The epilepsy has gone. Epilepsy: types, causes, symptoms, diagnosis, treatment

— —Yes! —Does epilepsy go away? —The doctor said that it can be cured. We were treated with antiepileptic drugs for 3.5 years, and after that the doctor canceled the pills for us. We have not had seizures for 3 years already, there is no epiactivity on the EEG, no other complaints. The doctor diagnoses us: Epilepsy, clinical-encephalographic remission for 3 years. We will continue to observe, but no longer need to be treated! Our epilepsy is gone!

Such a dialogue can be heard near the office of the epileptologist.

But can it be that epilepsy goes away?

Let's analyze own experience and information from the publication to answer the question: "Does the epilepsy go away?"

So, possible spontaneous remission when the seizures suddenly stop on their own without any treatment or against the background of treatment with antiepileptic drugs.

There are cases when patients get better while taking antiepileptic drugs, that is, the attacks do not recur for some time, then they decide to discontinue medications. Although, most often, the expected duration of treatment with antiepileptic drugs was negotiated by the doctor and known to patients. But hoping for a chance, patients "quit therapy" ahead of time. critical period when such a cancellation occurs, the term for cessation of seizures is from 6 months to 2 years.

And what happens after premature self-withdrawal of anticonvulsants?

There are two options for the development of events after discontinuation of therapy: the resumption of seizures or not.

1. First option - there is a relapse, that is, the resumption of seizures. Patients return to the epileptologist. Therapy is on again. As a rule, a slightly higher dose of antiepileptic drugs is required than previously taken. And the period of taking antiepileptic drugs increases by an average of 6 months - 1.5 years. After such a “life lesson”, patients become more disciplined. Spend the entire necessary period of treatment. And the doctor cancels the drugs after the required remission, as a rule, after a 3-year period.
2. The second option is when drugs are stopped prematurely and there are no more seizures . But the risk of relapse is high. More often, such a cancellation is decided by conducting therapy for half required time. And for another 10 years, the likelihood of resumption of seizures remains. In this case, the risk of recurrence is highest in the first 6 months, and then the risk remains high for 1 year. At this time, if the patient came to the appointment after self-cancellation of AED for a period of several months, then we do not recommend resuming medication. Assign EEG control, continue monitoring and wait possible attack, but only after the attack has occurred, we begin the selection of therapy again.

Usually events develop according to this scenario: the patient is adherent to the treatment, we call this the term "compliant". He realized the importance of the correct long-term continuous use of antiepileptic drugs. And after a few years, usually after 3 years, the epileptologist, gradually reducing the dose over several months, cancels anticonvulsants.

As a result of the joint efforts of the doctor and the patient the patient recovers. And he has epilepsy gone against the background of rational therapy.

I will bring case study which prompted the writing of this article.

I publish this real story with the permission of the patient and her parents, without specifying personal data.

A 13-year-old patient turned to an epileptologist in April 2011 with complaints:

The debut of seizures from the age of 12 (since July 2009) - loss of consciousness, stoppage of gaze, stoppage of activity, sits, does not react. Duration 3 seconds, then a feeling of tiredness, malaise, general weakness. Attacks were once a month, then became more frequent up to 2 times a month. An examination was carried out in a neurological hospital. EEG with sleep deprivation showed no epiactivity. Diagnosis: Syndrome autonomic dysfunction. There are no data for active epilepsy.

Such attacks continued with a frequency of 2 times a month. Then they were treated by the "grandmother", who said that it was epilepsy.

Repeatedly conducted an outpatient examination by a neurologist, who suggested the presence of a neoplasm of the brain and sent for an MRI.

According to MRI in October 2010 - cystic-solid mass in the occipital-parietal region of the left hemisphere.

At the repeated consultation nevrol og established the diagnosis: Symptomatic epilepsy. It was recommended to take Finlepsin 0.2 * 3 times a day for a long time.

Held in January 2011– microsurgical removal of an intracerebral tumor of the left occipital region under neuronavigation control. Neurosurgeons diagnosed: Oligoastrocytoma of the left occipital region. Symptomatic epilepsy.

The dose of Finlepsin was reduced in the neurosurgical hospital to 50-50-100 mg, and then reduced from April 2011 to 100 mg at night.

02/07/11 and 02/17/11 there were three secondary - generalized convulsive attack : nocturnal, pulled the arm and leg to the left with a turn of the head, hard breath, lasting about 1 minute. Then sleep. After 1.5 hours on February 7, 2011, the same attack occurred again.

