Nocturnal epilepsy. Symptoms and danger of epilepsy in a dream Does epilepsy happen in a dream

Sleep epilepsy is a disease in which seizures occur only at night. Most often occurs in children under 7 years of age and young people under 35 years of age. Characteristic feature the disease is that it can go away on its own, without treatment, which is due to age-related changes in the nervous system.

There are several reasons for the occurrence of this pathology.

• genetic predisposition, that is, if parents have such a disease, there is a high probability of its occurrence in children;
• head injuries;
• sleep disturbance, chronic lack of sleep;
• irregularities in work nervous system;
• alcohol abuse.

Sleep is rest for the whole body and an integral part of human life. With chronic lack of sleep, the occurrence of attacks will become more frequent. Provoking factors include: being on duty, going out, waking up at night, going to bed late. Happening nervous exhaustion, causing brain cells to become vulnerable.

Another cause of the disease is frequent time zone changes. Therefore, patients with epilepsy need to be more careful when traveling and first consult with a specialist.

A sharp loud sound can trigger an attack. Therefore, it is better to choose an alarm clock with a softer but audible melody.

In children, the main factors provoking the development of the disease include:

• birth injuries;
• infectious pathologies;
• traumatic brain injuries.

Often the baby suffers from cramps during sleep due to lack of sleep, severe stress, and boredom.

Symptoms of the disease

The most important symptom of epilepsy during sleep is seizures. In some cases, they disturb the patient not only during night sleep, but also during daytime rest.

The pathology is characterized by the following symptoms:

• convulsive state;
• abrupt awakenings for no reason;
• nausea, vomiting;
• indigestion;
• headache;
• unusual sounds in a dream, reminiscent of squelching;
• trembling in the limbs, body;
• distortion of the eyes, face.

In this case, the patient can get up on all fours in his sleep and make movements with his legs that resemble riding a bicycle.

The duration of attacks varies and can vary from a few seconds to 2-5 minutes. Children have virtually no understanding of the events of the night's incidents. But some adults retain them in memory and can describe their feelings.

Also to symptoms that indirectly indicate pathological condition can be attributed:

• the appearance of traces of blood on the pillow;
• tongue bitten;
• bruises and abrasions of unknown origin are observed on the body and limbs;
• muscle pain;
• wet bed due to involuntary urination;
• waking up on the floor rather than in bed.

In children

In children, this pathological condition most often manifests itself in the form of visual impairment, headaches, and manifestations of disorders brain activity on the electroencephalogram. The greatest peak appears between the ages of 3 and 7 years.

Seizures in children most often occur immediately after falling asleep or in the morning, closer to waking up. The main symptoms are: nausea, vomiting, severe muscle pain, pallor skin, turn your head to one side.

In adults

Signs of nocturnal epilepsy in adults are no different from manifestations in childhood. Their severity and intensity remain unchanged.

Classification

There are several forms of seizures that are associated with sleep.

1. Frontal. They are characterized by dystonia in the limbs, in some cases vocal manifestations, complex physical activity, rotational movements, which generally imply hypermotor seizures.
2. Temporal. This form is characterized by a complex combination of complex motor manifestations, which include psychological, autonomic and automatic symptoms.
3. Occipital. They are characterized by symptoms: impaired eye function, vomiting, headaches.

Nocturnal epilepsy also includes:

1. Parasomnias – strong twitching lower limbs while falling asleep and temporary immobilization during awakening.
2. Sleepwalking. It is characterized by sleepwalking and other physical activity, nightmares, and enuresis at night. Mostly children are susceptible to sleepwalking. Most often this goes away with age, but in some cases the disease remains for life. During somnambulism, a person can move, so there is a possibility of injury, since there is no control over oneself. One of the signs of sleepwalking is aggressive behavior while waking up. But at the same time, neither adults nor children remember the events of the past night.
3. Urinary incontinence during night sleep. Experts identify this deviation as separate species if there are no other symptoms. The disease affects children under 14 years of age, mostly boys. Approximately involuntary urination occurs 4 hours after going to bed.

Diagnostics

If you experience symptomatic signs of epilepsy during sleep, you should immediately consult a doctor. First of all, they visit a therapist, then a neurologist, an epileptologist.

