Personality changes in epilepsy. Psychological characteristics of patients with epilepsy

In fact, this problem is quite relevant in psychiatry, neurosurgery and neurology. different countries peace. Epilepsy leads to changes in a person’s life, reduces the quality of his life and worsens his relationships with family and friends. This disease will not allow the patient to drive a car ever again in his life; he will never be able to attend a concert of his favorite band or go scuba diving.

History of epilepsy

Previously, the disease was called epileptic, divine, demonic possession, and Hercules' disease. Many great people of this world suffered from its manifestations. Some of the loudest and most popular names include Julius Caesar, Van Gogh, Aristotle, Napoleon I, Dostoevsky, Joan of Arc.
The history of epilepsy is shrouded in many secrets and mysteries even to this day. Many people believe that epilepsy is an incurable disease.

What is epilepsy?

Epilepsy is considered a neuropsychiatric disease chronic course With multiple reasons occurrence. The symptoms of epilepsy are varied, but there are certain specific clinical signs:

repeated, which are not provoked by anything;
fickle, transient of man;
changes in personality and intelligence that are practically irreversible. Sometimes these symptoms develop into.

Causes and features of the spread of epilepsy

In order to accurately determine the epidemiological aspects of the spread of epilepsy, it is necessary to carry out several procedures:

brain mapping;
determine brain plasticity;
research molecular basis excitability nerve cells.

This is what scientists W. Penfield and H. Jasper did, who performed operations on patients with epilepsy. They, to a greater extent, created maps of the brain. Under the influence of current, individual parts of the brain react differently, which is interesting not only scientific point point of view, but also from a neurosurgical point of view. It becomes possible to determine which areas of the brain can be painlessly removed.

Causes of epilepsy

It is not always possible to identify the cause of epilepsy. In this case, it is called idiopathic.
Scientists have recently discovered that one of the causes of epilepsy is considered to be a mutation in certain genes that are responsible for the excitability of nerve cells.

Some statistics

The incidence of epilepsy varies from 1 to 2%, regardless of nationality and ethnicity. In Russia, the incidence ranges from 1.5 to 3 million people. Despite this, individual convulsive conditions that are not epilepsy are several times more common. Almost 5% of the population has suffered at least 1 seizure in their lifetime. Such attacks usually arise from the influence of certain provoking factors. Of these 5% of people, a fifth will definitely develop epilepsy in the future. Almost all people with epilepsy suffered their first seizure in the first 20 years of life.
In Europe, the incidence is 6 million people, 2 million of whom are children. On the planet on this moment There are about 50 million people with this terrible disease.

Predisposing and provoking factors for epilepsy

Seizures in epilepsy occur without any provoking moments, which indicates their unpredictability. However, there are forms of the disease that can be provoked:

flickering light and ;
and taking some medicines;
strong emotions of anger or fear;
drinking alcohol and frequent deep breathing.

In women, menstruation may become a provoking factor due to changes in hormonal levels. In addition, with physiotherapeutic treatment, acupuncture, active massage activation may be triggered individual areas cerebral cortex and, as a result, the development of a convulsive attack. Taking psychostimulants, one of which is caffeine, sometimes causes an attack.

What mental disorders can occur with epilepsy?

In the classification of human mental disorders in epilepsy, there are four points:

mental disorders, foreshadowing a seizure;
mental disorders that are a component of the attack;
mental disorder after the end of the attack;
mental disorders between attacks.

Mental changes in epilepsy are also distinguished between paroxysmal and permanent. Let's first consider paroxysmal disorders psyche.
The first are mental attacks that are harbingers of convulsions. Such attacks last from 1-2 seconds. up to 10 minutes.

Transient paroxysmal mental disorders in humans

Such disorders last for several hours or days. Among them we can highlight:

epileptic mood disorders;
twilight disturbances of consciousness;
epileptic psychoses.

