What is the epileptic crisis?

Epileptic seizure defines the transient appearance of signs and/or symptoms due to abnormal excessive and modern brain activity. Clinically it can occur with generalized tonic -collound spasms in the extremities and trunk, myoclonia, gaze dedication and even symptoms of the mental sphere such as a sudden feeling of fear or dejavu.

What is epilepsy?

Epilepsy is a common neurological disorder that affects 1 per 100 people worldwide. It is most commonly seen in extreme age groups such as in the first months of life and childhood but also in people over 65 years. Epilepsy is defined as the disease characterized by the persistent predisposition of the brain to cause epileptic seizures. Specific neurobiological, mental, psychological and social consequences of this situation are recognized.

Epilepsy has someone who has at least 2 unexpected judgments in more than 24 hours or has had an unexpected crisis but has an increased chance of recurring additional crises (at least 60% in the next 10 years). This increased probability (60%) is determined by any burdensome history (eg craniocerebral injury), clinical event (eg status epilepticus) or pathological findings of neurological examination and clinical control (electroencephalogram, brain imaging).

We must ensure that the crisis is not responsible for situations that “push the brain to its limits” such as extreme sleep deprivation, over -consumption/alcohol deprivation or other pathology that may cause a crisis. An exception is a special type of reflex epilepsy that is fired exclusively with a specific stimulus such as exposure to intermittent bright stimuli.

Anyone who is in crisis has epilepsy?

All patients with epilepsy have epileptic seizures but that does not mean that anyone who makes an epileptic seizure suffers from epilepsy. 40% of epileptic seizures occur in people with some acute brain attack but without epilepsy, and are called acute provocative or symptomatic crises.
Various causes of challenging crises such as infection, stroke, neoplasia, injury, autoimmune brain inflammation, electrolyte disorder, hypoglycaemia or hyperglycaemia are recognized. These can increase the excitability of the central nervous system by leading to an “easier” firing of seizures.

Once the provocative factor is removed or the reasons is reversed, these judgments stop and are not expected to reappear. However, in cases where structural brain abnormalities are found, the risk of developing epilepsy increases, so therapeutic management changes.

What types of epileptic seizures exist?

The classification of epileptic seizures is mainly according to the patient’s clinical picture, and is important for understanding and effectively managing them at the level of exploration of etiology and selection of appropriate medication.

The basic separation is about maintaining or affecting the level of consciousness, the possibility of awareness of the environment, that is, at the time of the crisis. Then there is a separation of a focal or generalized crisis. A focal crisis is eliminated by epileptic networks of the brain cortex of one hemisphere, even of the two hemispheres when there is an extension of electric discharge, but without the involvement of the chamber.

In focal judgments the clinical manifestation can be with abnormal movements, unhappiness of a part of the body, affecting emotion with or without affecting consciousness. The manifestation of the symptoms depends on the precise location of the affected brain area. Generalized crises respectively may be clinically manifested by motor disorders that relate to the whole body and loss of consciousness, as the brain is affected “whole”.

Particular references to epileptic syndromes that usually occur from neonatal to adolescence and have specific clinical and electroencephalographic characteristics. In some of these epileptic seizures are automatically undergoing age, others are fully controlled with long -term treatment, while the most serious of them may have difficult management seizures and are accompanied by neurodevelopmental delay.

What is electroencephalogram?

The basic examination performed in patients with epilepsy is electroencephalogram. It is an examination for which we have 100 years of experience in its use, demonstrating its high diagnostic value and utility.

The placement of the electrodes on the patient’s head and the recording of the brain waves is a completely safe, non -invasive process, without any contraindication. Also the use of a portable machine makes it easy to use despite the patient’s bed, even in urgent conditions.

The most important evidence of electroencephalogram are involved in epileptic patients, which receive valuable information on the diagnosis of epilepsy and epileptic syndromes. Electroencephalogram also contributes to the distinction of non -epileptic episodes such as syncope, migraine and paroxysmal or transient neurological disorders of another etiology. Finally, it is an important tool for diagnosis, assessment, prognosis and monitoring of brain function in patients with affected level of consciousness such as encephalopathy, memory disorders, coma or brain death.

When does long -record electroencephalogram need?

There are cases that are necessary to carry out a long videotape of a video recording, with a hospital stay usually for 24 or 48 hours. The main indication of a long recording is the pharmacist epilepsy where the distinction between epileptic or non -episodic episodes are sought, to record any focus and the location of an epileptic zone in the context of preoperative control. Long recording is also useful for the quantification of clinical-sub-clinical episodes and sensitizes the patient to the course of his or her disease, contributing to appropriate therapeutic monitoring.

At the same time it is possible to study sleep disorders with appropriate staging and possible combination control for respiratory diseases.
In the context of technological progress, there are wearables where the patient can make a record at home, which provides some useful information to doctors, but with many still restrictions.

In conclusion, the electroencephalogram of routine or long recording is made after a specialized neurologist and an important help tool in accurate diagnosis, prognosis and personalized therapeutic decisions.

How are the seizures treated?

The opposing drugs have various mechanisms of action aimed at reducing neuronal stimulation and inhibiting seizure triggering.

The decision to initiate medication as well as the selection of appropriate treatment depends on the type of epilepsy (focal or generalized), any diagnosis of a specific epileptic syndrome, any co -institutions, and always after first updating and there is the patient’s agreement.

The duration of treatment depends on the clinical and electroencephalographic course of the patient.

In cases of pharmacist resistants, where the crises are not effectively controlled, despite the administration of two or above drugs, there are additional solutions with specialized medication, neurotrophication, and even surgery, if there is a proper indication.