Since April 2011, at the primary outpatient appointment, a gradual increase in the dose of Finlepsin retard up to 0.2 * 2 times a day has been recommended. On the background long-term therapy finlepsin in this dose of attacks from 02.11 years was not until now. Seen regularly by an epileptologist necessary methods studies with a frequency of 1 time in 6 months.

Currently, remission for epilepsy against the background of therapy is 3 years 2 months and has already been going on for 2 months gradual decline finlepsina retard.

On the this moment in a patient epilepsy gone, that is, no focal neurological symptoms are determined, there are no seizures, and when examining a child, only the MRI picture of the brain reflects past disease. But it happened before: a neoplasm of the brain, an oligoastrocytoma of the left occipital region, a condition after neurosurgical treatment. Symptomatic epilepsy.

On brain MRI images— MR — signs of a postoperative cerebrospinal fluid cyst in the occipital lobe of the left cerebral hemisphere, 46*38*42 mm in size.

it clinical example,when did the epilepsy go away, that is, a long-term remission occurred against the background of ongoing treatment.

Of course, further observation by an epileptologist is required, but without therapy.

Does epilepsy go away? What do the statistics show?

15-35% of brain tumorscause symptomatic epilepsy.

In our experience, approx. 20% of children stop being seen by an epileptologist , starting treatment, and do not apply for repeated consultations.

The reasons for stopping observation by an epileptologist can be different:

1. Moving to a permanent place of residence in another city.
2. Began to see another epilepsy specialist at the medical center.
3. They continue to take drugs and do not apply for an appointment for several years.
4. Can't make an appointment with a specialist.
5. And also, those patients who spontaneously stopped taking antiepileptic drugs, and their seizures did not resume, there was a spontaneous remission for epilepsy.
6. Many others, including personal reasons.

Approximately 50% of patients who spontaneously stop taking medications experience spontaneous remission.

There are different types of epilepsy. And to hope that it is you who will not have a relapse is not correct. Learn more about epilepsy. Reading forums for patients with epilepsy, where many share advice with each other, you can get scared and decide not to risk your health. Better securely recover when the time is right.

Many people on the background of taking anticonvulsants go through a stage of wanting to quit treatment in the hope that epilepsy will go away on its own. Don't make this mistake! Freedom from epilepsy can be found! Observe rational recommendations doctors! And the probability of saying: "" - will be for every seventh out of ten people who conducted necessary treatment epilepsy.

What lifestyle should be followed after removal thyroid gland?

Is it necessary to take hormones after thyroidectomy?

- Yes. After surgery, there is a persistent deficiency of thyroid hormones. This condition is called hypothyroidism. However, this is not a complication of the operation, but its consequence. without mandatory substitution treatment thyroid hormones are indispensable. They are needed to maintain a normal metabolism.

Most often, L-thyroxine or euthyrox tablets are used for this. If their dose is chosen correctly, then the symptoms of insufficient thyroid function disappear. In the blood, the level of hormones T3, T4 and TSH is normalized. With hypothyroidism, you can and should live, work, relax, like everyone else normal people. The only thing that can reduce the quality of life is the need for daily intake drug.

“Is it really necessary to take L-thyroxine for the rest of your life?” Does he have any side effects?

- If the amount of the drug received corresponds to the needs of the body, no undesirable changes should occur. All side effects associated with either excess or deficiency of hormones in the blood. Control of the right choice doses are carried out with the help of periodic blood tests for the hormones T4 and TSH.

- How to determine that the dose of the drug is too high?

- With an overdose, a woman becomes irritable, whiny, restless, gets tired quickly. In spite of a good appetite she is losing weight. May also disturb the heartbeat, interruptions in the work of the heart, excessive sweating, trembling in the hands or in the whole body. In many cases there is a tendency to diarrhea. If there were similar symptoms you need to see a doctor.

- Will weight increase while taking this medication?

- Weight gain can occur with insufficient dosage of this drug. But if normal level hormones are laboratory confirmed, the cause of the weight change is not related to their intake.

- Can taking any other medications affect the level of thyroid hormones?

- Yes. Absorption of L-thyroxine may be reduced with certain stomach medications. These include antacids containing aluminum hydroxide, such as Maalox, Almagel, and Venter. Therefore, you need to drink the drug no earlier than two hours after taking antacids and Venter. It is advisable not to take other medications at the same time as hormonal pills. The two-hour interval is universal, during this time the medicine has time to enter the bloodstream.

