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Correct understanding of epilepsy

  Epilepsy, commonly known as “horn wind”, is a disease of the nervous system, a group of clinical syndromes caused by a variety of reasons for the highly synchronized abnormal discharge of brain neurons. The main manifestations are transient disturbance of consciousness, repeated seizures, such as falling, body twitching or convulsions, staring straight ahead, paresthesia, and fainting. Studies have shown that the current causes of epilepsy mainly fall into the following six categories: structural, genetic, metabolic, immune, infectious, and unexplained brain diseases, systemic or systemic diseases, etc. may cause epilepsy.
  How to tell if you have epilepsy?
  In terms of epilepsy diagnosis, long-term EEG, video EEG, and brain function monitoring in critically ill patients can greatly improve the diagnosis rate of epileptic abnormalities, and at the same time play an important role in clarifying the type of epileptic seizures.
  In terms of etiological diagnosis, in addition to conventional CT and MRI imaging methods, functional magnetic resonance imaging, SPECT, and PET-CT play an important role in the etiological diagnosis of epilepsy and the localization of epilepsy focus.
  Is Epilepsy Incurable?
  Epilepsy is curable, but most patients require long-term or even life-long treatment. If you receive standardized and reasonable antiepileptic drug treatment, 70% to 80% of patients can control their seizures, and some patients can stop taking drugs after 2 to 5 years of treatment.
  Patients with refractory epilepsy who are poorly controlled by drugs can also use methods and technologies such as transcranial magnetic stimulation, vagus nerve stimulation, epilepsy surgery, genetic testing, and precision therapy to alleviate the disease or control their seizures.
  Transcranial magnetic stimulation is a non-invasive diagnosis and treatment method. It acts on the cerebral cortex through a time-varying magnetic field to generate inductive bioelectric currents, affect the electrical activity of cells, and change the excitability of the cortex, thereby exerting a neuromodulatory effect. Repetitive transcranial magnetic stimulation via inhibition of neurotransmitter gamma? The release of GABA reduces the excitability of neurons, thereby inhibiting the function of the ascending reticular activating system of the brain stem, and improving sleep quality, depression, and seizures.
  Vagus Nerve Stimulation Vagus Nerve Stimulation is a new technology that has been gradually perfected and applied clinically in recent decades. It is a non-drug nerve control auxiliary treatment system. The system is mainly composed of a pulse generator, a vagus nerve spiral electrode and a controllable program regulator. The stimulating electrode sleeve is placed on the left vagus nerve trunk, connected to the pulse generator through a subcutaneous pathway, and can adjust and change parameters such as the frequency, intensity, and duration of stimulation. It has changed the previous treatment mode of focal resection and conduction pathway damage. It is a reversible, wirelessly controlled in vitro treatment method, and has played a positive role in the treatment of refractory epilepsy that cannot be controlled by drugs and cannot be surgically removed.
  Epilepsy surgery There are many surgical methods for epilepsy, and perfect preoperative evaluation and precise positioning are the keys to the success of surgery.
  Genetic testing and precise treatment
  Genetic abnormalities cause more than 70% of epilepsy syndromes. Therefore, genetic testing has become an integral part of the pediatric epilepsy investigation. Patients with genetic testing should include patients with refractory epilepsy, or associated malformation, developmental delay/cognitive decline, or intellectual disability. Genetic testing technology is also developing and updating with each passing day. Shift from single gene testing to multigene testing, whole exome sequencing, whole genome sequencing, and microarray testing for infants and children with epilepsy symptoms. Targeting treatment options for a single epilepsy syndrome based on the genes and specific molecular alterations involved is known as precision therapy. In addition to helping us identify the cause of epilepsy early, treat it in time, guide clinical precision treatment, and improve the cure rate of epilepsy, epilepsy genetic testing can also assist clinicians in judging the prognosis of the disease and provide genetic counseling information. After the genetic diagnosis, the patient’s prognosis can be clarified, and possible complications can be intervened in advance. It can also provide family members with disease risk assessment and fertility guidance to avoid unnecessary anxiety.
   What are the common misconceptions about epilepsy?
  Due to people’s misunderstanding of epilepsy, epilepsy patients encounter a lot of confusion in education, employment, marriage, life and other aspects.
  1. “I dare not let my child go to school or go out for activities, for fear that he will get sick outside and be seen by others…”
  A large part of the low self-esteem and shame of epilepsy patients, especially children, comes from the family. Parents concealing the condition and overprotecting often have a negative impact on the child’s psychology, making the child think that epilepsy is a disgraceful thing, and the inferiority complex also arises from this.
  In fact, under the premise of good epilepsy control, allowing children with epilepsy to move freely in the sun like normal children will help them better physically and psychologically.
  2. “If you have epilepsy, you can’t go to work, and people will become stupid and hopeless…”
  Apart from the fact that some causes of epilepsy may affect the cognitive function of patients, well-controlled epilepsy has little impact on cognitive function , Patients can also work within their capabilities. Of course, epilepsy patients should avoid engaging in driving, fire fighting, high-risk, high-altitude and underwater operations, etc.
  3. “Patients with epilepsy cannot marry and have children, and the disease will be passed on to their children.”
  Patients with well-controlled epilepsy can plan pregnancy under the guidance of a specialist. The vast majority of people with epilepsy have a definite, non-genetic cause, and this type of epilepsy is not hereditary. A small part of epilepsy is caused by genetic diseases, which may be inherited, mainly including tuberous sclerosis and neurofibromatosis.
  However, it is true that some epilepsy syndromes have been proved to have a certain genetic predisposition, such as juvenile myoclonic epilepsy, benign familial neonatal convulsions, autosomal dominant nocturnal frontal lobe epilepsy, etc., but it does not mean that these epilepsy syndromes It will definitely be inherited, but the probability of epilepsy in the next generation is higher than that of normal people. Genetic testing is an important auxiliary inspection method.
  What to do if someone has a seizure
  Ask the patient to lie down or lie on his side. Do not try to press or stop the convulsions. It is not recommended to stuff the patient’s mouth. Try to avoid bruises, falls, aspiration and suffocation, which will greatly reduce the impact of epileptic seizures on the patient. s damage.
  Epilepsy is not contagious, and seizures are not aggressive. I hope everyone can go forward bravely and help epilepsy patients when they have seizures.

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