The child has convulsive readiness how to treat it. Influence on character. Seizure threshold

Atherosclerosis of the cerebral vessels is a disease that is characterized by narrowing of the walls of the arteries as a result of the growth of atherosclerotic plaques on them. Most often, the disease appears due to the fact that lipid metabolism is disturbed in the human body. At the same time, the connective tissue begins to grow, and calcium salts are actively deposited in the lumen of the vascular walls.

This leads to the fact that the vessels are narrowed, and sometimes completely clogged. In the brain, multiple blockages of blood vessels can occur with deposits consisting of cholesterol plaques.

Danger this disease lies in its extremely slow development. At the initial stages of the disease, a person may not feel any suspicious symptoms at all, but meanwhile a dangerous process continues in the body, in which the internal organs receive less nutrients and vital oxygen.

Atherosclerotic plaques that fill blood vessels are made up of calcium and fat. The main risk group for this disease is adult men and women aged 50 years and above. Among them, atherosclerosis of cerebral vessels occurs very often - in every sixth person.

Causes and risk factors

The main reason for the occurrence of atherosclerosis of the main vessels of the brain is that normal fat metabolism is disturbed in the body, which leads to the accumulation of cholesterol in the vessels. The age factor of the disease is explained by the fact that in young people excess cholesterol is successfully excreted from the body. In the elderly, things are much worse with this - cholesterol accumulates and forms atherosclerotic plaques.

Scientists have not yet come to a consensus on the specific causes of the development of this pathology. There are only a number of factors that contribute to the occurrence of atherosclerosis:

Forms of the disease

There are two main forms of cerebral atherosclerosis - progressive and cerebral.

progressive

This type of disease is characterized by:

• memory impairment,
• fast fatigue,
• poor concentration,
• headaches,
• emotional swings, up to prolonged depressive states,
• sleep disorders,
• fainting
• dizziness, which can occur with a sharp rise from a sitting or lying position.

If atherosclerosis is progressive, it develops very quickly, and in no case should it be delayed with treatment. This form of the disease can affect the mental state of the patient.

cerebral

This form of the disease affects the central nervous system, disrupting its functionality. The degree of influence on the central nervous system depends on how severely the vessels of the brain are affected. Blood flow to the brain decreases, oxygen starvation occurs, as a result of which the neurons cease to function normally.

Signs of cerebral atherosclerosis directly depend on which part of the brain is affected. Among them are: memory impairment, tremor in the legs or arms, headaches, depression, insomnia, increased sweating, deterioration of intellectual abilities, hearing and vision impairment, photophobia.

stages

This vascular disease develops in several stages, each of which is accompanied by its own symptoms:

• First stage. There are no clear signs yet. You can only notice increased fatigue even with little physical exertion, sometimes dizziness, rare pain in the head. It becomes difficult for a person to remember some simple things. Symptoms almost always appear in the late afternoon, but after sleep they completely disappear.
• Second stage. Symptoms occur much more often, to which are added such phenomena as: tremor of the limbs, sudden mood swings, depressed emotional state, problems with speech.
• Third stage. At this stage, there are already severe lesions of the brain vessels, which is manifested by frequent cases of memory loss, the inability to perform simple daily actions, hand tremors, and heart rhythm failures.

Progressing, atherosclerosis leads to the fact that the patient is not able to remember any fresh information, but remembers the events of the past quite easily. The person loses control over his actions. It is not uncommon for him to turn on water or gas, and then go outside.

People with severe stages of atherosclerosis can easily get lost even in familiar areas, because they lose their orientation in space. Patients often cannot remember what day or even year it is. Such patients must necessarily be under the supervision of loved ones, or in special medical institutions.

What is dangerous and can there be complications?

As a result of the development of atherosclerosis, the lumen of the cerebral vessels narrows, which leads to insufficient saturation of cells with oxygen. If this condition is chronic, brain tissues begin to partially atrophy, mental and emotional disorders occur.

But the greatest danger in atherosclerosis is the possibility of developing a stroke. It occurs when the pressure inside the vessels of the brain reaches a peak value, the walls of the vessel do not withstand and burst, which leads to a hemorrhage in the brain.

First signs

Any form of atherosclerosis has common clinical manifestations:

• noise in ears;
• headache;
• insomnia;
• anxiety, excitability, nervousness;
• fast fatiguability;
• weakness and drowsiness during the daytime;
• poor concentration;
• memory problems;
• speech disorder, difficulty swallowing food.

Which doctor treats and when to contact him?

At the first signs of atherosclerosis, it is urgent to contact a cardiologist. The sooner measures are taken to cure, the higher the likelihood of a successful outcome.

If a person begins to feel inexplicable fatigue even with minimal exertion, noise or zones in the ears, frequent bouts of dizziness and headaches that do not go away under the influence of analgesics, you should not delay and consult a doctor.