Epileptic mood disorders

Of these, dysphoric conditions are considered the most common. The patient is constantly sad, embittered towards those around him, and constantly fears everything for no reason. From the predominance of the symptoms described above, melancholic, anxious, and explosive dysphoria occurs.
Very rarely there may be an increase in mood. At the same time, the sick person displays excessive and inadequate enthusiasm, foolishness, and clowns around.

Twilight darkness of consciousness

The criteria for this condition were formulated back in 1911:

the patient is disoriented in place, time and space;
there is detachment from the outside world;
inconsistency in thinking, fragmentation in thinking;
the patient does not remember himself in a state of twilight consciousness.

Symptoms of twilight consciousness

The pathological condition begins suddenly without warning, and the condition itself is unstable and short-term. Its duration is about several hours. The patient's consciousness is gripped by fear, rage, anger, and melancholy. The patient is disoriented, cannot understand where he is, who he is, what year it is. The instinct of self-preservation is significantly muted. During this state Vivid hallucinations, delusions, and inconsistency of thoughts and judgments appear. After the attack ends, post-attack sleep occurs, after which the patient does not remember anything.

Epileptic psychoses

Human mental disorders with epilepsy can also be chronic. Acute cases occur with and without clouding of consciousness.
The following acute twilight psychoses with elements of clouding of consciousness are distinguished:

Prolonged twilight states. They develop mainly after full-blown seizures. Twilight continues for up to several days and is accompanied by delirium, aggression, hallucinations, motor agitation, and emotional tension;
Epileptic oneiroid. Its onset usually occurs suddenly. This distinguishes it from schizophrenic. With the development of epileptic oneiroid, delight and ecstasy arise, as well as often anger, horror and fear. Consciousness changes. The patient is in a fantastic illusory world, which is complemented by visual and auditory hallucinations. Patients feel like characters from cartoons, legends, and fairy tales.

Of the acute psychoses without clouding of consciousness, it is worth highlighting:

Acute paranoid. With paranoia, the patient is delusional and perceives the environment in the form of illusory images, that is, images that actually do not exist. All this is accompanied by hallucinations. At the same time, the patient is excited and aggressive, since all hallucinations are threatening.
Acute affective psychoses . Such patients have a depressed, melancholy, angry mood with aggression towards others. They blame themselves for all mortal sins.

Chronic epileptic psychoses

There are several described forms:

Paranoid. They are always accompanied by delusions of damage, poisoning, relationships, and religious content. An anxious and angry character is considered specific to epilepsy. mental disorders or ecstatic.
Hallucinatory-paronoid. Patients express fragmented, unsystematized thoughts, they are sensual, undeveloped, there are a lot of specific details in their words. The mood of such patients is depressed, melancholy, they experience fear, and clouding of consciousness often occurs.
Paraphrenic. With this form, verbal hallucinations occur and delusional ideas are expressed.

Persistent mental disorders of a person

Among them are:

Epileptic personality change;
Epileptic dementia (dementia);

Epileptic personality changes

This concept includes several states:

A formal thought disorder in which a person is unable to think clearly or think quickly. The patients themselves are verbose and thorough in conversation, but they cannot express the most important thing to their interlocutor, they cannot separate the main thing from something secondary. The vocabulary of such people is reduced, they often repeat what has already been said, use formulaic figures of speech, and insert words into their speech in diminutive forms.
Emotional disorders. The thinking of these patients is no different from people with formal thought disorder. They are irritable, picky and vindictive, prone to outbursts of rage and anger, often rush into quarrels, in which they often show aggression not only verbal, but also physical. In parallel with these qualities, excessive courtesy, flattery, timidity, vulnerability, and religiosity are manifested. By the way, religiosity was previously considered a specific sign of epilepsy, by which the disease could be diagnosed.
Character change. With epilepsy, special character traits are acquired, such as pedantry, hypersociality in the form of thoroughness, conscientiousness, excessive diligence, infantilism (immaturity in judgment), the desire for truth and justice, and a penchant for teaching (banal edifications). Such people treat their loved ones with great value and are very attached to them. They believe that they can be completely cured. The most important thing for them is their own personality, their own ego. Moreover, these people are very vindictive.

