Seizure

Seizures do not always occur due to a disease such as epilepsy. The causes of convulsive seizures can be various diseases on nervous soil. These are such as various neurological diseases, traumatic brain injuries, physical and nervous exhaustion, various intoxications, lack of sleep and even overheating from the sun. Seizures for any disease are very similar and therefore help for any seizure is no different from each other. Many people in their lives have at least once seen when a seemingly healthy person and not showing any signs of having a seizure, suddenly, for no apparent reason, fell and began to have convulsive seizures. The spectacle is terrible, many are even overcome by fear and stress from what they see. Moreover, not everyone knows how to behave in such cases and how to help the person.

A seizure attack begins abruptly and unexpectedly

If you witness a convulsive attack, this is truly an extraordinary stress for a person without medical training, agrees neuropathologist Yuri Geryak. Typically, he says, people primarily perceive seizures as a symptom of epilepsy. But in fact, she may not be the only reason for them.

Convulsive syndromes can cause neurological diseases - stroke, meningitis, head injuries, as well as intoxication with alcohol and toxic substances, explains the doctor. - Other reasons include lack of sleep, severe emotional stress, overheating in the sun. Brain tumors often manifest themselves in such attacks.

Regardless of the cause, the cramps look the same. While completely at rest, the person suddenly loses consciousness and falls. In this case, he is often injured.
The first phase of a convulsive seizure is tension: the patient straightens his legs and bends his arms, explains the neuropathologist.

In the second phase, uncontrolled sudden movements of the body begin, often with turning the head and spasm of the masticatory muscles. The person may bite their tongue hard. Involuntary urination also occurs.

During the first phase, the person does not breathe. Then, after a deep exhalation, breathing is restored. In general, as the doctor notes, the attack lasts from 10 seconds to a minute. Very rarely - longer.

During convulsions, a person does not offer any resistance when his eyelids are lifted. The pupils are dilated and do not react to light. This means that the person is unconscious. If the eyelids are tense and cannot be opened, this is not an epileptic seizure, but a consequence of a mental disorder. A person feigns loss of consciousness.

Be careful after a head injury

Very often, seizures can be caused by traumatic brain injuries, which damage the brain.

Moreover, convulsive seizures can appear both immediately after the injury and several years later. That is why anyone who has suffered a traumatic brain injury should never neglect a medical examination.
In addition to injuries, the appearance of seizures is usually influenced by other provoking factors. First of all, prolonged lack of sleep and insomnia. Because of this, the body is exhausted and tired. Overheating in the sun, as well as physical and mental overload, can lead to seizures.

Convulsions may also occur after strong emotional stress. And also - after a certain time.

In children, seizures can occur after severe fright, in adults - due to sudden death relatives,” continues the doctor. - However, everyone experiences strong emotions, but only a few people experience convulsive seizures. Then doctors say that the person was prone to them.

First aid for seizures - minimal

In case of a convulsive seizure, call an ambulance in any case. Those who happen to be nearby can only protect the patient from injury.

Do not try to open the patient's mouth with your finger. The strength of the masticatory muscles is so significant that you yourself may become crippled. Also, do not try to push a metal object between the patient’s teeth - the teeth will crumble. If possible, you can push thick clothing, folded several times, or a plastic object between the jaws. If the teeth are already firmly clenched and the tongue is not bitten, it is better not to interfere at all.

Temporary cessation of breathing does not threaten a person’s life, the doctor adds. Therefore, it is not worth trying to perform artificial respiration on a person who is having convulsions.
When everything passes, the patient does not remember what happened to him. However, there are also local spasms, for example, on the face. They do not lead to loss of consciousness.

Treatment of epilepsy is very long.

When treating epilepsy, doctors first try to reduce the number of seizures.

However, it is usually impossible to achieve complete disappearance of attacks. Because it is impossible to completely avoid the numerous factors that provoke attacks.

It is imperative to consult a doctor if seizures occur, even if the seizures go away on their own, without medical intervention. After all, you need to be treated so that attacks do not recur. The local doctor will advise where to contact the right specialist.

The chances of having a healthy baby are great

If a mother suffers from seizures, this does not mean that her child will also suffer from them. Therefore, such attacks are not contraindications for pregnancy.

If pregnancy proceeds easily and without complications, the number of attacks a woman may even have decreases. However, if complications arise during pregnancy, attacks usually become more frequent.

The pregnant woman continues to take antiepileptic drugs while pregnant. The doctor only reduces the dose or replaces the drug with another one so that the harm to the fetus is minimal.

Very rarely, a mother who suffers from seizures also has children.

However, if seizures occur in early childhood, the disease is usually difficult to treat. Therefore, it is so important to notice the first signs in time.

Moreover, in children, convulsive seizures, according to the doctor, may occur more often against a background of high temperature.

Parents cannot help but notice a seizure. Moreover, in children it is mainly accompanied by involuntary urination and a change in complexion - it turns blue. However, there are attacks in which there is no sharp twitching of the body, but only a noticeable short blackout.