Diagnostics

With the use of modern diagnostic methods, atherosclerosis of the brain can be quickly detected in humans. The following examinations are usually prescribed:

• ultrasound scanning of blood vessels;
• blood test for cholesterol levels;
• tomography of the arteries of the brain;
• angiography;
• Ultrasound of the heart and internal organs.

For more information about the disease, see the video:

Therapeutic techniques

Atherosclerosis is a complex disease and its treatment should be comprehensive. In addition to taking medication, a special diet and daily exercise are prescribed, which improve blood circulation and strengthen the body.

Medical

Drugs that are prescribed for atherosclerosis:

• Vasodilators: Cinnarizine, Nimodipine, Corinfar, Cavinton, Eufillin, Papaverine, Isoptin, Vinpocetine, Nicotinic acid, Adalat.
• Preparations that strengthen the walls of the arteries: Selenium, Dihydroquerticin, Potassium.
• Cholesterol lowering agents: Simvastatin, Ciprofibrate, Lovastatin, Atorvastatin, Cenofibrate.

In addition to them, tranquilizers and andidepressants can be prescribed. With severe headaches, a course of analgesics is prescribed. Another article tells more about drugs for the treatment of cerebral atherosclerosis.

Diet

The diet in the treatment of this disease should also be adjusted. It is necessary to exclude a number of foods and dishes containing a large amount of cholesterol, namely:

• fatty meats;
• dairy products in which the fat content exceeds 1%;
• sugar, honey, sweet pastries.

Preference should be given to the following products:

• porridge (oatmeal), jelly;
• hawthorn puree;
• unsweetened fruits, vegetables;
• low-fat cottage cheese - you can use it no more than 150 g per day;
• sea ​​kale and seaweed - they are rich in vitamins and microelements that improve the blood supply to the vessels of the brain.

Find out more about the diet for cerebral atherosclerosis from another material.

Forecasts and preventive measures

Prevention of atherosclerosis of the arteries of the brain is the most important part of the treatment, with which you can prevent complications of the disease and improve your well-being. First of all, it is necessary to strictly follow all the doctor's prescriptions, give up cigarettes and reduce the consumption of alcoholic beverages to a minimum.

With timely treatment, the prognosis for this disease is very favorable. Adequate therapy, compliance with all medical recommendations and a healthy lifestyle will help to successfully cope with the disease and prevent possible complications.

What is arterial hypertension: causes and treatment of hypertension

Arterial hypertension is a chronic disease that affects a large number of modern people.

The difficulty is that many patients neglect preventive measures and a healthy lifestyle.

It is necessary to know what arterial hypertension is in order to start therapeutic procedures in a timely manner, preventing large-scale complications fraught with death.

The vascular system of the body is similar to a tree, where the aorta is a trunk that branches into arteries, which are subdivided into small branches - arterioles.

Their task is to carry blood to the capillaries that supply nutrients and oxygen to every cell of the human body. After the transfer of oxygen to the blood, they again return to the heart through the venous vessels.

In order for blood to flow through the system of veins and arteries, you need to expend a certain amount of energy. The force acting on the walls of blood vessels during the flow of blood is pressure.

The pressure depends on the functioning of the heart and on the arterioles, which are able to relax if you need to lower blood pressure, or contract if you need to increase it.

Arterial hypertension is a condition that is determined by a persistent increase in systolic pressure up to 140 mm Hg. st and more; and diastolic pressure up to 90 mm Hg. Art. and more.

There are such periods of changes in blood pressure:

1. drops from 1 am to 5 am,
2. rises from 6 to 8 in the morning,
3. drops from 23:00 to 00:00.

Pressure changes with age:

• indicators in children are 70/50 mm Hg. Art.,
• rates in the elderly are over 120/80.

Causes of arterial hypertension

In many cases, it is not possible to understand how arterial hypertension arose. In this case, we speak of primary essential hypertension. Some doctors believe that the stimulating factors of primary hypertension are:

• accumulation of salt in the kidneys,
• the presence of vasoconstrictors in the blood,
• hormonal imbalance.

Approximately 10% of people develop severe hypertension due to the use of certain drugs or the development of another disease. Such arterial hypertension is called secondary hypertension.

The most common causes of hypertension are:

1. kidney disease,
2. renovascular hypertension,
3. adrenal tumor,
4. pheochromocytoma,
5. Side effects of drugs
6. Increased blood pressure during pregnancy.

If the kidneys retain a lot of salt, then the volume of fluid in the body increases. As a result, blood pressure and volume increase. The kidneys also produce the enzyme renin, which plays a key role in determining blood pressure readings.

Renin also increases the production of aldosterone, a hormone responsible for the reabsorption of water and salt.

Severe renovascular hypertension is quite rare and affects the following groups of people:

• elderly people,
• smokers,
• Small children.

Renovascular hypertension is diagnosed by injecting contrast agent into an artery or vein and subsequent study of blood flow in the kidneys by X-ray irradiation.

