Why do epileptics get seizures

Epilepsy> General

1. The most important things in a nutshell

Epilepsy is a brain disease that can cause muscle spasms and impaired consciousness. The causes and forms are very different. An epileptic fit usually lasts seconds or minutes. Not every seizure can be recognized as such. During a seizure, bystanders should not try to hold the patient or influence the seizure. Then it is important to stay with the person affected until they can orient themselves again. If a seizure lasts longer than 5 minutes, it is an emergency and an emergency doctor must be called.

2. Brief information on the disease

To be ill with epilepsy means to suffer from sudden and short-term functional disorders of the brain with muscle cramps and disorders of consciousness. Colloquially it is referred to as "epilepsy" or "convulsive disorder". The first seizure doesn't have to mean epilepsy. In particular, triggers such as febrile seizures in infancy can encourage an occasional seizure. Experts only speak of epilepsy when a person is for no apparent reason at least 2 epileptic fits more than 24 hours apart. In addition, a so-called. Epilepsy syndrome present if the seizure characteristics can be integrated into an existing clinical picture.

Epilepsy is diagnosed in 3-4% of the world's population. There is a clear age distribution: Epilepsy is particularly common in the first years of life and then from 50 to 60. Age. However, the disease can occur at any age.

Epilepsy is considered "overcome" in patients with age-related epilepsy syndrome who are beyond the appropriate age and in patients who have been seizure-free for at least 10 years and have not taken anti-epileptic drugs for at least 5 years.

3. Seizures of epilepsy

An epileptic seizure occurs suddenly and usually subsides after a few seconds or minutes. The forms differ in whether the entire brain or only individual brain regions are affected. There are also numerous sub-forms. The consequences can vary from a brief loss of consciousness, the slight twitching of an extremity, to an uncontrolled seizure.

3.1. Generalized seizure

A generalized seizure affects the entire brain. The symptoms of this type of seizure characterize the well-known epilepsy attack (formerly: Grand times or great attack): The eyes are wide open, the body falls to the ground, cramps and stiffens (tonic phase) and then begins to twitch more and more violently (clonic phase). At the same time, the person affected becomes unconscious. This can lead to bluish discoloration of the skin, wetting and saliva leakage as well as bite injuries on the tongue. Many patients need more recovery time or sleep after a seizure and complain of memory loss.

A very mild form of the generalized seizure is the so-called. Absence (earlier: Petit times or small attack), which usually lasts only a few seconds and is often misunderstood as "dreaminess" or "dropouts". The person concerned experiences a short pause in consciousness and pauses in what he is currently doing. Sometimes the eyelids twitch slightly. Falls and pronounced cramps do not occur. The absence is very common in various forms Childrenand young people in front. However, there is a wide range of types of seizures in childhood and adolescence.

3.2. Focal seizure

This form of seizure is location-relatedi.e. it only affects certain parts of the brain. The type of attack depends on which area of ​​the brain is affected. It can motor symptoms Occur in strange and inappropriate behaviors such as smacking, chewing, picking clothes, humming, or making certain facial expressions. Also are sensory symptoms possible that cause visual or acoustic hallucinations or abnormal sensations such as feelings of cold or warmth. It is possible, however, that a focal seizure will develop into a generalized one in the further course and a tonic or clonic phase may be added.

3.3. Auras

Similar to a migraine, an aura can herald a seizure through a headache or emotional tension. However, an aura can also be its own form of seizure that is associated with distorted perception (e.g. sensory hallucinations) as well as psychological symptoms (e.g. fear, depression) or unpleasant physical feelings.

3.4. Status epilepticus

Any epileptic seizure that lasts longer than 5 minutes or 2 consecutive seizures over a period of more than 5 minutes without regaining the initial neurological status is called and treated as status epilepticus. This can life threatening and must be treated with medication immediately. Status epilepticus can occur in all types of seizures.

4. Causes and Risk Factors

Many aspects of the disease cannot be explained to this day, but a wide variety of causes and risk factors are known that can lead to a seizure.

Different classifications are used in the literature to explain why an epileptic seizure occurs. It can happen that the individual factors are mutually dependent and trigger an attack:

4.1. Genetic (idiopathic)

The seizure readiness is individually different and innate, e.g .: neuroanatomical malformations.

4.2. Structural (symptomatic)

The epileptic seizure can be a concrete cause can be attributed, e.g .:

  • Traumatic brain injury (e.g. in sports accidents)
  • tumor
  • Encephalitis, meningitis
  • Lack of oxygen and malformation of the brain during childbirth
  • Circulatory disorder (e.g. in the event of a stroke)
  • Metabolic disorder of the brain
  • Abuse of alcohol or medication
  • Acute general illnesses (e.g. hypoglycaemia, kidney failure, thyroid disease, fever, sleep deprivation)

4.3. Infectious

Epilepsy can also be caused by previous meningitis (e.g. due to herpes viruses, TBE viruses) or Lyme borreliosis.

4.4. Metabolically

Certain metabolic disorders such as low blood sugar levels have been associated with epilepsy.

4.5. Vascular

Disorders of the blood supply can trigger epilepsy. Above all, disorders of the blood supply in the brain (cerebrovascular insufficiency) are considered to be the main cause of epilepsy in old age.

4.6. Unexplained cause (cryptogenic)

There is no cause of the disease, but it does exist clear indications for the trigger of the seizure (e.g., excessive consumption of video games without breaks).