Epileptic dementia

This symptom occurs if the course of the disease is unfavorable. The reasons for this are not clear at this time. The development of dementia occurs mainly after 10 years of illness or after 200 convulsive attacks.
The progression of dementia is accelerated in patients with low intellectual development.
Dementia manifests itself as slowing mental processes, stiffness in thinking.

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At long term Diseases in patients often develop certain features that were previously not characteristic of them; a so-called epileptic character arises. The patient’s thinking also changes in a unique way, with an unfavorable course of the disease reaching typical epileptic dementia.

The range of interests of patients narrows, they become more and more selfish, they are entrusted with a wealth of colors and their feelings dry up.” One's own health, one's own petty interests - this is what is increasingly becoming the focus of the patient's attention. Internal coldness towards others is often masked by ostentatious tenderness and courtesy. Patients become picky, petty, pedantic, love to teach, declare themselves champions of justice, usually understanding Justice in a very one-sided way. A peculiar polarity appears in the character of patients, easy transition from one extreme to the other. They are either very friendly, good-natured, frank, sometimes even sugary and obsessively flattering, or unusually angry and aggressive. The tendency to sudden violent attacks of anger is generally one of the most striking features of the epileptic character. The affects of rage, which easily, often without any reason, arise in patients with epilepsy, are so demonstrative that Charles Darwin, in his work on the emotions of animals and humans, took as one of the examples the angry reaction of a patient with epilepsy. At the same time, patients with epilepsy are characterized by inertia and immobility of emotional reactions, which is outwardly expressed in rancor, “getting stuck” on grievances, often imaginary, and vindictiveness.

Typically, the thinking of patients with epilepsy changes: it becomes viscous, with a tendency to detail. With a long and unfavorable course of the disease, the features of thinking become more and more distinct: a kind of epileptic dementia increases. The patient loses the ability to separate the main thing, the essential from the secondary, from small details, everything seems important and necessary to him, he gets bogged down in trifles, with great difficulty switching from one topic to another. The patient’s thinking becomes more and more concretely descriptive, memory decreases, and becomes impoverished. lexicon, so-called oligophasia appears. The patient usually operates with a very small number of words, standard expressions. Some patients develop a tendency to use diminutive words - “little eyes”, “little hands”, “doctor, dear, look how I cleaned up my little bed.” The unproductive thinking of patients with epilepsy is sometimes called labyrinthine.

All of the listed symptoms do not necessarily have to be fully present in every patient. Much more typical is the presence of only some specific symptoms, which naturally always appear in the same form.

Most common symptom is a seizure. However, there are cases of epilepsy without grand mal seizures. This is the so-called masked, or hidden, epilepsy. In addition, epileptic seizures are not always typical. Meet and various kinds atypical seizures, as well as rudimentary and abortive, when a seizure that has begun can stop at any stage (for example, everything can be limited to just an aura, etc.).

There are cases when epileptic seizures occur reflexively, like centripetal impulses. The so-called photogenic epilepsy is characterized by the fact that seizures (major and minor) occur only when exposed to intermittent light (flickering light), for example, when walking along an infrequent fence, illuminated by the sun, in intermittent light from the ramp, when watching programs on a faulty TV, etc. d.

Epilepsy with late start occurs over the age of 30 years. A feature of late-onset epilepsy is, as a rule, the faster establishment of a certain rhythm of seizures, the relative rarity of the transition of seizures to other forms, i.e. characterized by greater monomorphism of epileptic seizures compared to early-onset epilepsy.

Some patients experience character changes soon after the onset of the disease. Patients lose interest in their surroundings and think only about themselves and their illness. At the same time, epileptics are very sensitive to insults, are vindictive, irritable and prone to outbursts of rage, during which they turn to aggression. All these character traits of epileptics lead to the fact that they cannot get along in a healthy team. Along with malice and vindictiveness, epileptics are characterized by sweetness: they are emphatically polite to staff and rude to patients. From obsequious bows and flattery they easily turn to abuse and insult if they are not pleased. Epileptics are characterized by religiosity; patients pray a lot, cross themselves, and bow.

