Epilepsy, commonly known as “sheep epilepsy”, is a temporary brain dysfunction caused by recurrent abnormal neuronal discharges in the brain, manifesting as different disorders of movement, sensation, consciousness, vegetation, psychosis, or both.
What are the causes of epilepsy?
Only a small percentage (about 1 in 5) of patients with epilepsy can find the cause of the disorder. The top three causes are head trauma, intracranial infection, and cerebrovascular disease, in that order. The etiology differs between children and adults: the leading causes in children are, in order, birth injury, neonatal damage, vascular damage, congenital or metabolic disorders, traumatic brain injury, infection, neoplastic, and genetics; whereas in adults, they are, in order, cerebrovascular disease, cranial trauma, drugs or alcohol (alcoholism), neoplastic, infection, and genetics.
Some factors, such as excessive upward brain activity, have the potential to induce seizures.
Clinical manifestations of epilepsy
There are many forms of seizures, the most common of which are generalized and limited seizures.
1. Generalized seizures.
(1) Generalized tonic-clonic seizures, also known as grand mal seizures. The patient suddenly loses consciousness, falls and sometimes screams, pauses breathing, foams at the mouth, generalized tonic convulsions, lip and tongue biting, and incontinence. 5-10 minutes to recover.
(2) Aphasic seizures, also known as petit mal seizures. It can be manifested in two ways: suddenly both eyes stare or turn upward, fluttering, interrupting activities and language, dropping objects to the ground, and calling out for about tens of seconds. Or a short (1~2 seconds) myoclonus occurs in the face, upper limbs, neck, trunk.
2. Partial or limited seizures.
(1) Simple partial seizures, such as short paroxysmal twitching or numbness and tingling at the corner of one side of the mouth, eyelid, fingers, toes or the end of one side of the face and limbs. The twitching may sometimes extend from the fingers to the upper limbs to the opposite side.
(2) Complex partial seizures, also known as psychomotor seizures. It is similar to a petit mal seizure, but lasts for more than 1 minute. Or a variety of hallucinations, delusions, unconscious movements, such as sucking, chewing, smacking, undressing, unbuttoning, etc.
First aid in grand mal seizures
Loss of consciousness and twitching of limbs during grand mal seizures should be well taken care of as follows.
1, protect the tongue, it is best to wrap a gauze tongue depressor (or make your own piece of wood or bamboo board about 20 cm long, 1.5 to 2 cm wide, 0.3 to 0.5 cm thick, with rounded edges) between the upper and lower molars of the patient to prevent the patient from biting the tongue during the spasms. If it cannot be put on during the aura period, it should also be put in when the patient opens his mouth during the tonic period, and should not be put in during the spastic period. The tongue depressor can also prevent the tongue from falling back and blocking the airway.
2, found when there is an aura quickly let the patient lie flat in bed, or lie down in a flat place nearby. If it is too late to make the above arrangement, when the patient is found to fall, he should quickly hold the patient and let him fall down in the trend to prevent him from suddenly falling down and injuring his head or body.
The patient’s head is tilted back excessively during the tonic phase and the jaw is over-extended, which can cause cervical compression fracture or dislocation of the jaw.
4, seizures when more respiratory secretions, easy to cause respiratory obstruction or aspiration pneumonia. Since the beginning of a grand mal seizure, the patient’s head should be turned to the side so that secretions can flow out naturally. In addition, it is best to unbutton the patient’s neck to keep the airway open.
5. During the spasm period, the muscles of the limbs contract, easily causing joint dislocation and limb abrasions. At this time, you can press the large joints of the limbs (such as shoulder, elbow, hip and knee) with appropriate force to limit their twitching amplitude. At this time, do not use excessive force and forceful pressure to avoid artificial injury or fracture of the muscles and joints.
6, seizures should also be unbuckled their belts, with dentures should be removed.
7, after the grand mal seizure has stopped, the patient can only return to normal after a few minutes, tens of minutes or even a few hours. During this time some patients are in a drowsy state, just let them sleep comfortably and quietly. Some other patients are in a hazy state and can have some purposeless and unconscious impulsive, destructive and aggressive behavior, sometimes self-injury, injury, suicide, murder, destruction, etc. At this time, in addition to immediately giving the patient intramuscular or intravenous sedatives such as luminal or valium, the patient’s behavior should be strictly limited to ensure safety.