The adrenal glands are two glands that secrete many hormones, including aldosterone, located at the top of each kidney. Aldosterone, produced by the adrenal glands, regulates the salt and water balance in the body.

In extremely rare cases, an adrenal tumor provokes an increase in the production of aldosterone, which contributes to the retention of water and salt in the body, thereby increasing pressure. Such arterial hypertension most often affects young women. There are additional symptoms:

• intense thirst,
• profuse urination.

Another rare type of hypertension is pheochromycytoma, which is caused by another type of adrenal tumor. At the same time, more adrenaline hormone is produced in the pancreas.

Adrenaline is a hormone that helps the body respond fully to stressful situations. This hormone has the following properties:

1. speeds up the heart rate
2. increases the pressure
3. promotes blood transport to the muscles of the lower extremities.

In pheochromocytoma, adrenaline causes:

• frequent heartbeat,
• shiver,
• heat.

Certain drugs and substances can increase blood pressure, such as:

1. steroids,
2. antipyretics,
3. glyceric acid.

Symptoms of arterial hypertension

As you know, arterial hypertension has the second name "silent killer", since its symptoms do not manifest themselves for a long time. Chronic hypertension is one of the main causes of strokes and heart attacks.

Hypertension syndrome has the following symptoms:

1. Pressive headache that comes on intermittently
2. Whistling or ringing in the ears
3. Fainting and dizziness
4. "Flies" in the eyes,
5. Cardiopalmus,
6. Pressing pains in the region of the heart.

With hypertension, symptoms of the underlying disease can be expressed, especially for kidney disease. Only a doctor can choose drugs for the treatment of hypertension.

Arterial hypertension largely contributes to the hardening of the arteries. Great pressure on the walls of blood vessels leads to their susceptibility to a set of fatty elements. This process is called vascular atherosclerosis.

Over time, the appearance of atherosclerosis provokes a narrowing of the lumen of the arteries and angina pectoris. Narrowing of the arteries of the lower extremities causes the following symptoms:

• pain,
• stiffness while walking.

Also, due to hypertension, blood clots occur. So, if a blood clot is in the coronary artery, then it leads to a heart attack, and if it is in the carotid artery, to a stroke.

Arterial hypertension, which has not been treated for a long time, often leads to the formation of a dangerous complication - aneurysm. Thus, the wall of the artery protrudes. An aneurysm often ruptures, causing:

1. internal bleeding
2. brain bleeding,
3. stroke.

A persistent increase in blood pressure is the cause of deformation of the arteries. The muscular layer, from which the walls of the arteries are made, begins to thicken, compressing the vessel. This prevents blood from circulating inside the vessel. Over time, thickening of the walls of the vessels of the eyes leads to partial or complete blindness.

The heart is always affected, due to prolonged arterial hypertension. High pressure stimulates the heart muscle to work hard to ensure adequate oxygen saturation of the tissues.

This condition causes the heart to enlarge. On the early stages an enlarged heart has more strength to optimally pump blood into the arteries at high pressure.

But over time, the enlarged heart muscle can weaken and become stiff, ceasing to fully supply oxygen. The circulatory system must provide a constant supply of nutrients and oxygen to the brain.

If the human body feels a decrease in the amount of blood that enters the brain, then compensatory mechanisms quickly turn on, they increase pressure, and blood from systems and organs is transferred to the brain. The following changes take place:

• heart starts beating faster
• the blood vessels of the lower extremities and the abdominal region are reduced,
• more blood flows to the brain.

As you know, with hypertension, the arteries that supply the brain with oxygen can narrow due to the accumulation of fat-like substances in them. Thus, the risk of strokes increases.

If the arteries of the brain are clogged for a short time, then there is a break in the blood supply to a separate part of the brain. This phenomenon in medicine is called a microstroke.

Even if the condition lasts only a minute, it requires immediate medical attention. If treatment is not performed, this is fraught with the development of a full-fledged stroke. Repetitive microstrokes lead to a weakening of brain function. This is how dementia develops in people with hypertension.

Each kidney is made up of millions of tiny filters called nephrons. Every day, over one and a half thousand liters of blood passes through the kidneys, where waste and toxins are filtered and excreted in the urine. Useful material go into the bloodstream.

High blood pressure makes the kidneys work harder. In addition, damage to the small vessels within the nephrons reduces the volume of filtered blood. After some time, this leads to a reduction in the filtering function of the kidneys.

Thus, the protein is excreted in the urine before being returned to the bloodstream. Waste products that need to be excreted can enter the bloodstream. This process leads to uremia, and then to kidney failure, which requires constant dialysis and blood purification.

As mentioned earlier, at the bottom of the eyeball there are a large number of blood vessels that are very sensitive to increased blood pressure. After several years of hypertension, the process of destruction of the eye retina can begin. Deformation may be due to:

• accumulation of cholesterol in blood vessels
• insufficient blood circulation
• local bleeding.

The diagnosis of arterial hypertension, as a rule, is not made after a single measurement of pressure, except when it is higher than 170-180 / 105-110 mm Hg. Art.

