Epilepsy is a chronic neurological disorder, also known as “sheep’s horn” and “sheep’s epilepsy” in China. There are currently more than 9 million people with epilepsy in China, from infancy to old age, and what is more worrying is that data show that only nearly half of the epilepsy patients in China have received regular treatment. The long duration of the disease, the high disability rate, and the irregularity of treatment impose a heavy burden on the patient’s body, mind, family, and even society. The most common cause of epilepsy is the lack of understanding of epilepsy and the prejudice and discrimination of some people in China. Some people with epilepsy have a sense of shame and are afraid of being known by others, and even gradually become paranoid and depressed. It is important to eliminate prejudice and understand epilepsy correctly. He pointed out that although epilepsy is a chronic disease with a long course, some patients even need to take medication for life. However, through regular treatment, most patients can completely control their condition and achieve clinical cure. Patients can work and live like normal people. ”Throughout history, many famous people were epileptics, but they were just as productive. For example, Julius Caesar, the famous military man and statesman of the ancient Roman Empire.” In addition to Caesar, British poet Byron, French novelist Maupassant, Russian writer Dostoevsky and Italian violinist Paganini were all epileptics. “So we want to tell patients that they should not be pessimistic and disappointed when they have epilepsy, and that they can be just like normal people or even make outstanding achievements through active and regular treatment.” Tracing the roots of the ten causes of epilepsy Why does epilepsy occur? The pathological basis of epilepsy is the occurrence of necrosis, absence, structural abnormality of nerve cells in a certain part of the brain, or blood supply disorder, etc., so that the ability of brain cells to maintain the stability of their own potential is reduced and they are in an unstable state. Once the internal and external environment changes, it causes the nerve cells in that part to discharge suddenly and causes more nerve cells to discharge simultaneously from near to far. In other words, patients with epilepsy have paroxysmal over-discharge of nerve cells in the brain at the onset of the disease, while exhibiting seizure symptoms such as dizziness, convulsions and foaming at the mouth. Epilepsy can be divided into two categories: primary epilepsy and secondary epilepsy, where secondary epilepsy is mainly caused by a variety of organic lesions of brain disease or metabolic disorders. Some patients with seizures have aura symptoms, such as dizziness and stomach discomfort, which mostly belong to secondary epilepsy. There are ten main causes of epilepsy as follows: 1. Genetic factors. Epilepsy has a certain degree of heritability, and primary epilepsy mostly has genetic factors. The offspring of people with epilepsy have a higher chance of developing epilepsy than normal people. 2, birth injury. Birth injuries are a common cause of secondary epilepsy in infancy. There are many reasons for birth injuries, such as abnormal fetal position, oversized fetus, forceps assisted delivery, fetal head suction device attraction, etc. The contusions, edema, and hemorrhage suffered by the infant during delivery may lead to local cerebral sclerosis and the formation of epileptic foci several years later. 3. Trauma. Trauma is mostly seen in various accidents such as traffic accidents, etc. When traumatic injuries such as skull fractures and dural tears occur, the sequelae of epilepsy are more common. This is also a major cause of secondary epilepsy. 4, hyperthermia convulsions. Severe and prolonged febrile convulsions can lead to brain damage including neuronal loss and gliosis, mainly in the medial temporal lobe, especially in the hippocampus. 5. Infections. Various bacterial meningitis, brain abscesses, sarcoidosis, viral encephalitis, and parasitic diseases may induce epilepsy. 6, poisoning. Lead, mercury, carbon monoxide, ethanol, fenugreek, isocarbohydrazide poisoning, and systemic diseases such as gestational hypertensive syndrome, uremia, etc. may induce epilepsy. 7. Intracranial tumors. Clinical intracranial tumors with epilepsy are more common. 8, cerebrovascular disease. Except for cerebrovascular malformations and subarachnoid hemorrhage which produce epilepsy at a younger age, post-stroke epilepsy is more common in middle-aged and elderly people, especially cerebral embolism, cerebral thrombosis and multiple cavernous seizures. Hypertensive encephalopathy is also often associated with epilepsy. 9. Metabolic diseases. Hypoglycemia due to islet cell tumors, diabetes, hyperthyroidism, hypoparathyroidism, and vitamin B6 deficiency can lead to seizures. 