I. Overview
Epilepsy, commonly known as “goat horns” or “goat epilepsy”, is a disease characterized by episodes of trance, or even sudden collapse, fainting, salivation, upward looking eyes, twitching of limbs, or strange screaming at the mouth, and awakening at a later time. It is characterized by abnormal discharge of brain neurons causing recurrent epileptic seizures.
Epilepsy is one of the neurological diseases and the second most common disease after stroke. There are about 9 million patients with an annual incidence of 65-70 million, and about 30% are refractory to epilepsy.
Etiology
It is extremely complex and can be divided into three main categories, with a variety of factors affecting the onset: idiopathic epilepsy and cryptogenic epilepsy (unknown causes) and symptomatic epilepsy (causes can be found, such as birth injuries, traumatic brain injury, tumors, etc.).
III. Diagnosis
1. A complete and detailed history is of great importance for the diagnosis, typing and differential diagnosis and treatment of epilepsy. No matter which type of epilepsy (simple partial seizure, complex partial seizure, generalized seizure, aphasic seizure or continuous seizure).
2. the EEG is the most important ancillary test for the diagnosis of epilepsy.
It is not possible to determine whether epilepsy is epilepsy solely based on abnormal or normal EEG.
3. Tests such as cranial CT or MRI can help diagnose the etiology of the patient, except for brain tumors, strokes, and traumatic brain injury.
IV. Treatment
1.Treatment principles.
Control seizures or minimize the number of seizures, no or few side effects of drugs, so that patients return to daily life.
2. Treatment methods.
(1) Western medicine treatment.
Initial treatment should be selected according to the type of seizure, either traditional antiepileptic drugs such as carbamazepine, phenytoin sodium, sodium valproate, phenobarbital, etc., or new antiepileptic drugs such as topiramate (Tolte), Kaipuran (levetiracetam), Depakene (sodium valproate extended-release tablets), lamotrigine, gabapentin, etc.
As far as possible monotherapy, about 70% to 80% of patients with epilepsy can control their seizures with monotherapy, and poor control can be considered a reasonable combination therapy.
Drug increases can be appropriately fast and should follow the principle of slow and gradual dose reduction. Drug reductions must be slow and must be increased or decreased one by one to facilitate exact assessment of efficacy and toxic side effects.
Each patient should be treated with individualized long-term regular treatment monitoring, and the timing and method of drug discontinuation should be mastered.
(2) Surgical treatment
For those who are not effective in long-term regular monotherapy; those who are treated with two antiepileptic drugs up to the maximum dose successively, and those who are not effective in one regular, combined treatment, surgical treatment of brain lobes or brain tissue can be considered.
(3) Traditional Chinese medicine treatment
Epilepsy is mainly located in the brain and involves dysfunction of the heart, kidney, liver and spleen. The pathological nature of epilepsy is based on deficiency of essence and loss of energy, with phlegm and stasis blocking the ligaments. According to the pathological mechanism of epilepsy, we generally adopt the treatment principles of quenching the wind, opening the orifices with phlegm, activating blood circulation and resolving blood stasis, such as Ding Epileptic Pill with addition and subtraction: Tianma, Chuanbei, Fuxia, Yunling, Fu Shen, Bile South Star, Calamus, Scorpion, Stiff Silkworm, Amber Powder, Cortex, Chen Pi, Yuan Zhi, Dan Shen, Mai Dong, Zhu Sha Powder, Zhu Li, Ginger, etc. bamboo leek, ginger juice, etc.
Acupuncture treatment, mainly to control seizures, reduce the number of seizures, calm the liver and quench the wind, open the orifices with phlegm, activate blood stasis, acupuncture points: Baihui, Fengchi, Yin Tang, Neiguan, Shenmen, He Gu, Foot San Li, Fenglong, Sanyinjiao, Tai Xi, Tai Chong, etc.
V. Precautions
1. to monitor regularly the changes in blood routine, liver and kidney functions to avoid side effects.
2, to monitor the blood concentration of the drugs taken to adjust the drug dose.
3, epilepsy is a chronic disease, the course of treatment is generally long, on the patient’s body, psychology, life and social relationships, patients are prone to anxiety, depression, low self-esteem and other adverse emotions, especially the physical and mental development of pediatric patients, which requires the community to give understanding, care and support to epilepsy patients, especially family members and people around them. In addition, avoid high-risk actions to avoid accidents.
4, do not blindly seek medical advice, do not listen to false advertising, some of the publicity pure Chinese medicine anti-epileptic Chinese medicine in the illegal addition of Western drugs (anti-epileptic drugs).