The female sex hormones estrogens can also reduce the effectiveness of thyroid hormones. They are found in birth control pills.

- Is it possible after the operation on thyroid gland get pregnant and give birth?

- If you get enough L-thyroxine daily, then there are no restrictions here. When planning a pregnancy, it is necessary to notify the attending physician about this. Every three months you will need to donate blood for a level test. TSH hormones and free T. Remember that the need for L-thyroxine increases during pregnancy.

— It is difficult to answer this question unambiguously. Age, weight and, of course, matter comorbidities. The diet must be selected individually. But there are also general recommendations.

The most important rule: all products must be fresh, and dishes must be freshly prepared. It is equally important to properly store food. For example, vegetable oil poorly preserved in plastic and metal dishes, does not tolerate contact with air and light. Therefore, it is better to keep it in a dark glass bottle. You need to follow the diet. It is better to forget about snacks with sandwiches and pies.

What foods should be preferred and which should be removed from the diet?

- Fat should be consumed no more than 90 g. Of these, a third should be fat plant origin. But they are not recommended for frying, because when heat treatment toxic substances are formed in the oil. The remaining two-thirds should be butter, cottage cheese, sour cream and meat.

Proteins require about 80-100 g per day. Beef, lean pork and cottage cheese, sea ​​fish eggs are reliable sources of protein.

But the amount of regular sugar should be minimized - up to 30-40 g per day. In the absence of allergies to bee products, it is better to replace it with honey. The complex carbohydrates contained in cereals, bread, vegetables and fruits, the body needs about 350 g per day. But it's very important to do right choice: from cereals, you should prefer buckwheat and oatmeal. It is very useful to eat bread with bran. And, of course, vegetables and fruits should be included in the diet. Firstly, they are rich in fiber, which stimulates the intestines. Secondly, they contain natural antioxidants - vitamin C and beta-carotene. Thirdly, there are bioflavonoids in red and yellow vegetables and fruits, which help the proper metabolism in cells.

- Fatty varieties of fish are very useful. They contain substances that "restore" cell walls. You can also recommend dried apricots, raisins: they have a lot of potassium, which strengthens the heart muscle. Good to include in the menu sea ​​kale: she is the champion in the content of trace elements. Kiwi, persimmon, pomegranates, feijoa, as well as black grapes, currants, and chokeberries are very useful.

- Are there any foods that should be tabooed?

- Recommended to be replaced fried foods boiled, steamed, stewed. The substances contained in cabbage inhibit the action of thyroid hormones. Therefore, cabbage should be abandoned. When eating soy, you may need to increase the dose of L-thyroxine, since its proteins reduce the absorption of the hormone. Pickled foods are best replaced with pickled ones. And spicy foods - smoked meat, fish, herring - it is desirable to exclude altogether.

Indeed, some women may experience a decrease in appetite after surgery. But smoked meats can successfully replace a sour apple or a glass of tomato juice 40 minutes before meals.

Do I need to take any dietary supplements?

— Biological needs active additives no after surgery. It is especially necessary to avoid taking "miracle remedies" under the influence of advertising.

- Is it possible to exercise after the operation therapeutic fasting?

- Not. Starvation is one of the factors that disrupt normal exchange thyroid hormones. Special care must be taken with various low-calorie diets.

- Is it possible to do fitness, aerobics after the operation?

- If there are no symptoms or laboratory findings of an overdose of thyroxin, then you can perform any physical exercises, unrelated to increased load on the heart. Quiet swimming, playing table tennis are well suited. Very helpful walks fresh air.

- Can women go south after thyroid surgery?

- You can go south, of course. However, lying on the beach or in the solarium in order to change the color of the skin is dangerous. Under the influence ultraviolet rays Unfavorable fluctuations in hormone levels may occur.

— Is it possible to bathe in the bath after the operation?

- You can go to the bathhouse and sauna, but the time spent in the steam room should be minimal. Sudden changes in temperature are not recommended, therefore, having steamed up, you do not need to jump into icy water.

- Are they able to affect well-being electromagnetic radiation, for example, from a computer?

- You can work on a computer. However, the monitor must be modern, meeting current security requirements.

- Do the removal of the thyroid gland and hypothyroidism affect the duration of subsequent life?