To establish the nature of the disease, the doctor will collect an anamnesis based on the patient’s complaints and also ask a number of questions:

1. Date of first attack.
2. About the presence of similar problems before.
3. Is this case primary or repeated?
4. Possible factors provoking attacks.
5. Presence of other complaints.
6. Have you had any previous head injuries?

This will help differentiate epilepsy from other similar diseases.

• MRI of the brain;
• EGG monitoring at night;
• daytime and nighttime sleep deprivation test;
• electroencephalography.

MRI is one of the ways to diagnose epilepsy

Seizures in children are noticed almost immediately by parents. In adults, this happens more difficultly and takes longer, especially if they live alone.

Treatment

Treatment in adults and children is aimed at relieving seizure symptoms at night. However, the focus of therapy itself varies depending on the age category.

Treatment in adults

To eliminate night pathology it is used anticonvulsants, which contribute to an initial reduction in the frequency of seizures, and subsequently to the complete elimination of signs of the disease.

The most commonly used drugs are:

1. Clonazepam is used for myoclonic, akinetic, focal, submaximal, temporal epilepsy, as well as other neurological problems.
2. Carbamazepine. Used for epilepsy various types except for absence seizures, myoclonic and flaccid seizures.
3. Topiramate. Has antiepileptic properties. Used as monotherapy and in combination with other drugs.
4. Levetiracetam. Used to treat seizures with secondary generalization.

Initially, the minimum dosage is calculated. During therapy, the patient may experience drowsiness and lethargy.

Therapy in children

Treatment for children is somewhat different from for adults. Epileptologists prescribe complex therapy, which includes:

1. Anticonvulsants. They stop the appearance of convulsions in the center of electrical activity of the brain. These include Levetiracetam, Ethosuximide, Phenytoin.
2. Neurotropic medications. Eliminate the transmission of nerve impulses in the brain.
3. Psychotropic drugs. They change the psychological status of the patient, forcing the nervous system to function differently.
4. Nootropics – help improve brain activity.

Levetiracetam is one of the drugs for the treatment of sleep epilepsy for children

Treatment of this disease is most often carried out on an outpatient basis. In this case, you should adhere to some rules:

1. Maintain strict intervals between medications. In this case, you should not change the dosage of the medication yourself or replace it with analogues.
2. You should not use other drugs without prior consultation with a specialist. This may reduce the effectiveness of the neurotropic drugs used. medicines.
3. When manifested side effects, unusual reactions should be reported to your doctor, as this will require replacing the drug with another one.

Forecast

Most positive results can be achieved in cases where organic brain damage has not occurred.

The development of children, both physically and psychologically, occurs normally, in accordance with standards and on an equal basis with their peers.

Prevention

In order to achieve full recovery must also be adhered to preventive measures, which will not only promote recovery, but will also help in the future not to provoke the return of the disease.

1. Strict adherence to the daily routine. Getting up and going to bed should happen at the same time. Also, there should be no irritating or distracting factors. Therefore, televisions, telephones, etc. should be excluded.
2. When the sun rises early, the curtains should be thick and cover the window well so as not to disturb the epileptic’s sleep.
3. Refusal bad habits, as well as abuse of alcohol, toxic or narcotic substances, and smoking, as they can cause serious consequences.
4. You should also review your diet by limiting meat dishes, minimizing them and adding as many fruits, vegetables and herbs as possible. To replenish the missing elements, it is recommended to take various vitamin and mineral complexes, but only after consulting a doctor.
5. Strictly adhere to all instructions of the attending physician, take in a timely manner and according to the prescribed dosage of medications. Do not resort to self-medication under any circumstances, as this can lead to various complications.

Epileptic seizures during sleep can be of a different nature and not always obvious. Therefore, it is worth noting indirect symptoms in order to promptly contact a specialist, diagnose the disease and prescribe the correct treatment. In this way, it will be possible to stop attacks more quickly and improve health conditions. This is especially true for children, since this disease can slow down their development compared to their peers.

Medicine does not use such terms, but this name for the disease is very firmly rooted. Attacks occur either when the patient is already asleep, or in the process of falling asleep. Moreover, the statistics of this phenomenon are very indicative: approximately a third of all people with epilepsy have only nocturnal attacks, that is, nocturnal epilepsy typical for approximately 30% of all patients.

