Epilepsy is a chronic brain dysfunction syndrome caused by a variety of etiologies. It manifests as loss of consciousness, limb convulsions, numbness, sweating, urinary incontinence and mental disorders, and each seizure lasts for a few seconds or minutes. Epilepsy is not only a medical problem, but also an important public health issue. Patients with epilepsy should get out of the misconceptions and choose a regular hospital for reasonable and standardized treatment.
I. Diagnostic misconceptions
Myth 1: If a patient has a convulsion, it is epilepsy.
Convulsions are one of the main symptoms of epilepsy, but they are not unique to epilepsy. Other diseases can also cause convulsions, such as hysterical convulsions, hypocalcemic convulsions, pediatric hyperthermia convulsions, hypoglycemic convulsions, etc. are not part of epilepsy. Therefore, convulsions may not always be due to epilepsy. Also, some types of epilepsy do not have convulsive symptoms, such as aphasic seizures, temporal lobe epilepsy, ventral epilepsy, and headache epilepsy. There is only numbness of the limbs or visual or auditory abnormalities, or only a single limb convulsion, or only a manifestation of unconsciousness, etc. Therefore, convulsions should not be equated with epilepsy. Epilepsy manifestation is twitching of the arms and legs, without convulsions it is not epilepsy.
Misconception 2, one seizure is epilepsy.
A single seizure can only be called an epileptic seizure, which is only a symptom, just as a cough is not necessarily the same thing as pneumonia. There are multiple seizures, and affect daily life, work to be called epilepsy, a group of diseases.
Myth 3: Large convulsive movements are grand mal seizures and small movements are petit mal seizures.
Both major and minor seizures are generalized seizures. The size of the seizure is not differentiated by the magnitude of the convulsive action. The major seizure has a full-body limb convulsion, while a typical petit seizure has only a brief (no more than 1 minute) loss of consciousness and no convulsive movements. Some patients or family members identify all other forms of seizures other than generalized grand mal seizures as petit mal seizures, which is obviously inaccurate. The clinician has to be accurate and select the right medicine according to the patient’s medical history and symptoms in order to receive better results.
The majority of patients with seizures are accompanied by loss of consciousness.
The vast majority of patients with epilepsy have loss of consciousness with their seizures. However, some types of epilepsy, such as limited seizures, myoclonic epilepsy and other patients are clearly conscious during seizures. Therefore, the diagnosis of epilepsy should not be denied and treatment should not be delayed because the patient does not lose consciousness.
Myth 5: Primary epilepsy is associated with heredity, while secondary epilepsy has nothing to do with heredity.
A large number of surveys of epileptic patients and their blood relatives found that not only is primary epilepsy associated with heredity, but the incidence of secondary epilepsy in the immediate family is much higher than in the general population. Patients who have had traumatic brain injury, encephalitis, meningitis, or a history of birth asphyxia do not always develop epilepsy. This suggests that the occurrence of epilepsy depends not only on the strength of environmental factors, but is importantly determined by congenital genetic factors. The lower the threshold, the more likely epilepsy will occur.
The actual fact is that you can find a lot of people who are not able to get a lot of money for their own use.
The most important thing to remember about epilepsy is that it is hereditary, but the effect on the next generation is not 100%. In general, only 5% of the children of epileptic patients have epilepsy, so epileptic patients can have children. The law in China does not explicitly forbid people with epilepsy from having children. However, from a eugenic point of view, it is best for epileptics to avoid marrying people with low convulsive thresholds (including epileptics and those with a history of febrile convulsions), and epileptics should have children after their condition is stable and their seizures are basically controlled.
Myth 7. A normal EEG does not diagnose epilepsy.
The EEG examination is of great value for the diagnosis of epilepsy, differential diagnosis, and is an essential auxiliary examination for the diagnosis of epilepsy. According to statistics, 80% of epileptic patients have abnormal EEG, while about 5-20% of epileptic patients have normal EEG during the interictal period, and there are some people with abnormal EEG who never have seizures. Therefore, the diagnosis of epilepsy cannot be ruled out clinically because the EEG is normal, nor can the diagnosis of epilepsy be made because the EEG is abnormal. The correct diagnosis can only be made by combining the medical history and clinical seizure performance and comprehensive analysis.
The first thing you need to do is to get a good idea of what you are doing.
The first thing you need to do is to take a look at the actual product.