- No, if a woman receives adequate treatment, then life expectancy does not suffer. This has been proven through long scientific research. Those who have undergone surgery and receive hormones are advised to be under the supervision of an endocrinologist, to examine annually TSH level and do an ultrasound of the thyroid gland.

Estrogens contained in birth control pills can reduce the effectiveness of thyroid hormones.

Ludmila ROMASHKINA

Curb the black sickness!

A brain disease characterized by recurrent seizures is perceived by most of us as severe. incurable disease. However, this opinion, entrenched in the mass consciousness, is refuted by Dr. medical sciences, corresponding member Russian Academy medical science, member of the Medical Society of Great Britain and the New York Academy of Sciences Vladimir Alekseevich Karlov in his article on the role concomitant treatment factors in the complex of modern antiepileptic therapy.

Don't encourage disease!
As you know, "the retinue plays the king." This expression also applies to epilepsy, whose seizures are often provoked by her "companions". Excitation of brain cells leads to their excessive bioelectrical activity. It causes a variety of seizures, similar topics that arise from electrical discharges. The most severe seizures. Depending on the part of the brain where the discharge occurs, muscle tension is replaced by convulsions, the patient's face becomes bluish (hence the old name " black sickness"). Provocateurs can be overexcitation, overwork, stress, lack of sleep, alcohol. It is they who often play a role trigger for the onset of the next attack of epilepsy.
Lack of sleep - at first glance, this is a mere trifle, nothing. However, for an epileptic, the normal eight-hour night rest - the most needed medicine. Therefore, you will need evening walks in the fresh air, otherwise - a reception sedatives- valocordin, infusion of valerian, wild peony. But discos, with their loud rhythmic music, flickering light, crush, are clearly contraindicated.
Sun glare on the waves of the sea, flickering bright flashes of light outside the window of a moving train also serve as risk factors for some forms of epilepsy. Naturally, they are easy to avoid, for example, with the help of tinted or special glasses, and tanners suffering from epilepsy are better off avoiding overheating in the sun. And many hours of sitting at a computer or in front of an ordinary TV, with its flashing frames, will also have to be left.
In physical education, you also need known limitations. Climbing, swimming, including scuba diving, boxing are contraindicated. It is better to give preference to walking, gymnastics and weightlifting, which help to suppress the epileptoid activity of the brain.
Seizures are stimulated and malnutrition. "Vodohlebam" should reduce fluid intake. An addiction to spicy, salty foods usually increases fluid intake. There is a delay in the body and swelling of the brain tissue, growing intracranial pressure and then another attack follows. But most worst enemy epileptic is considered alcohol. That is why doctors advise using decoctions for treatment, and it is imperative to dilute tinctures and extracts with alcohol.

Herbs, herbs...
Sick epilepsy shown herbal preparations, with soothing and soft .
Novopassit, for example, is a complex of dry or liquid extracts lemon balm, hawthorn, valerian, black elderberry, passionflower and excipient guaifenesin, which reduces the condition mental tension as well as fear. Novopassit is taken 1 tablet or 1 teaspoon with juice, tea three times a day.
An extract is prepared from the shoots of passionflower (meat red passion flower), which has a sedative effect on the central nervous system, has anticonvulsant activity. It is usually prescribed for 20-30 days, 20-40 drops three times a day.
ethnoscience recommends different ways help these patients. Fees of various medicinal plants provide a versatile and soft effect, complementing basic therapy and help reduce dosage pharmaceuticals. For the most part, these are collections of 6-8 plants, including calamus, yarrow, tansy and viburnum, St. John's wort, licorice, blue cyanosis, lemon balm, plantain. To prepare the infusion 1-2 tbsp. spoons of raw materials are poured into a glass of water, kept in a water bath for 15 minutes. Reception - 1/3 cup three times a day. Course - 3-6 months.
Has soothing properties, for example, infusion of roots: 1 tbsp. a spoonful of crushed roots is poured into 1 glass of cold boiled water, insist 6-8 hours, drink 1 tbsp. spoon (children - 1 teaspoon) three times a day. The course is 1.5-2 months. In addition, every other day take a 15-minute bath before going to bed from a decoction of valerian roots (a handful of roots per 1 liter).
The motherwort has also proven itself well: 2 teaspoons of the crushed above-ground flowering part are poured into 0.5 liters of boiling water and insisted for 2 hours. Drink 1-2 tbsp. spoons before meals 4 times a day.
With increased excitability, insomnia, an infusion of evading peony roots (marina root) is prepared: 1 teaspoon of crushed raw materials is poured with boiling water, insisted for 30 minutes in a tightly closed container and taken 1 tbsp. spoon three times a day 10-15 minutes before meals. An overdose is dangerous. If there is no wild peony, you should use pharmacy tincture(30-40 drops three times a day, the course is 30 days) or, at worst, take a dark red garden specimen of the plant. In the latter case, fresh petals and leaves (100 g each) are infused in 200 ml of alcohol for 2 weeks and 10-15 drops are taken, diluted with water, three times a day for half an hour before meals.
In Siberia, Transbaikalia and Primorye as anticonvulsant often used in the form of a powder and in a decoction, the rhizome of the Baikal skullcap or. single dose is 3-10 g. Usually, 20 g of the branches of this evergreen shrub collected during flowering are infused for 1 hour in a glass of boiling water and then drunk 1/3-1/2 cup before meals three times a day. Chernobyl roots collected during flowering are suitable for the same purpose: 30 g of roots are poured into 0.5 liters of beer and boiled for 5 minutes, drunk until the sweat stops.
Compliance with the simple rules that I have listed allows you to most often achieve improvement. For most patients, the disease does not interfere with life at all. full life and work productively. However, those who have lived without seizures for at least 3-4 years and whose electroencephalography confirms the absence of epileptoid brain activity can consider themselves cured.