Then the child, for example, does not hear what is being addressed to him, as if he “switches off.” This should alert parents. The doctor advises them to contact a pediatrician, who, if necessary, will refer the child to a pediatric neurologist. Actually, a timely visit to the doctor is also important for adults.

However, people often put off visiting a doctor for years, hoping that the disease will pass by herself. Patients forget that during an attack you can die - from injuries or from cerebral edema. In addition, with age, in the presence of frequent attacks, a person gradually develops mental disorders, behavioral disorders, and memory changes. Psychiatrists are already working with such patients. The drug Cortexin has proven itself to be effective in preventing seizures. See: Cortexin instructions for use.

In general, people who suffer from seizures are quite likely to be active social life- get an education and work.

There are only certain restrictions in choosing a profession. In particular, they cannot operate mechanisms that require constant attention: machines, vehicles. Also, such patients are prohibited from working in water, at heights or near fire.

CLASSIFICATION OF SEIZURES Generalized (the whole body is involved):

• Tonic-clonic (grand mal seizure).
• Absence seizures (minor seizure - petit mal).
• Partial, or focal (a specific part of the body is involved);
• Simple partials.
• Complex partials.
• Partial with secondary generalization.

Name the drugs of choice for the treatment of seizures.

For tonic-clonic seizures: Carbamazepine (Tegretol, Garbatrol), Phenytoin (Dilantin), Valproate (Depakine, Valproic acid).

For partial seizures: Carbamazepine (Tegretol, Garbatrol) - in children, Phenytoin (Dilantin) - in adults, Valproate (Depakine, Valproic acid).

For absence seizures: Ethosuximide (Zarohtin), Valproate.

What guides the doctor when choosing a drug for the treatment of epilepsy?

The choice of drug therapy depends on the type of seizure. The doctor’s task is to prescribe one drug in the minimum possible dosage that eliminates attacks and does not cause side effects. From the patient's point of view, the cost of the drug and its side effects. Antiepileptic therapy can prevent seizures in approximately 75% of patients with epilepsy.

Describe the possible manifestations of a seizure

Manifestations depend on the type of attack. In the department emergency care(SNP) the most common (and pronounced) manifestations are clonic-tonic seizures (called “grand seizures”). The patient suddenly loses consciousness, the muscles decrease sharply. In this case, the patient may fall and get injured. In the tonic phase, the patient's torso becomes rigid due to spasm of the extensor muscles of the torso, arms and legs. During this phase, many patients hold their breath. When the bladder and bowels are involved in an attack, urine and feces are involuntarily released.

In the clonic phase, strong rhythmic muscle contractions occur, accompanied by hyperventilation, sweating, tachycardia, and increased salivation. At the end of the attack, the muscles are relaxed and breathing is deep. Clonic-tonic convulsions, as a rule, last no more than 2 minutes, although eyewitnesses often overestimate their duration.

Classic absence seizures occur in children (4 to 12 years old). During an attack, the child seems to be looking into emptiness. The attack is short-lived (less than 15 seconds), begins and ends suddenly, after which the child returns to the interrupted activity, remembering nothing about what happened.

Partial, or focal, seizures are regarded as “simple” if they do not interfere with consciousness and perception of the surrounding world. Otherwise, the attack is considered “complicated.” Partial seizures can manifest as focal motor activity, somatic symptoms, and sensory disturbances. Partial seizures (simple or complex) with secondary generalization begin in one part of the body and spread to the entire body.

This is the result of a sudden uncontrolled influx electrical energy into the brain - like a short circuit. Some seizures look frightening: a person falls to the floor, his arms and legs twitch, and foam comes out of the mouth. Others are so short-lived and weak that they go unnoticed - even by those who have them.

Do not try to stop a seizure, for example, by pouring water on the patient.

Seizures are divided into two large groups:

• a partial seizure that occurs due to abnormal electrical activity in a specific area of ​​the brain;
• a generalized seizure resulting from abnormal electrical activity of nerve cells scattered throughout the brain.

Causes

Sometimes convulsive seizures do not occur apparent reason. Some of them can be correlated with conditions such as:

• head injury;
• brain tumor;
• infection;
• metabolic or hormonal disorders such as diabetes;
• alcohol abstinence.

Seizure monitoring

To help your doctor determine the type of seizure, watch the person closely during and after the seizure. Then try to write down the answers to the following questions.

• How long did the seizure last?
• When did it start?
• When did it end? What happened immediately before the seizure?
• Did the patient complain of strange sensations and moods right before the seizure?
• Did he see, hear, smell or taste anything unusual?
• What happened during the seizure?
• Did the patient lose consciousness or fall?
• What was the type of muscle movement? Rhythmic or not? Permanent or not?
• Did the patient laugh? Did you cry? Snored? Did you make any other sounds? Was there any drooling? Was he losing bladder control? Whether ? Is your breathing fast or deep? Foaming at the mouth?
• Did the patient make repetitive movements: licking lips, grimacing, chewing, scratching, shaking off clothes?
• What happened after the seizure?
• Did the patient appear drugged or drunk?
• Did he fall asleep?
• Have you complained of headaches, muscle pain, or fatigue?
• Does he remember the seizure?

