Causes of epilepsy

When it comes to diseases like epilepsy, I believe many people are familiar with them. In fact, epilepsy is a chronic neurological disease, and there are a lot of epilepsy patients in our country. About 5 to 8 people out of 100 are epilepsy patients. In addition, there is no correlation between the age of onset and the incidence of epilepsy, so there are as many young patients as older patients. Therefore, many people want to find a way to treat epilepsy. To treat epilepsy, we must first find out the cause. So what is the cause of epilepsy?

In fact, the causes of epilepsy are very complex and there are many types, mainly including congenital causes, such as genetics, etc., as well as acquired causes. Below I will give you a detailed introduction to the causes of epilepsy, hoping to help you with your disease.

Epilepsy is a chronic, recurring syndrome of transient brain dysfunction. It is characterized by recurrent epileptic seizures caused by abnormal discharges of brain neurons. Epilepsy is one of the common diseases of the nervous system, and its prevalence is second only to stroke. The incidence of epilepsy is related to age. It is generally believed that the incidence rate is highest within 1 year old, followed by a gradual decrease after 1 to 10 years old. The male-to-female ratio in my country is 1.15:1 to 1.7:1. There was no significant difference in prevalence by race.

Causes of epilepsy

The causes of epilepsy are extremely complex and can be divided into three categories. There are many factors that affect the onset of the disease: 1. Idiopathic epilepsy: suspected genetic tendency with no other obvious causes, often onset in a certain age group, with characteristic clinical and EEG manifestations, and a relatively clear diagnosis. 2. Symptomatic epilepsy: caused by central nervous system lesions affecting structure or function, such as chromosomal abnormalities, focal or diffuse brain diseases, and certain systemic diseases. (1) Localized or diffuse brain diseases: ① Congenital abnormalities such as various causes during embryonic development leading to brain perforation, microcephaly, congenital hydrocephalus, abscess of the corpus callosum and cerebral cortical hypoplasia, perinatal fetal brain damage, etc.; ② Acquired brain damage such as brain trauma, post-cranial brain surgery, post-stroke, post-incranial infection, and acute alcohol poisoning; ③ The incidence of neonatal epilepsy due to birth injury is about 1%, and birth injury during delivery is often accompanied by cerebral hemorrhage or cerebral hypoxia damage. The incidence of epilepsy in newborns with congenital brain malformations or birth injuries is as high as 25%; ④ Inflammation including central nervous system bacterial, viral, fungal, parasitic, spirochetal infections and AIDS neurological complications; ⑤ Cerebrovascular diseases such as cerebral arteriovenous malformations, cerebral infarction and cerebral hemorrhage; ⑥ Primary intracranial tumors such as gliomas and meningiomas; ⑦ Genetic metabolic diseases such as tuberous sclerosis, cerebrofacial angiomatosis, phenylketonuria, etc.; ⑧ Neurodegenerative diseases such as Alzheimer's disease and Pick's disease, about 1/3 of patients have epileptic seizures. (2) Systemic diseases: ① Anoxic encephalopathy such as cardiac arrest, CO poisoning asphyxia, anesthesia accidents and respiratory failure can cause myoclonic seizures or generalized seizures; ② Metabolic encephalopathy such as hypoglycemia is the most common cause of epilepsy. Other metabolic and endocrine disorders such as hyperglycemia, hypocalcemia, hyponatremia, as well as uremia, hepatic encephalopathy and thyrotoxicosis can all lead to epileptic seizures; ③ Cardiovascular diseases such as cardiac arrest and hypertensive encephalopathy; ④ Febrile seizures. Febrile seizures leading to hippocampal sclerosis are secondary to systemic seizures of temporal lobe epilepsy and have become an important cause of refractory epilepsy; ⑤ Eclampsia; ⑥ Poisoning such as alcohol, isoniazid, carbazole and other drugs and heavy metal poisoning such as lead and thallium. 3. Cryptogenic epilepsy: more common, clinical manifestations suggest symptomatic epilepsy, but no clear cause has been found. It may onset in a specific age group and has no specific clinical and EEG manifestations.

