I. Overview.
Epilepsy is a chronic brain disorder caused by multiple etiologies and is characterized by sudden, recurrent and transient central nervous system malfunctions due to excessive neuronal release in the brain. Depending on the site of involvement, the malfunction may manifest as different disorders of motor, sensory, consciousness, behavior, and autonomic function.
Epilepsy is a non-febrile epileptic seizure that can manifest with any type of seizure, usually more than 1 seizure, and may reappear at any time, with each seizure lasting a few seconds, minutes, or ten minutes before it can resolve spontaneously, in a few cases lasting more than half an hour. In the interictal period, everything is as usual for the patient except for the EEG, which may be abnormally issued.
The incidence of epilepsy is highest in childhood. Children, especially infants, are a critical period of brain development and are susceptible to seizures, causing a series of cognitive and behavioral abnormalities and other psychological problems, thus affecting the patient’s school performance and future quality of life. Seizures can avoid secondary cognitive impairment, and combined with early rehabilitation, can significantly improve the prognosis, therefore, epilepsy treatment should be grasped early and small.
Second, etiology.
The etiology of epilepsy is complex and diverse, and the pathogenesis is not yet well defined. Possible etiologies and risk factors include the following.
(a) genetic factors
(ii) Maternal illness, exposure to toxic substances, and psychological trauma during fetal life
(iii) Pathological factors at birth: obstructed labor, asphyxia, neonatal diseases
(iv)previous history of febrile convulsions
(v) neurological disorders and cranial trauma
(VI) Socioeconomic status
(iii) On-site first aid in case of seizures
Generally speaking, epilepsy does not require hospitalization unless the seizure lasts for more than 10 minutes or there are multiple seizures in a day. Prolonged generalized tonic-clonic seizures are sometimes life-threatening and should be treated promptly in hospital. If the child is having a convulsive seizure, he or she should be treated as follows.
1. Quickly hold the child to prevent falling and place him/her on a flat surface or a safe place.
2, untie the collar, cuffs, so that the airway is open, and turn the head and body to the side, so that saliva, mucus and other fluids flow out.
3. Stay by the child’s side until the seizure stops.
4. Observe carefully which parts of the body twitch during the seizure, whether there is consciousness and perception, and record the duration so that you can describe it to the doctor.
5. After the seizure stops, do a good job of cleaning and comforting to eliminate the child’s nervousness.
6. If the seizure persists for 5 minutes without relief, or if there are multiple seizures within 10 minutes, call for help or send the child to the hospital immediately.
IV. Measures and problems of epilepsy treatment
In developing and underdeveloped countries, the treatment status of epilepsy is very backward, and antiepileptic drugs are not promoted in many areas, and patients’ recurrent seizures are not controlled.
Due to the influence of traditional concepts, excessive pessimism about the prognosis, exaggeration and resistance to the side effects of western drugs, lack of confidence and non-compliance of patients, and the confusion of the epilepsy medical market in society, a large number of patients are nominally seeking treatment everywhere, but in fact they do not receive proper treatment, neither getting rid of the disease bundle, nor carrying a In fact, a large number of patients are not receiving proper treatment, not only are they not free from the disease, but they also carry a heavy economic burden, and even some fake Chinese medicines cause irreversible brain dysfunction.
Therefore, how to correctly understand epilepsy, build confidence, scientific and standardized management, and improve the treatment status is an urgent social problem.
The current main methods of treating epilepsy
1.Anti-epileptic drug treatment: It is the main treatment for epilepsy at home and abroad.
2, surgical treatment: only suitable for some patients with epilepsy that is difficult to control by drugs, with certain surgical indications.
3. Other treatments: adjuvant treatment for refractory epilepsy, such as: ketogenic diet, vagus nerve stimulation, transcranial magnetic stimulation, etc.
Five, anti-epilepsy treatment instructions
1. Drug therapy is an important means of seizure control and is the basic method of treatment for epilepsy at home and abroad.
The antiepileptic drug treatment program is long-term, reasonable and suitable for individual characteristics, and should be persistent.
The choice of medication should be made by the doctor according to the type of seizure, age, drug characteristics and side effects, and should not be used blindly.
4. Follow up on a regular basis to monitor the efficacy, drug side effects, intelligence, mental and behavioral, etc., to control seizures without side effects.
5. The medication must be taken on time, in sufficient quantity, regularly and throughout the course to avoid missing doses.
Avoid sudden withdrawal of medication or unauthorized withdrawal of medication.
The prognosis is good in 50-70% of children with epilepsy, who are sensitive to antiepileptic drugs and whose seizures can be easily controlled and successfully withdrawn once they are in remission. The prognosis is inexact in 10-20% of epilepsies, where antiepileptic drugs can control seizures, but they will recur after withdrawal and require lifelong medication, which may be improved by surgery. Another 20% or so of children with epilepsy have a poor prognosis. Most have underlying brain disease, where antiepileptic drugs only reduce seizures, and seizures continue despite multiple drug treatments.
Overall, after discontinuation of antiepileptic drugs, about one-third of patients have a recurrence, most occurring within 2 years. Risk factors for recurrence: seizure type, etiology, head trauma, intracranial infection, and those with abnormal EEG and neurological examination.
Sixth, pay attention to the psychological problems of children with epilepsy
Children, especially infants and toddlers, are a critical period of brain development. Recurrent seizures are bound to cause secondary damage to neurons in the brain, causing or aggravating brain dysfunction and leading to a series of psychological problems. Many children with epilepsy have abnormalities in cognition, learning, behavior, and personality development, which can affect academic performance and school performance in mild cases or prevent them from receiving normal education in severe cases. These fundamental problems, which affect the future quality of life of the affected children in the community, are often neglected in the early stages.
Therefore, infants and children with epilepsy should be monitored for motor, perceptual, and language development, and older children should have early comprehensive psychological evaluation and early intervention to help children build self-confidence and relieve fear, anxiety, dependence, capriciousness, low self-esteem, and other undesirable attitudes, so that children with epilepsy can have their seizures controlled while other functions of the nervous system are fully developed and lay a high quality survival This will lay a good foundation for quality survival.
In conclusion, the most ideal strategy for treating children with epilepsy should be.
Early diagnosis, early treatment, rational use of medication, and regular medication throughout the whole process – to achieve seizure-free;
The support of doctors, family members and society, and the rehabilitation of the whole brain function – sharing a bright life.