Symptoms

Symptoms depend on the type of seizure. Note: If possible, remember the symptoms you had (see “Observing a Seizure”).

Seizure "grand mal"

This generalized seizure is the most severe type of seizure. Immediately before its onset, the patient’s mood may change sharply; sometimes he experiences a condition that doctors call an aura. At the same time, the patient sees, hears, tastes and smells strange things. Then the following usually happens:

• a person loses consciousness;
• the muscles of the torso, arms and legs contract and freeze motionless;
• the man falls and stops breathing. He may bite his tongue and lose bladder control;
• the muscles begin to contract rhythmically;
• the person begins to sweat, breathe deeply and frequently, has a fast pulse, and foam may appear at the mouth;
• muscles relax and breathing becomes deeper;
• the seizure ends, the person comes to his senses, disoriented and with a clouded consciousness; complains of headache, muscle pain and fatigue.

Do not move the fallen person's neck. If you need to turn it on its side, for example, when vomiting, roll it over. You will need an assistant so that one person can hold the neck and head in one position while the other turns the body and legs.

Usually the patient does not remember anything about the seizure. Then he will sleep for several hours.

Myoclonic seizure

This is a type of generalized seizure where a person experiences twitching of one or more muscle groups. Lasts for several seconds.

Atonic seizure

This condition also causes the muscles to twitch and then relax.

Akinetic seizure

The person briefly completely loses muscle tone and consciousness. He falls and may suffer a head injury.

Absence seizure

The person stops all activity and stares at nothing for more than 15 seconds. At this moment he does not perceive anything. People around him may not notice anything unusual in his behavior, although closer observation may reveal moments of disconnection. Such seizures often occur in children.

Simple partial seizure

Happening strange movements one of the body parts that can spread to adjacent parts. Sometimes people feel tingling or numbness in the area, but their state of mind remains fairly normal.

Complicated partial seizure

Usually a person will have an aura and then lose consciousness. May be in a twilight state.

With abnormal activity of the temporal lobe of the brain, a person experiences automatisms, i.e. unconscious repetitive movements: chewing, licking lips, grimacing, stroking someone's clothes, etc.

Epileptic state

This can be one long seizure or many short ones, in between which the person completely returns to normal.

A generalized seizure can be life-threatening, compromising cardiac and respiratory function. An epileptic condition can also cause brain damage.

What to do

Most seizures stop on their own within 30 seconds or after a few minutes. the main objective- prevent a person from injuring himself during a seizure.

Prevent Injuries

Catch and lay down the falling person.

Remove sharp objects, furniture, etc. from the road.

If you do not have time to catch someone falling, protect his neck by placing a folded coat or something suitable under him.

Cover the patient with pillows or rolled blankets.

Loosen clothing around the neck.

Place the person on their side to prevent suffocation.

If the patient is vomiting, clear the vomit from the nose and mouth, but not with your fingers.

If the patient's teeth are clenched, do not try to put anything between them. You could damage his teeth, risk being bitten, and his tongue could fall back, blocking his airway.

Provide Help

Call an ambulance as soon as possible (see “When to Call an Ambulance”). After a mild seizure, you should consult a doctor.

What doctors are doing

If the seizure continues, doctors first provide access to air. The use of artificial ventilation may be necessary.

The patient is freed from restrictive clothing and placed on his side to facilitate breathing. Measures are taken to ensure the patient's safety and avoid injury from sudden movements.

Anticonvulsant drugs, such as Dilantin or Valium, may be given intravenously to stop seizures.

Do not restrain the patient unless the movements threaten his safety. Don't give him anything to eat or drink.

When to call an ambulance

For some people, seizures are very dangerous. Call an ambulance immediately if:

• a seizure occurs in a pregnant woman;
• a seizure occurs in a person who has never had a seizure before;
• the patient does not come to his senses for a long time;
• the seizure lasts more than 5 minutes;
• During a seizure, the patient was injured.

Treatment of epileptic condition

Doctors provide air access, oxygen, or intravenous Valium or another anticonvulsant drug to stop the seizure; monitor the work of the heart. If all else fails, general anesthesia may be used to stop the seizure.

What else do you need to know

When the patient's condition becomes stable, he should have an electroencephalogram - a recording of brain wave activity. This will help determine the location of abnormal brain activity. Other useful diagnostic procedures:

• computed tomography, which detects abnormalities in the brain;
• magnetic resonance imaging, which allows you to see areas of the brain hidden behind the bones;
• A blood test that measures blood sugar and calcium levels.