Generalized epilepsy - classification of seizures. Atypical epilepsy

Epilepsyrepresents chronic illness characterized by repeated, predominantly unprovoked attacks with impairment of motor, sensory, autonomic, mental or mental functions resulting from excessive neural discharges in gray matter cerebral cortex.

Epilepsy - one of the most common diseases in neurology, especially in children's and adolescence. The incidence (the number of cases of newly diagnosed epilepsy - repeated unprovoked seizures - in 1 year) ranges from 41 to 83 cases per 100,000 children, with a maximum among children of the first year of life - from 100 to 233 cases per 100,000. Prevalence (“cumulative incidence” - the number of patients with active epilepsy per this moment per 1000 population) epilepsy in the population is high and reaches from 5 to 8 cases per 1000 among children under 15 years of age, and in individual regions up to 1% Research recent years showed the prevalence of epilepsy in the Moscow region - 2.4, in the Leningrad region - 3.0 per 1000 of the total population, and in the Republic of Sakha (Yakutia) - 5.5 per 1000 child population [Guzeva V.I., 2007].

It has now been established that epilepsy is not a single disease with different attacks, but is divided into separate forms- epileptic syndromes. Epileptic syndromes characterized by a stable relationship between clinical, electrical and anatomical criteria; vary in response to antiepileptic therapy and prognosis. In this regard, in 1989 it was developed International classification epilepsy, epileptic syndromes and similar diseases. For the first time, the classification was based on a syndromic principle, and not on division into individual attacks. This classification is well known to practical doctors. It should be noted, however, that over the past 18 years, the imperfection of this classification is clearly visible. And in 2001, the International Commission on Classification and Terminology released a draft new classification epileptic seizures And epileptic syndromes (Epilepsy. - 2001. - V. 42. - N 6. - P. 796-803). This project has not yet received final approval, but is currently recommended for use in clinical practice.

In recent decades Significant progress has been made in the study, diagnosis and treatment of epilepsy. This progress is associated with changes in approaches to the classification of epilepsy and epileptic seizures, with the improvement of methods for diagnosing epilepsy (especially the development of video-EEG monitoring and high-resolution MRI), as well as with the emergence of more than ten new antiepileptic drugs, the creation of which was based on the principles of high efficiency and safety .

Due to progress in the study and treatment of epilepsy, epilepsy is now classified as a curable disease, and in most patients (65-70%) it is possible to achieve cessation of attacks or a significant reduction in their frequency, however, about 30% are cases of epilepsy that are difficult to treat. The persistence of a significant proportion of treatment-resistant epilepsy requires further study of this disease and improvement of methods for its diagnosis and treatment.

Treatment of a patient with epilepsy is a complex and lengthy process, the basic principle of which can be formulated as the desire to achieve maximum effectiveness ( minimizing epileptic seizures or their cessation) and the best possible tolerance of therapy ( minimum side effects). Doctors should be aware of the latest advances in the field of epileptology, modern approaches to the diagnosis and treatment of epilepsy. In this case, the maximum effect in treating the patient can be achieved.

However, very much of the treatment of epilepsy depends on effective collaboration between doctor and patient and the patient's family members, from correct implementation medical prescriptions, compliance with the regime, positive attitude for a cure.

This site was created both for doctors and for patients and their loved ones. The purpose of creating the site is to provide doctors with the most complete information in all areas of epileptology, as well as familiarizing patients and their loved ones with the basics of the disease, the principles of its treatment, the requirements for the regimen, the problems faced by the patient and his family members and the possibilities for solving them, as well as obtaining answers to the most important questions about epilepsy .

With deep respect, Professor, Doctor of Medical Sciences, Head of the Clinic of the Institute of Child Neurology and Epilepsy named after St. Luke,

Konstantin Yurievich Mukhin

Genetically determined focal epilepsy associated with age-related hyperexcitability of the central-temporal cortex of the brain. Benign rolandic epilepsy is manifested by rare, occurring mainly at night, convulsive seizures in one half of the face, tongue and pharynx; in some cases - generalized epileptic seizures. The diagnosis is made based on clinical features diseases and EEG data, if necessary, polysomnography and MRI of the brain are performed. Benign Rolandic epilepsy does not lead to disturbances in the psycho-physical development of the child and disappears without a trace by the end of adolescence.

