty seconds to three minutes. Subsequently, the patient feels mental confusion and drowsiness, and after losing consciousness he cannot remember what happened. During the long chronic course of the disease, mental disorders occur, repeated seizures result in a decrease in intellectual thinking, and changes in the patient’s personal characteristics.

What are cramps - symptoms of leg cramps

The life processes of the human body are accompanied by muscle contractions.

Some of them are beyond control and contract involuntarily. Skeletal muscles, in the absence of any violations, should contract only when it is really necessary: ​​their dynamics are associated with the factor of human will. However, in some situations, involuntary muscle tension occurs. In such cases they talk about a cramp .

This spasm may be short-lived (up to 10 seconds) or may last several minutes. Due to the inability to relax the muscle, severe pain occurs.

Video: Leg cramps - causes and treatment

There are two types of seizures:

1. Clonic. It is characterized by frequent twitching, which feels like a nervous tic. They end quickly without any medical measures.
2. Tonic. Accompanied by severe pain. The muscle becomes too hard and immobile. This state can last from 3 minutes or more. Most often, tonic seizures occur in older people, although in general they can bother people of different age groups.

Often, the condition in question occurs against the background of changes in the composition of the blood , which nourishes muscle tissue. This negatively affects the quality of nerve impulses: muscle activity is activated.

Another culprit of muscle spasms may be lactic acid , which interferes with relaxation processes. This substance can be produced in excess during active sports training.

Involuntary muscle tension can also occur due to improper neural regulation . This phenomenon is a consequence of nervous exhaustion of the body.

Types of partial seizures

Imaging of the clinical manifestation is classified according to the location of the pathology in focal seizures and secondary generalized seizures. Epilepsy attacks are structured depending on which affected area of ​​the cerebral cortex they are caused by.

The following types of manifestations of the disease are distinguished:

• Temporal - 44%.
• Frontal - 24%.
• Multifocal - 21%.
• Symptomatic occipital - 10%.
• Parietal - 1%.

If the frontal lobe of the brain is the source of pathological epileptic paroxysm, then attacks can be divided into the following types:

• motor, characterized by clonic convulsions of the arms and legs, somatosensory aura, the development of an attack and its transition to secondary generalization is possible;
• frontopolar (anterior), accompanied by an altered sense of time, dips and influxes of thoughts;
• cingulate, accompanied by affective, hypermotor attacks, ipsilateral blinking, facial hyperemia;
• dorsolateral, characterized by signs of eye adversion, speech arrest, bilateral proximal tonic seizures, secondary generalization;
• orbitofrontal, accompanied by vegetative-visceral attacks (cardiovascular, epigastric, respiratory), psychomotor in the form of automatism of gestures, pharyngeal-oral automatisms, hypersalivation;
• opercular, represented by oroalimentary automatisms in the form of coughing, smacking, swallowing, chewing, sucking movements, twitching of the eye muscles, speech disorders;
• supplementary motor areas, manifested by simple partial seizures, archaic movements, motor, speech or sensory, mainly occurring at night;
• rapidly progressing Kozhevnikov syndrome, difficult to cure.

Right-sided and left-sided temporal lobe epilepsy differ in characteristics during, between, and after seizures.

Temporal lobe epilepsy comes in two forms:

1. Amygdalo-hippocampal (paliocortical, medio-basal), manifested by sensory, motor, vegetative-visceral effects, mental dysfunction, automatism, loss of consciousness and a state of amnesia during complex attacks.
2. Lateral (neocortical), characterized by dizziness, speech impairment, and the appearance of auditory or visual hallucinations.

Parietal epilepsy is represented by:

1. posterior parietal seizures, characterized by immobility, visual defects and impaired awareness;
2. anterior parietal attacks, characterized by sensory phenomena;
3. lower parietal attacks, manifested by disorientation, discomfort in the abdomen, dizziness;
4. paracentral seizures, characteristic pathological sensations in the genital area, rotational movements and postural changes.

Depending on the causes of the disease, pathological types of epilepsy differ:

1. Idiopathic - congenital, arising due to genetic predisposition and neurological or mental pathologies, congenital abnormalities of the brain.
2. Symptomatic - secondary, complicated by a primary brain disease.
3. Cryptogenic - paroxysms of unknown etiology.

