Epilepsy


What causes epilepsy?
The causes of epilepsy mainly include some congenital factors, such as pathological changes during pregnancy or childbirth, which can lead to the occurrence of epilepsy in children. In adults, epilepsy is generally secondary to severe head trauma, cerebrovascular disease, intracranial tumors, encephalitis, etc. Therefore, for patients with epilepsy, it is first necessary to actively remove various inducements and then to treat according to the type of epileptic seizures. Epilepsy mainly includes generalized seizures and partial seizures. Patients with generalized epileptic seizures can take medications such as sodium valproate and diazepam for treatment. Patients with partial epileptic seizures can take medications such as carbamazepine, oxcarbazepine, gabapentin, and levetiracetam for treatment. Generally, the symptoms of epilepsy can be effectively controlled after patients follow a standardized medication treatment regimen.


What are the symptoms of abdominal epilepsy?
Patients with abdominal epilepsy can experience abdominal pain, and some may show symptoms of bloating, nausea, and vomiting, as well as diarrhea. Abdominal epilepsy is a type of epilepsy, commonly seen in children and adolescents. The symptoms generally recur and last mostly from three to five minutes. If the symptoms last more than five minutes, it is usually called a status epilepticus, and some antiepileptic drugs can be used to control the seizures. After an epileptic episode, an EEG might show spike-and-wave patterns. If the EEG is normal, a dynamic EEG can be conducted, which might increase the positive diagnostic rate for patients.


Why does epilepsy occur at night?
Epilepsy that occurs at night is called sleep-related epilepsy. There are many reasons for this phenomenon, such as excessive fatigue, irregular sleep, menstrual onset, anxiety, depression, and more. Additionally, some patients exhale more carbon dioxide during sleep, causing hyperventilation and internal environmental imbalances, which can easily lead to abnormal discharges of brain neurons. When some patients experience symptoms of epilepsy at night, timely intervention and treatment are needed. First, patients should develop a good lifestyle, go to bed on time, get up on time, avoid staying up late, and avoid excessive fatigue. Furthermore, targeted medication should be given to prevent the onset of the condition. Common medications include lamotrigine, levetiracetam, carbamazepine, and sodium valproate. Besides, patients also need to maintain a good mindset and avoid tense and anxious emotions that could exacerbate symptoms.


What are the emergency measures for an epileptic seizure?
Epilepsy is a chronic disease characterized by transient brain dysfunction caused by sudden abnormal discharge of brain neurons. When a patient has an acute attack, several emergency measures should be taken to prevent injury: 1. During an epileptic seizure, the patient should lie flat, with the head turned to one side or on their side, to keep the airway clear and prevent the inhalation of vomit or secretions into the respiratory tract. 2. Be aware of the surrounding environment to prevent the patient from bumping into tables and chairs, causing secondary injuries. Closely observe the patient's consciousness, breathing, and pulse. 3. Loosen the patient's collar and belt to reduce resistance in the respiratory tract, and place a gauze-wrapped tongue depressor between the teeth to prevent tongue biting and vocalization. 4. Observe whether the patient shows symptoms of increased intracranial pressure and follow medical advice for medication when necessary. Additionally, for persistent epileptic seizures, call emergency services promptly for treatment.


Can acquired epilepsy be treated?
Acquired epilepsy can be treated. Most cases of acquired epilepsy are due to some organic lesions, also known clinically as secondary epilepsy, primarily treated by addressing the underlying disease. Common clinical conditions include brain organic lesions such as cerebral hemorrhage, cerebral infarction, brain tumor, encephalitis, and brain parasitic infections. Systemic diseases like diabetes and hyperparathyroidism can also lead to epilepsy. If epilepsy persists or if there is a major epileptic seizure, it can lead to brain cell hypoxia and even brain edema in severe cases. When necessary, treatments to protect the brain and reduce intracranial pressure are required. Medications for brain protection include Cytidine Diphosphate Choline and Lacosamide, while drugs to lower blood pressure mainly include Mannitol, Glycerol Fructose, and Furosemide. Most patients potentially can be carefully cured through the treatment of the underlying disease, and if seizures persist after the treatment of the primary disease, antiepileptic drugs should be administered. (The use of medications should be under the guidance of a physician.)


