People with epilepsy live among us. Do you know how to properly help a person who suddenly had cramps? How do you feel about people who suffer from this disease?
“Letidor” attended the event “Pediatric Epilepsy: a Disease to be Treated” and prepared a selection of the most useful information about this ailment.
Experts:
Elena Dmitrievna Belousova Doctor of Medical Sciences, Professor, Head of the Department of Psychoneurology and Epileptology of the Scientific Research Clinical Institute of Pediatrics named after Academician Yu. E. Veltishchev FSBEI HE RNIMU them. N. I. Pirogova of the Ministry of Health of Russia, Honored Doctor of the Russian Federation.
Valentina Ivanovna Guzeva Doctor of Medical Sciences, Professor, Corresponding Member of the Russian Academy of Natural Sciences (RAEN), the main non-staff child specialist-neurologist of the Ministry of Health of the Russian Federation, head of the Department of Nervous Diseases SBEI HPE "St. Petersburg State Pediatric Medical University" of the Ministry of Health of Russia.
They don’t like to talk about the problems of people suffering from epilepsy: they seem to meet infrequently and let these “fits” be treated where necessary. Those who think so do not know that according to statistics in our country, almost 26 thousand children suffer from this disease and this is one of the most common diseases of the nervous system in children. And any of us can replenish the ranks of “fits”, since most often epilepsy is associated with some kind of brain damage, for example, after an injury.
Therefore, let us be attentive to each other and will be ready to help a person in difficult times. And so that the help is correct, we will announce the most important facts about epilepsy.
Important day
International Epilepsy Day is celebrated every year on the second Monday of February in more than 120 countries. This day is a joint initiative of the International Bureau for Epilepsy and the International League against Epilepsy. It is designed to increase public awareness of this disease.
In addition, there is also the so-called "Purple Day", which was invented by the Canadian girl Cessidy Megan. Having epilepsy, she faced many problems, including the rejection of her peers, and therefore called on the whole world to pay attention to such patients and prove that they are no different from the rest and have the right to a normal life.
What is epilepsy
In fact, this is not one disease, but a whole large family of a variety of diseases that occur in different ways, starting at different ages and having a different prognosis. From situations that do not require treatment, to very serious conditions that cause disability of the patient. These diseases are combined into one group, because they are treated according to a general algorithm.
How is epilepsy transmitted?
There is a block of genetic epilepsy, but they are rare. Epilepsies associated with any kind of brain damage, for example, after an injury, after a lack of oxygen in newborns, and so on, predominate.
A woman suffering from epilepsy in 97% of cases gives birth to a perfectly healthy child.
There is a small block of genetic epilepsy, and now it is the most popular topic in epileptology, especially in relation to children. There are genetic epilepsies that are difficult to treat. There are few of them - 0.5% of all cases, if not less, but this is a separate situation.
Today, 65-70% of patients with epilepsy manage to achieve a cessation of seizures or a significant reduction in their frequency. But in 30% of cases of epilepsy, they do not respond well to therapy.
What are epileptic seizures
Basically, we know epilepsy by what we see in cinema, on television, on the street: how a person loses consciousness, falls and his limbs begin to twitch. A few minutes later he comes to himself, stunned, listless, poorly understands where he is. This is a special type of epileptic seizure, it is called generalized tonic-clonic seizure.
For example, he may lose consciousness, but not change his posture. In children, there is a type of seizure such as abscess. That is, the patient simply stops responding to others within 10-20 seconds. However, he does not fall. And there can be hundreds of such attacks per day.
Another option is, for example, in a dream we often flinch when we fall asleep. But there are also such epileptic seizures in the form of trembling.
It happens that a person twitches one arm or one leg or arm and leg on one side. At the same time, he may not lose consciousness.
How to recognize epilepsy
Only the electroencephalogram can indicate the epileptic "nature" of the attack. If pathological discharges are visible at the time of the attack or just twitching on the encephalogram, then it means epilepsy.