Reasons for the development of the disease

Pathological processes occurring in the brain provoke the appearance of epileptic seizures. Several neurons generate pathological impulses of low amplitude and high frequency.

There is a disruption in the membrane permeability of brain cells, which desynchronizes the work of cells near negative neurons.

The pathological rhythm of a group of neurons creates a focal epileptic activity in the damaged part of the human brain. As a result of some exogenous factors, neural impulses spread and cover neighboring tissues, manifesting themselves in an epileptic seizure. The causes of epileptic paroxysms can be perinatal and postnatal factors.

Perinatal causes are called:

• intrauterine infection;
• hypoxia;
• ectomesodermal and cortical dysplasia;
• birth trauma.

Partial epilepsy develops with the following postnatal organic lesions of the cerebral hemispheres:

• cysts;
• acute circulatory disorders;
• bruises;
• tumors.

Among the reasons for the formation of pathological foci of the medulla are:

• infectious inflammatory diseases: abscess, encephalitis, meningitis;
• viral, bacterial, protozoal infection;
• post-stroke condition;
• dysgenesis, atriovenous malformation;
• rheumatic diseases of the nervous system;
• presence of multiple sclerosis;
• foci of gliosis;
• alcohol, amphetamine, cocaine, ephedrine and other drug addictions;
• long-term effects of antipsychotics, antidepressants, bronchodilators;
• presence of antiphospholipid syndromes;
• neurofibromatosis, tuberculous sclerosis;
• poisoning with poisons (lead, mercury, gasoline, barbiturates);
• infections: typhoid and malaria;
• endogenous intoxication due to liver and kidney pathologies;
• hyperglycemia.

Emergency care for seizures

It can be quite a scary experience the first time. However, don't panic. If you want to help a victim, there are two things you can do to save their life:

• First, make sure that the person does not fall on objects that could cause pain.
• The next thing to do is to make sure that the airway is not blocked due to secretions or vomiting. To do this, it is best to turn the person on his side.

Seizures or fits in young children are called febrile seizures.

Usually occurs after the child has experienced a high fever. This does not cause brain damage and does not lead to an epileptic attack when the baby grows up. Usually ends when the child reaches the age of 6 years. It is important not to panic when your baby experiences febrile seizures. Seek medical attention immediately.

EEG (Encephalogram)

Must be done to confirm epilepsy. Long-term treatment is required to control epileptic seizures. Seizures can usually be controlled with medication, but they cannot be cured. Surgery is used for severe cases when pills do not work.

Symptoms

The occurrence of epileptic seizures can occur at any age, but most often it occurs in the preschool period and in primary school age. Focal seizures can last several minutes, sometimes ending in a generalized seizure. Patients experience convulsions, spasms, numbness of the limbs, speech impairment and hallucinations. Symptoms depend on the location of the pathology.

Symptoms of frontal lobe epilepsy

Clinical contractions of the facial muscles and limbs cover one half of the body. The head and eyes turn in one direction. The phenomena of shouting, chewing, smacking, drooling, and rolling the eyes often begin.

Arms and legs tense and stretch along the body. Phenomena of auditory and visual hallucinations are often observed. Paroxysms are distinguished by motor automatisms or autonomic disorders.

Symptoms of temporal lobe epilepsy

Temporal lobe epilepsy is characterized by an abundance of olfactory, visual, auditory and gustatory hallucinations. For example, objects lose their usual size, the patient feels a strong smell of paint, gasoline or burnt rubber, and an auditory hallucination appears in the form of noise and hum, and other unusual sounds.

Many experience a feeling of déjà vu, increased heart rate, abdominal pain, nausea, fever and severe sweating. The patient may experience euphoria, dysphoria, or other obsessive states.

Symptoms of parietal epilepsies

The symptoms of this type of seizure vary depending on the location of the epileptic focus. With lower parietal paroxysms, disorientation in space and dizziness appear. Anterior parietal seizures are accompanied by a feeling of numbness and paralysis of the limbs. A posterior parietal seizure is characterized by impaired awareness, freezing, and a fixed gaze.

Symptoms of occipital epilepsies

Occipital seizures are characterized by visual hallucinations such as colored spots, circles and lines, blinking, and eye socket twitching.