In this case, the epileptic is interested only in rituals, only the ostentatious side of religion, and they perform these rituals with their usual thoroughness. If you are among the sick, an epileptic who constantly prays and bows may be subject to ridicule. And ridicule and careless words can cause an outbreak of anger in epileptics, accompanied by aggression towards the offender. The nurse should be aware of these character traits of the epileptic and, taking them into account, always treat such patients calmly and carefully. One should not place special trust in epileptics; one should not make promises to them if one is not sure of it. that the promise can be kept.

Calm and so-called conscious epileptics often try to help the medical staff in their work, performing various tasks. They are very proud of the work entrusted to them and try to earn the trust of the staff with emphasized diligence. This is very easy for epileptics, since their character traits include sweetness, accuracy and pedantry. But nurse We must not forget that a minor offense can cause an outburst of rage in an epileptic, that sometimes an epileptic, harboring a grudge, can take cruel revenge when the offender has long forgotten about the conflict that once took place.

Epileptics are often annoying; they make the same request several times. After listening to the doctor or nurse’s explanation of the impossibility of fulfilling his wishes, the patient continues to repeat his own. It must be taken into account that this importunity is the same manifestation of the disease as agitation, delirium, hallucinations, and one must respond to the epileptic calmly and politely.

Memorizing facts and events, epileptics cannot distinguish the main from the secondary; the details of the event seem to epileptics to be as important as the event itself. Therefore, when talking about something, the patient cannot briefly express his thought, but marks time for a long time, talks about trifles, and says a lot of unnecessary words. When listening to such a patient, one should not be irritated, since the patient cannot speak more briefly and clearly.

The emotions of an epileptic are persistent: if, under the influence of a conflict or unpleasant news, an epileptic falls into a state of irritation, then he remains in this state for a long time. It’s hard to distract him with anything, funny things don’t make him bold, happy event doesn't make him happy.

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Expressiveness personal characteristics in patients, according to most researchers, depends on the duration of the disease and the severity of its manifestations. The main features of the psyche of such patients is the slowness of all mental processes, primarily thinking and affects. Torpidity, viscosity of thinking, a tendency to be thorough and to get stuck on small, unimportant details are well known to every practical psychiatrist and epileptologist. With a long course of the disease, such features of thinking deepen more and more, the patient loses the ability to separate the main from the secondary, and gets stuck on small, unnecessary details. Conversations with such patients drag on indefinitely. long time, the doctor’s attempt to switch attention to the main topic does not lead to results; patients persistently state what they consider necessary, adding more and more details. Thinking is becoming more and more concretely descriptive, template-based with the use of standard expressions, it is unproductive; According to a number of researchers, it can be described as “labyrinthine thinking.”

A significant role in the structure of personal changes is played by the polarity of affect in the form of a combination of affective viscosity, especially negative affective experiences, on the one hand, and explosiveness and explosiveness, brutality, on the other. This determines such personality traits of patients with epilepsy as vindictiveness, vindictiveness, malice, and egocentrism. Quite often one observes also exaggerated sanctimonious sweetness, emphasized servility, affectionate behavior and a combination hypersensitivity, vulnerability with brutality, malice, hostility, sadistic inclusions, anger, aggressiveness. Even in the old days, religiosity was considered almost a pathognomonic character trait of an epileptic. Now this is explained not so much by the disease itself, but by the fanatical mood of the patients, adherence to the belief system and environment in which they were brought up, which is generally characteristic of infantile people. Patients with epilepsy are often characterized by extreme pedantry in relation to both their clothing and special order in their home and workplace. They make sure that everything is perfectly clean and that objects are in their place.

Patients with epilepsy also have hysterical and asthenic personality traits. These can be hysterical discharges with throwing, breaking dishes, loud shouts of abuse, which is accompanied by angry facial reactions, “shaking of the muscles of the whole body,” a high-pitched squeal, or characteristic of asthenia, which is observed in about a third of patients (A.I. Boldyrev, 1971) .

