The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy

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How to Prevent Seizures

While there’s no one way to prevent a seizure, following a well-rounded treatment and management plan can help.

A seizure occurs due to abnormal or overactive electrical activity in the brain, which disrupts brain cells from effectively sending messages to each other.

According to the Centers for Disease Control and Prevention (CDC), if you’ve had two or more seizures, your doctor may diagnose you with epilepsy.

If you have epilepsy, or another condition that puts you at risk of recurring seizures, it’s important to take preventive measures to stop them from occurring.

Follow these tips to keep someone safe during a seizure.

What to do

In the case of a seizure, you can help a loved one by:

• remaining calm
• placing a pillow or cushion under their head
• laying them on their side for protection if no cushioning is available
• creating space to avoid injuries by moving surrounding furniture and objects
• noting the time the seizure begins and ends
• staying with your loved one for the entire seizure — they can last a few seconds or up to 2 to 3 minutes

What not to do

It’s just as important to know what not to do if your loved one is having a seizure. You can avoid further complications by not:

• placing anything in their mouth in an attempt to prevent tongue biting — this may cause injuries
• moving them to another room
• restraining them
• leaving them alone

When to call 911

While not all seizures require emergency medical attention, you should call 911 or local emergency services if:

• it’s the first time this person has ever had a seizure
• a child has a seizure of any duration
• an adult has a seizure lasting longer than 5 minutes
• the individual doesn’t wake up after a seizure
• the individual experiences repeat seizures
• the individual is injured during a seizure
• the individual who had a seizure is pregnant

Was this helpful?

Keep in mind that there are different types of seizures that may affect different parts of your brain. Each person’s experiences with seizures may vary, too.

This information can also help reduce the chances of developing related conditions, such as:

• difficulty with thinking
• injuries
• death

Seizure prevention is dependent on an overall management and treatment plan, such as taking your prescribed medications and making lifestyle changes.

Talk with a doctor about incorporating the following measures into your overall treatment and management plan to help prevent seizures.

1. Take your medication as prescribed

Antiepileptic drugs (AEDs) are prescription medications designed to help prevent seizures. It’s important to never stop taking these medications without a doctor’s approval — even if your condition seems to be improving.

In fact, not taking your medications properly puts you at risk of uncontrolled seizures.

Withdrawal seizures can occur if you skip medication. Medication toxicity from taking too much at a time can result in side effects, which may involve seizures.

2. Avoid consuming alcohol

Alcohol isn’t recommended for people with epilepsy, due to an increased risk of seizures. You may help prevent future episodes by avoiding alcohol.

If you’re experiencing alcohol misuse, be sure to talk with a healthcare professional about how to safely quit drinking.

3.

Avoid substance misuse

In addition to alcohol avoidance, it’s important to avoid substance misuse as part of your seizure management plan.

Talk with a medical professional if you’re having challenges with using legal or illegal substances.

4. Practice stress management

Stress can be a trigger for seizures in epilepsy. It may help you reduce your risk of seizures if you manage your stress by:

• getting enough sleep
• exercising
• taking time to relax

5. Maintain a sleep schedule

Waking up and going to bed at the same time every day can help you maintain a sleep schedule.

Tiredness and short-term sleep deprivation are considered triggers for seizures, so regular sleep can help prevent them.

6. Keep a consistent meal schedule

Hypoglycemia from skipping a meal can cause a seizure, particularly for people with diabetes.

It’s a good practice to keep a consistent meal schedule and have fast-acting sources of glucose on you at all times if you have diabetes.

7. Avoid flashing lights

According to the Epilepsy Society, it’s estimated that about 3% of people with epilepsy have a rare form called photosensitive epilepsy. With this type of epilepsy, seizures may be triggered by flashing lights or contrasting patterns of light.

If you’re photosensitive, such exposure to lights could trigger a seizure immediately.

While AEDs can help prevent seizures, it’s also important to avoid flashing lights and images, as well as those in geometric patterns. Playing video games with rapidly flashing graphics may also trigger seizures in some people.