Attacks can vary in intensity. For example, doctors distinguish between seizures during sleep and seizures while falling asleep. Separately, sleepwalking and sleep-talking stand out, as well as other, less serious sleep disorders.

Causes

So, why do people with epilepsy have seizures at night? First of all, it should be noted that there is a direct connection between nocturnal epilepsy attacks and sleep deprivation. The more often the patient denies himself sleep or systematically lacks sleep, the more intense the nighttime seizures will be. For this reason, nocturnal lifestyle is strictly contraindicated for patients, since such a sleep and rest pattern significantly weakens the nervous system, as a result of which attacks can become more frequent.

In general, epilepsy to this day remains a rather poorly understood disease, but doctors say that if a patient has only night attacks for a long time, then the chances that epilepsy attacks will continue during the daytime are extremely small.

Manifestations

How does nocturnal epilepsy manifest? First of all, this significant nervous excitement , accompanied by involuntary body movements and muscle contractions. This includes stretching and sudden contractions of the body. In a word, movements atypical for sleep. Sleepwalking can also be one of the manifestations of nocturnal epilepsy.

Safety regulations

For people suffering from nocturnal epilepsy attacks, it is necessary A complex approach to solving health problems. First of all, need to get enough sleep, and in no case neglect night sleep. As mentioned above, the less time you spend sleeping, the higher your risk of having seizures, and the more severe the seizures will be. This key rule, which must be followed on the path to disease control.

Next important question- This medicines. During the daytime, and even more so in the evening, it is necessary to refuse various kinds stimulants (use strong tea or coffee with caution), since taking them may affect the quality of falling asleep. As for the drugs themselves for epilepsy, they have such an unpleasant side effect like daytime sleepiness. However, it is under no circumstances worth fighting it with stimulants.

One of the ways to fall asleep well and minimize the manifestations of nocturnal epilepsy is to accustom yourself to a certain sleep ritual. Let it be a book or giving up any gadgets half an hour to an hour before going to bed. Gradually, the body will get used to this way of acting, falling asleep will improve, and you will be able to avoid attacks of nocturnal epilepsy, which, as is known, occur in the first phases of sleep - when the body is most susceptible to the manifestation of the disease.

It is also important to take care of the safety of the sleeping place. High sofas and fragile objects near the bed should be avoided. Alternatively, you can purchase an additional mattress or mats to ensure that a person does not cause damage to their body if they fall out of bed while sleeping.

Treatment of nocturnal epilepsy

As for the actual treatment of the disease, doctors, in addition to following the recommendations listed above, will prescribe you antiepileptic drugs. Depending on the intensity of the seizures, as well as the time of their occurrence, the dose will vary. As already noted, some of these drugs can cause daytime sleepiness.

It is important to distinguish between nocturnal epilepsy and ordinary sleep disorders. In the case of the latter, other treatment methods must be used, and antiepileptic drugs in this situation can only do harm. Symptoms such as enuresis, rapid eye movements in the phase REM sleep, as well as rhythmic movements in sleep are by no means always a death sentence - often these are banal sleep disorders that can be treated or corrected.

Diagnostics

So serious illness as epilepsy, especially accompanied by nocturnal attacks, must be clearly diagnosed. If the symptoms of the disease indicated in the article appear, you should consult a doctor. If one of your relatives had epilepsy, then the risk of the disease increases significantly and you need timely diagnosis and treatment. It will be necessary to conduct an electroencephalogram study, in particular against the background of sleep deprivation. This is the main way to diagnose the disease.

Epilepsy is a disease characterized by seizures. They can occur not only during the day, but also in the morning or during sleep. Night attacks are the most dangerous: they most often lead to the development of life-threatening complications. Therefore, you need to be able to recognize the first signs of the disease and consult a doctor in time.

Causes and manifestations of pathology

It is not known exactly why nocturnal epilepsy occurs. But the main factor contributing to the occurrence of convulsive seizures is considered to be the lack of proper sleep.

Frequent lack of sleep leads to depletion of the energy reserves of the central nervous system, disruption of the processes of excitation and inhibition. As a result, epileptogenic foci are formed in the cerebral cortex. How longer person neglects rest, the higher the likelihood of seizures during sleep.