Measurements are taken over a set period to confirm the diagnosis. It is necessary to take into account the circumstances during which measurements are taken. The pressure gets higher

• after smoking or drinking coffee,
• against the backdrop of stress.

If the blood pressure in an adult is more than 140/90 mm Hg. Art., then re-measurement, as a rule, is performed after a year. In people whose pressure is from 140/90 to 160/100 mm Hg. st, re-measurement is carried out after a short time. With high diastolic pressure from 110 to 115 mm Hg. Art. urgent treatment is needed.

Elderly people sometimes develop a rare type of hypertension called isolated systolic hypertension. Indicators of systolic pressure, while exceeding 140 mm Hg. Diastolic pressure remains at around 90 mm Hg. st or lower. This type of disease is considered dangerous because it provokes strokes and heart failure.

In addition to measuring blood pressure, the doctor should check for changes in other organs, especially if the pressure is constantly at high values.

The eyes are the only organ of the human body in which blood vessels are clearly visible. With the help of a bright stream of light, the doctor examines the fundus of the eye with a special device - an ophthalmoscope, which allows you to clearly see the narrowing or expansion of blood vessels.

The doctor can see small cracks, hemorrhages, which are the consequences of high blood pressure.

The inspection also includes:

1. listening with a stethoscope for heart sounds
2. measuring the size of the heart by palpation,
3. The use of an electrocardiogram helps to examine the electrical activity of the heart and also to assess its size.

In addition to instrumental studies, the doctor prescribes:

• examination of urine to rule out kidney infections,
• blood sugar test,
• blood test for cholesterol.

The fundus of the eye, kidneys and blood vessels act as target organs for abnormal blood pressure.

Treatment of arterial hypertension

Around the 1950s of the last century, the pharmaceutical industry recorded an increase in the production and synthesis of new groups of antihypertensive drugs.

Previously, the treatment of hypertension involved:

1. salt free diet
2. surgical interventions,
3. phenobarbital as a stress reliever.

There is information that in the early 1940s, every third or fourth place in the hospital was occupied by a patient with hypertension or its consequences. AT last years A large number of studies have been conducted, which has led to an increase in the effectiveness of the treatment of arterial hypertension. Now the number of deaths and serious consequences of the disease has significantly decreased.

In Russia and European countries, the best medical professionals worked on research and confirmed that only drug treatment of high blood pressure makes it possible to reduce the risk of:

1. cardiovascular disease,
2. strokes
3. lethal outcomes.

However, some people are convinced that arterial hypertension is not treated with medications, as this reduces the quality of life and leads to the development of various side effects, up to depressive states.

Almost all drugs have side effects, but studies show that when using drugs that reduce blood pressure, side effects are recorded in only 5-10% of patients.

The existing variety of groups of drugs that reduce blood pressure allows the doctor and the patient to choose the most optimal treatment. The doctor is obliged to warn the patient about the possible side effects of the drugs used.

Diuretics or pressure diuretics treat blood pressure by increasing the excretion of water and salt by the kidneys. Thus, relaxation of the blood vessels is created.

Diuretics are considered the oldest group of antihypertensive drugs. These drugs have been used since the 50s of the 20th century. They are now also widely used, often in combination with other drugs.

Beta blockers appeared in the 1960s. With the help of drugs, angina pectoris was treated. Beta-blockers reduce blood pressure by acting on the nervous system. They block the influence of beta-nerve receptors on the cardiovascular system.

As a result, the heart rate becomes less active and the volume of blood that is ejected by the heart per minute decreases, which reduces pressure. Beta-blockers also lower the effect of some hormones, so the pressure also normalizes.

Because beta-blockers can constrict peripheral blood vessels, they are not recommended for people with upper or lower extremity circulatory disorders.

Calcium channel blockers are a group of drugs that block the flow of calcium within muscle cells. Thus, the frequency of their contractions decreases. All muscle cells need calcium, if it is absent, then the muscles cannot contract normally, the vessels relax and blood flow improves, which lowers blood pressure.

Angiotensin II receptor blockers are the most modern group drugs. Angiotensin II is an effective vasoconstrictor, its synthesis is carried out under the influence of renin, a renal enzyme. Angiotensin II has the main property, it stimulates the production of aldosterone, which delays the excretion of water and salt by the kidneys.

Drugs that block angitensin II receptors. Treatment of hypertension is not complete without these drugs, because they:

1. prevent further vasoconstriction
2. facilitate the removal of excess water and salt from the body.

Treatment with ACE inhibitors is widely used for arterial hypertension. With the help of drugs, the ratio of compounds changes in favor of vasodilating biologically active substances. Medicines in this group are usually prescribed to people with hypertension due to kidney disease or heart failure.

Alpha blockers act on the nervous system, but through different receptors than beta blockers. Alpha receptors cause arterioles to contract, so they relax and blood pressure decreases. Alpha-blockers have a side effect - orthostatic hypotension, that is, a sharp decrease in pressure after a person assumes an upright position.