Symptoms of Kozhevnikov syndrome

This syndrome affects half of the patient’s body with convulsions; attacks often end in paralysis of the arms and legs. Patients become aggressive, often fall into depression, and their intellectual level decreases. The syndrome is complicated by phobias and destruction of personal qualities.

Partial seizure: signs, symptoms and treatment

With epilepsy, metabolic processes in the patient's brain are disrupted, and this leads to epileptic seizures. Seizures are divided into generalized and partial. They differ in clinical features and mechanism of development.

An attack occurs when pathological excitation in the brain dominates the processes of inhibition. A generalized epileptic seizure differs from a partial seizure by the presence of an abnormal process in both hemispheres.

In partial seizures, a focus of excitation is formed in only one area of ​​the brain, spreading to neighboring tissues. Treatment of the disease depends on the type and nature of the attack.

What is epilepsy?

Partial is a type of epilepsy in which a specific part of the brain is damaged, neurons send pathological signals with impaired intensity and spread to all abnormal cells. The result is an attack. The classification of partial epilepsy according to the location of the affected lesion is as follows:

• temporal lobe – is one of the most common types of epilepsy, it is detected in almost half of all patients who consult a doctor;
• frontal – observed in a third of patients;
• occipital – accounts for only 10% of cases;
• parietal - is rare and is detected in less than 1% of patients.

The peculiarity of partial epilepsy is that the disease is formed in a separate part of the brain, all other parts of it remain intact.

Most often, partial epilepsy occurs in children due to intrauterine developmental anomalies of the fetus or those born after prolonged oxygen starvation as a result of difficult childbirth.

In adults, epilepsy can occur as a secondary illness after illness or brain injury. In this case, epilepsy is called symptomatic.

Symptomatic epilepsy develops as a result of acquired or congenital diseases. It occurs for the following reasons:

• hematomas;
• stroke;
• malignant and benign neoplasms;
• circulatory disorders in the cerebral cortex;
• staphylococcal, streptococcal and meningococcal infections;
• abscess;
• herpes virus;
• encephalitis and meningitis;
• postpartum trauma;
• congenital pathological changes;
• the body's reaction to long-term use of medications;
• traumatic brain injuries.

In addition, epilepsy can be caused by metabolic disorders in the body, various endocrine diseases, syphilis, tuberculosis, rubella measles, long-term use of alcoholic beverages and drugs. The disease can be provoked by:

• wrong lifestyle;
• pathological pregnancy;
• severe stressful situation.

Symptoms of partial epilepsy

The symptoms that occur with partial seizures depend on the area of ​​the brain affected. It is expressed as follows:

• Temporal – This lobe of the brain is responsible for emotional processes. The patient may experience anxiety, euphoria or anger. Sound perception is impaired and memory is distorted. The individual hears music or certain sounds. He is able to remember long-forgotten events.
• Frontal - controls motor processes. During a partial seizure, the patient makes stereotypical movements of the tongue or lips. His limbs twitch involuntarily, his hands and fingers move. Changes in facial expressions occur on the face, eyeballs move from side to side.
• Occipital - where visual signals are processed. During an attack, the patient sees colored spots, spots appear before the eyes, and flashing lights appear. In addition, he may not see some objects and phenomena; they simply disappear from sight. After a partial seizure, the patient suffers from severe migraine-like headaches.
• Parietal – causes sensory seizures. A person feels warmth, coldness, or tingling in some part of the body. There is often a feeling that part of the patient's body is separating or increasing in size.

Sometimes, after partial epilepsy, generalized epilepsy may immediately begin. The patient develops convulsions, paralysis occurs, and muscle tone is lost.

To make a diagnosis, the doctor carries out the following activities:

• Listens to the story of a witness who was present during the victim’s seizure. The patient himself with complex partial seizures often does not remember the attack. In simple cases, the patient can talk about how he feels during a seizure.
• A neurological examination is performed. The patient is tested for coordination of movements, performing a finger-nose test, questions are asked to test intelligence, and simple logical problems are solved.
• MRI is necessary for diagnosing epilepsy with congenital structural pathologies and various brain tumors, cystic formations, vascular diseases of the head, multiple sclerosis.
• EEG (electroencephalogram) - determines the location of the focus and the form of epilepsy. In some cases, the examination is carried out several times.