Clinical manifestations

1. Generalized tonic-clonic seizure (grand mal seizure): refers to an attack of whole-body muscle twitching and loss of consciousness. Birth injuries, brain trauma, brain tumors, etc. are more common. Tonic-clonic seizures can occur at any age and are the most common type of seizure among all forms of epilepsy. Its typical attack can be divided into four clinical stages: prodromal stage, tonic stage, clonic stage, and recovery stage. During the attack, the EEG shows typical bursts of multiple spikes and spike-slow waves, and each spike-slow wave complex may be accompanied by muscle twitching. 2. Simple partial seizure: refers to the symptoms corresponding to the function of local cortical discharges in the brain, including motor, sensory, autonomic, mental symptoms and signs. They were divided into four groups: ① with motor symptoms; ② with somatic or special sensory symptoms; ③ with autonomic nervous system symptoms and signs; ④ with mental symptoms. 3. Complex partial seizure: also commonly known as psychomotor seizure, accompanied by impaired consciousness. Auras often occur before or when consciousness is about to be lost, so the patient can still recall it after the attack. 4. Absence seizure (petit mal seizure): Its typical manifestation is a brief disturbance of consciousness without any premonitory or post-ictal symptoms. 5. Status epilepticus: refers to a single epileptic seizure lasting more than 30 minutes, or frequent epileptic seizures, so that the patient has not fully recovered from the previous seizure and another seizure occurs, with a total duration of more than 30 minutes. Status epilepticus is a medical emergency that requires emergency treatment.

treat

The treatment of epilepsy can be divided into five aspects: seizure control, etiology treatment, surgical treatment, general hygiene and prevention. The most important thing is to control the seizures, and currently the main treatment is drug treatment. In clinical practice, anti-epileptic drugs can be selected according to the type of epileptic seizure. Once the drug and dosage that can completely control the seizure are found, they should be used continuously. Generally, after the attacks are completely controlled, the drug should be continued for 3 to 5 years without adverse reactions before stopping. Currently, it is mostly advocated to use one drug, and only after it is confirmed that the single-drug treatment has failed, can a second drug be added. If absence seizures or myoclonic seizures cannot be controlled by a single drug, a combination of ethosuximide and sodium valproate, or one of them plus a benzodiazepine, may be effective. For mixed epilepsy, drugs can be used in combination according to the type of seizure, but it is advisable not to use more than 3 drugs. The medication should be started with a small dose and then gradually increased to the minimum effective dose that can control the attack without causing toxic reactions. When changing medication, the principle of adding new medication and gradually reducing the amount of old medication should be followed. Do not stop the medication suddenly.

Some epilepsy patients with organic brain disease may need to take medication for life; some people advocate that those who are over 30 years old at the time of onset should stop taking medication with caution, because their relapse rate after discontinuation is high and they need to take medication for a long time or for life. However, 10% to 15% of patients still have difficulty controlling seizures and can be treated with surgical treatment.

prevention

1. To prevent the occurrence of epilepsy, a detailed family investigation should be conducted to understand whether the patient's parents, siblings, and close relatives have epileptic seizures and their characteristics. For some serious genetic diseases that can cause mental retardation and epilepsy, prenatal diagnosis or neonatal screening should be performed to decide on termination of pregnancy or early treatment. Preventing delivery accidents. Neonatal birth trauma is one of the important causes of epilepsy. Avoiding birth trauma is of great significance in preventing epilepsy. 2. Epilepsy patients should be diagnosed promptly and treated early. The earlier the treatment, the smaller the brain damage, the fewer relapses, and the better the prognosis. Eliminating or alleviating the primary diseases that cause epilepsy, such as intracranial space-occupying diseases, metabolic abnormalities, infections, etc., is also of great significance for cases of recurrent seizures. 3. Epilepsy is a chronic disease that can last for years or even decades, and can therefore have serious adverse effects on the patient's physical, mental, marital, and socioeconomic status. The misfortunes and setbacks that patients experience in family relationships, school education and employment, as well as restrictions on cultural and sports activities, can not only cause patients to feel ashamed and pessimistic, but can also seriously affect their physical and mental development. This requires all sectors of society to understand and support epilepsy patients.

After reading the detailed answer to the question of what are the causes of epilepsy above, I believe that all patients with epilepsy already know the treatment methods for the various causes of epilepsy. Different individuals, different symptoms, different causes, etc., require different treatment methods. Therefore, if you have a disease such as epilepsy, you should go to the hospital for medical treatment in time. Do not be afraid to see a doctor, otherwise it will easily worsen the disease and even be life-threatening.