If you’re suddenly exposed to flashing lights or patterns, quickly cover one or both eyes with your hand. According to the Epilepsy Society, this may help prevent the onset of a seizure.

8. Protect yourself from head injuries

Head injuries can lead to a single seizure or recurrent seizures in someone who doesn’t have epilepsy. The related seizures may occur weeks, months, or even up to a year after the injury.

According to the CDC, 1 in 10 people ages 15 and older who were hospitalized for a traumatic brain injury go on to develop epilepsy within 3 years.

A head injury can also trigger a seizure in someone who already has epilepsy. So, it’s important to protect yourself from future head injuries and the possibility of more related seizures.

Wear a helmet when bicycling, skating, or playing contact sports. Talk with a medical professional about stability exercises to help decrease your risk of falls.

9. Pay attention to fevers

Some children between the ages of 6 months and 5 years may be at risk of developing febrile seizures. These are triggered by fevers of 101°F (38°C) or higher and may accompany infections.

Not every child with a high fever will develop a febrile seizure, and the episode may occur hours later.

Call 911 or local emergency medical services if your child has a seizure. Children with febrile seizures may be at a higher risk of having future episodes, so medication may be necessary to prevent them.

A few options are available for treating seizures. It’s important to work with a doctor to develop the right epilepsy treatment plan for you.

Medications

Prescription AEDs are first-line treatments for seizures. These drugs are also known as antiseizure medications or anticonvulsants, and they come in various types and brands.

Some AEDs treat partial seizures, for instance, while others treat more generalized ones.

AEDs can’t cure epilepsy, but they may help prevent future seizures. It’s also important to talk with a healthcare professional about possible side effects, such as:

• fatigue
• dizziness
• difficulty with thinking

Some AEDs may pose long-term health issues, such as increasing your risk of osteoporosis.

Devices

According to the Epilepsy Foundation, 3 in 10 people with epilepsy either don’t have success with AED mediation or deal with bothersome side effects. For these people, implanting devices that send small electric currents to the brain may help prevent seizures. Options include:

• vagus nerve stimulation
• responsive neurostimulation
• deep brain stimulation

Surgery

If you’ve tried medications, devices, and other lifestyle changes but your seizures aren’t well-controlled, undergoing brain surgery may be an option. Common surgical procedures for epilepsy include:

• focal resection, or the removal of a known area in your brain where seizures begin
• disconnection surgery, or the removal of brain connections that cause seizures to spread from one side of the brain to the other

Not everyone who experiences seizures is a good candidate for surgery. Talk with a doctor about your options.

After you experience a seizure, your primary care doctor may refer you to a special type of neurologist known as a epileptologist. This type of doctor specializes in diagnosing, treating, and managing seizures.

Once you’ve had a seizure, you may be at risk of future episodes the rest of your life. A neurologist or epileptologist can help you come up with a seizure treatment and management plan. This likely includes:

• medications or other treatments
• lifestyle changes
• other preventive measures

It’s also important to check in with your neurologist or epileptologist if you’re concerned with medication side effects, or if you continue to have seizures despite taking AEDs. They may recommend an alternative treatment to help.

Due to the intricate nature of seizures, there’s no way to completely prevent them once you’ve had one.

But taking AEDs and maintaining a healthy lifestyle are strategies that can help.

It’s important to never stop taking medications on your own without consulting a medical professional. Contact your doctor if you’re not happy with your current treatment plan. Together, you can discuss next steps.

Memo to a patient suffering from epilepsy | Ministry of Health of the Chuvash Republic

First aid for an epileptic attack

Patient with epilepsy. Advice for patients and their relatives.

Introduction

The first mention of epilepsy in the writings of Hippocrates over 2000 years ago. The name epilepsy comes from the Greek word, which literally means “to possess”, “to seize”.