What causes epilepsy in children?
The causes of epilepsy in children primarily include congenital factors and acquired factors. Congenital factors are mainly due to premature birth, difficult labor, umbilical cord around the neck, neonatal intracranial hemorrhage, drug factors, etc. Acquired factors mainly include brain trauma, central nervous system infections, cerebrovascular disease, intracranial tumors, and other causes. Therefore, when a child exhibits symptoms of epilepsy, it is necessary to promptly visit the department of neurology to conduct relevant examinations to determine the cause. The examination methods mainly include CT, MRI, EEG, cerebrospinal fluid analysis, etc. After identifying the cause, symptomatic treatment methods should be adopted to control the symptoms of epilepsy episodes. In clinical practice, controlling epilepsy is mainly achieved through drug treatment, with commonly used medications including carbamazepine, sodium valproate, gabapentin, etc. For some patients with refractory epilepsy, surgical treatments may also be used to control symptoms.


What are the prodromal symptoms of epilepsy?
The prodromal symptoms of epilepsy are diverse, generally involving movement, sensation, and mood. Some patients may experience transient numbness or weakness on one side of their body prior to a seizure, while others may have hallucinations and atypical mental or behavioral changes. However, these symptoms are not necessarily indicative of an impending seizure. When such symptoms occur, it is crucial to consider the possibility of an epilepsy attack, and patients should promptly visit the neurology department of a hospital for a thorough examination, including an electroencephalogram (EEG). If the EEG shows significant abnormalities such as spikes, sharp waves, slow waves, spike-and-wave complexes, or sharp-and-slow wave complexes, it suggests the potential for an epileptic seizure. In such cases, preventive medication should be administered promptly, such as carbamazepine or sodium valproate.


What causes benign epilepsy in children?
There are multiple causes of benign epilepsy in children, with significant genetic factors often involved. It generally occurs during a specific developmental period in childhood due to localized diseases, and the prognosis is usually good. Such seizures in children may be caused by conditions like tuberous sclerosis, cerebral trigeminal angioma, and neurofibromatosis. Intracranial infections, such as viral encephalitis, bacterial meningitis, and tubercular meningitis, can also trigger benign epilepsy in children. Therefore, once diagnosed, early intervention treatments should be initiated to prevent the symptoms from worsening. Regular follow-ups with electroencephalograms are also necessary to understand the effects of epilepsy medications and treatments.


What can severe epilepsy lead to?
Severe epilepsy can cause many complications, such as cerebral edema, brain herniation, upper gastrointestinal bleeding, etc. Therefore, severe epilepsy can seriously threaten the patient's life. If the patient's epilepsy is not controlled in time, it can easily lead to a state of status epilepticus. Status epilepticus is a very dangerous central nervous system disease. Patients may experience sudden respiratory and circulatory arrest and uncontrollable massive gastrointestinal bleeding. For severe epilepsy patients, it is necessary to promptly administer medications such as diazepam and sodium valproate to terminate the seizures. If status epilepticus occurs, the patient needs to be urgently sent to the ICU for observation and treatment, and effective interventions for various complications must be provided. For example, in the case of cerebral edema caused by epilepsy, medications such as mannitol and glycerol fructose are needed to dehydrate and reduce intracranial pressure. If epilepsy causes acute upper gastrointestinal bleeding, treatments to suppress acid, stop bleeding, and maintain blood pressure are required.


What are the signs before the onset of epilepsy?
Before the onset of epilepsy, most patients do not exhibit any signs and can suddenly experience an epileptic seizure. Different types of epilepsy have different symptoms. For example, during a major seizure, symptoms can include limb twitching, eyes rolling upwards, frothing at the mouth, clenched teeth, loss of consciousness, and abnormal blood pressure, which can lead to severe falls and injuries. During a minor seizure, the patient mainly shows transient loss of consciousness, objects in hand may suddenly drop, unresponsiveness when called, and a vacant stare. Most patients do not fall, and the symptoms generally last for only a few seconds to tens of seconds. If autonomic epileptic seizures are considered, symptoms may include nausea and vomiting. Psychotic symptom seizures can present with hallucinations and delusions.