TO possible reasons The development of epilepsy at night also includes:

It is impossible to independently understand what triggered the occurrence of convulsive seizures during sleep. Determine the cause of epilepsy and select correct treatment Only a doctor can do this after the patient has undergone an examination..

In the nocturnal form of epilepsy, seizures most often occur in the first half of the night, during the REM sleep phase (this is due to changes in brain activity). Their appearance can be triggered by a sudden awakening or a sudden phone call.

If the disease progresses, convulsive crises appear in any phase of sleep, regardless of the presence of provoking factors. Let's look at the main types of attacks (Table 1).

Table 1 - Types of nocturnal seizures

The symptoms of nocturnal epilepsy are practically no different from the clinical picture of the daytime form of the disease. Immediately before a seizure appears:

• intense headache;
• feeling of discomfort;
• nausea;
• spasm of the facial and laryngeal muscles;
• speech disorder;
• chills.

After these symptoms appear, cramps occur in a specific muscle group. They then spread in a sequence corresponding to the location of the brain centers that control movement. The patient has difficulty breathing, it is noted increased salivation. Involuntary urination and defecation may occur.

Clinical manifestations of epilepsy at night in adults can be supplemented by symptoms that are characteristic of a sleep disorder:

• sleepwalking;
• nightmares;
• panic attacks;
• walking and talking while sleeping.

In general, an epileptic seizure lasts from 10 seconds to 5 minutes. After this time, the person falls asleep. After waking up, he does not remember the events that took place during the night. Epilepsy during sleep is not always accompanied by seizures. Non-convulsive seizures can be recognized by the following signs:

• dilated pupils;
• blank look;
• lack of response to the environment.

Treatment methods and consequences

Clinical manifestations of nocturnal epilepsy resemble symptoms of a common sleep disorder. To confirm the diagnosis, electroencephalography or video monitoring is prescribed. Research is carried out while the patient is asleep. This makes it possible to identify the focus of the disease (the area of ​​the brain where excessive activity occurs during an attack) and establish the form of epilepsy.

Helping a sick person

The patient’s condition after an attack depends on the assistance provided. To minimize the risk of negative consequences necessary:

1. Place the patient on a flat surface with a blanket under his back.
2. Unbutton the victim's clothes.
3. Place a soft object in his mouth: a napkin, a handkerchief.
4. Turn the patient's head to the side: this will prevent vomit and saliva from entering the Airways and the occurrence of asphyxia.
5. Hold the person's legs and arms without resisting the cramps.
6. Call an ambulance.

It is prohibited to unclench closed teeth during an epileptic attack: this risks damaging them.

You should also not forcibly hold the patient’s tongue or give him water or any medications. Such actions can lead to negative consequences.

If after the examination the diagnosis is confirmed, the patient is prescribed nootropics (Encephabol, Cerebrolysin) and anticonvulsants(Depakine, Carbamazepine). When is epilepsy caused? infection or inflammation meninges Antibiotics are also prescribed.

Medications are started with small doses: they cause daytime sleepiness. Then the dosage of medications is gradually increased. After achieving the effect of therapy, use medications stop.

Sleep epilepsy is a highly treatable disease. But the danger of the disease lies in the fact that symptoms appear at night. This increases the likelihood of negative consequences. Complications of convulsive crises may include:

In addition, nocturnal epilepsy leads to worsening general condition. There is a feeling of weakness in the body, dizziness (during the day), and a feeling of exhaustion.

This leads to an increase in attacks during sleep, a decrease in the patient’s ability to work and quality of life in general. Epileptic seizures in children negatively affect their academic performance and general development. Therefore, it is important to notice the presence of the disease in time and begin taking therapeutic measures.

With timely and properly selected treatment, the prognosis is favorable: it is possible to reduce the frequency of attacks or achieve complete remission of the disease.

To prevent exacerbation of nocturnal epilepsy and the occurrence of complications after seizures, it is necessary to follow a daily routine, rules of preparation for bed and lead a correct lifestyle.

