What causes epilepsy in adults. Epilepsy: what you need to know about the disease

Symptoms of epilepsy are a combination of neurological factors, as well as somatic and other signs, which indicate the occurrence of a pathological process in the neurons of the human brain. Epilepsy is characterized by chronic excessive electrical activity of brain neurons, which is expressed by periodic seizures. IN modern world About 50 million people (1% of the world's population) suffer from epilepsy. Many people believe that with epilepsy a person must fall to the floor, struggle, and foam must flow out of his mouth. This is a common misconception, imposed more by television than by reality. Epilepsy has a lot different manifestations, which are worth knowing about in order to be able to help a person during an attack.

Precursors of an attack

Aura (from the Greek - “blow”) is a harbinger of an epileptic attack and precedes loss of consciousness, but not in any form of the disease. An aura may appear various symptoms– the patient’s muscles of the limbs and face may begin to contract sharply and frequently; he may begin to repeat the same gestures and movements – running, flapping his arms. Various paresthesias can also act as an aura. The patient may feel numbness in various parts of the body, he will begin to be bothered by supposedly crawling goosebumps on the skin, and some areas of the skin may burn. There are also auditory, visual, gustatory or olfactory paresthesias. Mental precursors can manifest themselves in the form of delirium, which is sometimes called pre-seizure insanity, a sharp change in mood towards anger, depression, or, conversely, bliss.

In a particular patient, the aura is always constant, that is, it manifests itself in the same way. This is a short-term state, lasting a few seconds (rarely more), while the patient is always conscious. An aura occurs when an epileptogenic focus in the brain is irritated. It is the aura that can indicate the dislocation of the disease process in the symptomatic type of epilepsy and the epileptic focus in the genuine type of the disease.

What do seizures look like in epilepsy?

Seizures due to changes in certain parts of the brain

Local, partial or focal seizures are the result of pathological processes in one part of the human brain. Partial seizures can be of two types - simple and complex.

Simple partial seizures

With simple partial seizures, patients do not lose consciousness, but the symptoms present will always depend on which part of the brain is affected and what exactly it controls in the body.

What do nocturnal epilepsy attacks look like?

Epileptic seizures during sleep occur in 30% of patients with this type of pathology. In this case, seizures are most likely the day before, during sleep or just before waking up.

Sleep has fast and slow phases, during which the brain has its own peculiarities of functioning.

At slow phase sleep electroencephalogram demonstrates an increase in excitability nerve cells, epilepsy activity index, seizure probability. During REM sleep, bio synchronization is disrupted electrical activity, which leads to the suppression of the spread of electrical discharges to neighboring brain regions. This generally reduces the likelihood of an attack occurring.

When shortening fast phase the threshold for seizure activity decreases. Sleep deprivation, on the contrary, increases the likelihood of frequent seizures. If a person does not get enough sleep, he becomes drowsy. This condition is very similar to slow sleep phase, which causes abnormal electrical activity in the brain.

Also, attacks are provoked by other sleep problems, for example, even the only a sleepless night may cause someone to develop epilepsy. Most often, if there is a predisposition to the disease, the manifestation is influenced by a certain period during which the patient suffered a clear lack of normal sleep. Also, in some patients, the severity of attacks may increase due to disturbances in sleep patterns, too sudden awakenings, from taking sedatives or overeating.

The symptoms of nocturnal epilepsy attacks, regardless of the patient’s age, can be varied. Most often, nocturnal seizures are characterized by convulsions, tonic, clonic seizures, hypermotor actions, and repetitive movements. With frontal autosomal nocturnal epilepsy, during attacks the patient may walk in his sleep, talk without waking up, and experience fear.

All of the above symptoms can appear in all sorts of combinations in different patients, so there may be some confusion when making a diagnosis. Sleep disturbances are typical manifestations various pathologies central nervous system, and not just epilepsy.

Alcoholic epilepsy

In 2-5% of chronic alcoholics, alcoholic epilepsy. This pathology is characterized by severe personality disorders. It occurs in adult patients who have suffered from alcoholism for more than 5 years.

Symptoms alcoholic form diseases are very diverse. Initially, the patient experiences signs of an approaching attack. This happens several hours or even days before it starts. Precursors in this case can last a different amount of time, depending on the individual characteristics of the organism. However, if warning signs are detected early, a seizure can be prevented.