General information

A pathognomonic sign of benign rolandic epilepsy is the detection of high-amplitude sharp waves or peaks located in the central temporal leads against the background of normal basic activity. Often the peak is followed by slow waves; together with the peak they form the so-called “Rolandic complex” lasting up to 30 ms. Visually, such complexes resemble the QRST complexes on an electrocardiogram. Typically, “Rolandic complexes” are localized on the side opposite to the seizures, but they can also be bilateral. Features of EEG patterns of benign rolandic epilepsy include their variability from one EEG recording to another.

Differential diagnosis of benign rolandic epilepsy

First of all, benign rolandic epilepsy needs to be differentiated from symptomatic epilepsies that occur with traumatic brain injury, inflammatory lesions brain (abscess, encephalitis, purulent meningitis). Rolandic epilepsy is confirmed by the absence pathological changes V neurological status and behavioral disorders, intact intelligence, anamnestic data, normal basic activity on the EEG. In some cases, an MRI of the brain is performed to clarify the diagnosis.

Presents great difficulties differential diagnosis benign rolandic epilepsy and nocturnal epilepsy with complex partial seizures. This is due to the fact that speech disturbances typical for an attack of benign rolandic epilepsy can be interpreted as disturbances of consciousness. On the other hand, it is quite difficult to adequately diagnose nocturnal disorders of consciousness. In such cases, EEG data plays a decisive role in making a diagnosis, which, in frontal and temporal lobe epilepsy, demonstrates focal changes in brain activity in the corresponding leads.

Certain difficulties are caused by differentiating classic benign Rolandic epilepsy from pseudolennox syndrome, which is observed in 5% of patients with symptoms of Rolandic epilepsy. The combination of typical rolandic epileptic seizures with atypical absences, myoclonic and asthenic seizures, intellectual-mnestic disorders, as well as the detection on the EEG of diffuse peak activity or slow complexes characteristic of Lennox-Gastaut syndrome, testify in favor of pseudolennox syndrome.

Treatment of benign rolandic epilepsy

For pediatric neurologists and epileptologists, the question of the appropriateness of treatment for benign rolandic epilepsy is highly controversial. Since benign rolandic epilepsy ends in recovery even without treatment, according to some authors, it is not an indication for antiepileptic therapy. Other neurologists, pointing to the likelihood of a diagnostic error when diagnosing “benign rolandic epilepsy” and taking into account the possibility of its transition to pseudolennox syndrome, recommend antiepileptic therapy for repeated epileptic attacks.

In the treatment of children with benign rolandic epilepsy, only 1 antiepileptic drug is always used (monotherapy). Treatment usually begins with one of the drugs valproic acid. If it is intolerable or ineffective, they usually switch to topiramate or levetiracetam. In children over 7 years of age, carbamazepine can be used, but it should be remembered that in some cases it can lead to the phenomenon of aggravation, i.e., an increase in the frequency of attacks.

Generalized epilepsy, also known as primary generalized epilepsy or idiopathic epilepsy, is a form of epilepsy that is characterized by generalized seizures without an obvious etiology.

Generalized epilepsy, as opposed to partial epileptic seizures, are a type of seizure that reduces the patient's consciousness and distorts the electrical activity of all or most of his brain.

Generalized epilepsy causes epileptic activity in both hemispheres of the brain, which can be recorded on electroencephalography (EEG).

Generalized epilepsy is a primary condition, as opposed to secondary epilepsy, which occurs as a symptom of a disease.

Types of attacks

Seizures of generalized epilepsy can manifest as absence seizures, myoclonic seizures, clonic convulsions, tonic-clonic seizures or atonic seizures in various combinations.

Generalized epilepsy seizures can occur in a variety of seizure syndromes, including myoclonic epilepsy, familial neonatal seizures, absence epilepsy, infantile spasms, childhood myoclonic epilepsy, and Lennox-Gastaut syndrome.

Forms of the disease

During attacks of generalized epilepsy, a person usually loses consciousness. But sometimes an attack can be so short that the patient does not notice it. During an attack, the person's body muscles may tense and/or twitch, and the person may fall unexpectedly.

The different types of generalized seizures include:

tonic-clonic seizures;
tonic seizures;
atonic seizures;
myoclonic seizures;
absence seizures.

Symptoms

Tonic-clonic seizures

There are two phases in tonic-clonic seizures – tonic (tonic) seizures and clonic.

