epilepsy in children and basic concepts
General Approach to Epilepsy in Children and Basic Concepts
Epilepsy is one of the most common neurological diseases in the world and there are at least 700 thousand people with epilepsy in our country. referred to as seizure , short-term in-temporal consciousness or memory involvement, movement disorders or Often feeling changes are indicative of the presence of epilepsy. The cause of these seizures is the transient, abnormal and excessive electrical discharge of a group of nerve cells in the brain. Sometimes the cause of these electrical discharges is not epilepsy. To learn about general approach and basic concepts of epilepsy in children, you should read.
For example, in some infants, many of the seizures observed with high fever are called simple fever seizures ‘and are frequently seen after 6 months of age and disappear after 5 years of age. Or some metabolic imbalances, such as lack of calcium or sugar in the blood, can also be observed in epileptic seizures. To replace the missing substance in the treatment of these seizures is enough to free the patient from seizures. That is, every epileptic seizure hast is not an indication of epilepsy.
What is epilepsy?
The result of the electrical discharges in the brain, seizures in the form of changes in consciousness, short-term plunge, blank staring, fainting, percent, arms or legs contraction, teeth in the lock, eyes glide, foaming and urinary incontinence manifests itself with findings such as.
It is known as Epilepsy among the people and it is often thought that there is no treatment. However, children can be treated with great success.
Then what conditions can we call epilepsy? To be able to call a table epilepsy (epilepsy disease), the classical approach requires the presence of epilepsy seizures with recurrent or recurrent tendencies, depending on the conditions that directly or indirectly affect the brain.
A third condition is the non-epileptic seizures, which do not have epileptic seizures, but mimic these seizures. These include psychogenic events, nervous system or heart-circulatory-induced syncope (fainting) or some other non-epileptic brain diseases.
Epilepsy seizures are common in the body or local contractions, rhythmic repetitive contractions and splashes, numbness, tingling, pain-like temporary sensations, visual and speech disorders, bad smell sensations, bizarre behavior, communication gap, memory and loss of consciousness, heart palpitations, fear sensation, etc. Their duration is usually short, often limited to seconds. Rarely, a seizure can take very long (hours), or many seizures follow each other with short intervals. Such conditions require hospital treatment.
There are a variety of conditions leading to epilepsy, some of which are more common in certain ages. These include, but are not limited to, oxygen and / or bleeding deficiencies of the brain, bleedings, infections, head injuries, metabolic or genetic diseases, and developmental disorders of the brain. In these cases, brain imaging techniques and biochemical studies often provide information about the diagnosis. Some genetic epilepsies begin at certain ages and tend to fade out in a few years. Sometimes, the physician does not need medication.
Electroencephalography (EEG) is the research method that provides the most information about whether a symptom is epileptic seizure or what kind of epilepsy. Several imaging modalities, mainly cranial magnetic resonance (CMR) or computed tomography (CT), are used in many diseases that affect the brain structurally. Genetic studies also contribute to the diagnosis of epilepsy by gaining great acceleration.
epilepsy in children and basic concepts
The treatment of epilepsy also depends on the type. The most common drug treatment. Epilepsy surgery, which is another option, is developing rapidly in the world and in our country and can be the only and very successful solution for certain epilepsies. There are different methods applied in the surgical treatment according to the situation. There are also epilepsies where other treatments (ketogenic diet, vagus nerve stimulation) may be useful.
In summary, epilepsy is not a single disease, there are several epilepsy. Sometimes epileptic seizures can be caused by causes other than epilepsy, as in the case of febrile transfer. In addition, each come-in temporary incident is not a seizure of epilepsy; there may be other physiological or pathological conditions that may mimic epileptic seizures.
On the way to diagnosis, the observer’s attention and / or home videos can be very useful. The physician decides what is needed for diagnosis and treatment after a detailed and careful information and examination.
Does your child love at regular intervals? Do you feel sad because of this fainting and say, “Epilepsy? Are you hiding and hiding? Well, do you know there’s a cure for epilepsy?
What is Epilepsy?
It is not a mental illness or madness; As it is not contagious, children with epilepsy are not dangerous and harmful to others. Because of these false perceptions in our society, families hide their children’s epilepsy. In fact, it is seen that they spend a significant part of their days at their school, even from their teachers.
What to do at the time of the seizure?