Imidazoline receptor agonists are one of the most promising antihypertensive drugs. Treatment with drugs of this group allows you to eliminate vasospasm, as a result of which the pressure begins to decrease.

Imidazoline receptor agonists are used to treat moderate forms of hypertension and are routinely prescribed in combination therapy.

Non-drug treatment

Therapy of arterial hypertension without medication involves, first of all, reducing salt intake. It is also important to review the number of alcoholic beverages. It is known that drinking more than 80 grams of alcohol per day increases the risk of developing cardiovascular diseases and hypertension.

Overweight is recognized if it exceeds 20% or more of normal body weight, depending on height. Obese people are often prone to developing arterial hypertension. They usually have high cholesterol levels in their blood.

Elimination of excess weight will help not only reduce pressure, but also help prevent dangerous diseases:

• atherosclerosis,
• diabetes.

It is important to remember that there is no one set diet that will never bring back the weight you have lost.

Arterial hypertension can reduce symptoms if you adhere to such therapy: sports activities,

1. restriction of salt intake,
2. diet food intake.

Lessons exercise for half an hour three or four times a week, will achieve weight loss and normalization of pressure. educational video This article will talk about the dangers of arterial hypertension.

on the

How to determine increased intracranial pressure?

With a lack of treatment and a proper complex, increased ICP (intracranial pressure) threatens with serious complications. A drop in vision may begin up to its loss, circulatory failures of the brain, problems with the nervous system. At sharp rise in advanced cases, even death is possible.

For increased intracranial pressure, the symptoms are quite characteristic and it is important to pay attention to them in a timely manner. Especially because this pressure is an indicator of others - ailments with even more serious consequences.

Having discovered the first signs of the disease, you should visit a doctor as soon as possible for an MRI or other suitable methods examinations. This will allow you to make an accurate diagnosis and prescribe a complex of treatment. It is never permissible to ignore the signals of the body, indicating that there is some kind of destructive process in the body. Even a headache will not arise from scratch.

Definition and causes of the disease

According to the physiological explanation, intracranial pressure appears due to cerebrospinal fluid(liquor). It accumulates in increased amount or vice versa in a deficiency in a certain part of the skull. This happens due to problems with its circulation process. The function of the cerebrospinal fluid is to protect the gray matter from overload, as well as mechanical damage.

The substance is under constant pressure, goes through a process of renewal and circulates in different areas. It usually takes a week to replace the fluid, but for various reasons it can accumulate and for this reason there will be signs of increased intracranial pressure.

Accordingly, ICP is a characteristic of a quantitative type, reflecting the degree to which the cerebrospinal fluid affects the brain tissue. This indicator in a normal situation - from 100 to 151 mm. water. Art.

Very often the cause of this situation is a head injury, but there can be many other negative factors, including various diseases. The most common conditions when the problem appears are:

Common symptoms in most cases

The clinical picture of increased intracranial pressure symptoms in adults is somewhat different than in children. In most situations, the development of symptoms occurs gradually. The main signs of painful processes of this nature:

Headaches usually come to the fore in terms of symptoms, have a pressing and bursting sensation, sometimes there is an unpleasant throbbing feeling. The provoking factor, due to which the pain usually occurs in the morning, is the horizontal position of the body, coughing or sneezing, straining, too much hyperextension of the head. May be accompanied by nausea, noise in the head, vomiting.

Visual disturbances occur in the case of increased ICP due to swelling in the papilla of the optic nerve and can reach blindness. Visual symptoms may be in the bifurcation of objects.

First, there is a deterioration in peripheral vision, and then central. In addition, high intracranial pressure can cause symptoms in the form of swelling of the eyelids and face, bruising under the eyes, tinnitus and hearing loss, pain in the upper part of the cervical vertebrae, as well as the spinal cord.

In addition to these syndromes, autonomic dysfunction can be added, accompanied by such factors:

In severe cases, due to increased ICP, stroke-like conditions occur that seriously threaten the patient's life. Such states will occur with impaired consciousness up to falling into a coma, unsteadiness when walking and severe dizziness, loss of strength in the limbs, speech disorders, severe incessant vomiting.

Symptoms and causes of high ICP in children

Increased intracranial pressure in a child sometimes manifests symptoms even from the first minutes of birth. In the early period there are more high risk complications, therefore prompt measures for treatment should be taken. For infants, such a diagnosis, unfortunately, is not uncommon. Symptoms that indicate ICP above normal in children are:

The main factor causing increased intracranial pressure in infants is almost always associated with complications and injuries during childbirth or intrauterine infections, hydrocephalus. The child can be more or less calm all day, and in the evening begin to cry a lot and not calm down, which will cause sleep disturbances.