But the anamnesis is also important: when it happened, what time, what reason, how it happened, what happened after the attack, the algorithm of the attack itself. Sometimes, during the course of an attack, it can be said that the epileptic focus is located in the left frontal lobe. For the doctor, it is very important that without any MRI studies to track the attack.
By the behavior of the child during and after the attack, it will be easier for the doctor to recognize the type of epilepsy.
Who treats epilepsy
In Russia, neurologists are most often involved in the diagnosis and treatment of epilepsy. To a lesser extent, psychiatrists. Over the past 20 years, a whole system has been created in the country to help children with epilepsy. There are a lot of specialized classrooms, departments where people who study for many years in this area work.
What lifestyle do children with epilepsy lead
There is a general law in epileptology: any patient with epilepsy should lead as close to a normal lifestyle as possible, without unnecessary restrictions.
There are outstanding athletes with epilepsy who take drugs and participate in competitions. It all depends on the specific situation. If the patient does not have seizures while watching television or working on a computer, then you do not need to prohibit them. The same applies to the limitation of physical activity: they do not provoke an epileptic seizure in a child - let him do physical education in school.
There are many limitations to the pool. But if the child has no attacks for a long time, he takes the drug and the risk of relapse is unlikely - let him practice in the pool. That is, a child suffering from epilepsy should have reasonable limits.
What others should know
If the attack was episodic, the doctor prescribed a drug, after which there was no relapse, then it is hardly necessary to tell the friends and teachers of the child about this. However, if the attacks are regularly repeated, then parents are obliged to warn the teacher in kindergarten, teachers at school and friends of the child about this.
How to predict an attack of epilepsy
Unfortunately, the main nuisance during epilepsy is the unpredictability of an attack. That is, there are no clear provocative factors. Now in epileptology there is even a separate direction. Moreover, there are specially trained dogs that can call for help if a person has an attack.
Sometimes an attack begins with unusual sensations. That is, a person has not lost consciousness yet, but he has a hunch about an attack. This is called an aura. Then the patient can, firstly, tell others that “I will have an attack”, can go to bed, to lie down, so as not to hit, and so on. All this also needs to be explained to parents and sometimes to the patient himself, that if he feels how the perception of the environment is changing, some sounds or olfactory hallucinations appear, and so on, you need to be careful. Sometimes you can anticipate an attack, sometimes not. But, unfortunately, there are no devices for this.
Parents of teenagers note
There are cases when, after prolonged treatment, there is no progress, parents give blood in a panic and it turns out that there is no therapeutic drug in the child's body. He just stops taking the medicine.
An individual approach is necessary, because no matter what other disease, the condition of the liver and kidneys is important in order to know how the drug is excreted in the patient.
Epilepsy: what is it?
First you need to understand the nature of the disease. An attack occurs if the patient's brain emits too intense electrical impulses. They can affect only one of the areas of the brain, then the patient has a partial seizure, and if both hemispheres are affected, then generalized seizures occur. These impulses are transmitted to the muscles, hence the characteristic cramps.
Doctors still can’t say exactly what exactly causes the disease, but there is an assumption that the reason is a lack of oxygen during fetal development, trauma during childbirth, meningitis or encephalitis, neoplasms in the brain or an innate feature of its development. Pathology can manifest itself at any age, but children and people of advanced age still enter the risk group.
There are still studies that will help clarify the underlying causes of the disease, but there are suggestions that the triggering factors are:
- stress,
- alcohol abuse
- smoking,
- bad dream
- hormonal disruptions during the menstrual cycle,
- excessive use of antidepressants,
- premature refusal to take drugs that were prescribed to the patient.
This is only a small fraction of what a person needs to know in order to immediately understand what is happening to him and why. In addition, you need to know what to do with epilepsy attacks in order to provide first aid to the patient.
How to suspect a fit
If a person has already had attacks of epilepsy, then his relatives should know when they are more often, how everything starts and what to do first of all to cope with the situation. Harbingers of an epileptic seizure may be:
- increased irritability of the patient,
- a change in patient behavior - drowsiness or, conversely, increased activity,
- short-term twitching of muscles that pass quickly and without assistance,
- in rare cases, symptoms such as tearfulness and anxiety may appear.
