Epilepsy is a sudden, recurrent and transient brain dysfunction caused by abnormal discharge of nerve cells in the brain, which can manifest as motor, sensory, consciousness, mental and other dysfunctions. The causes of epilepsy are complex, including genetic factors, birth injuries, abnormal cortical development, brain tumors, traumatic brain injury, infections, cerebrovascular disease, metabolism, and poisoning.
The International Health Organization estimates that there are approximately 50 million people with epilepsy worldwide. According to the latest domestic statistics, the incidence of epilepsy is 28.8/100,000 per year, and the prevalence rate is 6.8‰, so there are about 9 million epilepsy patients in China, of which 20-30% are drug-refractory epilepsy and need to consider surgical treatment.
What should family members do when having a seizure?
Family members should carefully observe the symptoms of seizures, including seizure aura, body movements, etc., and make records to help doctors diagnose them when they visit.
2, seizures, the patient should quickly let the patient lie down, to prevent their own sudden fall to the ground and fall head or body, the patient’s head to the side, so that the natural flow of respiratory secretions, the patient’s neck buckle unbuttoned to keep the airway open; to protect the tongue, it is best to put a towel between the patient’s upper and lower molars when the aura symptoms appear to prevent the tongue bite broken, do not forcefully pry open. After the convulsions have stopped, the patient should be supervised to prevent self-injury, accidental injury, injury to others and destruction of objects before consciousness returns.
3. The patient will recover from the seizure after one to two minutes, but if there are two situations, the patient must be sent to the hospital: (a) The whole body is still stiff for more than 5 to 10 minutes. (b) If the patient does not wake up after the grand mal seizure, and then the limb convulsions appear.
4. Give the patient full moral support and help them to build up confidence to overcome the disease.
Timely and regular treatment
If the seizures are more than twice and the EEG confirms epilepsy, they should be treated formally. Drug treatment is the basic method of treating epilepsy, and the basic principles that must be followed are.
1. the diagnosis of epilepsy must be clear.
2. regular and rational use of medication.
3, individualized medication.
4. Blood concentration monitoring is required.
Surgical treatment
Surgical treatment of epilepsy is mainly for drug-refractory epilepsy. It is a treatment method to reduce or eliminate seizures by surgically removing the lesion, blocking the epileptic transmission pathway or reducing the excitability of the cortex.
There are various types of epilepsy surgery.
(1) resection of the epileptogenic focus.
(2) corpus callosotomy.
(3) multiple subchondral transverse fiber dissection.
(4) Stereotactic brain disruption surgery.
(5) chronic vagal nerve stimulation.
(6) deep brain electrical stimulation, etc.
The most ideal and effective method is epileptogenic foci resection, which is one of the internationally respected methods, but the prerequisite for surgical treatment of epileptogenic foci is the precise localization of the epileptogenic foci and cortical functional areas, and only when the localization is clear can the epileptogenic foci be adequately removed under the protection of pre-cortical function.
The main basis of epileptogenic foci localization and the main methods of cortical function localization are.
(1) clinical symptoms during seizures.
(2) long-range video electroencephalography monitoring (V-EEG).
(3) high-resolution magnetic resonance imaging (MRI) examination, and
(4) magnetoencephalography (MEG), the
(5) PET/SPECT.
(6) functional MRI (fMRI).
(7) buried intracranial electrodes, long-range intracranial EEG recording, and
(8) electrical stimulation to localize the distribution of cortical functions such as speech, sensory, motor, etc.
Postoperative precautions
1, postoperative need to follow the medical advice to continue to take medication, adhere to the medication for more than 3 years.
2, regular monitoring of blood drug concentration, liver and kidney function, and blood routine.
3.Regular rechecking of V-EEG.
4. If there is no seizure for 3 years after surgery, the medication can be reduced under the guidance of the doctor.