Repetitive regurgitation in a large volume at elevated pressure is due to irritation of the centers in the medulla oblongata, which is responsible for these symptoms. An increase in the head to a size disproportionate to the body, divergence of sutures in the bones of the skull are caused by stagnation and accumulation of cerebrospinal fluid in those spaces that are responsible for the CSF ducts.

Increased ICP causes excessive accumulation and stagnation of blood in the venous network of the head, and it will be clearly visible under the skin of the child. The manifestation of Graefe's symptom (disturbances in the functioning of the oculomotor nerves due to birth trauma) in the form of uncontrolled downward deviations of the eyeballs can occur periodically.

Indicators indicating hydrocephalus in a child

Hydrocephalus - excess fluid due to the formation of liquor and its accumulation. This is also facilitated by the appearance of an obstacle in the outflow tract, inflammation in the brain tissues. Increased intracranial pressure in an infant caused by hydrocephalus is accompanied by the following symptoms:

Diagnostic methods

Assess the degree of intracranial pressure for prescribing suitable treatment using the following research:

• A catheter with a further connection of a pressure gauge is inserted into the area between the spinal canal or the ventricles of the brain - it works according to the scheme of a mercury thermometer;
• Computed and magnetic resonance imaging;
• For children under the age of 1 year - neurosonography (ultrasound of the brain);
• echoencephaloscopy (also used for infants);
• Examination of the fundus for blurred contours, edema of the optic nerve head.

Patients who have experienced acute circulatory problems are usually given a CT scan or fundus evaluation. For children, it is advisable to use other diagnostic methods - starting with an examination by a neurologist to identify deviations in reflexes, excessive development of the head and checking the fontanelles.

Also, it would not be superfluous to visit an ophthalmologist to establish changes at the bottom of the eye, vein dilation, arterial spasm and other negative aspects inherent in this diagnosis. While the fontanelles are still open, ultrasound of the brain will be the most informative option. In this case, an increase in the size of the ventricles, possible deformations, displacements and other volumetric formations in the cranium will be revealed.

According to the requirement of the Ministry of Health, neurosonography is necessary to check for increased intracranial pressure in children under six months of age 3 times and the first time within 30 days from birth. This frequency is required because the situation will constantly change even after the first successfully completed study.

The procedure and the ultrasound itself are harmless to the baby. When the fontanelles are no longer there after a year, it will be advisable to conduct a magnetic resonance or computed tomography. One of the biggest misconceptions on this issue is that it goes away on its own with age - this is not so.

Modern methods of treating the disease

When it becomes necessary to decide how to treat increased intracranial pressure in adults, the cause of the disease is first established and it is she who is eliminated. If a hematoma or tumor or other problem that requires surgical intervention, then it is performed to remove the volumetric formation. After this, the second stage begins - drug treatment to correct the degree of pressure. For these purposes, drugs of this type are used:

1. Osmodiuretics, which reduce fluid volume;
2. Furosemide;
3. Dexamethasone (hormonal drugs);
4. Diacarb;
5. Glycine and others.

The next step will be medical manipulations, such as ventricular puncture and other ways to reduce fluid volume. Diet therapy is an obligatory component of complex treatment. The fluid entering the body, as well as salts, should be limited. In order for the cerebrospinal fluid to be excreted faster and better absorbed, diuretics may be prescribed.

High intraocular pressure - causes, symptoms and treatments

Increased intraocular pressure is a rather rare and dangerous disease. The reason for its appearance is associated with the secretion of the natural fluid of the eyeball and pressure on the cornea and sclera. Due to disruptions in the body, secretion increases and this leads to painful sensations. Or the anatomical structure of the human eye can affect the appearance of the problem.

It is felt as heaviness and arching pain in the eyes, especially sharp when touching closed eyelids. In advanced cases, without treatment, it can lead to visual impairment and complete blindness. The situation worsens in the presence of other diseases, such as colds, runny nose, headaches.

When the doctor has established increased intraocular pressure, treatment is prescribed depending on the stage at which the disease is located. At the initial stage, regular eye exercises can help, as well as limiting computer work and TV viewing.

You will need to remove all activities that are too straining on the eyes, like beading and other types of painstaking needlework. With a progressive disease, there can be two solutions: laser excision of the iris or laser stretching of the trabeculae. Medical treatment is also effective in some cases.

Periodically, it will not be superfluous to drink a vitamin course. Regular exercise and sufficient exposure to fresh air are essential to maintaining health.

Vertebrobasilar insufficiency (VBI) is one of the forms of damage to cerebral vessels. This type of cerebrovascular pathology is characterized by episodes of reversible ischemia of the brain structures, which are supplied with blood by vessels extending from the main and vertebral arteries. These episodes may be repeated. This syndrome also occurs in children.

• The reasons
• Symptoms
• Diagnostics
• Treatment
• Forecast
• Prevention

The reasons

The main reason for the development of VBN is a violation of the patency of the main head arteries. First of all, the extracranial sections of the arteries of the spine are subjected to deviation. The stenosis often involves arterial sites up to the point where the artery enters the bony canal. Sometimes stenosis is localized in the innominate or subclavian arteries. Basically, the vessels are affected due to atherosclerotic stenosis. Congenital abnormalities in the structure of the vascular bed also play an important role. More rare causes are inflammatory diseases such as arteritis or dissection of the basilar or vertebral artery.