Taking into account all the data that was obtained during the study, as well as the causes and symptoms of partial epilepsy, the doctor builds a treatment strategy for the patient.

Treatment of the disease

When treating symptomatic epilepsy, an integrated approach is used. To do this:

• timely and accurate diagnosis of the disease;
• monotherapy – one effective drug is used;
• experimental way of selecting a medicine;
• the dose of the drug is increased until the symptoms of the disease disappear;
• selection of another medication if there is no effect.

Then stop treating partial epilepsy, signs and symptoms stop appearing for a long period of time. Therapy is carried out on an outpatient or inpatient basis depending on the severity of symptoms. The treatment aims to achieve the following goals:

• prevent new attacks;
• reduce the duration and frequency of seizures;
• reduce side effects from drugs;
• achieve drug withdrawal.

For treatment use:

• nootropics – affect the nerve impulse of the brain;
• anticonvulsants – shorten the duration of an attack;
• psychotropic drugs – neutralize the effects of neurological disorders.

In some cases, long-term use of medications does not produce a positive effect, then surgery is performed. It is shown when:

• tumors;
• cysts;
• abscess;
• hemorrhage;
• aneurysm.

Using surgery, the area connecting the two hemispheres is dissected, cysts and tumors are removed, and sometimes one of the hemispheres is removed. The prognosis of surgical intervention is positive, most patients get rid of the symptoms of focal epilepsy.

What are partial seizures?

Focal or partial seizures are characterized by localization in one part of the brain. The location of the lesion can be guessed by the symptoms that are present during the attack. They occur with or without loss of consciousness.

With a simple partial attack, the individual does not lose consciousness; he is characterized by various emotions and sensations. Suddenly he feels happy, sad or angry. He feels different tastes and smells, hears and sees what is not in reality.

With a complex partial seizure, the patient's consciousness changes or completely loses.

The condition is accompanied by convulsions, convulsive curvature of the lips occurs, frequent blinking begins, and he can walk in circles. In this case, the patient continues to perform the same actions that were started before the attack. Sometimes, a particularly complex attack begins with an aura.

These are sensations characteristic of a particular individual: an unpleasant odor or fear. The aura is a warning to the patient about the occurrence of an attack. Therefore, he or his family are quite capable of taking certain actions aimed at reducing the likelihood of injury.

Each time the attack manifests itself approximately the same.

Types of partial seizures

All seizures are divided into:

1. Simple. The patient does not lose consciousness during these attacks. The following paroxysms belong to this group:

• Motor – characterized by muscle cramps, various twitches, possible rotation of the body and head, lack of speech or pronunciation of sounds, chewing movements, licking lips, smacking.
• Sensory - manifested by a tingling feeling, the presence of goosebumps or numbness of some part of the body, a feeling of an unpleasant taste in the mouth, a disgusting odor, blurred vision: flashes before the eyes.
• Vegetative - a change in skin color occurs: redness or pallor, a rapid heartbeat appears, the value of blood pressure and the pupil changes.
• Mental - a feeling of fear arises, speech changes, pictures of previously heard or seen are reproduced, objects and parts of the body may seem to be of a completely different shape and size than they actually are.

2. Complex. This occurs when a simple partial seizure is accompanied by a disturbance of consciousness. The person realizes that he has had an attack, but cannot make contact with the people around him. He forgets all the events that happen to the patient. He has a feeling of unreality of the events taking place.

3. With secondary generalization. Seizures begin with simple or complex partial ones and progress to generalized seizures that last no more than three minutes. After they are over, the patient usually falls asleep.

Features of simple focal seizures

As noted earlier, with simple partial or focal epileptic seizures the patient is conscious. Epilepsy attacks last no more than five minutes. They are characterized by the following symptoms:

• Rhythmic convulsive contractions of muscles with varying strength of manifestation. Spread to the upper and lower extremities, as well as the face.
• Dysfunction of the respiratory system.
• Blueness of lips.
• Profuse salivation.

In addition, attacks are characterized by vegetative symptoms:

• rapid heartbeat;
• heavy sweating;
• feeling of a lump in the throat;
• depression, fear or drowsiness.

Simple attacks are accompanied by sensory reflexes: auditory, taste and visual hallucinations occur, and sudden numbness of body parts occurs.