During the tonic phase, a person loses consciousness, his body becomes uncontrollable and he falls.

During the clonic phase, the patient's limbs begin to twitch, bladder or bowel control may be lost, the tongue may be bitten, or inner surface cheeks, and also clenching of teeth.

The person may stop breathing or have difficulty breathing, the person may have blue circles around the mouth.

After a tonic-clonic seizure, the patient may experience headaches, fatigue, and feel very unwell. May come deep dream, but after waking up headache and the pain in the muscles of the body persists for some time.

The symptoms of a tonic seizure appear as tonic-clonic seizures. However, in a tonic seizure, it does not reach the muscle twitching stage (clonic stage).

During atonic seizures, a person loses the tone of all muscles and falls. These seizures are very short and usually allow the person to get up immediately. However, physical injury can also occur during these seizures.

Myoclonic seizures

Myoclonic seizures typically involve isolated or brief muscle jerks that can affect some or all parts of the body.

Seizures are usually very short (lasting a fraction of a second) to affect a person's consciousness. Muscle twitching can range from mild to very strong.

Absence seizures

Absence seizures in generalized epilepsy usually develop in children and adolescents. The two most common types of absence seizures are typical and atypical absences.

Typical absence seizures

In a typical absence seizure, the person's unconscious state usually lasts only a few seconds. He seems to be lost in thought, or "switched off" for a second. Minor twitching of the body or limbs may occur. With prolonged absence seizures, a person may perform brief, repetitive actions. During an attack, a person does not know what is happening around him and cannot be brought out of this state. Some people experience up to hundreds of absence seizures per day.

Atypical absence seizures

This type of absence seizure is similar to typical absence seizures, but they last longer.

In atypical absence seizures there is less loss of consciousness and less change muscle tone.

The person can move around, but becomes clumsy and needs help.

During atypical absence seizure, a person may be unable to respond to stimuli.

Diagnostics

Generalized tonic-clonic seizures occur in many various types epilepsy, and establish accurate diagnosis generalized epilepsy based solely on the descriptive or even the observable part of it is quite difficult.

The first difference is determining whether there is actually an event that triggered the attack.

If the inciting stimulus cannot be identified, the second step to determine whether underlying idiopathic generalized epilepsy is present is to conduct appropriate investigations.

The result can be achieved by carefully monitoring the patient's medical history and using EEG and/or MRI studies, with periodic Video-EEG monitoring to fully characterize the epileptic syndrome.

If, as a result of research, it is established that existing signs reflect idiopathic generalized epilepsy, will require additional research, based on careful assessment of seizure types, age of onset, family history, response to therapy, and supporting data.

The disease can be analyzed for the absence of myoclonic, tonic-clonic, atonic, tonic and clonic seizures.

The patient may experience one type of seizure or a combination of several, depending on the underlying syndrome of the disease. As a result, the disease picture can be quite different, and it is required full cycle research to make the correct diagnosis.

Treatment and therapy

There are seven main antiepileptic drugs recommended for the treatment of primary generalized epilepsy:

Felbamate;
Levetiracetam;
Zonisamide;
Topiramate;
Valproate;
Lamotrigine;
Perampanel.

Valproate – relatively old drug showing high efficiency, and which is often considered medicinal drug first line. However, its association with fetal malformations when taken during pregnancy limits its use in young women.

All antiepileptic drugs, including those listed above, can be used in cases of partial attacks of generalized epilepsy.

Limiting certain foods in the diet can significantly reduce the incidence of epileptic seizures.

Epilepsy is a widespread paroxysmal disorder of brain function, manifested by convulsive syndrome. Early detection of the first signs of epilepsy in children makes it possible to control epileptic activity, improving the prognosis of the disease.

Why is it developing?

Idiopathic epilepsy develops spontaneously among full health a child without any provoking factors preceding the onset of the disease. An important role in the development of epilepsy is played by hereditary or acquired predisposition.

Hereditary predisposition

In first place among hereditary causes There is a dominant type of inheritance, when the disease is transmitted to children through a direct hereditary line from the mother or father, usually through a generation. This type of inheritance includes roladnic epilepsy, which is transmitted from a parent to his grandchildren, and children become carriers of the genetic defect.