 

5. Precautions

An epileptic seizure can put people in dangerous situations. The following tips can help reduce the risk of injury in everyday life:

  • The most common deaths from epilepsy are from drowning. Therefore, those affected are advised to only bathe under supervision and, for their own safety, to prefer to shower.
  • Smokers are at risk of fire in the event of an attack. Therefore it is best not to smoke or only smoke around other people.
  • Choose a low bed frame because of the risk of falling while sleeping.
  • Secure or remove sharp edges and objects in the apartment.
  • Use only the back hobs when cooking to minimize the risk of burns.
  • Short distances when transporting objects or hot food.
  • Maintain a safe distance from streets, open fire pits and bodies of water.
  • Consume alcohol only in small amounts and not regularly.
  • Pay attention to a constant sleep rhythm and individual trigger factors, avoid heavy stress.
  • One Seizure calendar use to be better prepared for future seizures while on the move. Such a calendar can be downloaded from www.epilepsie-vereinigung.de> search term: "Anfallskalender".

6. First aid

How to behave during a seizure is different at each stage of an epileptic seizure. Various instructions and rules of conduct must be observed in order to be able to effectively provide first aid to an affected person.

6.1. Beginning seizure

  • Lay the patient on the floor (remove glasses if necessary).
  • Place a pillow or item of clothing under your head.
  • Remove all objects that could injure the patient during the seizure. Since violent twitching and cramping can occur during the seizure, keep all sharp-edged objects out of reach.
  • Loosen tight clothing, especially around the neck, as much as possible.

6.2. During the seizure

  • Under no circumstances hold your arms and legs.
  • Do not put a wedge between your teeth to prevent tongue or bite injuries.
  • Do not try to influence or interrupt the course of the seizure. This means under no circumstances try to open cramped fists.
  • Outsiders should keep calm.
  • Observe the duration and accompanying symptoms of the seizure.
  • If the attack lasts longer than 5 minutes, call the emergency doctor (Tel. 112) immediately!

6.3. After the attack

  • Put the affected person in the stable side position, as this often leads to increased salivation.
  • Keep airways clear.
  • A seizure is usually followed by a short sleep or recovery phase. In the meantime, you should not wake the affected person, but protect him from hypothermia.
  • It is essential to stay with the person affected until they are completely oriented again. This can be found out by asking simple questions such as "What's your name? Where are you? What day is today?"
  • It is also important to document every seizure, especially for the attending physician, because drug use is only possible with precise information about the time, duration and type of the seizure.

7. First visit to the doctor

Especially with the first epilepsy attack, the attending physician has little information about the symptoms of the attack. Although an initial physical examination includes technical aids such as electroencephalography (EEG) and magnetic resonance imaging (MRI, especially in children), it may be advisable to do so face of the victim during the seizure taking photos. The affected person's eyes in particular provide important information: If the eyes are closed at the beginning of an attack, the chances are good that it is not an epileptic attack. Experts advise after the second attack at the latest for medical treatment.

8. Aids for seizures

8.1. Signaling devices

Signal devices can especially help epilepsy patients who have seizures especially at night. A sensor is mounted on the mattress of the epilepsy patient. The sensors distinguish normal sleep movements from a seizure with convulsions.

In the event of an attack, the device triggers an alarm, e.g. in the parents' bedroom, with the partner, other relatives or in an emergency call center. Safe care of the patient is thus possible. The seizure is also recorded and documented with its duration and severity. This also provides important information for the attending physician.

Signaling devices for epileptic seizures can be prescribed by the doctor and are covered by the statutory health insurance as an aid. In the aid catalog they have the item no. 21.46.01.0 and run under "Devices with bed sensor". Insured persons aged 18 and over make an additional payment of 10% of the sales price, a minimum of 5 € and a maximum of 10 €.

8.2. Fall detector

Fall alarms can help with patients who lose consciousness and fall during seizures. The device reacts when the wearer is immobile and triggers an alarm if there is no reaction after a certain period of time.

As with the signaling devices, this two-stage system prevents false alarms. In addition, a patient can trigger an alarm himself if he is conscious but needs help.

The prerequisite for this is that the patient has a home emergency call device so that an alarm can be sent to relatives or to an emergency call center. A home emergency call system costs a one-time connection fee as well as monthly rental fees. If the person concerned has a degree of long-term care, the long-term care fund grants a subsidy for the connection fee, usually of a maximum of € 10.49 and a maximum of € 23 for the monthly fees, upon application and after examination by the Medical Service. The person in need of care must bear the remaining costs himself. If the income is low, the social welfare office can also provide a subsidy.

8.3. Epilepsy dogs

In contrast to other guide or service dogs, future epilepsy dogs usually grow up with the patient and his family and are trained there. The reason is that they have to get to know the patient very well in order to recognize changes before the seizure.

There are 2 types of epilepsy dogs:

  • Warning dogs have the ability to sense an upcoming seizure and then warn the person affected so that they have time to protect themselves against injuries, for example. The warning is usually given by nudging or laying on the paw.
  • Display dogs learn to recognize an actual seizure and then to help in a previously practiced manner, e.g. to set off an alarm, to draw the attention of other people to the emergency situation, to bring emergency medication or to remove dangerous objects from the reach of the patient.

Health insurance companies usually do not cover the costs for epilepsy dogs.

The assistance dog center for epilepsy at www.assistenthunde-zentrum.de> Assistance dogs> Epilepsiewarnhund offers extensive information and contacts to assistance dog trainers.

8.4. Practical tip

At www.rehadat.de> search term: Epilepsy you will find a list of useful aids for everyday life.

9. Practical advice

Free download: Epilepsy Guide as PDF with information on all of the above topics and the information in the articles linked below.

10. Related links

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