If you have previously experienced epilepsy attacks during sleep, it is recommended:

1. Go to bed and wake up at the same time (lack of sleep increases the likelihood of attacks in the morning or afternoon).
2. Avoid mental emotional overstrain before bedtime.
3. Close the curtains at night.
4. Stop smoking, drinking alcohol, strong coffee and tea, and sedatives.
5. Sleeping on a small pillow: This reduces the risk of suffocation during a seizure.

Epilepsy and sleep are closely related to each other: night cramps lead to the development of insomnia in the patient and decreased ability to work, and the lack of proper rest provokes an increase in the frequency of seizures. Therefore, if you suspect a disease or sleep disorder, you should immediately consult a doctor: he will conduct an examination and prescribe treatment.

Epilepsy is chronic disease, which is characterized by the appearance of convulsive seizures, accompanied by loss of consciousness, vomiting and other dangerous symptoms.

Seizures can occur at any time, but if they only disturb the patient at night when he is sleeping, he is diagnosed with nocturnal epilepsy.

Epilepsy in sleep has its own characteristics. This disease must be treated.

This type of epilepsy is characterized by the occurrence of seizures during night sleep. In some cases, seizures also appear during the daytime rest.

This disease is characterized by:

In a dream, an epileptic can get up on all fours and make movements with his legs that resemble riding a bicycle.

When do epileptic seizures occur?

Nocturnal epilepsy attacks can occur at different times:

1. Early at night - within 2 hours after falling asleep.
2. Early - 1 hour before waking up. After this, the patient can no longer fall asleep.
3. Morning - 1 hour after waking up.
4. Mixed - at different points in time.

During night attacks, tonic convulsions are replaced by tonic-clonic ones, after which the patient falls into deep sleep.

His rib cage becomes motionless due to severe spasm, breathing stops. During the tonic phase, he may involuntarily make erratic body movements.

Causes of the disease and risk factors

At the moment, the nature of the appearance of nocturnal paroxysms is not fully understood.

The main reason is considered to be inadequate sleep, when the patient wakes up from loud noise.

With frequent lack of sleep, time zone changes, and repeated awakenings, seizures become more frequent and intense.

Sometimes it occurs due to burdened heredity. In this case, we are talking about a type of epilepsy. Seizures in a child occur due to lack of sleep, boredom, and severe stress.

Symptoms at night

Apart from sleep disorders, nocturnal seizures do not differ from the usual clinical picture of this disease.

The tonic component is expressed by spontaneous muscle hypertonicity and deterioration of breathing.

The upper limbs are in an abducted state, the lower limbs are in an extended state.

During the spasm, involuntary bowel movements and urination occur. By clenching the jaws tightly, the patient may bite the tip of the tongue, which leads to bleeding. Tonic convulsions last for a minute, after which clonic convulsions occur.

The epileptic begins to move his limbs, his entire body, and his neck chaotically. Then breathing is restored. Foam appears around the mouth, which may have a scarlet tint when biting the tongue.

After 3 minutes, the muscles relax, the patient plunges into a state of deep catatonia. This can lead to tongue retraction and airway obstruction.

After a seizure at night, patients may retain memories of what happened. The fact that there was an attack during sleep is indicated by:

• rumpled sheets;
• stains from saliva, foam;
• traces of urine and feces.

Classification of attacks

There are different types of night attacks:

Most often, patients experience frontal attacks. Other species are less common. determined by doctors during a thorough examination.

Diagnostics

If a patient experiences epileptic seizures at night, he should see a doctor as soon as possible.

Since this disease is considered neurological, it is necessary to see a neurologist.

The doctor will examine the patient and listen to his complaints. To make a correct diagnosis, he will ask some questions:

1. When was the first attack?
2. Have similar problems happened in the past?
3. How often do seizures occur?
4. What can trigger them?
5. Are there any other complaints?
6. Has the patient had any head injuries?

Having received the answers, the specialist will be able to quickly understand the diagnosis. To clarify it, you need to go through:

• MRI of the brain;
• night EEG monitoring;
• sleep deprivation test;
• electroencephalography.

After studying the research results, the doctor will prescribe treatment. Usually used to control seizures.

Seizures in children, as a rule, are noticed by parents immediately, but adults may not know about the presence of a problem for quite a long time, especially if they live alone.

They need to be attentive to their health, and if stains of saliva and urine appear on the bed, visit a neurologist.