The recessive type of inheritance includes the juvenile myoclonic form of the disease, which is extremely rare among the pediatric population. For the development of the disease, it is necessary that each parent have a genetic defect that is passed on from generation to generation, but does not lead to the development of the disease. In other words, epileptic symptoms are absent in both parents; planning children in this case requires genetic analysis.

Acquired predisposition

The cause of acquired epilepsy, also known as symptomatic epilepsy, is the influence of various provoking factors. Due to immature brain structures, children are more susceptible to the pathological influence of epilepsy risk factors than adults. The reasons lie in the high lability of the neuro-humoral mediator systems of the central nervous system.

The disease may begin in at different ages, the first signs of epilepsy in infants, provoked by birth trauma or severe hypoxia, are often detected. The reasons that provoke the onset of the disease include:

traumatic brain injuries;
previous viral or bacterial infection;
inflammation meninges, brain structures;
brain cysts;
hemorrhages of brain tissue;
various neoplasms;
rheumatism;
post-vaccination complications;
tick-borne encephalitis;
meningitis;
birth injuries;
infections suffered by a pregnant woman (measles, influenza, scarlet fever).

The time period from the moment of exposure to the provoking factor to the first signs of epilepsy in a child may vary. This depends on the strength of the damaging mechanism, the time of its impact on the brain structures, and the degree of maturity of the brain.

Epilepsy of psychogenic origin, developing due to severe psychological trauma or fright, is a separate rare type of disease. Increased sensitivity the child’s nervous system to psychotraumatic factors leads to the onset of severe neurological or mental disorders, which causes the gradual development convulsive syndrome.

Idiopathic form

Idiopathic, that is, primary epilepsy, develops in completely healthy children without a genetic or acquired predisposition. Morphological changes no anatomical structures of the central nervous system are detected, except for epileptic activity.

Idiopathic epilepsy in children develops spontaneously, in some cases it takes sufficient quantity time due to wear clinical picture. Epilepsy refers to chronic diseases However, with timely initiation of treatment and careful monitoring of exacerbations, convulsive syndrome can be completely stopped.

Causes of epilepsy in children, treatment. Episyndrome. Mom's review.

The Whole Truth About Epilepsy

Epilepsy in children. Signs of epilepsy. Treatment, symptoms. Pediatric epilepsy

The predominance of excitatory mediators over inhibitory ones leads to the appearance of focal paroxysmal activity and the development of convulsive syndrome. In primary epilepsy, such an imbalance may be physiological phenomenon, leading to a seizure only when exposed to additional factors of aggression.

How is it developing?

Main pathogenetic mechanism development epileptic syndrome is the occurrence of spontaneous focal or generalized instability of cell membranes, which provokes the formation of paroxysmal depolarization shifts on the neuronal membrane. Violation of the physiological balance by inhibitory and excitatory neurotransmitter mechanisms leads to depolarization shifts.

In idiopathic epilepsy in children, genetic defects of potassium-sodium metabolism are detected, in which it is impossible to maintain a normal concentration gradient of active ions, and there is a constant release of excitatory mediators. The mechanism of development of epileptic activity consists of:

increased paroxysmal (convulsive) readiness;
epileptic focus;
external epileptogenic stimulus.

Primary generalized childhood epilepsy is characterized by the appearance of an electrical discharge, initially arising in the cerebral cortex, which spreads to the large intralaminar nuclei of the thalamus. This provokes instant involvement in pathological process generalized excitation synchronously bilaterally of both hemispheres of the brain.

Epilepsy in children often develops during puberty, which is caused by global neuro-endocrine changes in hormonal levels and puberty. A pediatrician will determine the beginning signs of epilepsy in a child based on the characteristic clinical picture.

Symptoms

Children's epileptic activity differs significantly from the course of the disease in adulthood - in newborns and infants In the first year of life, tonic convulsions predominate, and in some cases a seizure cannot be distinguished from the child’s normal mobility. Epilepsy in children includes symptoms of convulsive activity, speech paroxysms, and psychosensory disorders.

Harbingers

The disease is characterized by a chronic progradient course with a gradual increase in symptoms, their frequency and severity. The periods between exacerbations gradually become shorter, the duration of seizures increases. From the age of five, the nature of the clinical picture begins to change, precursors or an aura of increasing seizures appear. The aura includes:

headache;
feeling of increasing discomfort;
weakness;
decreased performance;
sudden change of mood.