Epilepsy is a chronic brain disease characterized by repeated, spontaneous (unprovoked) seizures in the form of a violation of motor, sensory, autonomic, mental or mental functions resulting from excessive discharges of nerve cells in the cerebral cortex. Epilepsy can occur at any age, but is more common in childhood and older adults. This is one of the most common diseases of the nervous system, occurring in 0.5-1% of the population of developed countries. This means that about 50 million people worldwide have epilepsy.

Epilepsy is a treatable brain disease, and there are still a number of errors and warnings associated with the diagnosis of epilepsy in society. Patients still experience the burden of social stigmatization, which is especially typical in those countries where modern knowledge about epilepsy is not widespread in society and in the medical environment. Patients meet with limitations in various areas of life, including when looking for a job, in the learning process. Often, in order to avoid social stigmatization, patients hide their diagnosis, which can lead to irreparable consequences that pose a threat to the health and life of the patient.

Currently, on average, 65-70% of patients may have a complete cessation of seizures. However, lifelong therapy is not always required, and in many cases gradual withdrawal of the drug is possible in the future. The quality of life of patients with epilepsy also improved significantly.

Helping the sick during an attack.

1. If the patient anticipates an attack, should he take the necessary safety measures? Lie on the bed or on the ground, away from traumatic objects, loosen the tie (for men). The child should be placed on a flat bed or floor, and tight clothing should be loosened or loosened, especially at the throat, to clear the airway. Outside the home, the child must be moved to a safe place (away from water, traffic, sharp objects and corners), put something soft under his head (for example, a folded jacket, jacket). It is necessary to protect the patient from injuries, especially head injuries.

2. If a seizure occurs suddenly and the patient does not anticipate it, he himself cannot protect himself from injury, and precautions must be taken after the onset of the seizure. During an attack, the patient must not be carried, except in cases where he may be in danger, for example, on the roadway, near the fire, on the stairs or in the water.

3. In case of increased salivation and vomiting, the patient should be laid on his side so that he does not choke. This should be done gently, without using force.

4. Do not try to hold the patient by restricting his movements. Also, do not try to open the patient’s mouth, even if biting the tongue has occurred: this can lead to injury to the teeth, oral mucosa and tongue. Remember that when the head is positioned on its side, the retraction of the tongue never occurs and recommendations for unclenching the jaws of pulling out and even fixing the tongue are not justified and harmful. Such a dangerous complication of an attack as retraction of the tongue, leading to asphyxia and death, occurs only if the head is positioned face up with the head thrown back. In no case do not allow this position of the head!

5. It is necessary to wait for the attack to end, being close to the patient and carefully observing his condition in order to correctly and fully describe the manifestations of the attack to the doctor.

It is very important to note the time when the attack began, since the duration of the attack or series of attacks, approaching 30 minutes, means that the patient is entering a life-threatening condition – status epilepticus – a dangerous condition that requires urgent hospitalization and intensive care.

After an attack, the patient falls asleep. In this case, it is not necessary to disturb him in order to allow the nerve cells exhausted from the attack to recover. It is necessary to stay close to the patient and wait until the post-attack period ends and consciousness is fully restored.

6. During an attack, one should not try to restrain and limit the patient’s convulsive movements by using force. Also, you can not unclench the jaws compressed by cramps with your own hands or with a hard object. You can not water the patient with water, do artificial respiration. It is also not recommended to try to wake the patient after an attack by shaking him, tapping him, letting him sniff pungent odors, or using any other methods.

7. Most attacks end on their own and last for a short time (several seconds or minutes). Seizures usually spontaneously stop after 1-3 minutes, and therefore usually the patient does not need the help of a doctor. However, if the duration of the attack exceeds 5 minutes, it is necessary to call a doctor, intramuscular or intravenous administration of the drug is required to stop the attack.

Safety rules for patients with epilepsy.

Patients with epilepsy should try to lead a normal life, avoiding excessive unjustified restrictions. However, it is necessary to comply with a number of security measures, especially while maintaining seizures with loss of consciousness.

The patient should not be without insurance at a height, at the edge of the platform of railway stations, near fire and near water!

Household safety rules.

