Epilepsy

Epilepsy is a chronic neurological condition characterized by recurrent and sudden crises. The condition is named from the greek epilambanein, which means' be overwhelmed, be caught by surprise '. Indeed, this disease, or rather this set of diseases (if you know more than 40 different types) is characterized d improvvisa onset of epileptic seizures that precisely captures the patient by surprise.

It is commonly controlled with medication, although experimental surgical methods are slowly catching on. It should be noted that drug therapy is only symptomatic, managing to control the occurrence of crises, but in no way is an effective prophylactic or curative therapy.

In the past, epilepsy has been associated with religious experiences and even demonic possessions. Historically, epilepsy was known as the "Sacred Disease" because according to one popular view is believed that the seizures were a form of attack of demons or a manifestation of occult power.

It is among the most frequent neurological diseases: affects three to seven persons per thousand, about 2 million people in the United States. The epilepsies affect 1 percent of the Italian population, over 500,000 people. The incidence is 50 cases per 100,000 people each year, some 25,000 new units per year. May occur at any age, in about 80% of cases, however, the crisis begins before the age of 20, in childhood and adolescence.

The term epileptic crisis is transient alteration of behavior, without apparent cause, resulting in a pathological discharge, and synchronous rhythm of a group of brain neurons.

The origin of the crisis is in the brain.
Patients sick of epilepsy occurs that a certain group or groups of neurons are, for various reasons, the most excitable of normal and tend to suddenly turn on all together.

This phenomenon is called weak, because in fact corresponds to an electric discharge. This discharge may remain localized at the level of the group of neurons that has generated or propagate, just like a thunderbolt, the whole brain.

Depending on the point where the download starts and areas of the brain that are interested, now or later, there will be various types of symptoms.

They may also not epileptic crisis, if caused by external agents such elettroconvulsivante therapy (ECT, the common "shock"), or drugs convulsivanti. By the end of epilepsy, however, is a neurological disorder characterized by un'imprevedibile frequency of occurrence of seizures.

The causes that lead a normal brain to work in paroxysmal to cause an epileptic crisis are still in the dark: the latest research are turning to the role of transmembrane channels for the electrolyte voltage-dependent.

CLINICAL CLASSIFICATION

Idiopathic epilepsy:
at the base there is a specific genetic mutation
eg juvenile myoclonic epilepsy
characterized by the absence of structural or metabolic diseases of the brain causing the disorder and a neurological totally normal during periods intercritici, ie in the intervals between crises

Symptomatic epilepsy:
caused by an injury due to parenchymal injury pre-peri-natal, which can be from trauma or birth complications such as perinatal anoxia, perinatal infections (especially by Cytomegalovirus - CMV), malformations (eg lissencefalia, or eterotopia); diseases cerebrovascular, which changes the cellular architecture at the level of injury, with alterations to load the network of neurotransmitters (eg glutamate).
epileptic crisis may be a sign of suffering premonitory of a particular brain region, and be an "alarm bell" for the future occurrence of a cerebrovascular accident, malignancy, cranial trauma, inflammatory diseases such as encephalitis, meningitis or infection with HIV, degenerative diseases such as Alzheimer's disease.

Epilepsy criptogenica:
do not know the origin but which are supposed to result from structural abnormalities of the brain
occur in early childhood

More speech is that of determining the cause of seizures isolated, sporadic, occurring in certain contexts. Let us say that we assume that each brain, if exposed to certain stimuli, can respond with an epileptic discharge, without any need for the subject should be considered epileptic.

These stimuli consist of:
intermittent light stimulation
sleep deprivation
abuse, or abrupt discontinuation of alcohol or psychotropic substances
metabolic disorders (especially hypoglycaemia)
iperosmolarità, or iposmolarità

The response to these stimuli with an epileptic crisis (not to be regarded as an expression of a disease, but a "hypersensitivity" of the brain that responds with a discharge to levels lower than the average. The expulsion from the harmful stimulus leads in almost all cases, not to have ever more in the other life crises.

Some women may have seizures at the menstrual cycle and these crises, called "catameniali", should not be considered an expression of a defined epileptic syndrome, but abnormal responses to stimuli (such as humoral changes induced by the menstrual cycle in women) which in itself constitute a stress for the brain.

There are also different from epilepsy pathological conditions that can cause the onset of tonic-clonic crisis.

These conditions are:
diabetes
brain infections (meningitis, encephalitis)
heat stroke
poisoning
pregnant eclampsia (a complication that can occur in pregnancy)
hypoglycaemia (blood sugar levels very low)
high fever
cranial trauma.

In all these cases, the onset of an epileptic crisis is a sign of extreme aggravation of the disease and requires immediate action in emergencies.