In children from the age of five years, the aura begins to differ depending on the progression of the underlying disease, with severe course Hallucinations are warning signs of a seizure. In such situations, children see various pictures, usually of a frightening nature.

Seizure

The clinical picture is characterized by seizures, the severity of which depends on the localized form of epilepsy and the strength of the provoking factor. There are several types of seizures:

tonic;
clonic;
tonic-clonic;
atonic;
myoclonic;
absence seizure;
atypical absence seizure.

The differences in seizures are due to different localization pathological focus - in the temporal, occipital or parietal lobes, age of children, etiological factor leading to the development of the disease. In newborns suffering from childhood epilepsy, seizures can only be detected after reaching one and a half years of age due to uncharacteristic symptoms.

The clinical characteristics of the signs of epilepsy in children are the same: seizures pass from one type to another, gradually fading. The classic manifestation of epilepsy is a tonic seizure, gradually turning into clonic muscle contractions.

Tonic seizures

With convulsive tonic syndrome, the child suddenly loses consciousness, falls to the floor, tension appears in all the striated muscles of the body, but the convulsions themselves do not develop. During a fall onto a horizontal surface, a characteristic cry occurs, which is caused by a sharp compression chest respiratory muscles.

Due to spasm and limited mobility of the chest, the skin of children begins to turn pale, and cyanosis gradually increases. As a rule, a child bites his tongue, involuntary defecation and urination. Tonic syndrome lasts no more than one or two minutes, more a long period leads to fatalities, disability of children due to complete cessation of breathing.

When a generalized tonic seizure develops, the pupils dilate and there is no reaction to the light stimulus. Upper limbs bend in elbow joints, lower limbs fully straightened.

Clonic seizures

After a short tonic phase, the classic clonic phase begins, manifested by convulsions of the limbs - jerky movements of chaotically contracting muscles of the limbs, torso, and neck. Breathing is completely restored, tongue retraction, congestion large quantity saliva makes it hoarse and heavy.

Cyanosis skin disappears after breathing begins, foam appears at the mouth white, if the child bites his tongue, the foam becomes colored pink color. The clonic period lasts no more than three minutes, then symptoms begin to regress.

The muscles gradually relax, and complete relaxation, the baby falls asleep. After an attack, patients do not respond to stimuli; superficial and deep reflexes are absent. Soporous depression of consciousness in older children persists for up to three minutes, after which it begins deep sleep.

Atypical seizures

In addition to classic major seizures, there are atypical minor seizures, which last less time and are not accompanied by a fall of the child. A cataleptic attack occurs spontaneously during a violent emotional experience, often during laughter, which is manifested by a loss of balance, a temporary complete loss of muscle tone - the “limping” effect.

During a narcoleptic attack, children may suddenly fall asleep, take atypical positions, and after waking up do not remember what happened. The condition is completely normalized, there are no signs of impaired consciousness. The child feels as if after a night's sleep - cheerful, well-slept, rested.

A hysterical attack occurs as a result mental trauma, accompanied by pronounced negative background, always present strangers. Psychologists identify a special type of hysteria with convulsive syndrome, which accompanies demonstrative behavior disorders in children with attention deficit disorder. The child carefully falls to the floor, controlling the process of falling, screams, hits with his arms and legs, arches his back, hysterical attack can last up to thirty minutes.

Treatment

Early treatment of epilepsy in children allows for optimal control of the condition; early diagnosis mitigates the steady progression of symptoms. Before starting treatment for epilepsy in children, the causes of the disease are determined, a mandatory diagnostic minimum is carried out, and examinations are carried out by specialist doctors - a neurologist, a psychiatrist, a psychologist.

The speed of diagnosis depends on the time and frequency of occurrence of convulsive syndrome and the presence of classic seizures. There are situations when the doctor requires long-term monitoring of the patient, for example, in cases of hysterical attacks.

Treatment for children includes several required components, providing versatile A complex approach. Treatment contains:

adherence to a general schedule and daily routine;
diet;
drug therapy;
neurosurgical manipulations;
psychotherapeutic consultations.

Latest clinical researches epilepsy determined that there is a pattern between early onset illness and severe progressive course. Besides, chronic course, the characteristics of seizures in different children lead to a strictly individual approach to treatment, the absence of general schemes.