1. All sources of fire must be properly covered, and heaters must be removed to a safe place.

2. If the child sometimes has sudden (without aura) seizures, you can put plastic rounded plates on the corners of the furniture.

3. If possible, doors, especially bathrooms and toilets, should open outward so that a fallen child does not block the door. Latches and locks from the inside are also undesirable.

4. A child should take a bath at a shallow water level and always in the presence of an adult. The water should not be very hot. The shower must be fixed high and securely.

5. Sometimes the patient is advised to wear special protective equipment, helmets.

Provoking factors for seizures.

Attacks usually occur without antecedent factors (spontaneously, randomly) and are completely unpredictable. However, in some patients, seizures are triggered by certain situations (eg, flickering lights, sleep restriction, stressful situations, strong feelings of fear or anger, certain medications or alcohol, hyperventilation). If factors that provoke the occurrence of seizures are identified, they should be avoided, this will lead to a decrease in the frequency of seizures.

Lifestyle advice for people with epilepsy.

1.Sleep. A patient with epilepsy needs to sleep enough hours a day, avoid sleep disturbances, early or abrupt awakenings. It is necessary to choose a mode of operation that meets this requirement, since in many patients sleep restriction provokes seizures. It is necessary to avoid physical and mental overload, to properly alternate work and rest.

2. Nutrition.

Must be complete and contain sufficient vitamins and minerals. A special “ketogenic diet” has been developed as a method of treating resistant and severe forms of epilepsy, but it is used only according to indications, under the supervision of a doctor in specialized medical centers.

3. Alcohol.

Increases the frequency and severity of seizures, and also increases the side effects of antiepileptic drugs, so you need to completely stop drinking alcohol!

4.Sport .

Professional sports are excluded for patients with epilepsy. However, patients with epilepsy can and should go in for sports (physiotherapy exercises), observing certain rules and restrictions (especially if seizures persist). Prohibited are sports related to climbing (mountaineering), speed sports, contact martial arts (for example, boxing), water sports. Cycling, inline skating, skateboarding, or ice skating is possible with full seizure control or aura, and only with protective gear such as a helmet and knee pads; at the same time, it is necessary to avoid busy streets and squares, roads with heavy traffic. Sports activities associated with climbing to great heights and the danger of falling, as well as dangerous sports equipment, while maintaining seizures, should be excluded. In patients with attacks provoked by hyperventilation, it is dangerous to engage in those sports in which hyperventilation is expressed (ie, deep and frequent breathing).

Children should bathe only with adults who can provide immediate assistance in case of initial manifestations of an attack (loss of coordination, purposefulness or slowing down of movements). Swimming lessons are possible only in cases of persistent medical control of seizures, in the presence of an instructor who knows about the disease and is able to provide assistance.

Yoga, qigong and oriental tai chi systems, including physical and psychological exercises, as well as control of the depth of breathing, may be useful for patients with epilepsy.

Rules to be observed by a patient with epilepsy when watching television:

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3. Additional lighting of the room is required to reduce the light contrast

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5. To control the TV, use the remote control

6. To reduce the effect of flickering when viewing flickering pictures, flashes, close one eye

7. Do not watch TV if the patient has not had enough sleep, is tired or does not feel well enough

Rules to be followed by a patient with epilepsy while working or playing on the computer:

which are necessary for resting the eyes

2. The distance from the eyes to the monitor must be at least 35 cm for 14-inch screens

3. Additional room lighting is required to reduce the light contrast

4. Glare from windows and other light sources must not fall on the monitor

5 .The monitor is preferably liquid crystal

6.Do not view small details of the image at a close distance

7.It is necessary to remove other monitors and TVs from the field of view

8. Do not watch, work/play on the computer if the patient has not had enough sleep, is tired or feels unwell , sparkling snow on a sunny day, the alternation of light and shadow, for example, if you look from the window of a moving train at the flickering of tree trunks at sunset) – such phenomena are often found in nature, they can also provoke patients with photosensitivity.

It is recommended to close one eye during intense light stimulation.

Sunglasses help on sunny days.