10. Degenerative diseases. Epilepsy is one of the main manifestations of tuberous sclerosis. Alzheimer’s disease is also often associated with epilepsy. Out of misconceptions Epilepsy needs formal treatment At present, the proportion of epilepsy patients with formal treatment in China is still low, which is very unfortunate. Due to social prejudices and misconceptions about epilepsy, many patients have taken a wrong turn in their medical treatment. Some patients are reluctant to admit that they have the disease and are afraid of long-term medication, stopping it on their own when their symptoms improve slightly; some patients are anxious to seek medical help and pursue the “root cause”. The main treatment options for epilepsy include The main types of treatment for epilepsy include medical treatment and surgical treatment. Do I have to take medication for epilepsy? In principle, medical medication should be started after a seizure in order to control the condition and prevent another seizure. However, there is a tendency in the medical community to believe that if a patient has no more than 2 seizures in 6 months, he or she can temporarily stop taking medication and start with lifestyle prevention combined with clinical observation of changes in the condition. Lifestyle prevention should mainly pay attention to: avoid over-stimulating sports, too intense sports may induce seizures; avoid risky work, because seizures may cause patients to become unconscious or fall, and accidents may occur, so avoid such as waterfront, high-altitude work, also should not be a driver, electrician, etc.; diet to avoid tobacco and alcohol, do not drink strong tea, strong coffee, nicotine, alcohol, caffeine, etc., on the The first thing you need to do is to avoid the use of a ketogenic diet, i.e., a diet high in fat, low in carbohydrates and appropriate protein; avoid staying up late and being overly fatigued. 2. Does epilepsy require lifelong medication? Once you start using medication to control your epilepsy, is it impossible to stop taking it? It is not absolute. In most patients, the condition is usually controlled clinically for 4 to 5 years, i.e. the brain wave examination confirms that there is no excessive discharge and no clinical seizure symptoms. At this time, under the guidance of a professional physician, the drug can be gradually reduced and discontinued over a period of six months to a year until the disease is still under control without seizures after complete discontinuation of the drug. It should be noted that the adjustment of drugs must be guided by a professional physician, not to think that the control is very good during this period of time and do not eat. Otherwise, it is easy to relapse again. Of course, there are still some patients who need to take medication for life. It is also important to remind patients that epilepsy treatment is a long-term process that requires patience and confidence, and that they should not be impatient just because they occasionally have a relapse. During the medication period, including the drug reduction phase and the early stage of drug discontinuation, it is important to review regularly, and the number of checks should be more frequent at the beginning, usually once every half month. After the disease is under control, the examination is usually once every one to two months, including blood tests to check the damage of the drug to the liver and kidneys, any other side effects, etc., and to monitor whether the blood concentration is within the normal range, in addition to checking the electroencephalogram. These tests can help doctors and patients understand whether the drugs are working and whether they should be added or changed. 3. Can epilepsy be cured? After regular medical treatment, 70% of patients with epilepsy can be cured clinically. However, for patients with poor drug control, are there other treatments available? Is it reasonable for some patients to be anxious to “cure” epilepsy? With the rapid development of EEG and neuroimaging technology, neurosurgical treatment of epilepsy is now a reality. Current surgical procedures include: corticotomy (including temporal lobe and extra-temporal lobe corticotomy), functional cerebral hemispherectomy, corpus callosotomy, multiple subcallosal transection, brain stereotactic surgery (destruction of targets, mainly amygdala and vault), and chronic cerebellar stimulation. In recent years, intermittent stimulation of the vagus nerve has shown some efficacy in intractable partial seizures of unknown origin. Of course, it is important to note that both medical and surgical treatments are not 100% effective. There are both “medically refractory epilepsy” and “surgically refractory epilepsy” in epilepsy patients, which requires further research by the medical community in order for more epilepsy patients to benefit from it.