What are the signs before the onset of epilepsy?

Written by Yuan Jun Li
Neurology
Updated on November 16, 2024
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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.

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Written by Yan Xin Liang
Pediatrics
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What are the symptoms of epilepsy in children?

Common symptoms of epilepsy in children generally include sudden convulsions. During a convulsion, the typical manifestations are tightly closed or staring eyes, rolled-up eyeballs, clenched teeth, twitching at the corners of the mouth, frothing at the mouth, head and neck thrown back, and repetitive flexing or rigid shaking of the limbs. Generally, these can last for a few minutes, or vary from several seconds to ten minutes. Of course, there are also focal seizures, such as twitching of one side of the body, or absence seizures. Some infantile spasms are characterized by jackknife movements, occurring in clusters, with each display being different. The symptoms described earlier are typical of a generalized tonic-clonic seizure.

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Written by Liu Shi Xiang
Neurology
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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.

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Written by Liu Shi Xiang
Neurology
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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.

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Written by Yan Xin Liang
Pediatrics
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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.

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Written by Yuan Jun Li
Neurology
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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.)