Treatment for adults and first aid

Nocturnal epileptic seizures are corrected by taking anticonvulsant medications. Initially, they allow you to keep the attacks under control, and over time they completely eliminate them.

Most often used:

• Clonazepam;
• Carbamazepine;
• Topiramate;
• Levetiracetam.

First, the patient receives the drug in a minimal dosage. During treatment, he may feel drowsy during the day.

After completing the course, the doctor examines the patient. If the frequency of seizures remains unchanged, the dosage is increased.

First aid to a patient is designed to protect him from possible injury. It is necessary to place the epileptic on a flat, soft surface. You can lay a blanket on the floor.

It is better to take off your pajamas and underwear so that your clothes do not hinder your movement.

The patient's head should be turned to the side so that the vomit comes out and does not enter the respiratory tract.

While the attack continues, the epileptic's limbs should be held with hands, but the convulsions cannot be counteracted.

To prevent tongue biting, insert a handkerchief or rolled up towel into the patient's mouth.

Therapy in childhood

Neurologists prescribe the following medications for children:

1. Anticonvulsants- stop the appearance of convulsions directly in the focus of electrical activity in the brain. These may be ethosuximide, Levetiracetam, Phenytoin.
2. Neurotropic- inhibit the transmission of nerve impulses.
3. Psychotropic- are able to change the psychological status of the patient, make his nervous system function differently.
4. Nootropics- improve the flow of processes in the brain.

When conducting outpatient treatment, patients must adhere to the following rules:

1. Maintain a time interval between taking medications, do not change their dosage yourself, and do not try to replace them with analogues.
2. Do not use other medications without a doctor’s prescription, as this can reduce or completely eliminate the effect of the prescribed neurotropic medications.
3. Inform the doctor about emerging side symptoms, any manifestations that cause concern. In this case, it may be necessary to change the main drug.

Forecast and preventive measures

If the patient strictly follows the doctor’s instructions and will undergo treatment completely, then it is quite possible that he will be able to get rid of the attacks.

As a rule, up to 80% of patients recover.

The prognosis is most favorable when there are no organic pathological lesions in the brain. After rational treatment, children develop normally.

Attacks include strict adherence to the daily routine. The patient should wake up at the same time, go to bed in a relaxed, calm state, so you should avoid watching TV, talking on the phone, etc.

The curtains in the bedroom should be drawn so that the morning rays of the sun do not disturb the epileptic's sleep.

Patients should completely give up alcohol, preferably quit smoking, since the toxins contained in tobacco and alcohol can cause serious side effects.

If an epileptic is attentive to his health and follows all the instructions of the attending physician, he can reduce the likelihood of a seizure to a minimum or even get rid of seizures altogether.

It is important to undergo treatment under the supervision of a specialist and not to prescribe medications to yourself, so as not to aggravate the situation. Preventive measures will help avoid provoking factors that cause epileptic seizures.

Generalized seizures

Generalized seizures are among the most well-known and dramatic types of epileptic seizures. All epilepsy attacks can be divided into primary generalized and secondary generalized. The onset of a generalized convulsive seizure is often preceded by certain symptoms, called a precursor or prodrome. This is the name for states of aggression, anxiety, general discomfort, irritability and headaches. The appearance of precursors may occur several days and hours before the onset of a generalized convulsive attack, but they may be absent.

A secondary generalized seizure occurs after the onset of the so-called aura, which includes a whole range of symptoms. These include: a feeling of discomfort in the area gastrointestinal tract, a feeling of detachment from everything that is happening and its unreality, auditory and visual hallucinations, perception of non-existent odors, usually unpleasant. The patient remembers the aura of the attack after he comes to his senses, when the attack is already over, since the aura is part of the attack itself. Usually this is a fairly short period of time, often no more than a few seconds, but for the patient it has great value. During this time, many manage to protect themselves by calling for help, stopping the car, or sitting on the floor. Doctors who specialize in diagnosing and treating the consequences of epilepsy attacks, based on the stereotypicality of the aura and its repeatability from one attack to another, are able in certain cases to accurately determine the location of the source of the disease.

