History of epilepsy
The disease has been known since ancient times, and the first descriptions of epileptic seizures originate some 2,000 years before Christ and are found in the so-called. The ancient Greeks considered that epilepsy was a worldwide illness and that it reflected the body’s obsession. That epilepsy caused by brain disease was first pointed out by Hippocrates who opposed the ancient Greek thought that the brain was a source of epileptic seizures. The attitudes of the disease changed over time, but the dominant popular understanding of the disease is characterized by marked stigmatization throughout all times, up to this day. In spite of scientific knowledge about epilepsy, its emergence, and ways of treatment, the stigmatization of children who suffer from it has been a problem at present and it is a big problem for both children and their parents.
What is actually this disease?
Epilepsy is a chronic neurological disease or a disorder that affects about 2 million children worldwide. It is a Greek origin and means being attacked. The main clinical manifestation is an epileptic seizure, which, like an electrical storm in the brain, besides flash and lightning, causes an eclipse, or various disorders of the state of consciousness, of the motor and sensory phenomena resulting from the outburst and electrical discharge of neurons.
This is one of the most common neurological diseases, affecting more than fifty million people worldwide. It is manifested by the repetition of epileptic seizures, which are transient disorders of brain function. Attacks occur suddenly and in most cases stop spontaneously. It is believed that as many as ten percent of humanity can have one or more seizures during their lifetime. Hippocrates is about 400 BC. The first one found that epilepsy is caused by a natural cause, brain disease, and can be treated like other diseases. It is rarely said that epilepsy is a “stigmatized disease”, followed by discrimination in society.
Epidemiological data show that epilepsy is a very widespread disease in the world. The incidence is 0.5-1%, which means that the number of patients with epilepsy in the world today exceeds 60 million. In the age below 20 (1%) and older than 75 (3%), a significant proportion of epilepsy was significant. In underdeveloped countries, the proportion of epileptic patients (almost 80% of the total) is significantly higher, and the data on a significantly greater prevalence of epilepsy in the so-called ” middle age.
What is an epileptic seizure?
The epileptic seizure is a short-term and sudden disorder of the activity of the neurons (nerve cells) of the cortex of the brain, for which a person can partially or completely lose consciousness-sometimes with convulsive elements.
There are several types of epileptic seizures, but one that is most easily observed is a convulsive generalized attack. It causes simultaneous activation of the entire cerebral cortex – it starts abruptly with the fall, exclamation, and jerks (convulsions) of the muscles of the body. It lasts an average of 1-2 minutes and when the person completes can be disturbed and disoriented for some time.
The second type of seizures, which are more frequent than convulsions, are partial seizures in which a person has only a partial disturbance of consciousness. There is one focal point in the brain that represents the epileptogenic region. Partial attacks can be preceded by an aura (insomnia), after which a person stares at one point, flapping her mouth, and is not in verbal contact. This partial attack usually lasts up to one minute, and afterward, the person gradually comes to full consciousness.
Risk factors for seizures
There are more risk factors that result in epileptic seizures. One group includes those that are a toxic cause, e.g. consuming alcohol or drugs, and in the second, an epileptic seizure usually occurs because the person did not take the therapy, for an unsafe night or an elevated temperature, usually above 38.5C. As most of the above-mentioned risk factors are seen, it can be easily controlled, which every person with epilepsy needs to know.
Division of epilepsy
The classification of epilepsy and seizure epilepsy is very complex and with regard to the development of epileptology, neurogenetics, and pharmacogenetics since 1960. to date, it has been revised more than once in the jurisdiction of ILAE.
Epileptic attacks are divided into:
- “focal” (focal or partial) arising from certain anatomical areas of a single hemisphere of the brain, and whose functional definition makes specific clinical manifestations. They are divided into “simple” without change of consciousness and “complex” with narrow consciousness.
- “Primarily generalized” where both hemispheres of the brain and the neurological manifestations are affected also result in complete loss of consciousness (grand mal attack, absence, myoclonus epilepsy, etc.). It is possible to switch focal points to generalized attacks.
According to the cause of epilepsy, they are divided into:
- idiopathic (“genetic”) associated with genetic deficiency
- Symptomatic (“structural-metabolic”) associated mainly with acquired structural metabolic changes in the brain (post-contraction, post-have magnetic changes, vascular lesions of the brain, tumors …)
- “unknown etiology” (formerly “cryptogenic”).
The diagnosis of epileptic seizures is primarily clinical. The first step in the diagnosis of epileptic seizures is the detailed use of autocatalytic and hetero-anemic data and the overall neurological examination. Laboratory tests to be done immediately are glycemic value (SCT), complete blood count, serum calcium value. After the first search, an electroencephalographic finding (EEG) is indicated, and in some cases a long-term video EEG monitoring. In determining the etiology of the attack, (and in the case of the first partial seizures, it is mandatory), is indicated computerized tomography (CT) of the brain or the finding of nuclear magnetic resonance (NMR) of the brain. Using expensive radioactive substances (Tehnicium 99), an increase in local metabolism of the epileptic focus can be demonstrated (Positron emission tomography – PET; Single-photon emission computed tomography – SPECT).
In therapy, only one antiepileptic is used, and less often in the therapy, there are two or more drugs that operate with different mechanisms. In severe forms of epilepsy, the most common is organic brain damage, which can sometimes be diagnosed as a form of mental retardation or other types of brain damage due to congenital hypoxia or encephalopathy.
Most antiepileptics can, most often at the start of taking the drug, cause a dangerous allergic reaction for which the medication should immediately be discontinued. Sedation is no longer the common side effect of the drug, as with the “older” generation of anti-epileptics. Most antiepileptics are metabolized and activated in the liver and due to the induction of the enzyme, blood tests should be performed regularly and the liver function monitored. Also if a person takes some kind of antibiotic or other medicines.