If such symptoms appear, then those who are nearby need to know what to do if a person has an epilepsy attack so that he does not cause serious harm to himself, because at this moment the patient does not control his actions.
What does an epilepsy attack look like?
At first glance, it might seem that everything starts instantly, and a person who is nearby does not know what to do if an epilepsy attack occurs. Most often, the patient makes a cry and loses consciousness. During the tonic phase, his muscles tighten strongly, breathing is difficult, and it is precisely because of this that his lips turn blue. After the clonic phase begins, at this moment all the limbs begin to strain or relax, from the outside it looks like a jerky twitch.
Sometimes patients during a seizure bite their tongue or the inner surface of their cheeks. Spontaneous emptying of the bladder or intestines, profuse salivation, or vomiting may also occur. After the end of the attack, the patient often feels drowsiness, sometimes there is a memory loss. Also, after an attack of epilepsy, my head hurts. What to do to alleviate the patient’s condition, how to reduce seizures and is it possible to prevent them?
What does it look like
Usually from the side it seems that the attack began absolutely suddenly. A man makes a cry and faints. During the tonic phase, his muscles are tense, and breathing is difficult, which is why his lips turn blue. Then the cramps enter the clonic phase: all the limbs begin to strain and relax, it looks like an erratic twitch. Sometimes patients bite the tongue or the inner surface of the cheeks. Perhaps spontaneous emptying of the intestines or bladder, profuse salivation or vomiting. At the end of the seizure, the victim often suffers from drowsiness, headache, and memory problems.
Can an attack be prevented or reduced?
Very often, a stressful situation or lack of sleep can become provoking factors for the onset of an epileptic seizure. It is for this reason that patients need to carefully observe the daily routine, relax as much as possible, exercise, in order to relieve stress. You can prevent a seizure if you do not violate the regimen of drugs that are prescribed by your doctor. In no case is it recommended to change the dose of medication or disrupt the course.
Tip: it is worth remembering that patients with epilepsy should not take alcohol, since it can significantly change the effect of drugs and disrupt sleep, which ultimately provokes frequent seizures.
What to do
1. Do not panic. You take responsibility for the health of another person, and therefore you must remain calm and have a clear mind.
2. Stay close for a fit. When it's over, reassure the person and help recover. Talk softly and smoothly.
3. Look around - is the patient in danger? If everything is in order, do not touch or move it. Move furniture and other objects away that it might accidentally hit.
4. Be sure to note the start time of the attack.
5. Lower the patient to the ground and place something soft under his head.
6. Do not keep it stationary while trying to stop the cramps. It will not relax the muscles, but it can easily cause injuries.
7. Do not put anything in the patient’s mouth. It is believed that during an attack, the tongue may sink, but this is a misconception. As mentioned above, at this time, the muscles - including the tongue - are in hypertonicity. Do not try to unclench a person’s jaws and place any solid objects between them: there is a risk that during the next tension he will either bite you accidentally or crush his teeth.
8. Check the time again.
If the seizure lasts more than five minutes, call an ambulance.
Long attacks can cause permanent damage to brain cells.
9. After the seizure has stopped, put the person in a comfortable position: it is better to turn him on his side. Make sure your breathing is normal. Carefully check if the airways are clear: food pieces or dentures can block them. If it’s still difficult for the victim to breathe, call an ambulance immediately.
10. Until a person fully returns to normal, do not leave him alone. If he is injured or if the first attack immediately follows a second, immediately consult a doctor.
Remember that epilepsy is by no means a stigma or sentence.
For millions of people, this disease does not prevent them from leading a full life. Usually, competent supportive therapy and supervision by specialists help to keep everything under control, but if suddenly an attack begins with a friend, colleague or bystander, each of us must know what needs to be done.