Only together
Friendly association "doctor, patient and environment of the patient" - necessary condition success in the fight against epilepsy. Everyone on the team has a role to play. The doctor determines the strategy drug treatment. notice, that universal remedy capable of eliminating all types epileptic seizures not yet found. But an effective combination different medicines, if necessary, is realistic, although it requires careful selection of combined drugs that affect the concentration of anticonvulsants in the blood.
Modern medicine can reduce the frequency of seizures and even stop them completely. Now about 20 drugs are used, the selection usually begins with the appointment of one of the basic ones (finlepsin, valproate, tegretol, depakine).
In spite of high efficiency, anticonvulsant drugs give side effects: drowsiness, lethargy, allergic rash and others. And here the patient himself should act as a partner of the doctor, strictly observing medical advice. And the patient, it happens, stops taking the pills, becoming a violator of the much-needed continuous and long-term treatment. Deviations can exacerbate the disease and even lead to the so-called status epilepticus, that is, attacks that repeat one after another or one, but protracted, and sometimes with a fatal outcome.
I advise you to cook in the evening, in advance necessary pills the next day. In addition, an alarm clock or cell phone call can serve as an assistant reminding you of the time to take the medicine.
The help of relatives and friends of the patient is also an important component of the treatment program. The complicity of others is simply necessary so that the patient does not feel isolated, cut off from other people and does not suffer from an inferiority complex.
In everyday life, it is important to know how to properly provide first aid to the patient. During an attack with loss of consciousness, do not try to hold it and move it to another place. To prevent a person from injuring himself, to avoid injury, put something soft under his head, unbutton clothes that make it difficult to breathe. And don't try to open your jaw, put pills in your mouth, or pour in water.
If the attack lasts more than 5 minutes or recurs, medical attention is required.

Doctor of Medical Sciences, Vladimir Alekseevich Karlov

According to the magazine " healthy image life" №12 for 2008

-- [ Page 2 ] --

Paraclinical methods included: EEG - study in dynamics, MRI of the brain, hormonal examination, with determination of the level of sex hormones (luteinizing, follicle-stimulating, prolactin, progesterone, estradiol, testosterone) on fixed days menstrual cycle(7 and 21) and thyroid hormones (TSH, T3, T4), All patients underwent ultrasound procedure thyroid and pelvic organs. All women were examined by a gynecologist and an endocrinologist.

The results of the study were subjected to statistical processing methods using multifactorial analysis of variance(MANOVA), Student's t-test, test 2 (SPSS 11 version).

Psychopathological qualification of mental disorders in the clinic of epilepsy in women was carried out according to diagnostic criteria ICD-10, on the basis of which patients were selected for the study in accordance with section F.06 " Mental disorders due to damage or dysfunction of the brain.

When determining the form of the disease and the structure of the leading paroxysmal syndrome used the modern classification of epilepsy (New Daily, 1989) and epileptic seizures (Kyoto, Japan, 1981).