Drugs

The choice of drug is made by the attending physician, taking into account the frequency, severity, types seizures, the level of potential toxicity of the drug is assessed. Treatment always begins with one drug, and its dosage is gradually increased. As the severity of the course increases and complications arise, the doctor adds new drugs or replaces the previous ones.

Drug therapy depends on many factors; more than twenty types have been developed medicines aimed at relieving seizures. The ketogenic diet, a complete restriction of fast, easily digestible carbohydrates, has a beneficial effect on the course of the disease. Diet therapy is prescribed by the attending physician; a detailed menu will reduce the risk of vitamin deficiency and low intake of nutrients necessary for a growing body.

If the child begins to attend kindergarten or school, the doctor selects convenient ones for admission medications, parents teach the child to take medications correctly. In addition, caregivers and teachers should be aware of the disease and have a separate medication schedule for children with epilepsy.

Other treatments

Despite significant progress medical science, the disease cannot be completely cured, but it is possible to influence its course, up to the complete relief of attacks throughout life. The benign course of epilepsy responds well drug therapy, does not require additional treatment measures.

If convulsive activity occurs in response to the baby’s tension, the mother can independently learn the technique of relaxing massage. How to carry it out correctly is taught in special courses. In addition, showing various relaxation videos with animals or other positive images has a good effect on the hysterical form of epilepsy.

Stimulation of the tenth pair of cranial nerves – vagus nerve has recently been practiced by domestic doctors, while neurosurgical interventions are used relatively rarely. It's connected with difficult recovery after surgery, the development of postoperative complications.

Epilepsy is a psychoneurological disease that is manifested by the occurrence of sudden convulsive attacks. The disease occurs in a chronic form.

The mechanism of development of attacks is associated with the emergence of multiple foci of spontaneous excitation in different departments brain, and accompanied by disorders of sensory, motor, mental and autonomic activity.

The incidence of the disease is 1% of the entire population. Very often, seizures occur in children due to high convulsive readiness child's body, mild excitability of the brain and a generalized reaction of the central nervous system to stimuli.

There are a lot various types and forms, let's go through the main types of diseases and their symptoms in newborns, children and adults.

Newborn disease

Epilepsy in newborns is also called intermittent. Seizures wear general character, spasms move from one limb to another and from one side of the body to the other. Symptoms such as foaming at the mouth, tongue biting, and post-attack sleep are not observed.

Manifestations may develop against the background of high body temperature. After consciousness returns, there may be weakness in one side of the body, and this can sometimes last for several days.

Symptoms that are warning signs of an attack include:

irritability;
lack of appetite;
headache.

Features of epileptic seizures in children

Over time, myoclonus occurs - involuntary muscle contractions. Mental changes occur very often.

The frequency of attacks can be completely different. They can happen every day, several times a month or even less often. Along with seizures, disturbances of consciousness may occur. However, this form of the disease is the easiest to treat.

This form of epilepsy develops due to brain damage caused by. Symptoms appear in. This type of epilepsy occurs in approximately 10% of victims who have suffered such an injury.

The likelihood of pathology occurring increases to 40% with penetrating brain injury. Characteristic signs diseases can occur not only in the near future after the injury, but also after several years from the moment of injury. They will depend on the site of pathological activity.

Alcohol injection into the brain

- one of the serious consequences of alcoholism. Characterized by sudden seizures. The cause of the pathology is long-term alcohol intoxication, especially against the background of taking low-quality drinks. Additional factors are, previous head injuries, atherosclerosis.

It may occur in the first few days after stopping alcohol consumption. At the beginning of the attack, loss of consciousness occurs, then the face becomes very pale, vomiting and foaming from the mouth occur. The seizure ends as the person regains consciousness. After the attack, a long, sound sleep ensues. Symptoms:

convulsions;
burning pain;
feeling of skin tightening;
hallucinations.

Nonconvulsive epilepsy

This form is a common variant of the development of the disease. Symptoms are expressed in personality changes. It can last from several minutes to several days. It disappears as suddenly as it begins.

In this case, an attack is understood as a narrowing of consciousness, while the patient’s perception of the surrounding reality is focused only on phenomena that are emotionally significant for him.

The main symptom of this form of epilepsy is hallucinations that have a frightening connotation, as well as the manifestation of emotions in extreme their expressions. This type of disease is associated mental disorders. After attacks, a person does not remember what happened to him, only sometimes residual memories of events may arise.