First aid during an attack
As we have already said, the relatives of a patient who suffers from epileptic seizures should know what to do with bouts of epilepsy, if they have not been prevented already. You need to help on time, but no excessive physical effort. In those cases, if the attack happened in front of an unprepared person, then he can greatly scare him. Convulsive convulsions, foam from the mouth, high blood pressure, pale skin - all this can cause severe stress.But you definitely need to pull yourself together and do everything possible to help the patient cope with the attack:
- It is necessary to lay the patient as quickly as possible on a flat and soft surface and all because during a seizure it is most often possible to avoid injuries and bruises.
- Take off all tight-fitting clothing.
- If possible, then the patient's head must be turned to the side.
What can not be done during an attack?
We have already talked about what to do during an episode of epilepsy, but every person who lives next to an epileptic should also know what he should never do:
- in order to open the jaw during an attack, you do not need to use hard objects, it is best to make a soft roller from a handkerchief, towel or scarf,
- when opening the jaw, do not use force, otherwise you will break it,
- no need to restrain the patient’s movements: do him even more harm,
- do not need to do artificial respiration, during a seizure, the patient may lose rhythm for 20-30 seconds, this is normal,
- do not hit the patient on the cheeks, spray him with water,
- you should not give him a drink during an attack,
- do not give medication during an attack; do not self-medicate.
Having all the necessary knowledge in what to do after an attack of epilepsy in a person, you will not do any harm and help to cope with the situation very quickly.
First aid tips for an epileptic seizure
If your loved one has been diagnosed with epilepsy, there is nothing to be done about it, you need to come to terms and discuss with the doctor what to do after an epilepsy attack and during it to help? Here are some tips from doctors that can help you quickly deal with the situation and help a person during an epileptic seizure:
- First of all, you don’t need to panic, you should pull yourself together,
- you need to be around until the attack stops and the patient wakes up, even if he falls asleep, it’s better to watch him,
- take a look around and take away everything that could threaten a person’s life, because during an attack he does not control his actions,
- be sure to remember how long the attack lasted,
- lay the man down and slightly raise his head,
- do not hold it by force, trying to stop the cramps, at this moment nothing will help to relax the muscles,
- don’t open your mouth, because there is an opinion that at this moment the patient’s tongue may fall, everything is completely wrong, it’s better to just put a soft roller in your mouth, so you can protect your teeth from injury.
Be sure to monitor how long the attack lasts, so that you can decide later whether to call an ambulance or not.
When does the patient not need to call an ambulance?
Qualified medical assistance is not required in such cases:
- if the epilepsy attack lasted no more than 5 minutes,
But there are times when the patient simply needs the help of doctors and as quickly as possible.
When should I call an ambulance?
The help of doctors in very difficult cases is simply necessary, otherwise any slowdown can be fatal:
- when an attack lasts more than 5 minutes, that’s why doctors advise time tracking,
- if during an attack the patient is injured, his breathing is difficult,
- if an attack occurred in a woman while carrying a baby.
It is not difficult to provide assistance during an attack, the main thing is not to get lost and act quickly, then the patient will transfer it more easily and will not harm himself. In the presence of a disease such as epilepsy, it is very important to follow all the recommendations of the attending physician, then you can significantly reduce the likelihood of an attack and improve the quality of life.
Epilepsy - a mental illness
Epilepsy is a chronic neurological disease that periodically manifests itself, primarily, loss of consciousness or a short-term loss of self-control. This problem is physical, not mental, it is based on the pathological activity of neurons in the cerebral cortex. Patients are treated and registered not with psychiatrists, but with neuropathologists and neurologists.
All epileptics suffer from dementia
The statement is completely false. Most people with epilepsy show no signs of decreased intelligence or mental difficulties. In the intervals between attacks, they live normally, work actively and achieve considerable professional success. It is enough to note that many great writers, artists, scientists, politicians and military leaders were epileptics.
With some severe brain lesions, manifested by dementia, epileptic seizures are also observed, but in these cases they will be a concomitant condition, and not the cause of mental retardation.