Seizures usually stop spontaneously within a few minutes. Therefore, when we see a person with seizure without panic in the head during the seizure of the head to damage itself, to prevent the bite of the tongue is prevented, lying on the side of a non-rigid flat surface to keep the airway open, if there is foaming and vomiting in the mouth is cleared. If the seizure is not terminated within 2 to 4 minutes, it is tried to reach the most appropriate health center by calling 911.
Would it be helpful to smell alcohol or onions during the seizure?
It is of no use to hold firmly to prevent contraction, which is commonly applied among the population, to pour water or cologne to the face, or to smell alcohol or onions. Trying to drink something is too dangerous and can cause lungs to escape and even death.
Is it helpful to have a cold shower during the epileptic seizure?
It is not helpful to keep the child under the tap or take a cold shower during the seizure. Especially in children who have feverish seizures, the cold shower quickly cools the outside of the body, leads to more blood in the brain and increases the fever in the brain, which can be more harmful for the seizure. On the other hand, it may be useful to have a warm shower in the hot boy without a seizure.
What is the cause of epilepsy?
Although many events such as high fever, head trauma, intoxication, cysts, tumors, bleeding and brain development defects cause epilepsy, the cause of epilepsy is genetic in 50-60% of patients. Seizures seen only during the febrile illness are not considered as epilepsy and often do not require treatment. Also, most of the fiery referrals are related to genetic predisposition.
What are the types of epilepsy?
Because it has more than a hundred species, recognizing the seizure of epilepsy is sometimes not even easy for experts. A short period of 5-10 seconds may be a seizure of epileptic seizure, and a vacancy in the arms or legs may be a seizure of epilepsy. Symptoms such as fainting, loss of consciousness, contraction, tooth lock, mouth wheezing and urinary incontinence are only seen in large seizures.
What are the factors that increase epileptic seizures?
Long-term hunger, stress, sleepiness, alcohol, coffee and cola drinks can facilitate the seizure of children with epilepsy susceptibility. It is not correct and necessary to prohibit all children with epilepsy as bright light-emitting devices such as computers and television will cause seizures only in children with light-sensitive epilepsy.
Should the EEG and MRI used in the diagnosis be taken to each patient?
EEG for the diagnosis of epilepsy; To find the cause of epilepsy is also very useful to attract MRI. However, EEG and MRI can be diagnosed without epilepsy, and EEG and MRI may be normal in epilepsy patients.
Can epilepsy be treated?
Epilepsy can be successfully treated with medications. Although effective drugs have been known for nearly 100 years, drugs have been discovered in the last 20 years with very important, effective and side effects. Today, in general, 70-80 percent of children with epilepsy and 100 percent of some epilepsy types are fully healed with these drugs. In some patients, non-drug treatment options may be more important.
When is epilepsy surgery necessary?
Especially the patients who do not respond to the medication and who are not suitable for surgery and who will not have a permanent post-operative disability, are applied with success in the advanced centers experienced in epilepsy.
Who will wear the epilepsy battery?
Seizure treatment can be provided by giving a caution to the vagus nerve extending from the neck to the brain with a stimulating battery placed under the skin in the chest wall. It is especially preferred in patients who cannot respond to medication and are not fit for surgery.
Who can apply ketogenic diet therapy?
Ketogenic diet with a high proportion of fat and very low carbohydrate content can be promising for some selected epilepsy patients. This treatment method, which is somewhat troublesome, is not suitable and necessary for every patient. Other treatment modalities should be properly evaluated before the ketogenic diet. However, in some metabolic diseases, ketogenic diet can be used primarily and sometimes as a single treatment.
What is the duration of treatment?
The duration of treatment should be at least 2-4 years even if the seizures are fully controlled with medication or other treatment methods. Drugs should not be stopped suddenly; The doctor should decide to discontinue medication and the cut-off period should be at least 6 months-1 year. During this period, it is necessary to carry out checks at Child Neurology Clinics at the latest every 6 months.
Can children who continue treatment continue their normal lives?
Children in control of their seizures by drug treatment, daily activities, to go to nursery-kindergarten or school, school sports activities and laboratory work is not any problem. However, dangerous sports such as swimming and cycling should be carried out after the seizure control is provided and under supervision. Children with epileptic friendships with other children have no problem with both sides of the game. Therefore, the exclusion of these children by their teachers and friends during school years is extremely wrong.