Epilepsy is a very ancient disease, which is recorded in the Yellow Emperor’s Classic of Internal Medicine, indicating that our ancestors have been studying this disease for a long time and have been exploring the treatment of this disease since ancient times. It is undeniable that there are many kinds of treatments for epilepsy and epilepsy in traditional Chinese medicine, such as the use of herbal medicine or acupuncture, but due to the lack of a validation system similar to that of modern medicine, there is so far no validity of fat ひ窖еぞ荼荼 uller 髦幸┛ seizures. From the current situation, Chinese medicine can only be used as an adjunctive treatment drug for epilepsy, and must not be used alone.
Nowadays, many street advertisements deceive patients under the guise of so-called “ancestral recipes” or “latest scientific achievements”, adding to the so-called “ancestral drugs” such as phenytoin sodium, carbamazepine and valproate. The company’s main goal is to provide a comprehensive range of products and services to the public.
Misconception 2, too much worry and fear of drug side effects.
There is a fear of taking anti-epileptic drugs, believing that these drugs have too many side effects and can lead to liver and kidney function damage, or even lead to mental retardation, etc., thus refusing to take medication.
It is undeniable that anti-epileptic drugs have different degrees of toxic side effects, but as long as patients use these drugs scientifically and correctly under the guidance of a specialist, the side effects can be well controlled and resolved. In fact, after the seizures are controlled with medication, the patient’s intelligence and quality of life can be significantly improved. On the contrary, if seizures are allowed to occur without medication, the patient’s condition will be aggravated, leading to a decline in intelligence and loss of the patient’s ability to work and live.
The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.
Many patients are eager to control their seizures, so when they start taking medication, the dose is too high or the dose is increased too quickly, leading to an increased incidence of side effects.
The initial dose of drugs such as phenytoin sodium, carbamazepine, dutasteride, lamotrigine, etc. should be started at a small dose, and the dose should not be increased too quickly.
Myth 4: Discontinuing drugs without permission.
Many patients do not know enough about the long-term, regular and systematic nature of drug therapy, and once their seizures are controlled, they stop taking drugs or reduce their dose at will, which leads to increased seizures and even becomes a continuous state of epilepsy, endangering lives.
There are strict indications for discontinuing medication in epilepsy patients: only after 3~5 years of complete seizure control and basic normalization of EEG, it is possible to gradually stop medication under the guidance of doctors, and the discontinuation should be slow, and the process of medication reduction should be at least half a year. However, there are many patients, especially those with symptomatic epilepsy, who may need long-term medication treatment and are not suitable for medication discontinuation.
Misconception 5: Take multiple medications at the start of treatment.
Some patients believe that the more medications they take, the better the treatment will be. The advantages of monotherapy are fewer side effects, better patient compliance, and no drug interactions. The advantages of monotherapy are fewer side effects, better patient compliance, and no drug interactions.
Myth 6: Surgical treatment must be good
Some patients and their families, bent on surgical treatment of epilepsy, only want a knife down, everything can be, there are also individuals for surgery, indeed epilepsy treatment has surgery, stereotactic radiosurgery (r-knife), vagus nerve stimulation, etc.. These treatments all have strict indications and contraindications, and the main target should be refractory epilepsy for which drug therapy is ineffective. The fundamental prerequisite for surgery and r-knife treatment is accurate diagnosis and localization of the lesion, so a combination of clinical manifestations, structural imaging (e.g., MRI, CT) and functional examinations (e.g., conventional EEG, dynamic EEG, magnetic resonance spectroscopy, single photon emission computed tomography, positron emission computed tomography, and magnetoencephalography) are needed to identify the epileptic lesion so that better The results can be better. Some medical units, for economic reasons, indiscriminately administer surgical treatment to patients who can be controlled by drugs, whose localization is not clearly defined, or whose diagnosis is not even determined. Surgical treatment is ultimately destructive, so it is self-evident that it leads to serious adverse consequences. The correct approach is to ① strictly grasp the indications for surgical treatment – refractory epilepsy; ② comprehensive clinical manifestations, structural and functional examination for localization, accurate identification of the lesion site, the choice of surgery is correct.
Third, pay attention to treatment, ignore prevention
Most people attach importance to treatment, but in fact, prevention of epilepsy causes includes eugenics, pregnancy care, perinatal care and prevention of intracranial infections, febrile convulsions and traumatic brain injury, stroke, etc. Many patients have relapsed due to neglect of triggering factors, although medication is valued. These triggering factors include alcohol consumption, overexertion, lack of sleep, overeating, fever with shock, infectious diseases, and excessive time spent watching TV and computer.
We hope that patients and their families will treat the reality correctly and take a scientific attitude to receive standardized treatment to facilitate early seizure control and recovery. The above-mentioned and other misconceptions may delay treatment and affect physical and mental health.