Epilepsy can be infected
Probably, the reason for the error was the fact that in newborns, epilepsy sometimes develops as a result of intrauterine infection. For example, a sick child may be born to a woman who suffered from rubella or toxoplasmosis during pregnancy.
But the disease itself has nothing to do with infections. It is impossible to become infected.
The main symptoms of an attack are convulsions combined with foam from the mouth.
The name "epilepsy" unites about 20 conditions, only a small part of which manifests itself in this way. In many epileptics, seizures do not look spectacular at all. Most often, patients for a few seconds or minutes simply lose touch with reality. At the same time, others may not notice anything unusual, taking the stillness and absent glance of a person as signs of deep thought. In other patients, the disease leads to convulsions of certain muscle groups without loss of consciousness. Many epileptics note visual, audible or olfactory hallucinations, panic attacks or, conversely, unreasonable mood rises and even feelings of deja vu.
Such seizures also occur during which patients, being in a state of losing touch with reality, perform complex actions that look outwardly meaningful, but do not realize their purpose and consequences.
The approach of a fit is easy to predict.
Epileptics do sometimes sometimes have characteristic sensations by which it is possible to determine the approach of a seizure a few seconds before it begins. Unfortunately, such a hunch is rare and practically does not affect the quality of life, since the patient still will not be able to prevent an attack. That is why certain types of activities (driving a car, working near water bodies, etc.) are contraindicated for people with epilepsy.
Antiepileptic drugs are very dangerous.
Modern drugs against epilepsy are serious drugs that have contraindications and side effects. The choice of medicine should be done by a doctor. Typically, treatment with such drugs begins with a minimum amount at a time, gradually increasing the dose until a therapeutic effect is achieved. Medications take a long time. You can’t interrupt the course without consulting a specialist, this is fraught with activation of the disease and the development of life-threatening conditions.
Epilepsy develops in people who were easily excitable in childhood.
This is a very old misconception, which is sometimes observed even among doctors. Subjected pediatricians sometimes prescribe overly excitable children anticonvulsants.
In fact, the inability to concentrate, mood swings, a tendency to tantrums and other qualities inherent in some restless children have nothing to do with the causes of the development of epilepsy. This does not mean that such a child does not need the help of a neurologist or child psychologist.
All epileptics suffer from a disease from an early age
Epilepsy can occur at any age, but about 70% of cases occur in people who have become ill in early childhood or in old age. In infants, the disease develops as a result of hypoxia transferred during the period of intrauterine development or in the process of being born, as well as due to congenital diseases of the brain. In older people, the cause of epilepsy often becomes strokes and brain tumors.
The main factor provoking an attack is flickering light.
This is not true. The list of factors that can cause an epileptic seizure includes:
- a decrease in blood glucose (for example, due to a long break between meals),
- lack of sleep, fatigue,
- stress, anxiety,
- alcohol intake, hangover,
- use of drugs
- taking certain medications (including antidepressants),
- fever
- menstruation.
Women with epilepsy cannot get pregnant
The presence of the disease does not affect the possibility of becoming pregnant and having a baby. On the contrary, during the period of gestation, the condition of expectant mothers suffering from epilepsy improves, seizures almost stop. The disease is not inherited. About 95% of pregnancies in female epileptics end in the birth of healthy babies.
Epilepsy is a rare disease
In the world, about 50 million people suffer from epilepsy. In terms of prevalence, this is the third neurological disease after Alzheimer's disease and stroke. Experts say that almost 10% of people have experienced a seizure at least once in their life, but the diagnosis of epilepsy is made only in cases when the seizures are repeated regularly.
Misconceptions about epilepsy are very tenacious. They affect the attitude towards patients who, because of this, may experience serious problems with professional implementation and adaptation in society. It is necessary that people understand that the person suffering from epilepsy, despite the “strange” behavior, is not only not dangerous to others, but also periodically needs their help.
Video from YouTube on the topic of the article:
Education: First Moscow State Medical University named after I.M. Sechenov, specialty "General Medicine".
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