In the present study, two subtypes of epilepsy were studied: catamenial and non-catamenial, with an assessment of the characteristics of their course depending on the presence of concomitant psychopathological disorders and endocrine and gynecological disorders.

Research results

It was found that catamenial epilepsy in the entire studied sample was no more than 19%, while non-catamenial epilepsy, respectively, accounted for 81%, i.e. non-catamenial epilepsy occurs 4 times more often than catamenial epilepsy.

At the same time, among patients with a catamenial pattern, women with a perimenstrual subtype of onset of seizures prevailed (20 people, 87%) over patients with a follicular subtype of onset of seizures.

Comparison of patients with catamenial and non-catamenial onset of seizures revealed some differences, indicating a longer duration of endocrine pathology in the group of catamenial patients. In addition, there was a trend towards more early start, both epilepsy and endocrine pathology compared with patients with non-catamenial epilepsy (see Table 1).

Table 1. Clinical and anamnestic age characteristics of patients with catamenial and non-catamenial epilepsy

Age-related clinical and anamnestic characteristics	Catamenial epilepsy (n=27)	Non-catamenial epilepsy (n=114)	Differences
Age	26+-7,4	25,4+-7,4	n.z.
Age of onset of epilepsy	12,6+-4,9	15,4+-7,7	n.z.
	16,9+-4,1	19,4+-6,8	n.z.
Duration of epilepsy	13,5+-8,6	10,3+-8,0	n.z.
	9,3+-7,0	5,8+-3,8	p=0.0013
- diseases	4,3+-5,3	3,9+-7,8	n.z.

Table 2 Correlation between menstrual dysfunction and thyroid pathology

Endocrine-gynecological pathology	Pathology of the thyroid gland	Absence of thyroid pathology	Total
Menstrual dysfunction	7	83	90
Normal menstrual cycle	24	27	51
Total	31	110	141
Significance	2 =29,29	= 0,45	p= 0,000

Moreover, it turned out that thyroid pathology and menstrual dysfunction are largely mutually exclusive ( 2 =29.29; p=0.0000). At the same time, in the entire sample of patients, the simultaneous presence of thyroid pathology and menstrual dysfunction occurred only in 5% of patients. On the contrary, a combination of thyroid pathology and normal menstrual function - in 17% of women; whereas normal condition thyroid gland and menstrual dysfunction - in 59%, and the normal state of the thyroid gland and normal menstrual function - 19% of women.

So the pathology endocrine system in the studied contingent of women with epilepsy, it mainly goes in one direction. In this case, either the hypothalamic-pituitary-gonadal axis is predominantly affected (59%), or thyroid pathology occurs (17%). Approximately one fifth of women do not have any neuroendocrine pathology.

At comparative analysis age-related characteristics of neuroendocrine disorders and epilepsy revealed some dependencies (see Table 3).

Table 3 Age characteristics epilepsy and endocrine pathology, depending on the nature of the comorbid endocrine disorder

Index	Violations reproductive function(n=73)	Thyroid disorders (n=26)	Significance
Age of patients	25+-0,93	26+-1,5	n.z.
Age of onset of epilepsy	14,7+-0,92	15,2+-1,4	n.z.
Duration of epilepsy	10,7+-1,06	11,5+-1,5	n.z.
Age of onset of endocrine pathology	17,9+-0,77	22,1+-1,2	p=0.005
Duration of endocrine pathology	6,7+-0,61	4,9+-0,60	n.z.
Interval between the onset of epilepsy and endocrine pathology	3,2+-0,97	6,9+-1,20	p=0.04

It follows from the table that the entire group reproductive disorders debuts in female epilepsy before pathology thyroid gland for an average of about 4 years (p=0.005). This also corresponds to a shorter interval between the onset of epilepsy and the appearance of reproductive disorders compared to the interval between the onset of epilepsy and thyroid pathology (p=0.04).

Thus, it can be considered that a group of reproductive disorders in women with epilepsy occurs at an earlier date than thyroid pathology. It is likely that the disunity of the appearance of these disorders in time to a large extent predetermines their mutual exclusion in most patients. Epilepsy in this case first affects the hypothalamic-pituitary-gonadal axis and only after about 4 years on the hypothalamic-pituitary-thyroid axis.

Given the high incidence of menstrual dysfunction and thyroid pathology in women with epilepsy, it seemed appropriate to analyze possible links between this pathology and catameniality/non-catameniality factor. The main data for this section are presented in Table 4.