E.K. Krasnushkin (1960) conducted a ranking typical manifestations epileptic nature, determining that in the first place is slowness (90.3%), followed by viscosity of thinking (88.5%), heaviness (75%), hot temper (69.5%), selfishness (61.5%) , rancor (51.9%), thoroughness (51.9%), hypochondriacity (32.6%), litigiousness and quarrelsomeness (26.5%), accuracy and pedantry (21.1%). Appearance patients with epilepsy is also quite typical. They are slow, restrained in gestures, laconic, their face is inactive and inexpressive, facial reactions are poor, and a special, cold, “steel” shine in the eyes is often striking (Chizh’s symptom).

A very close connection can be traced between the personality characteristics of patients with epilepsy and the formation of final epileptic states (S.S. Korsakov, 1901, E. Kraepelin, 1881). The most successful definition of epileptic dementia is as visco-apathetic (V.M. Morozov, 1967). Along with pronounced stiffness of mental processes, patients with epileptic dementia experience lethargy, passivity, indifference to the environment, lack of spontaneity, and dull reconciliation with the disease. There is unproductiveness of viscous thinking, memory loss, vocabulary becomes impoverished, and oligophasia develops. The affect of tension and malice is lost, but traits of servility, flattery, and hypocrisy may remain. IN initial states the patients lie there, indifferent to everything, their feelings “dry up” (V. Griesinger, 1868). One's own health, petty interests, egocentrism - this is what comes to the fore in the final stage of the disease.

Eilepsy is a disease characterized by convulsive attacks with a disorder of consciousness and peculiar disorders mental activity.

Eilepsy how complex disease has been known for a long time. Back in the 5th century. BC. Hippocrates described the clinic convulsive conditions. He noticed that in some patients, convulsions occurred due to trauma or other painful condition, in others it was an independent disease and was observed throughout life. In this regard, Hippocrates divided all cases of convulsive conditions into a syndrome (against the background of another disease) and an independent disease.

In the 11th century Avicenna introduced the concept of epilamvano, which meant “I grasp,” when describing a grand mal seizure. This word became the basis of the term "epilepsy". Currently there is a division into epileptic syndrome and epilepsy - independent disease, caused by hereditary organic factors. Her hereditary predisposition caused by violation metabolic processes at the genetic level. The organic structure of epilepsy is associated with birth-related traumatic brain injury, infection, intoxication, toxic-allergic lesions of the brain (against the background common infections).

Eilepsy as an independent disease of hereditary organic origin is characterized by large and small attacks, equivalent to a major epileptic seizure, changes in character according to the epileptic type. Episyndrome, which occurs against the background of a skull injury, is accompanied by a change in character according to the traumatic type.

A seizure may occur at night or during the day. It is preceded by distant and immediate harbingers. Distant warning signs (occur several hours before an attack) include dysphoria (changes in mood), headaches, pain in internal organs.

The closest signs of an upcoming attack include the phenomenon manifested by symptoms of irritation of the sensory organs - “aura” (breathing): visual, auditory, olfactory, gustatory, tactile, motor aura (the patient is running somewhere), psychogenic (fear behind the back), vegetative (pain in the abdomen or other organs). Each patient has his own constant aura, indicating the main focus of the lesion. Patients know their aura, sometimes they manage to say that an attack is about to happen, or accept comfortable position. In other cases, the aura time is very short and the patient does not have time to warn others. The attack is characterized by two types of convulsions: tonic and clonic.