Photos from open sources

causes and symptoms of the development of the disease, modern diagnostic and treatment options

Contents of the article

1. Difference between epileptic syndrome and epilepsy
2. Causes of epilepsy in adults and children
3. Signs of epilepsy
4. Complications after epilepsy
5. Epilepsy diagnostics
6. Treatment of epilepsy
7. Preventive measures to prevent the development of epilepsy
8. FAQ

Epilepsy belongs to the group of chronic diseases of the brain. Its most characteristic manifestation is recurrent seizures with simultaneous impairment of motor, sensory and mental functions. With a regular repetition of seizures, doctors talk about epileptic syndrome – systematic seizures. They are caused by tumors in the brain, adhesive or scar formations that irritate the nerve endings. The severity of seizures varies in duration and intensity, but has the same type of character and is manifested by similar external signs.

Distinguishing epileptic syndrome from epilepsy

These two concepts have a significant difference. Epileptic syndrome is more often a consequence of a serious illness, while epilepsy is an independent pathology, the causes of which are still unknown. The epileptic syndrome may not be associated with epilepsy, and there is the possibility of its complete removal, provided that the provocative cause is eliminated. In addition, it does not affect the mental and physical abilities of a person, while epilepsy is accompanied by serious mental disorders and contributes to a decrease in intellectual activity.

Causes of epilepsy in adults and children

To provoke the development of the disease can:

• traumatic brain injury;
• genetic disorders in the structure of the brain;
• previous brain diseases;
• consequences of infectious diseases;
• circulatory disorders in the head.

Among the factors contributing to the development of the disease are:

• stress, emotional strain;
• overwork;
• abrupt changes in climatic conditions in the region of residence.

It is often not possible to determine the exact cause of epilepsy in adults. More than 50% of patients have an idiopathic form with an unknown mechanism of development. Often, several of these factors affect the patient at once. In addition, for modern medicine, the human brain is not yet a fully explored area, and it is not possible to study individual pathological manifestations in detail.

If the cause of epilepsy has been stopped, experts call this form a secondary type of epilepsy. Among its main reasons:

• tumor processes in the brain;
• meningitis and encephalitis;
• hemorrhages in the brain structure;
• consequences of traumatic brain injury;
• effects of alcohol or chemical intoxication;
• influence of genetic factors;
• brain abscesses.

The risk group for the development of epilepsy includes patients with traumatic brain injury, stroke or inflammatory diseases of the brain, relatives of epileptics, persons with a tendency to regular alcohol consumption.

Signs of epilepsy

The first symptoms of epilepsy are noted at the age of 5-15 years. The possible onset of an attack is indicated by characteristic signs – deterioration in sleep and appetite, increased irritability, headache.

The seizure occurs suddenly, depriving the patient of consciousness and motor activity. He falls to the ground, there are tonic convulsions, the body and limbs are stretched, the head is thrown back. Within 15-20 seconds from the onset of an attack, its character changes: signs of clonic convulsions are noted, the skin turns blue, the tongue sinks, foam is released from the mouth. The sense of orientation in space is completely lost, hallucinations may occur. Within a few minutes, without assistance, the patient’s condition stabilizes, he regains consciousness, and the ability to move and think returns to him.

Often an attack of epilepsy causes drowsiness, a feeling of weakness and fatigue. In case of an unsuccessful fall, injuries can occur that can aggravate the patient’s condition. Characteristically, the patient himself cannot describe his condition and feelings during an epileptic attack.

Seizures, during which the patient has a loss of consciousness with full preservation of motor activity, are singled out in a separate group. Qualified diagnostics allows to accurately indicate the epileptic nature of this pathology.