When analyzing the relationship between the pathology of the gynecological sphere and the thyroid gland with indicators of catameniality and non-catameniality, there were revealed trends in the relationship between catamenial epilepsy with concomitant pathology in the form of menstrual disorders (p=0.056), while in non-catamenial epilepsy - with thyroid pathology (p=0.076) .

Table 4

Correlation between menstrual dysfunction and thyroid pathology with catameniality factor in women with epilepsy

Pathology	catamenial epilepsy	Non-catamenial epilepsy	Total
Menstrual dysfunction	21	66	87
Normal menstrual function	6	48	54
Total	27	114	141
Significance	2 =3,65	= 0,17	p= 0.056 (n.c.) p=0.04, (T.m.F).
Thyroid pathology	2	29	31
Absence of thyroid disease	25	85	110
Total	27	114	141
Significance	2=3, 15	= 0,17	p=0.076 (n.c.) p=0.03 (T.m.F.)

The diagnosis of "epilepsy" is the basis for the refusal of a person when applying for a job in many specialties. For example, those suffering from convulsive epileptic seizures are forbidden to work as teachers, doctors, they cannot go on stage as an actor, and it is not recommended to perform duties in other areas where contact with people is expected. In a number of countries, with any type of epilepsy, until recently it was forbidden to officially register a marriage union.

What is epilepsy: types and symptoms of the disease

So what is epilepsy, and why are the symptoms of this disease of such high concern?

Epilepsy (from Greek epilepsia - to take, to seize) is chronic illness manifested by convulsive and non-convulsive seizures, mental disorders and specific personality disorders. This disease was also called "sacred" (due to frequent psychoses of a religious nature), "lunar" (due to sleepwalking - sleepwalking), "falling".

What is epilepsy, and what are the characteristics of each type of this disease?

Distinguish between true (idiopathic) epilepsy as an independent disease and symptomatic - as epileptic syndrome with the underlying disease, whether it be the consequences of a craniocerebral injury, neuroinfection, vascular, tumor brain damage or manifestations of intoxication, for example, with alcoholism. In the latter cases, there is a change in the metabolism in the brain due to its edema, due to irritation of its membranes, due to malnutrition or destruction of its cells, and so on. Here important role plays the treatment of the underlying disease, which often removes attacks or makes them more rare.

True epilepsy can develop without visible reasons, so many believe that it is based on hereditary factors. The body's predisposition to seizures is associated with a hereditary change in metabolism. But even here, in many cases, it is still necessary to implement this hereditary predisposition with various factors acting during the period prenatal development, during childbirth and immediately after them (infections, intoxications, injuries).

With the manifestation of signs of epilepsy, electroencephalography of the brain is done to diagnose the disease. This method allows, based on the electrical activity of the brain, to identify a decrease in the threshold of convulsive readiness and an epileptic focus.

Everyone has convulsive readiness, that is, the readiness of the brain to respond to an irritant with an epileptic discharge. But for healthy person this irritant must be of extreme strength, for example, a body temperature of 40 degrees against the background of severe dehydration, an electric shock.

And sometimes it is enough for a patient with epilepsy emotional tension, loud sound, bright light, and more often even without provocation. He has already formed an autonomous pathological epileptic system, consisting of an epileptic focus (group nerve cells, constantly in excitation), pathways for the propagation of an electrical discharge and brain structures that activate the focus (limbic-reticular and thalamic systems responsible for biological rhythms human, body homeostasis). Therefore, often the symptoms of epilepsy appear only at night, or on a full moon, or only during menstruation.

If a person is not treated, then this stable system formed on average within 4 years. And treatment involves taking antiepileptic drugs for 3-5 years from the last attack.

In contrast to the epileptic one, there is also an antiepileptic system with its own inhibitory centers and substances that extinguish many discharges along the way, preventing them from escalating into an attack.

Types of seizures in epilepsy: generalized and partial seizures

What are epileptic seizures and what are they significant difference? All seizures in epilepsy can be divided into generalized (with loss of consciousness) and partial (local).

Often, but not always, a seizure in epilepsy is preceded by an aura (from the Greek for "breath"), a fleeting sensation. These can be flashes of light, a change in contrast or illumination, or the color of objects. Patients may smell various non-existent odors (smoke, rot, apples) or hear sounds that are not actually there. Various sensations in the body, nausea, vomiting and palpitations may occur. There may be experiences of something terrible, terrible, or, conversely, something pleasant and sublime. These states last a few seconds, but during this time you can prepare for an attack, take a safe position. Helps prevent this type of seizure in epilepsy in some cases deep breathing squeezing the thumb on the sides of the nail or little finger across the nail, or wrap thumb inside the palm, or press on the point under the nose above upper lip. You can come up with something of your own that can bring down painful impulses in the brain.