The risk of ischemia in the vertebrobasilar basin increases when the possibility of collateral circulation is limited. This is observed with the following deviations:

• non-closure of the circle of Willis;
• severe hypoplasia of any vertebral artery;
• abnormal discharge of small branches from the vertebral and basilar arteries.

It is impossible not to pay attention to the possibility of compression of the vertebral arteries by altered vertebrae, which can occur with spondylosis and osteophyte. Such a situation could become main reason development of VBN. In addition, collateral circulation in the vertebrobasilar basin has considerable possibilities, which is due to the presence of the Zakharchenko ring where the region of the brain stem is located, the circle of Willis on the brain base, extra-intracranial connections among the arteries and anastomotic systems on the surface of the brain. Such ways of bypass blood circulation make it possible to compensate, in full, for expressed defects in the vascular bed, regardless of their nature, acquired or congenital.

There are several anatomical factors that predispose to a large compression of the vertebral arteries with the risk of developing severe complications, among which there is cerebral ischemia, which is clearly visible in the diagnosis:

• exostoses with the formation of a retroarticular canal;
• anomaly Kimmerle;
• other anomalies in the structure of the cervical spine.

If these factors are present in a person, the role of functional factors increases, which include rotation of the cervical vertebrae with arterial compression and displacement, as well as trauma to the cervical spine.

Intracranial arteries may have such a variant of the structure as dolichoectasia. Modern non-invasive and invasive methods for diagnosing vascular brain system allowed more frequent detection of such anomalies. Dolichoectasia is a peculiar combination of signs of ischemia of structures that are supplied with blood from the vertebrobasilar basin and cranial nerve compression.

The cause of VBI may lie in the defeat of small-caliber arteries. This may be due to diabetes mellitus and arterial hypertension, as well as a combination of these two disorders. Sometimes the causes lie in cardiogenic embolisms, which are usually accompanied by occlusion of a large vessel and the development of a severe neurological deficit. A prerequisite for the development of VBN can be circulating aggregates of blood cells and a high ability to aggregate formed elements.

Vascular disorders of the vertebo-basilar system among adults account for 30% of acute cerebral circulatory disorders and 70% of transient disorders. Approximately 80% of strokes are ischemic, and a quarter of them occur in the vertebrobasilar system (VBS). As noted, VBN also occurs among children. With the help of qualitative diagnostics, such a diagnosis is detected in many children from birth, and the cause may be natal damage to the vertebral arteries and spine. Today, the number of such disorders among children and young people is increasing. VBN is chronic.

There are several classifications of this syndrome. One of them was presented in 1989 by Bakulev. He identified three stages in the development of this disorder:

• Stage 1 - compensation, when there is an asymptomatic course or there are initial manifestations syndrome in the form of focal neurological disorders.
• Stage 2 - relative compensation. Here transient ischemic attacks occur, i.e. acutely developed disorder of cerebral circulation, combined with rapidly passing cerebral or general symptoms. At the same stage, a small stroke occurs, i.e. completely reversible neurological deficit, and dyscirculatory encephalopathy.
• Stage 3 - decompensation. Here, a completed ischemic stroke occurs, which has varying degrees of severity, as well as dyscirculatory encephalopathy, but already in the third degree, while in the previous stage it had the first or second degree.

In accordance with the neurological classification, 4 stages are distinguished:

1. angiodystonic stage. In this case, subjective clinical symptoms predominate, rather than symptoms of focal brain damage.
2. Angiodystonic-ischemic stage.
3. Ischemic stage, when the symptoms of cerebral ischemia predominate in the vertebrobasilar basin. The vegetative-irritative symptoms practically disappear.
4. The stage of residual phenomena.

Symptoms

Symptoms of VBN can be divided into two groups:

1. Temporary signs usually develop with transient ischemic attacks. Their duration varies from several hours to several days. At the same time, a person complains of pain in the back of the head, which has a pressing character, discomfort in the neck and severe dizziness.
2. Persistent symptoms. They are always present with a person and gradually increase. Exacerbations can occur, in which ischemic attacks come, which can lead to vertebrobasilar strokes. Among the constant signs of the syndrome, one can single out frequent headaches in the back of the head, tinnitus, impaired vision and balance, memory loss, fatigue, dizziness attacks, fainting, sensation of a lump in the throat.

The most common manifestation of the syndrome is dizziness, which occurs abruptly. Most patients describe the nature of such vertigo as a feeling of rectilinear movement or rotation. own body or surrounding objects. This may take several minutes or hours. Dizziness is often combined with hyperhidrosis, nausea, and vomiting.