Big epileptic seizure begins with a tonic spasm - a spasm in all striated (skeletal) and smooth muscles. The patient falls, loses consciousness and stretches out (tonic convulsion). Due to spasm of the glottis, a cry occurs. Spasm of the articulatory muscles causes tongue bite. Spasm smooth muscle brain vessels causes disruption of the nutrition of nerve cells. Muscle spasm Bladder and rectum leads to involuntary urination and defecation. Breathing and heartbeat decrease sharply. Color changes skin. Coma lasts 20-40 seconds. Then comes the second stage of a convulsive attack - clonic convulsions: rhythmic twitching in all muscle groups, the function of the heart muscle and breathing is activated. Breathing is heavy, hoarse. The saliva forms a bloody foam. The degree of consciousness disorder is stupor. Gradually the cramps become weaker and stop. The patient falls asleep deep sleep; it is impossible to wake him up. This state lasts for several hours. Then the sleep weakens, the patient wakes up. Having woken up, the patient is in a state of prostration, disoriented in the surrounding environment, and does not remember what happened.

The frequency of attacks can vary: from daily to rare (several times a year). For some severe forms epilepsy attacks can follow one after another (up to 50 per day). This condition is called status epilepticus and it may end fatal. In this regard, if an epileptic attack occurs, it is necessary to call ambulance and hospitalize the patient.

Minor seizures manifest themselves in the form of a fleeting loss of consciousness, rapid paleness and gaze forward. Due to a short loss of consciousness, the patient drops objects in his hands and speech is interrupted. Having woken up, he continues his work, the conversation he started, not realizing what was happening to him. One teacher described her student’s condition as follows:
"... M. is working, writing or reading, suddenly he turns pale, his eyes become glassy, his gaze is motionless, he does not respond to calls; after a minute he comes to his senses, yawns and gets back to the interrupted work. When asked what happened to him, he answers that he felt dizzy."

Psychic equivalents.

Sometimes in patients with epilepsy, instead of a convulsive seizure, a confused state of consciousness appears, during which they vaguely, semi-consciously perceive the surrounding reality (twilight state). In this state, patients are able to wander aimlessly, even go to another city, and sometimes commit whole line absurd acts (arson, damage to property, injury, etc.). After the patient regains consciousness, he usually does not remember his actions and actions. Duration mental equivalents can be from several hours to several days. One of the types similar conditions is the so-called sleepwalking (somnambulism), more often known in everyday life called sleepwalking. The essence of the specified pathological condition is that a child, being in a semi-conscious state, can perform a number of unmotivated actions and actions: leave the house, climb onto the roof, walk along the ledge, etc. Moreover, it should be noted that all these movements are performed with maximum precision due to the inclusion of subcortical, brainstem and spinal mechanisms. The patient’s actions are as if automatic. They are deprived top control cortex, which is inhibited during this period.

Manifestations of epilepsy in the form of various seizure substitutes are very diverse. So, in childhood There may be peculiar nodding movements of the head that are of a violent nature (Salaam convulsions). Sometimes a seizure is expressed in the form of a kind of rapid epileptic run forward, accompanied by a cry from the patient.

Epileptic character.

Patients with epilepsy are characterized by peculiar character traits. And sometimes when hidden forms epilepsy, characterological features may be the only signs of the disease, against the background of which, in some cases, certain already pronounced symptoms of the disease may suddenly appear - a twilight state, seizures. Persons suffering from epilepsy are often characterized by a tendency to the affects of anger (pathological malice), cruelty, and traits of sadism, which in children can manifest themselves in the desire to torture animals, mock minors, etc. Sometimes malice and arrogance can be combined with a special cloying politeness, even to the point of sweetness and servility. The mood of epileptics is usually unstable. The so-called “good” and “bad” days are characteristic, and the closer to the attack, the gloomier the mood becomes, melancholy and affective outbursts increase. Epileptics are also characterized by stereotypical behavior; it is difficult for them to adapt to a new environment, to a new regime. From here even minor changes V in the prescribed manner life can lead them into a state of indignation. Epileptic children cannot stand it when someone touches their toys, makes certain movements on the table, in a cabinet, etc. They are characterized by pedantry, sometimes pettiness, reaching the point of scrupulousness in performing assigned tasks. In most cases, they willingly take on work, although their pace labor activity characterized by slowness and low productivity. The intelligence and thinking of epileptics in cases of rare seizures usually do not undergo drastic changes. Such patients can remain productive, study at school, work in production and exhibit extraordinary activities. However, with more frequent seizures, resulting in depletion of the cortex, there is a slowness of thinking, a decrease in intelligence up to dementia (epileptic dementia). Some students with apparitions mental degradation transferred to auxiliary schools.