8. If the seizure is continuous, call 120 for help and send the patient to the hospital to continue resuscitation. If the patient has dentures, they should be removed daily before going to bed. When an epileptic patient sleeps in a single bed, increase the bed block on the side of the bed to prevent falling out of bed during an attack.
Precautions for epilepsy treatment
If you have more than two seizures, you should take regular medication under the guidance of a neurologist after the diagnosis of epilepsy is confirmed.
At present, epilepsy is still mainly treated by medication, and once medication is started, it must be adhered to for a long time.
If the epilepsy has been treated for more than 2 years without seizures and the EEG is normal, the medication can be reduced or even discontinued under the guidance of a doctor, and the reduction process should last at least two years. You cannot stop or change your medication on your own.
Home care for epileptic patients
1. Observation of the condition
(1) Fully understand the patient’s seizure characteristics, such as seizure triggers, places, seizure time, seizure aura, duration, etc.
(2) Closely observe the characteristics of the seizure, mainly observing whether the seizure is dominated by convulsions or loss of consciousness, the site of convulsions, whether there is incontinence, bitten tongue and trauma, etc.
(3) Observe the performance after the seizure, such as the presence of headache, weakness, nausea, vomiting, etc. Only by presenting the detailed situation to the doctor can targeted treatment be given.
2.Medication care
(1) Family members should supervise and check that the patient takes medication on time and in the right amount, to prevent underdosing, omission and overdosing.
(2) Family members should not casually change drugs and doses, whether to increase or decrease drugs and change the variety of drugs, should be under the guidance of the doctor.
(3) Treatment should be maintained for a longer period of time. The longer the duration of the disease, the larger the dose, the more slowly the medication should be discontinued, and a few may need to take medication for life.
3.Life care
(1) Patients should establish a good living system, life should be regular, can appropriately engage in some light physical labor, but avoid excessive exertion, tension, etc.
(2) Diet should be nutritious and easy to digest food, eat more light, high vitamin vegetables and fruits, do not overeat.
(3) Avoid dangerous places and dangerous goods as much as possible, do not engage in high-altitude work and highly energetic work, such as mountain climbing, swimming, driving, bicycling, children should not be alone by the river or fireside, and should not go out alone at night, especially do not do modern high-altitude games, such as bungee jumping.
4.Psychological care
Epilepsy is a chronic disease, physical pain, family discrimination, social prejudice, seriously affect the physical and mental health of patients, patients often feel nervous, anxiety, fear, emotional instability, etc., always worried about the onset of the disease again, family members should often give care, help, love, and timely guidance for the mind concerns, so that they have a good living environment, a happy mood, good mood.
5.Seizure care
Once a seizure occurs, there is no need to panic, the patient should immediately lie flat, head to the side, quickly loosen the collar and trouser belt, stuff the towel between the upper and lower teeth to avoid biting the tongue, do not forcefully press the convulsing body to avoid fractures and dislocations. If there is a continuous state of epilepsy, you should be sent to the hospital for treatment and terminate the seizure as soon as possible.
The precautions in the life of epilepsy patients
1, patients and family members should treat the disease correctly, establish confidence in overcoming the disease, maintain optimism, avoid irritation and emotional stimulation, eliminate fear and low self-esteem.
2, the patient’s life should be regular, regular rest and rest, work and rest, avoid overwork, cold and fever, should not play cards, chess, playing video games to prevent triggering.
3, to ensure sufficient sleep, do not stay up late.
4, to develop good habits, diet, avoid eating raw and cold food and radish, eggplant, chili and greasy and heavy food, avoid too full, too hungry or drink a lot of water at once. It is not advisable to drink strong tea, coffee and drinks with excitatory effects. Prohibit smoking and alcohol.
5, should choose the appropriate occupation, should not operate machinery, driving, wading, climbing, contact with electrical appliances, toxic substances and flammable and explosive substances.