Partial (local) seizures of epilepsy are characterized by the absence of loss of consciousness, falling. An epileptic discharge does not capture the entire cerebral cortex, but is limited to one or more foci. Seizures depend on what exactly this zone innervates. These can be convulsions of individual muscle groups, elementary sensations in the body (tingling, burning), sensations of changes in individual parts of the body (more, less) or objects, illumination, contrast, speed of subjective movement of time. Seizures can be accompanied by various hallucinations, and can be manifested in the acceleration or deceleration of thinking, in the form of paroxysmal mood changes (fear, rage, joy, ecstasy). Such signs of epilepsy as sensations of deja vu (deja vu) - “already seen”, “already experienced”, “already heard” - also belong to the partial type of seizures. The same can be said about some headaches ().

Large and small convulsive epileptic seizures

Generalized seizures can be divided into major and minor.

Big epileptic seizure occurs instantly with loss of consciousness, lasts 2-5 minutes. More often it consists of two stages: tonic and clonic.

After turning off consciousness, the patient falls, and fractures, dislocations and bruises are possible. During the tonic phase, there is a sharp tension of the entire musculature. The patient may scream because of the convulsively compressed glottis.

Usually the eyes are open, breathing stops, blueness appears skin, involuntary urination. This phase lasts 30-50 seconds.

Then comes the phase clonic seizures. There are alternate contractions of the flexor and extensor muscles of the trunk, arms, legs. Breathing is hoarse, gurgling. The patient's eyes roll back. Foam appears on the lips, a bite of the tongue is possible. To prevent it, a spatula or the back of a spoon is inserted between the molars, always wrapped in a napkin or towel to avoid damage to the teeth. The person is placed on their side to prevent vomit from entering the lungs. The duration of the phase is 1-3 minutes.

The post-seizure state lasts from several minutes to several hours. The gaze is wandering, the consciousness is unclear, the speech is incoherent. Most of the time, sleep follows. The seizure is completely amnesic (can't remember). The epileptic seizure ends on its own, without requiring any medicines, call an ambulance. Unless it's status epilepticus when the attacks follow one after another and in the intervals between them the patient does not regain consciousness, or not a series of seizures, when the patient comes to, but there are several attacks. In these cases, emergency assistance is needed.

Small epileptic seizures are short-term (several seconds) switching off of consciousness, convulsive phenomena are insignificant. At the same time, a person does not fall, and others may not even notice a seizure. One of the varieties of small seizures is absence (from the French absence - “absence”). At the same time, a person freezes in one position for several seconds, becomes silent, as if turned off, his gaze is fixed on one point. And then he continues the interrupted conversation or lesson from the place where he stopped. At the same time, he also does not remember the attack.

Do's and Don'ts for Epilepsy

Everyone should be able to help with an epileptic seizure, because anyone can become a witness to a seizure in a patient.

Here's what to do during an epileptic seizure to help relieve a person who has a seizure:

1. When assisting with epilepsy, remain calm and do not panic, remember that an extended epileptic seizure does not last long.

2. Remove solid or sharp objects, remove it from the danger area (for example, from the carriageway).

3. Put something soft and flat under his head.

4. Take off your scarf, tie, open your shirt collar, etc. to make it easier for him to breathe.

5. If possible, lay the patient on their side to prevent vomit from entering the Airways.

6. Stay with the patient until the end of the attack and calm him when he comes to his senses.

What to do with epilepsy if:

• the seizure lasts more than 4 minutes;
• seizures follow one after another with short breaks;
• the patient does not regain consciousness after the cessation of convulsions;
• there are noticeable injuries;
• Does the person feel sick after the seizure is over?

In this case, you should immediately call an ambulance.

You also need to know what you can not do with epilepsy, so as not to harm the patient:

• try to delay convulsions: the patient can break his bone, tear his muscles;
• sticking hard objects between the teeth: the patient may break the teeth or bite off part, and foreign body may enter the respiratory tract;
• do artificial respiration if breathing has not stopped, especially if there is a possibility of vomit entering the respiratory tract; you need to clear your mouth of them.