So, with warning signs of alcoholism epileptic seizure, as a rule, arise:

• insomnia, ;
• headache, nausea;
• weakness, melancholy;
• soreness in various parts of the body.

Such warning signs are not the aura that represents the onset of an epileptic seizure.

The aura cannot be stopped, nor can the seizure that follows it. But the warning signs, detected in a timely manner, can be treated, thereby preventing the occurrence of attacks.

Nonconvulsive manifestations

About half of epileptic seizures begin with non-convulsive symptoms. After them, all kinds of motor disorders, generalized or local convulsions, and disorders of consciousness can be added.

Among the main non-convulsive manifestations of epilepsy are:

• all kinds of vegetative-visceral phenomena, failure heart rate, episodic body, nausea;
• nightmares with sleep disorders, talking in sleep, screaming, enuresis, somnambulism;
• increased sensitivity, fatigue and weakness, vulnerability and irritability;
• sudden awakenings with fear, sweating and palpitations;
• decreased ability to concentrate, decreased performance;
• hallucinations, delirium, loss of consciousness, pale skin, feeling of deja vu;
• motor and speech (sometimes only in a dream), attacks of numbness, disturbance in the movement of the eyeball;
• dizziness, headaches, memory loss, amnesia,.

Duration and frequency of seizures

Most people believe that an epileptic attack looks like this: the patient’s cry, loss of consciousness and a person’s fall, muscle spasms, shaking, subsequent calming down and restful sleep. However, convulsions do not always affect the entire human body, just as the patient does not always lose consciousness during a seizure.

A severe seizure may be evidence of generalized convulsive status epilepticus with tonic-clonic seizures lasting more than 10 minutes and a sequence of 2 or more seizures, between which the patient does not regain consciousness.

To increase the percentage of detection of status epilepticus, time lasting more than 30 minutes, which was previously considered the norm for it, it was decided to reduce it to 10 minutes in order to avoid wasted time. With untreated generalized statuses lasting an hour or more, there is a high risk of irreversible damage to the patient’s brain and even death. At the same time, the heart rate and body temperature increase. Generalized status epilepticus can develop for several reasons at once, including traumatic brain injury, rapid withdrawal of anticonvulsants medicines and so on.

However, the vast majority of epileptic seizures resolve within 1-2 minutes. After the completion of a generalized attack, the patient may develop a postictal state with deep sleep, confusion, headache or muscle pain, lasting from a couple of minutes to several hours. Sometimes Todd's palsy occurs, which is a neurological deficit of a transient nature, expressed by weakness in the limb, which is opposite in location to the focus of electrical pathological activity.

In most patients, it is impossible to find any neurological disorders in the periods between attacks, even if the use anticonvulsants actively inhibits the function of the central nervous system. Any reduction mental functions is associated primarily with neurological pathology, which initially led to the occurrence of seizures, and not with the seizures themselves. Very rarely, there are cases of non-stop seizures, as is the case with status epilepticus.

Behavior of patients with epilepsy

Epilepsy affects not only the patient’s health, but also his behavioral qualities, character and habits. Mental disorders in epileptics occur not only due to seizures, but also on the basis social factors, which are caused by public opinion, which warns all healthy people from communicating with such people.

Most often, in epileptics, character changes affect all areas of life. The most likely occurrences are slowness, viscous thinking, heaviness, hot temper, attacks of selfishness, rancor, thoroughness, hypochondriacal behavior, quarrelsomeness, pedantry and accuracy. The appearance also shows features characteristic of epilepsy. A person becomes restrained in gestures, slow, taciturn, his facial expressions become impoverished, his facial features become less expressive, and the Chizh symptom (a steely shine to the eyes) appears.

With malignant epilepsy, epilepsy gradually develops, expressed in passivity, lethargy, indifference, and resignation to one’s own diagnosis. A person’s vocabulary and memory begin to suffer; in the end, the patient feels complete indifference to everything around him, besides his own interests, which is expressed by increased egocentrism.

Epilepsy is one of the most common neurological diseases, affecting up to 0.5-1% of the world's population.

At the present stage of development of medicine, many classifications of forms of epilepsy have been proposed, which are based on the probable causes of the development of seizures, as well as on the localization of the epileptic focus in the brain.