Seizures

Partial crisis:
Partial crisis:
about 60% of all forms of epilepsy
often caused by a cortical lesion from trauma, malformations in raising, stroke or other brain, and rarely are determined genetically
are characterized by primary involvement of a well-localized part of the cortex, that the outbreak may remain localized or spread to involve both hemispheres (crisis partial secondarily generalized), generalized crisis in which it involved the entire cerebral cortex from the beginning of crisis.
the neuronal discharge may reverberate, especially at the level of the thalamus (which would make the so-called crisis of the type "no").
divided into simple (do not cause loss of consciousness) and complex (loss of consciousness)

Effects of the crisis:
abnormalities without focal motor movement (eg hand tremor duration of 30 seconds-1 minute)
focal motor abnormalities in gear (gear Jacksoniane the epileptic crisis spreads through the motor coteccia then there is a shock to the hand, then your arm, leg, and then finally to the face sometimes followed by paralysis Todd)
somatosensoriali symptoms or special sensory symptoms
vegetative symptoms (epigastric sensation, piloerection, dilated pupils, flushing, sweating)
psychological symptoms (hallucinations, fear, anger, distortion of the sense of time, altered perception)
loss of consciousness and automatisms like to chew and swallow in complex crises)

General crisis:
represent 40% of all epileptic syndrome and, generally, have un'eziologia genetics
possoo be simple or complex
are classified into different categories according to their effect

Type of absence attacks
interruption of the state of consciousness where the person experiencing the attack seems to be absent and insensitive for a short period of time (usually 30 seconds)
can read muscle contractions occur
there is no loss of postural tone

Tonic-clonic attacks
an initial phase of muscle contraction (tonic phase) which can lead to chewing the language (morsus), to lose sphincter control and a degree of apnea the more dangerous the longer the duration of the crisis itself
rhythmic muscle contractions (clonic phase)
concludes with a resolution of this phase where the subject appears confused and aching with strong headache

Myoclonic attacks
sporadic muscle contraction and can result in contraction of muscles or muscle groups in increments
event is rapid and duration of less than 500 mmsec

Clonic attacks
rapid muscle tremors lasting a greater 500mmsec

Attacks atony
carry the relaxation of muscle tone causing collapse to the ground of epilettico

Epilepsy partialis continua
rare type of recurrent attacks engines that are local (face and hands) and use every few seconds or minutes for extended periods (days or years)

In addition to the classification of seizures, there is a classification that covers the epileptic syndromes, or the recurrence of periodic and unpredictable seizures. These are classified according to the type of crisis that characterized the age of onset,  eziologia, and various other factors. Have been identified more than 40 epileptic syndromes. Here are the most popular.

SYNDROMES epileptic

Rolandi epilepsy benign or benign partial epilepsy of childhood
is a primary or idiopathic epilepsy characterized by partial crisis that can often generalize (crisis partial secondarily generalized)
originate in the area of the brain roland. The crisis affecting the partial face, with loss of saliva from the mouth and temporary inability to speak, if generalized, is the traditional framework of seizure (tonic-clonic crisis)
almost always occur in the hours notturnenel 95% of the cases healed spontaneously before adulthood

Small Picnolessia or male:
or epilepsy with typical absence of crisis
idiopathic or primary epilepsy of childhood, characterized by generalized non-convulsive
in 40% of the cases healed before reaching adulthood

Juvenile myoclonic epilepsy (Janz of):
generalized epilepsy that occurs in puberty due to a genetic malformation that has been identified (alteration of a gene on chromosome number 6)
characterized by spasms of the muscles of the arms (which are raised and lowered the shutter), which typically arise in the morning on awakening

Temporal lobe epilepsy:
the most frequent type of epileptic syndrome and partial symptomatic or secondary
originates in the temporal lobe of the brain
the seizures presenting with predominantly psychological symptoms, such as shots of anger, or with cognitive
most frequent cause of epilepsy is temporal lobe sclerosis of ippocampo, a congenital malformation of this region of the brain

West syndrome:
severe form of epilepsy criptogenetica of early childhood (onset between 6 and 12 months)
always has three characteristics associated with each other (defined diagnostic triad): infantile spasms, arrest of psychomotor development of children and a characteristic framework  EEG said ipsaritmia
the development of the child in terms of intellectual and motor stops
the origin of the disease, although not yet identified, is in a profound alteration of the structure of the brain

Syndrome of Lennox-Gastaut:
severe form of epilepsy criptogenetica childhood, occurs in an age of 1 to 8 years
characterized by many different types of crises, such as absences, atonic crisis (sudden relaxation of the muscles, instead of the contraction that characterizes the crisis tonic, so the patient can fall from the chair or the head may fall on the chassis of school) crisis and generalized tonic-clonic
This is invariably a mental retardation more or less serious
often follows the West's Syndrome

Epilepsy reflected:
crises are triggered by an environmental stimulus
the most common type is the photosensitivity
begins in childhood and is associated with picnolessia
in a high percentage of cases resolved in adulthood

Crisis cluster:
crises that occur with frequency close to each other
last few minutes
may evolve into a state of male epileptic

Rule of male epileptic
condition of continuous seizure that does not stop spontaneously, and that if untreated can lead to death of the patient

Febrile crisis:
tonic-clonic crises that occur in association with episodes of infection with fever, usually but not necessarily high
widespread phenomenon (affecting 3-4 percent of all children) in the age between 3 months and 5 years
component of familiarity
not a form of epilepsy

Among the food adjuvants to traditional treatments of epilepsy, we remember those containing:
piri-piri
mulungu
Manach
amor seco
passionflower
catuaba
Muira Puama
graviola
tayuya

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