Classification of epilepsy by areas of brain damage

Exist the following types diseases in this classification.

Frontal form of epilepsy

Frontal epilepsy is characterized by the location of pathological foci in frontal lobes brain Can appear at any age.

The attacks occur very often, do not have regular intervals, and their duration does not exceed a minute. Start and end suddenly. Symptoms:

feeling of heat;
disordered speech;
senseless movements.

A special variant of this form is . It is considered the most favorable variant of the disease. In this case, the convulsive activity of neurons in the pathological focus increases at night. Since excitement is not transmitted to neighboring areas, attacks proceed more mildly. Nocturnal epilepsy is accompanied by such conditions as:

somnambulism- committing any active work at the moment of sleep;
- uncontrollable shuddering of the limbs when waking up or going to sleep;
enuresis- involuntary urination.

Lesion in the temporal lobe

Develops due to the influence of many factors, it may be birth injury, damage temporal lobe upon receipt or inflammatory processes brain. Characterized by the following short-term symptoms:

nausea;
stomach ache;
cramps in the intestines;
rapid heartbeat and heart pain;
labored breathing;
profuse sweating.

There are also changes in consciousness, such as loss of motivation and performing meaningless actions. In the future, the pathology can lead to social maladjustment and severe autonomic disorders. The disease is chronic and progresses over time.

Occipital epilepsy

It occurs in small children aged 2 to 4 years, has a benign nature and a favorable prognosis. The causes can be various tumors, congenital brain defects. Symptoms:

visual disturbances - lightning appears;
hallucinations;
rotation of the eyeballs.

Cryptogenic nature of the disease

This type of disease is spoken of when it is impossible to detect main reason occurrence of convulsive attacks.

Symptoms will directly depend on the location of the pathological focus in the brain.

Often this diagnosis is intermediate character, and as a result of further examination, it is possible to determine the specific form of epilepsy and prescribe therapy.

Types of seizures

Epileptic seizures are classified into groups depending on the source of the epileptic impulse. There are two main types of seizures and their subtypes.

Seizures in which the discharge begins in localized areas of the cerebral cortex and has one or more foci of activity are called (focal). Seizures characterized by simultaneous discharges in the cortex of both hemispheres are called generalized.

Main types of epileptic seizures:

At partial During seizures, the main focus of epileptic activity is most often localized in the temporal and frontal lobes. These attacks may be simple, with preservation of consciousness, when the discharge does not spread to other areas. Simple attacks can turn into complex ones. Complex ones may be symptomatically similar to simple ones, but in this case there is always a blackout of consciousness and characteristic automated movements. Also distinguished partial seizures with secondary generalization. They can be simple or complex, but in this case the discharge spreads to both hemispheres and transforms into a generalized or tonic-clonic seizure.
Generalized Seizures are characterized by the occurrence of an impulse that affects the entire cerebral cortex from the onset of the attack. Such attacks begin without a preceding aura, loss of consciousness occurs immediately.

Generalized seizures include tonic-clonic, myoclonic seizures and absence seizures:

Semiology of epileptic seizures:

Briefly about the main thing

It has two directions - surgical. Medication consists of prescribing a complex anticonvulsants, affecting a specific area of the brain (depending on the location of the pathological focus).

The main goal of such therapy is to stop or significantly reduce the number of attacks. Medicines are prescribed individually, depending on the type of epilepsy, the patient’s age and other physiological characteristics.

As a rule, such medications have a number of side effects, so it is necessary to strictly follow all the specialist’s instructions and in no case change the dosage.

If the disease progresses and drug treatment remains unsuccessful, surgical intervention. This operation is the removal of pathologically - active zones cerebral cortex.

If epileptic impulses occur in areas that cannot be removed, incisions are made in the brain. This procedure prevents them from moving to other areas.

In most cases, patients who have had surgery do not have seizures again, but they still need to take medications in small doses for a long time to reduce the risk of seizures returning.

In general, therapy for this disease is focused on creating conditions that will ensure rehabilitation and normalization of the patient’s condition at the psycho-emotional and physical level.

With properly selected and adequate treatment, you can achieve very favorable results, which will help you lead a full life. However, such people should adhere to correct mode, avoid lack of sleep, overeating, staying at high altitude, exposure to stress and other unfavorable factors.

It is very important to avoid drinking coffee, alcohol, narcotic drugs and smoking.