1. Focal forms of epilepsy:
   1. Symptomatic epilepsy:
      • Chronic progressive or Kozhevnikov syndrome
      • Frontal
      • Parietal
      • Temporal
      • Occipital
   2. Idiopathic epilepsy:
      • Rolandic
      • Gastaut syndrome
   3. Cryptogenic epilepsy
2. Generalized forms of epilepsy
   • Symptomatic
   • Idiopathic
   • Cryptogenic
3. Unclassified forms of epilepsy
4. Situational epileptic seizures.

Generalized epilepsy

This type of disease is characterized by convulsive seizures, the clinical picture of which indicates the involvement of large areas of both hemispheres of the brain in the pathological process.

Clinically, generalized epilepsy manifests itself as grand mal seizures with severe widespread convulsions. Before an attack, there are warning signs, during which the patient becomes irritable and his behavior changes. Immediately before a seizure, an aura occurs, which manifests itself differently in each person. Some people have minor muscle twitching in their limbs, while others experience unreasonable feeling delight. After which the patient loses consciousness and falls. Breathing becomes shallow and rare, skin turn pale.

Then twitching of the limbs and the whole body begins. Increasing arterial pressure, pupils dilate, blood rushes to the face. There may be foamy saliva coming from the mouth, involuntary urination and defecation. The cramps last a few seconds or minutes and go away on their own. The patient regains consciousness, there are no memories of the attack.

Treatment of generalized epilepsy is aimed at preventing seizures, as well as eliminating the factors that provoke them. IN in rare cases applies surgery. Most patients are forced to take anticonvulsants throughout their lives.

One of the variants of the course of generalized epilepsy is the non-convulsive form. Its peculiarity is that the patient loses consciousness, but at the same time maintains balance and the ability to perform certain actions. Outwardly, this is manifested by freezing, lack of reaction to light and sound. Minor twitching of the muscles of the limbs is possible. An attack of non-convulsive epilepsy lasts from a few seconds to 2-3 minutes and is not stored in the patient’s memory.

Focal or patchy epilepsy

This form of the disease has a clear connection with damage to a certain area of ​​the brain. The clinical manifestation of seizures will depend on the location of the epileptic focus.

Depending on the cause of the epileptic focus, focal epilepsy is divided into the following forms:

• Symptomatic
• Idiopathic
• Cryptogenic

Symptomatic form

This type of focal epilepsy is a complication of various diseases and injuries. Occurs more often after 20 years.

Causes of development of symptomatic epilepsy:

• Brain tumors of various localizations.
• Traumatic brain injuries. In this case, the duration of the damage does not matter, since epilepsy attacks can occur even after several years.
• Damage to the blood vessels of the head and neck (tumors, aneurysms).
• Damage to brain tissue by infectious agents (tuberculosis, meningitis, typhoid, viral diseases).
• Rheumatic damage to nervous tissue.
• Cerebrovascular accidents (stroke), brain hypoxia during childbirth.
• Toxic damage from poisons (alcohols, mercury, barbiturates, gasoline) and products of impaired metabolism (in case of hepatic-renal failure, diabetes mellitus).

Frontal epilepsy

With this type of epilepsy, pathological foci are located in the frontal lobes of the brain. Debut age - any. Typically the attacks are frequent, do not occur at regular intervals, and occur during sleep. Automatisms of gestures with a sudden beginning and end are characteristic. The duration of the seizures does not exceed 30 seconds. They are accompanied by wild speech and bizarre movements. The aura before an attack is vague in the form of a sensation of warmth or touch.

Frontal epilepsy is difficult to treat. The use of anticonvulsants is indicated, as well as the elimination of the cause that caused the development of epilepsy. If there is no effect of therapy, surgical treatment is indicated.

A special variant of the frontal form of the disease is nocturnal epilepsy. In this case, the convulsive activity of neurons in the pathological focus increases at night. But the excitement does not spread to neighboring areas of the brain, so the attacks pass more mildly.

Nocturnal epilepsy manifests itself in the following forms:

• Sleepwalking - a sleeping person gets out of bed, performs externally conscious actions, and talks. After the attack ends, he returns to bed and does not remember the episode.
• Parasomnias - trembling of the limbs when waking up or falling asleep. They may manifest themselves in involuntary contractions of the facial muscles.
• Enuresis is bedwetting. During an attack, the bladder goes beyond the control of the brain and involuntary emptying occurs.

The nocturnal form of epilepsy is a favorable variant of the disease. It responds well to therapy and in most cases can be cured with age.

Temporal lobe epilepsy

This form of the disease most often occurs due to damage to the temporal lobes when birth injuries, but other reasons cannot be excluded. Temporal lobe epilepsy characterized by polymorphic paroxysms with a characteristic aura and lasting several minutes.