Pathogenesis of a seizure.

The basis of an epileptic seizure is a stagnant focus of pathological excitation with increased tone (I.P. Pavlov), located in the cortex cerebral hemispheres. Irritation from this focus periodically spreads to the cortex. Any additional irritation increases increased tone, which, reaching the motor analyzer, causes a nervous discharge, an “explosion”. After the first excitation (convulsions), inhibition occurs, which can explain the occurrence of sleep after a seizure. It can be assumed that the formation of a stagnant focus of excitation is the result of various pathological impulses sent to the cerebral cortex.

Manifestations of epilepsy in their pathological basis have a violation correct interaction between irritative and inhibitory processes. Formation of lesions stagnant excitement or inhibition determines the clinical forms of the disease, which, as is known, can be different. The mechanism of the seizure, especially when severe course disease, occurs as a result of neurodynamic disorders, but the latter themselves can be caused structural changes brain tissue. These changes in some forms of chronic epilepsy can be significant. Jacksonian epilepsy (named after the English neuropathologist J. Jackson who studied it) occurs in connection with organic lesions brain, such as a tumor or focal inflammatory process. Typically, attacks are focal in nature and begin with clonic seizures in a specific muscle group, then spreading to other muscles. After the seizure ends, paresis may occur. After surgical treatment, for example, removal of a tumor, seizures stop.

Kozhevnikovsky epilepsy is special clinical form epilepsy, first described by A.Ya. Kozhevnikov in 1894. It is characterized the following signs: the patient, outside of an attack, experiences constant small convulsions in a certain muscle group, which can periodically turn into a seizure. This form epilepsy often occurs after the patient has suffered tick-borne encephalitis.

Convulsions in young children that arise as a result of metabolic disorders, for example, spasmophilia (so-called birthmarks), as well as convulsions in acute period at various intoxications.

Pedagogical activities.

The teacher needs to correctly navigate in cases where a student has an epileptic seizure in the classroom. First of all, you need to make sure that the child does not injure himself traumatic injuries during severe convulsions. It is recommended to support the baby's head. To avoid biting your tongue, you should place a tourniquet of a handkerchief or towel between your jaws. It is strictly forbidden to give water or any medicine to drink during an attack, as the patient can crush the dishes with his teeth, the medicinal liquid can enter the windpipe and cause aspiration. It is advisable that other students do not witness the seizure. If it is possible to note the period of precursors, it is advisable to take the student to the doctor's office or teacher's room. If the seizure started in the classroom, it is better to take the students out of the classroom and into the hallway. It is not recommended to move the patient during an acute attack and generally disturb him. After graduation acute stage(convulsions), it is necessary to ensure rest by transferring the patient to an isolated room.

A child’s ability to study at school depends on the state of his mental sphere. In cases where seizures are rare and psychic sphere the child was not harmed, he can go to school, receiving appropriate treatment and withstanding specific mode. For frequent seizures accompanied by disturbances in mental tone, it is necessary special treatment and relief from academic workload. Children suffering from chronic epilepsy with degradation mental development, have to be translated into special schools.

The upbringing and education of children suffering from epilepsy is given great importance. The formation of the patient’s personality, character, attitude towards himself and others, and, consequently, his social attitudes and place in society depends on the educator. The processes of education and training are inextricably linked. The characterological characteristics of children suffering from epilepsy require a fair and equal attitude from educators. Parents and teachers should not aggravate their feelings of resentment and discontent. Children need to be involved in work at home and at school, to instill in them neatness and respect for work, and a good emotional attitude.

Currently available a large number of medications that weaken or stop seizures, in connection with which children can attend preschool and school institutions. However, one should remember the characterological characteristics of these children, which require attention and the right attitude.