Epilepsy


Does epilepsy have symptoms when it is not causing seizures?
When epilepsy is not active, there are no symptoms. Patients mainly show recurrent epileptic seizures, usually lasting three to five minutes. After the seizure stops, the patient does not exhibit any symptoms or signs. Clinically, epilepsy is categorized into primary and secondary types. For primary epilepsy, if a patient experiences more than two episodes, routine use of anti-epileptic drugs is recommended. The choice of medication varies depending on the type of epilepsy. Typically, monotherapy is preferred initially. However, if monotherapy is ineffective or causes substantial side effects, a combination of two or more anti-epileptic drugs may be used to try to control the seizures. In cases of secondary epilepsy, which often has a clear cause, the primary focus is on treating the underlying condition. This includes long-term cerebrovascular diseases like cerebral hemorrhage and cerebral infarction, as well as conditions like encephalitis and brain tumors. Treatment should be tailored to the specific disease.


What is an effective treatment for epilepsy?
To effectively treat epilepsy, it is crucial to adhere to the principles of medication use and cessation. First, epilepsy medication should generally be administered for one to two years without seizures before gradually reducing the dose. If seizures reoccur after dose reduction, or if there is significant worsening on electroencephalography (EEG), the dosage should be restored. If switching medications, take both medications concurrently for about a week, then gradually reduce the original medication to cessation while increasing the new medication to an effective dose. These are the principles of medication exchange and use. Then, consider the principles for attempting medication cessation. Generally, medication should not be ceased any earlier than one year and abrupt cessation should be avoided to prevent epilepticus status. If there is clear organic brain disease, persistent positive neurological signs, or continuous mental disorders with abnormal EEG readings, lifelong medication may be necessary. Some suggest that individuals older than 30 should be cautious about stopping medication. Since the recurrence rate upon cessation can exceed 50%, lifelong medication may be necessary.


Can mild epilepsy be treated?
Mild epilepsy is treatable. If the patient is experiencing their first seizure or if the seizures are infrequent, it’s generally appropriate to observe clinically and not rush to use anti-epileptic drugs. Such patients typically experience only very mild neurological symptoms during a seizure, such as limb weakness, numbness, or facial droop. However, if the patient's seizures occur frequently, it is necessary to control the symptoms with anti-epileptic medications, which often include drugs such as levetiracetam, gabapentin, sodium valproate, and lamotrigine. Patients with mild epilepsy should also work on strengthening their exercise routines, maintaining a calm mind, and getting sufficient sleep to help prevent seizures to a certain extent. If the patient's condition worsens or becomes intractable epilepsy, surgical treatment methods may be considered to control the symptoms.


Precursors to epileptic seizures in children
The majority of childhood epilepsy seizures occur without any precursors, as they arise and cease suddenly with stereotyped movements. However, some seizures are preceded by prodromes, such as sudden onset of consciousness disturbances, or fainting symptoms. Other seizures can present with motor dysfunctions, displaying sudden weakness or fatigue in certain limbs, followed by an epileptic attack. Additionally, some may experience abnormal sensations, such as numbness in a specific area or visual disturbances, including sudden flashes or even visual distortions, leading to convulsive seizures.


What are the symptoms of epilepsy in children?
The typical symptoms of childhood epilepsy include sudden loss of consciousness, followed initially by tonic and then clonic convulsions, often accompanied by screaming, cyanotic facial complexion, frothing or bleeding at the mouth, dilated pupils, generally lasting 40 seconds or up to 15 minutes. The convulsive seizure stops naturally, followed by a state of coma. Of course, some affected children also display varying degrees of consciousness disorders, evident disruptions in thinking, perception, emotion, and psychomotor functions, and may show signs of conditions like somnambulism and noctambulism, among other automatisms.


Early Symptoms of Baby Epilepsy
The early symptoms of epilepsy in babies include excessive sweating on the head during feeding and sleep. Due to the irritation of the sweat, the child likes to shake their head, which causes friction on the back of the head, leading to hair loss over time. Additionally, the child appears restless and easily wakes up during sleep. If parents notice these symptoms of epilepsy, they should seek treatment for their child early to avoid delays and recurrent conditions.


What are the early symptoms of epilepsy in children?
Epilepsy is a particularly common chronic disease in life. If the brain is underdeveloped and there are neurological disorders, it can cause epilepsy. What are the early symptoms of childhood epilepsy? The manifestations of a child's epileptic seizure are diverse, but all have the characteristics of sudden onset, sudden cessation, and periodic attacks. Common types in children include major seizures, absence minor seizures, and benign childhood epilepsy. During a major seizure, the child suddenly loses consciousness, breathing stops, the complexion turns cyanotic, the pupils dilate, the limbs stiffen, and the hands clench into fists, then switching to paroxysmal convulsions, foaming at the mouth, with the attack generally lasting 1-5 minutes. Children with absence seizures appear to suddenly lose consciousness, stop their activities, and stare upward or roll their eyes, but they do not fall down or convulse, lasting 1-10 seconds, with consciousness quickly recovering after the attack. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, and tongue, possibly accompanied by abnormal sensations in those areas, inability to speak, and drooling, typically with clear consciousness, and more frequently occurring at night.


What medicine should not be taken for epilepsy?
Patients with epilepsy mainly rely on some internal medicine drugs for treatment. There are many drugs available today, many of which can effectively control the occurrence of epilepsy and improve the quality of life of the patients. However, it is also important to note that some drugs should not be taken in reduced quantities, Firstly, there are some drugs that affect the liver. Many drugs can impact the liver, and since many antiepileptic drugs are metabolized through the liver, combining them can increase the burden on the liver and even induce necrotic hepatitis, Secondly, it is necessary to choose the medication according to the type of epileptic seizures. For example, if it is a visual seizure, or a myoclonic seizure, then one should not take Phenytoin sodium and Carbamazepine, as these two drugs can potentially exacerbate myoclonic and visual seizures, Thirdly, patients with epilepsy should also avoid taking drugs that affect the metabolism of epilepsy medication. If used together, it can cause a reduction in the efficacy of the epilepsy drugs, easily triggering an epileptic attack, or even a prolonged state of epilepsy.


Can children's epilepsy be effectively treated?
Can childhood epilepsy be cured? Firstly, it depends on the type of epilepsy. If the symptoms are not very severe, the frequency of convulsions is low, and comprehensive exams such as brain MRI and genetic testing show no problems, and the child's intellectual development is normal, then this type of epilepsy might be curable. Generally, after 2 to 3 years of effective antiepileptic drug treatment and then gradually discontinuing the medication if there are no further seizures, the condition can usually be controlled. However, some types of epilepsy are associated with underlying diseases, such as cerebral palsy, inherent metabolic genetic disorders, poor brain development, or organic brain lesions. The treatment outcomes for these types of epilepsy are not good, and they are generally difficult to control.


incidence of epilepsy in children
Epilepsy is a common neurological disorder, with the highest incidence in children under the age of one. The prevalence of epilepsy in China ranges from 0.4% to 0.7%, with nine million epilepsy patients, of which six million have active epilepsy. Every day, there are 400,000 new cases of epilepsy, with a prevalence of up to 1% among those aged sixteen and under. There are many children with epilepsy, experiencing various types of seizures, each with its own characteristics, but all share the features of sudden onset, abrupt cessation, and periodicity.