Features of temporal lobe epilepsy

• Sensations during attacks can be of the nature of damage to internal organs (abdominal pain, nausea and vomiting), as well as symptoms of heart failure (heart pain, tachycardia, shortness of breath).
• Changes in consciousness (loss of orientation in space and time, euphoria, hysterical episodes, panic attacks).
• Performing actions that have no motivation (undressing, folding clothes, rearranging things).
• Vivid auras with impaired sense of smell and vision, derealization of the surrounding reality.

This form of epilepsy is progressive. Over time, patients develop severe autonomic disorders and social adaptation disorders.

Treatment includes both traditional anticonvulsant drug therapy and surgical techniques removal or destruction of a pathological focus in the brain.

Idiopathic form

This form of epilepsy is not a consequence of organic brain damage. Its development is associated with changes in the functioning of neurons, an increase in their activity and degree of excitability.

Causes of development of idiopathic epilepsy:

• Hereditary predisposition.
• Psychoneurological diseases.
• Congenital brain abnormalities.
• Toxic effects of alcohol and drugs without structural damage to neurons.

One of the varieties of the idiopathic form of the disease is rolandic epilepsy, which affects children aged 3-13 years. The epileptic focus is located in the Rolandic fissure of the cerebral cortex. Seizures are partial and motor in nature. A convulsive episode primarily involves the muscles of the face and pharynx. In more rare cases, unilateral twitching of the arm or leg is observed.

Typical clinical manifestations of Rolandic epilepsy

• Somatosensory aura, in which there is tingling and numbness in the tongue, cheeks and lips.
• Unilateral muscle spasms of the face, arms and legs.
• Difficulty speaking.
• Increased salivation.
• Preserved consciousness, absence of amnesia after the attack.
• The onset of seizures occurs primarily at night.

Rolandic epilepsy is benign and goes away with age. By age 16, 98% of sick children recover. Therefore, patients often do not require specific treatment. In rare cases, antiepileptic drugs are indicated.

Cryptogenic form

The diagnosis of “cryptogenic epilepsy” is made in cases where it is not possible to determine the cause of convulsive seizures using all available diagnostic methods. Clinical manifestations, as with symptomatic epilepsy, depend on the location of the pathological focus in the brain.

Many people are tormented by the question, what causes epilepsy in adults and children? But before you understand the main causes, you need to understand what kind of disease it is, what its symptoms are and how to treat it. Epilepsy is a neuropsychiatric disorder that is characterized as hidden. This disease is characterized by attacks that appear suddenly and rarely. Epileptic seizures are caused by the appearance of many foci of spontaneous excitation in various parts of the brain. From a medical point of view, they are characterized by a violation of the motor, vegetative, sensory and mental functions of the body.

So, how often do people have epileptic seizures? Frequency of occurrence similar disease ranges from eight to eleven percent of the entire world population, regardless of climatic conditions. Almost every twelfth person experiences various microsigns. Many people suffering from this disease believe that it is incurable, but this is not the case. Modern medicine has learned to fight the disease. Now there are many antiepileptic drugs that effectively help suppress seizures and significantly reduce them.

Patients often wonder why epilepsy occurs, because it is very dangerous disease requiring immediate treatment. There are three main groups of factors that can contribute to its development:
1. Idiopathic - the disease is transmitted hereditarily, even after dozens of generations. Organic damage no, but present specific reaction neurons. This form is unstable, attacks often occur for no reason;
2. Symptomatic - there is always a reason for the development of foci of pathological excitation. Epilepsy can occur after injury, cyst, tumor, or intoxication. This form is the most unpredictable; a seizure can develop from the slightest irritant.
3. Cryptogenic - in this case, it is impossible to say what causes epilepsy, since the cause cannot be established. Seizures may occur due to minor irritating factor, for example, from strong resentment.

It is these groups that can explain the appearance of symptoms of the disease in patients different ages. To protect yourself, you need to know who is most susceptible to this disease.

When the disease occurs

Seizures are often observed in newborns when the temperature rises. But this does not mean that the person will suffer from the disease in the future. Many people do not know what causes epilepsy and who gets it. Teenagers often suffer from this disease. Statistics show that almost seventy-five percent of cases are patients under twenty years of age. In people older than this age, may occur due to various injuries or stroke. Also at risk are the population over sixty years of age.