Features of complex symptomatic attacks

Complex attacks are much more severe than simple attacks. The main syndrome of partial epileptic seizures of a complex type is a disturbance of the patient’s consciousness and the following characteristic signs:

• the patient becomes lethargic, inactive, and mentally depressed;
• the gaze is directed to one point;
• no external stimuli are perceived;
• the same actions are repeated: stroking or marking time;
• there are no memories of what happened. After an attack, the patient may continue to do what he was doing before and not notice the attack.

A complex partial seizure can develop into a generalized one, in which a focus of excitation is formed in both hemispheres of the brain.

Classification of attacks

There are more than thirty types of epileptic seizures, which vary in nature. There are two main types of seizures:

1. Partial (focal or patchy) occur in a limited part of the brain.
2. Generalized, or general, covers both hemispheres.

Partial seizures include:

• Simple - consciousness never turns off, accompanied by unpleasant sensations in one part of the body.
• Complex – expressed by motor manifestations, they are accompanied by a change in consciousness.

The following subspecies belong to the generalized ones:

• Tonic-clonic - manifested by loss of consciousness, tonic convulsions, twitching of the torso and limbs, often biting the tongue, urinary incontinence, sometimes holding the breath, but suffocation does not occur.
• Absence seizures - consciousness instantly turns off for up to 30 seconds, movement suddenly stops, there is no reaction to external stimuli, eyes may roll back, eyelids and facial muscles twitch, then there are no convulsions. The attack occurs up to a hundred times a day. More common in teenagers and children.
• Myoclonic - seizures last several seconds and are manifested by jerky muscle twitches.
• Atonic or akinetic - a sharp loss of tone of the entire body or a separate part of it. In the first case, the person falls, in the second, the head or lower jaw hangs.

All types of partial and generalized seizures can occur unexpectedly and at any time, so patients always remember this.

Prevention

There are no specific methods to prevent the development of epilepsy. The disease often occurs spontaneously and is difficult to diagnose during the latent stage of its course. The following recommendations will help reduce the risk of developing the disease:

• strict adherence to the daily routine, adequate sleep and rest;
• timely treatment of brain diseases and infectious diseases;
• thorough treatment of traumatic brain injuries;
• refusal to use alcohol and drugs;
• consultation with a geneticist when planning pregnancy;
• a calm lifestyle: if possible, avoid stressful situations and depression.

The prognosis of the disease is favorable, up to 80% of all patients live a full life and forget about partial convulsive seizures if they receive appropriate therapy in a timely manner and follow all the doctor’s recommendations. Expectant mothers should pay special attention to their health; recently, epilepsy often occurs in childhood due to intrauterine anomalies.

Conclusion

Patients suffering from epileptic seizures strive to get good medical care and get rid of seizures in the future.

Medicine is able to provide all patients with the necessary drug treatment, with the help of which it is possible to achieve positive dynamics.

During the rehabilitation period, it is necessary to follow all the doctor’s recommendations, maintain a proper diet and a healthy lifestyle.

Source: https://FB.ru/article/395245/partsialnyiy-pripadok-priznaki-simptomyi-i-lechenie

Simple seizures

The code for partial seizures of this type is G40.1 according to ICD-10. Previously, the complex of symptoms preceding a seizure of secondary generalization was designated by neurologists as “aura.” Based on short-term convulsive manifestations, the localization of the source of excitation can be determined. Aura happens:

• Motor or rotatory, when the affected area of ​​brain cells is in the anterior central gyrus. Externally, this type is manifested by the patient running or rotating around its axis.
• Auditory, accompanied by noise, ringing in the ears. It occurs against the background of irritation of Heschl’s temporal gyrus, the primary hearing zone.
• Visual is the result of excitation of the occipital lobe, namely the primary visual center. Symptoms are described as "sparks, flashes in the eyes."
• Olfactory in the form of a sensation of unpleasant odor, epileptic activity is noted in the hippocampus.

The listed types of aura represent a separate partial convulsive attack or precede secondary ones with subsequent generalization. They last no more than a few seconds while maintaining consciousness.

That is, the patient remembers this condition, but due to its short duration, he cannot prevent the consequences (injuries during seizures, falling). Motor partial seizures are also called Jacksonian seizures, after the name of the doctor who first described them.