In the case of primary generalized convulsive seizures, the aura may be completely absent; such attacks are extremely dangerous due to their suddenness. Most often, such epileptic seizures occur immediately after waking up in the morning; seizures often occur directly in sleep. The onset of an attack is usually preceded by a loud cry, after which all the muscles of the body are tense, the lips are clenched, the teeth are clenched, and the tongue is often bitten. Breathing may stop completely for some time, after which cyanosis of the skin appears, the so-called cyanosis. After this, rhythmic convulsive twitching of the body and all limbs is observed. As a rule, the attack lasts from one to five minutes, after which it stops just as suddenly. When an epileptic attack occurs, it is extremely important to be able to provide first aid to the patient. A doctor who specializes in the treatment of epilepsy may prescribe treatment using anticonvulsants, which are good for treating seizures, which can achieve complete remission of seizures. In order to assign adequate treatment, it is important to wisely use all the information obtained from sleep monitoring using EEG. Recording is carried out within ten minutes after the patient awakens, this applies to all cases, especially if there is a suspicion of generalized idiopathic epilepsy. It is during this period after the end of the patient’s sleep that an increase in epileptiform activity can be observed.

Seizure causes

A seizure is a storm of electrical impulses in the brain, which occurs as a result of the passage of pathological impulses through the neurons of the brain and huge amount impulses corresponding to the norm. Such activity is chaotic, resulting in a malfunction of the brain and the development of a convulsive attack. The conclusion is that a seizure is not a disease, but a symptom. As for epilepsy, this is a condition during which typical seizures are repeated. The very concept of “epilepsy” has Greek origin and means “attack”. Such seizures are common in the United States, where approximately one in every hundred residents suffers from them. However, a single epileptic seizure in itself does not mean the onset and development of the disease.

Sometimes convulsive seizures occur without any visible reasons. The occurrence of some of them can be explained for the following reasons: brain injuries, tumors of the intracranial space, consequences of a stroke, consequences of infectious lesions of the body, impaired metabolism, hormonal imbalances in the body, consequences of the disease diabetes mellitus, excessive consumption of alcoholic beverages and drugs.

Convulsive attack with loss of consciousness

A convulsive attack with loss of consciousness is observed in diseases of various forms of epilepsy. One of these is juvenile absence epilepsy, which is one of the forms of idiopathic generalized epilepsy, the onset of which lies in puberty. A similar form of epilepsy manifests itself in typical absence seizures.

This type of epilepsy is common on a scale of up to three percent of total number all types of epilepsy and up to ten percent among types of idiopathic generalized epilepsy in adults over twenty years of age. In three quarters of all cases, there is a hereditary predisposition to this species diseases.

The clinical picture of this type of epilepsy is a sudden manifestation of periods of instant “freezing”, loss of consciousness over a period of time from several seconds to several minutes. The attack itself occurs within a few seconds. It is accompanied by loss of all orientation in space, interruption of all activities, blackout of consciousness for the period of “freezing”, absent gaze during an attack. The patient is not able to independently track the process of loss of consciousness. Moments of “switching off” consciousness can occur several times a day. Basically, such seizures occur upon awakening or during sleep (up to 60% of all cases). With a certain frequency, attacks may occur with convulsive contractions of the muscles of the whole body with biting the tongue and involuntary urination (up to 70% of all cases).

When conducting an objective examination of the patient, it may be impossible to identify pathological abnormalities in his neurological status, however, absence seizures and generalized tonic-clonic seizures are detected.

Seizure in sleep

If we talk about the time of manifestation of epileptic seizures, in relation to different daily periods, they can be divided into nocturnal attacks, mainly nocturnal, seizures that occur at any time of the day, only during the day. The standard time of onset of epilepsy attacks during sleep is waking up or falling asleep, particularly during excessively early forced awakening or sleep deprivation.

Using statistical calculations, it was found that among all patients suffering from epileptic seizures, only a third have exclusively nocturnal epileptic seizures. Various data indicate approximately 10-45% of such patients among the total number.

This form of epilepsy is informally called “nocturnal” epilepsy because it is associated with sleep. It should be recognized that there is no such term in epileptology.