Complications after epilepsy

Refusal to seek qualified help from a doctor can cause a number of serious pathological changes in the patient’s body:

• status epilepticus – a sharp reduction in the intervals between attacks, when the patient does not regain consciousness. In the absence of medical assistance, the onset of a coma is likely. The causes of the phenomenon are the consequences of a traumatic brain injury, infectious diseases, negligence in the passage of the prescribed conservative course, a tendency to drink alcohol;
• condition of aspiration pneumonia – caused by foreign objects or vomit entering the respiratory tract during an attack;
• neurogenic pulmonary edema caused by overload of the left atrium due to disorders in the functioning of the nervous system and arterial hypertension;
• development and consolidation of mental disorders: selfishness, captiousness, aggressiveness, vindictiveness, depressive states;
• sudden death during an attack.

Epilepsy diagnostics

When collecting a patient’s history, the following questions are clarified:

• year and age of the patient at the time of the first attack;
• regular occurrence;
• sensations of the patient before the onset and immediately after the end of the seizure;
• the nature of muscle spasms.

It is possible to get answers to these questions from relatives of the patient who are witnesses of seizures. Given an accurate description of the disease, the neuropathologist can easily determine in which area of ​​the brain the focus of epilepsy is located – a pathology that irritates the nerve endings and causes seizures.

The only instrumental method for diagnosing epilepsy is an electroencephalogram. The electrodes located on the patient’s head write off the signals of the brain in its different parts, which is recorded in the computer in the form of characteristic graphs. Based on the picture obtained, signs of epileptiform activity can be easily seen. An informative diagnostic method is reading the readings of brain activity during seizures. Comparison of a video recording of the patient’s behavior and EEG data allows you to identify pathology in a certain area of ​​the brain and take measures to eliminate it.

The method of magnetic resonance imaging can be useful in the risk of developing the disease. It is prescribed for patient complaints of headaches, unsteady gait and noticeable weakness in the limbs. These symptoms indicate organic brain damage that can provoke the onset and regularity of seizures.

The development of epilepsy is not a reason for assigning disability status. The patient can continue to lead a normal life and work in a safe environment, regularly taking prescribed medications and monitoring for possible exacerbations. It is important that in the event of an abrupt onset of an attack, he should be given first aid for epilepsy by relatives or others.

Epilepsy treatment

The diagnosis of “epilepsy” in children or adults is not a final sentence for life. Subject to timely seeking medical help and a favorable clinical picture, a complete cure is possible with the disappearance of seizures without the need to regularly take medications.

Treatment of epilepsy symptoms can be conservative or surgical. In the first case, the patient is prescribed a complex of drugs that suppress epileptiform activity and eliminate the cause of the pathology. During surgical treatment, the focus of epilepsy – scars, tumors or foreign fragments after a traumatic brain injury – is removed from the brain structure without damaging healthy tissues. The recovery period after surgery depends on the area of ​​brain damage, the severity of the disease and the general condition of the patient’s body.

Preventive measures to prevent the development of epilepsy

Among the measures that prevent pathological brain activity, note:

• protection against traumatic brain injury;
• timely treatment of infectious diseases;
• reduction of high temperature during the acute stage of the disease, the exclusion of situations with a high risk of overheating or hypothermia;
• seeking medical attention for suspected trauma or tumor in the brain;
• blood pressure control;
• moderately active lifestyle;
• giving up bad habits and drinking strong coffee.

In addition to the above measures, during the recovery period of epilepsy treatment, it is recommended to strictly follow the doctor’s prescriptions and avoid physical and emotional overload.

Frequently asked questions

Frequently asked questions are answered by:

SEMENOVA

Olga Vladimirovna

Experience 7 years

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Is epilepsy inherited?

SEMENOV Olga Vladimirovna

Neurologist, Head of the Department for Diagnostics and Treatment of Cognitive Disorders

The hereditary factor is relevant for patients with epilepsy in more than 50% of diagnosed cases. Genetic disorders in the structure of the brain can be transmitted from one or two parents. It is possible to accurately name the cause of the disease on the basis of data

Is there a cure for epilepsy in children?

SEMENOV Olga Vladimirovna

Neurologist, Head of the Department of Diagnostics and Treatment of Cognitive Disorders

Recovery from epilepsy is possible at any age, provided that you seek help in a timely manner and cooperate with a qualified neuropathologist.