Symptoms develop in the following order: twitching of the corner of the mouth, spasms of facial muscles, convulsions of the arms, torso and lower extremities. Jackson also established the relationship of these PPs with the anterior middle gyrus.

Types of visceral attacks

For diagnosis and timely treatment, it is important for the doctor to be able to identify partial vegetovisceral convulsive manifestations.

These paroxysms are often mistakenly attributed to symptoms of vegetative-vascular or neurocirculatory dystonia.

However, despite their isolation, they can transform into complex or secondary generalized seizures. There are two types of vegetative visceral attacks.

Vegetative with characteristic symptoms: redness of the face, sweating, increased blood pressure, pain in the heart, a rise in temperature to subfebrile levels, cardiac arrhythmias, thirst, chills.

The second form - visceral - is characterized by either unpleasant sensations in the epigastrium or sexual paroxysms. These include erection, orgasm, and irresistible sexual desire.

The types of partial seizures with corresponding symptoms are discussed in more detail below.

Aphasic

They first appear in childhood, starting at the age of 3, and are characterized by the gradual development of aphasia - the loss of already acquired speech skills. At first, this sensorimotor disorder looks like a lack of reaction on the part of the child when addressed to him. Then, over the course of several months, the pathological signs increase: the answers become monosyllabic, then speech disappears completely.

At this stage, aphasia is joined by a disorder of auditory perception - agnosia, which contributes to the formulation of diagnoses such as autism or hearing loss. After a few weeks, epileptic seizures themselves appear, most often generalized with a tonic-clonic type of seizures (alternating prolonged spasms and twitchings).

In parallel, in most cases there is an increase in aggressiveness, irritability, and hyperactivity.

Illusory

Despite the name, delusional seizures are related to perceptual disturbances rather than illusions. If psychosensory synthesis is disrupted, the following types of this disorder can be observed:

• Metamorphopsia is a distortion of the perception of the environment. The patient “sees” how objects change their shape, color and size, and move in space. Objects can come closer or further away, spin around, or disappear. This vestibular disorder is called an “optical storm” and allows one to identify a lesion at the junction of several lobes of the brain - parietal, occipital and temporal.
• Somatopsychic depersonalization is also manifested by distorted perception, but in this case the object is one’s own body. It seems to the patient that it or individual parts are enlarged, curved, the limbs fill the entire surrounding space or are separated from the body.
• Autopsychic depersonalization is the result of right-sided irritation of the temporoparietal lobe. It is expressed in the form of a feeling of unreality of one’s own personality, fenced off from the surrounding world. The reflection in the mirror is perceived as alien; in especially severe cases, the syndrome of autometamorphosis or transformation into another person is diagnosed.
• Derealization is characterized by the seeming unreality of the situation, objects are perceived as unreal, their colors and shapes can be blurred, depersonalized, and lacking volume. In this case, external information hardly reaches the patient’s consciousness and is poorly perceived. The cause of this condition is damage to the posterior part of the temporal gyrus.

All of the listed paroxysms are united under the term “special states of consciousness,” that is, its change.

Hallucinatory

Visual hallucinations often accompany a partial seizure. They are divided into elementary and complex.

In the first case, patients complain of geometric shapes, lightning or flashes of light appearing before their eyes.

The second type is distinguished by a complex composition with figures of people, plants and animals, and the images are detailed and moving. According to descriptions, such illusions are similar to a film, often repeating the events of the past.

Auditory hallucinations can also be simple, in the form of noise effects - ringing, crackling, thunder. Complex ones manifest themselves, as in schizophrenia, in voices of an imperative or threatening nature to the patient.

With olfactory attacks, the patient is haunted by an unpleasant odor. It may be familiar (feces, gasoline, paint) or undifferentiated.

Taste illusions are also characterized by those sensations that the patient does not like - the taste of unloved foods, bitterness, metal.

Complex

The main symptoms of complex partial seizures are short-term motor activity and twilight stupefaction. The attack lasts several minutes, during which the following types of automatisms may occur:

• Gestures - moving furniture, fiddling with objects, unbuttoning or buttoning clothes, rubbing hands.
• Oral – chewing, tongue protruding, swallowing, licking, other movements.
• Speech - pronouncing interconnected words or incoherent, abrupt speech.
• Outpatient – ​​meaningless movements in the form of running, pushing others around.
• Sexual – indecent acts, masturbation, exhibitionism.
• Somnambulism or sleepwalking is the performance of automatic actions in a dream.