Main features

As a rule, symptoms are individual in each specific case. It depends on the affected areas of the brain. Symptoms are directly related to the functions that these departments perform. The following disorders may occur with the disease:
movement disorders;
speech is disrupted;
decline or rise muscle tone;
dysfunction of various mental processes.

The main set of symptoms depends on what kind of epilepsy there is in a particular case. There are several types of disease.

Jacksonian attacks

In this case, pathological irritation is localized in a certain area of ​​the brain, without affecting neighboring areas. This is why symptoms appear in certain muscle groups. Typically, such disorders do not last long, the person is fully conscious, but at the same time loses contact with the outside world. The patient does not accept help from strangers because he is not aware of the dysfunction. The seizure lasts several minutes, then the condition returns to normal.

The attack is accompanied by convulsive twitching or numbness of the hands, feet, and legs. Therefore, there are several answers to the question of what causes epilepsy. Over time, numbness can spread throughout the body, causing seizure or as it is also called generalized. A major attack consists of phases that replace each other:
1. Precursors - before an epileptic seizure, the patient is seized with anxiety, then nervous excitement gradually increases.
2. Tonic convulsions - they are characterized by a sharp contraction of muscles, as a result of which the patient loses his balance and falls. The person has difficulty breathing and his face turns blue. This phase lasts about a minute.
3. Clonic spasms - when all the body muscles begin to contract convulsively. The patient turns blue, excessive salivation appears from the mouth, similar to foam. To understand how often epilepsy attacks occur, it is recommended to be examined by a specialist.
4. Stopper – strong braking begins, the patient’s muscles completely relax, involuntary release of urine and feces is observed. Such an attack can last for half an hour.

After recovering from an epileptic seizure, a person will suffer from weakness for three days, headaches and motor disturbances may be present.

Minor attacks

Minor seizures are more mild. Often, symptoms are expressed by contraction of facial muscles, a sharp drop in their tone, or, conversely, tension. Then the patient either loses his balance, falling sharply, or freezes in one position, his eyes rolling back. Consciousness is completely preserved. After the attack, he does not remember what happened. Most often, such signs occur in children preschool age, the reasons why epilepsy occurs are due to congenital or acquired factors.

Status epilepticus

This is a whole series of seizures that repeat one after another. Between them the patient is disconnected from consciousness, decreased tone is observed muscle mass and complete reflex absence. The pupils at this time are narrowed or dilated; there are cases when they different sizes, the pulse is difficult to palpate. Similar condition requires urgent help doctors, as cerebral edema may occur from increasing hypoxia. Lack of medical intervention can lead to death. All attacks begin and end spontaneously.

Causes of the disease

There is no clear answer to the question of what causes epilepsy, since it occurs due to many different reasons. This disease is not hereditary disease, however, in those families where one of the relatives suffered from it, the likelihood of the disease increases significantly. According to statistics, more than forty percent of patients have relatives suffering from epilepsy. There are several types of seizures, which are accompanied by varying severity and consequences. An attack in which only one part of the brain is to blame is called a partial attack. If the whole brain is affected, then this is a generalized seizure. There are mixed attacks, as a rule, they begin with one part, gradually covering the other.

Regardless of the fact that this disease is dangerous and serious, timely diagnosis and with the help of competent treatment, epilepsy is curable in half of the cases. Also modern medicine learned to achieve remission in eighty percent of patients. If doctors have found out why epilepsy occurs in a particular case, and have prescribed correct treatment, then in two thirds of patients the seizures either stop altogether or fade away for several years. Such a disease is treated depending on its form, main symptoms and age of the patient. There are two main types of medical care:
surgical;
conservative.

However, it is the second one that is used more often, since taking antiepileptic medications is effective and helps to achieve lasting positive progress. Drug treatment is divided into several stages:
1. Differential diagnosis - necessary in order to determine what kind of epilepsy there is and choose the right medications;
2. Establishing the causes - in the most common form of the disease, that is, symptomatic, it is necessary to carefully examine the patient’s brain for the presence of defects;
3. – first aid, .

The patient is required to strictly follow all the rules, namely, take medications at the exact time, avoid risk factors that contribute to the occurrence of seizures.

Doctors resort to surgical treatment when it is observed, that is, the main cause is caused by various brain diseases. This disease is curable if you immediately consult a doctor when symptoms are detected. After all, it is very important what causes epilepsy, since treatment is prescribed based on the reasons.