A certain set of terms related to events occurring during sleep is identified: convulsive epileptic seizures occurring during sleep, nocturnal seizures, nocturnal paroxysms, seizures that occur when falling asleep, awakening or against the background of sleep deprivation, paroxysms that occur during sleep against the background of non-epileptic genesis , various shapes parasomnias, including somnambulism (sleepwalking) and somnillaquia (sleep talking), insomnia, disruptions in sleep processing, hyperkinesis, benign myoclonus and other options.

The wide variability of manifestations in sleep determines such a variety of various terms, and also indicates the high frequency of paroxysms and the associated complexity of diagnosis. There are all sorts of combinations of various sleep disorders associated with epilepsy and seizures that have nothing to do with it.

Epilepsy with generalized seizures

Epilepsy with generalized seizures or idiopathic epilepsy with isolated generalized convulsive seizures is a benign disease with a clinical picture based on tonic-clonic seizures. This disease usually begins in adolescence, around 12-15 years. TO this disease There may be a genetic predisposition.

The seizure occurs suddenly, without any preliminary part. The initial phase of the attack is clonic and lasts from ten seconds to half a minute. The patient suddenly loses consciousness and falls with a loud cry, which occurs as a result of a spasm of the vocal cords. After this, a strong tension occurs in all muscle groups, as a result of which the body bends back, legs and arms are extended. The eyes remain open, the pupils dilate, breathing stops, and facial cyanosis occurs. After which the attack passes into the second phase - clonic, which lasts up to ten minutes in the most difficult case. The patient involuntarily takes a deep breath, all the muscles of the body twitch, and these twitching gradually turns into rhythmic contractions. Breathing is wheezing, foam is released from the mouth, often stained with blood resulting from biting the tongue, and sometimes involuntary urination occurs. After the attack, the patient experiences some lethargy, is weakened and quickly falls asleep.

The frequency of epileptic seizures varies from once or twice a year to once a month. Attacks can be triggered by disturbances in the daily routine, interruptions in sleep, drinking alcohol or narcotic drugs, violent awakenings. IN clinical picture diseases of secondary types epileptic seizures are simple absence seizures.

A neurological examination of patients with this type of epilepsy does not reveal any abnormalities. The diagnosis is based on eyewitness testimony describing the attack, since the patient is unconscious at the time of the attack and cannot describe it. The patient undergoes an EEG, which reveals activities without a certain asymmetry, while no deviations from the norm are detected.

Seizure first aid

When a person falls as a result of convulsions, you should try to catch him and, if possible, lay him on a soft horizontal surface. True, this cannot be done if the seizure occurred in transport or on the street. If this happens, you should, first of all, isolate the patient from objects that can injure him - anything sharp, cutting, piercing. Often, this requires the help of other people, since the convulsions can be so strong that it is difficult to hold the patient alone.

Preventing oxygen starvation, you should free your chest and neck from constricting clothing, turn your head to the side, in order to prevent the possibility of the patient choking on vomit.

To prevent the tongue from sinking, you should insert a spatula into the patient’s teeth and press it against the root of the tongue if possible. Fulfill this procedure it is necessary to be very careful, since the patient may involuntarily clench his teeth and this will injure the person providing assistance if he inserts his fingers into the patient’s mouth.

Standard, public medications are not suitable for providing first aid to a patient with epileptic seizure. To stop convulsive contractions, the patient should be given an intravenous diazepam solution in a volume of 0.3 ml per kilogram of his weight, the dose is calculated approximately. If the effect is insufficient, the injection should be repeated after 10-15 minutes.

Seizure treatment

If possible, treatment for seizures should begin as early as possible, since this makes it possible to stop the development of the disease and prevent changes in the patient’s psyche. After the disease has manifested itself, an encephalography should be done and treatment prescribed if a cluster is detected nerve cells. Treatment is carried out long time. Medicines stop taking it only after two to three years of taking it, earlier talk about complete cure no need to.

Seizure in a child

Seizures in children are very common, and their occurrence can be explained by many reasons. The most common factor explaining their appearance is the fact that the brain of children is still in the developmental stage and this determines the high excitability of the child’s nervous system. Children have extremely thin vessel walls and the penetration of various infections due to this circumstance is not difficult. The result may be swelling of the brain, accompanied by seizures.

In addition, seizures can occur as a result of exposure to many other factors that influence the development of the child in the womb, during childbirth and in the first months of an infant’s life.