All actions performed by the patient are not conscious of them and are automatic in nature (twilight consciousness). At the end of the attack, amnesia is always observed.

Diagnostics

If signs of impaired brain activity or epileptic seizures appear, you should urgently seek the advice of a neurologist or epileptologist. The doctor will conduct an examination, collect medical history data and prescribe a full examination to determine the type and characteristics of this epilepsy. Information received by doctors from the patient’s relatives is of great importance for the correct diagnosis.

The description should include:

• features of the state before the attack (excitement, complaints of feeling unwell);
• duration of the attack (preferably as accurate as possible);
• characteristics of the onset of the attack (gradual or sudden);
• description of the passage of the attack (reaction of speech, eyes, limbs, convulsions, loss of consciousness);
• examples of assistance provided;
• age of the patient at the time of the first seizure.

Diagnosis is based on the etiology of the disease, examination of the clinical picture of attacks, indications of neuroradiological analysis, as well as the mental and neurological state of the patient. Pathologies of neuronal activity are detected by instrumental and laboratory examinations.

Instrumental examination methods are:

• electroencephalography;
• CT scan;
• Magnetic resonance imaging;
• X-ray examination of the skull;
• ECG study (to exclude the cardiogenic origin of seizures).

Laboratory examination methods include:

• biochemical analysis of blood and urine;
• cerebrospinal fluid analysis;
• chromosomal karyotype study;
• DNA analysis to detect the fragile chromosome.

Treatment

Treatment of epilepsy achieves complete or partial cessation of epileptic seizures and minimization of side complications. Drug therapy is the main treatment method for epileptics. Individually selected drugs take into account the type of epilepsy, where the pathological focus is located in the brain, and the characteristics of the attacks.

The correct selection of medications affects the effectiveness of therapeutic effects and reducing the frequency of attacks, maintaining a normal lifestyle for the patient and the onset of stable remission. Conservative therapy controls up to 70% of partial changes.

The first choice antiepileptic drug is carbamazepine .

Additional drugs: Clonazepam, Valproate, Clobazam and benzodiazepines .

Anticonvulsant drugs are widely used: Finlepsin, Tegretol, Zeptol, Actineural, Diphenin, Tiagabine, Ethosuximide, Lamotrigine .

Long-acting medications are preferred because they can be taken once a day. Medications are discontinued by gradually reducing the dosage in the absence of attacks for the last 5 years.

If the use of anticonvulsants does not show positive dynamics, neurosurgery may help the patient. Surgical treatment methods include removal of a tumor or hematoma, lobectomy (removal of pathological areas of the brain), insertion of a subcutaneous vagus nerve stimulator, callesotomy (consisting in dissection of the cerebral hemispheres). Recent advances in surgical techniques have proven that epilepsy is not incurable.

First aid

If partial convulsive seizures occur very often, then you must know how to provide first aid to a person. If an attack occurs, you must:

You should not try to control the convulsions, and it is strictly forbidden to perform artificial respiration or chest compressions. After the end of the attack, you need to give the person the opportunity to come to his senses and urgently call an ambulance and hospitalize the patient in a hospital. It is imperative to provide timely assistance to the victim, since such seizures can lead to the death of the patient.

Prevention and prognosis

Preventive measures for epilepsy consist of systematically keeping the patient at the dispensary and conducting clinical examinations every 6 months.

Such an examination includes:

1. electroencephalograms;
2. magnetic resonance imaging of the brain;
3. appointments with neurologists and psychiatrists;
4. laboratory diagnostics (blood and urine tests).

Prevention of seizures of partial epilepsy is directly related to the healthy functioning of the epileptic.

An urgent need is to stop smoking and drinking alcohol. It is necessary to exclude coffee and strong tea from the diet. Patients must adhere to normal sleep and wakefulness and diet. Epileptics will have to avoid negative factors (extreme sports, climbing to heights, etc.).

Recovery prognosis differs for different types of disease and individual characteristics of the patient. Most patients achieve long-term remission and a decrease in the number of seizures. Much depends on timely treatment and compliance with doctors’ recommendations. About a third of cases of epilepsy are not amenable to medication and are cured by neurosurgery.