VBN syndrome can occur even in children aged 3 to 5 years, as well as in the range of 7-14 years, although previously it was considered impossible. Now it is clear that there is no age limit. There is specific features VBN in children. If they are observed, it is necessary to urgently contact a medical institution, undergo a diagnosis and begin treatment. The future of the child depends on timely diagnosis and treatment. Signs of the development of the syndrome in children include:

• violation of posture;
• frequent tearfulness, increased drowsiness and fatigue;
• the child does not tolerate stuffiness, which leads to fainting, nausea and dizziness;
• the child sits in an uncomfortable position.

Some diagnoses that are made to children at an early age can provoke the development of the syndrome. These include perinatal encephalopathy and spinal trauma during childbirth or during sports.

Diagnostics

Timely diagnosis helps to start early treatment and avoid serious complications such as stroke. Diagnosis is of particular importance for children, since timely treatment makes it possible to make a favorable prognosis for the development of VBI.

At the very beginning of the diagnosis, it is important to determine the damage to the vessels of the vertebrobasilar basin based on the clinic and the results of functional tests. All patients need to do auscultation of the projection of the supraclavicular region. You can confirm the lack of blood flow in the pool using several functional tests:

• intensive hand work;
• de Klein test;
• hautant's test, when the patient sits with a straight back and closed eyes;
• vertebral artery test, when the patient is lying on his back;
• dizziness test, when the patient turns his head to the left and right, turns to the sides only with his shoulders.

Based on the patient's condition during these tests, it is possible to confirm a violation of blood flow in the vertebrobasilar basin. Further diagnostics include ultrasound methods, which can be used to determine the localization of the lesion and assess the hemodynamic significance of stenosis or pathological tortuosity of the vessels. Such methods help to determine the functional and structural reserves of compensation.

Angiographic diagnostic methods, such as MRI, CT, X-ray contrast angiography, allow you to accurately determine the type, extent and localization of the lesion, to identify multi-level lesions.

After carrying out all the necessary studies, a diagnosis is made in accordance with the ICD-10, then treatment is prescribed, and the sooner this is done, the better, as it will avoid complications in the form of a stroke and other consequences, and even death.

Treatment

If the syndrome is at the initial stage of development, treatment is carried out in outpatient settings. If symptoms of acute VBN are clearly manifested, the patient is placed in a hospital for observation and prevention of strokes.

Most often, when prescribing treatment, doctors combine medical methods with physiotherapy. The patient must understand that it is necessary to regularly monitor pressure and follow a diet. Given the chronic nature of the disease, it is important to assess the patient's readiness to systematically use prescribed medications.

Some forms of the disease are not treated with drugs at all. That is why it is necessary to determine the presence of the disease as early as possible. An individual treatment is selected for each patient. When drug treatment is prescribed, drugs from the following groups are selected:

1. Vasodilators, i.e. vasodilators preventing occlusion. Most often, treatment with these drugs begins in the fall or spring. At first, small doses are prescribed, which are gradually increased. If the expected effect is not observed, the drug is sometimes combined with other drugs of similar action.
2. Antiplatelet agents that reduce blood clotting. It prevents blood clots. The most popular drug from this group is acetylsalicylic acid. For a day, the patient needs to consume 50-100 milligrams. However, patients with gastrointestinal diseases should be careful when taking this drug, because. gastric bleeding may open, and therefore, aspirin is forbidden to be taken on an empty stomach.
3. Nootropic and metabolic drugs that improve brain function.
4. Antihypertensive drugs that regulate blood pressure.
5. Painkillers.
6. Sleeping pills.
7. Antidepressants.
8. Antiemetic drugs.
9. Medicines to reduce dizziness.

The following therapies are used:

1. Massage. It improves blood circulation.
2. exercise therapy. Regular therapeutic exercises allow you to get rid of spasms, strengthen your spine and improve your posture.
3. Reflexology. It also relieves muscle spasms.
4. Magnetotherapy.

When complex treatment does not give results, surgical treatment is prescribed. The operation is performed to improve blood circulation in the vertebral and basilar arteries. In this case, angioplasty is common, in which vertebral artery a special stent is inserted. It does not allow the arterial lumen to close and maintains normal blood circulation. With atherosclerosis, an endarterectomy is performed, the essence of which is to remove an atherosclerotic plaque. Microdiscectomy helps stabilize the spine.

In children, the syndrome is easily corrected. Medical treatment is practically not used. Rarely, when cases are extremely severe, surgery is performed.

Alternative methods of treatment can also be used, but only as an addition to the main treatment and after consulting a doctor. Noted positive action vitamin C. To prevent thrombosis, it is advised to use viburnum, cranberries, sea buckthorn, currants and other foods containing this vitamin.

Forecast

The prognosis of VBI is determined by the nature and severity of the underlying disease and the degree of damage to the vascular bed. If the narrowing of the arteries progresses, there is persistent arterial hypertension and there is no adequate therapy, the prognosis is poor. These patients are at high risk for stroke. They may also develop dyscirculatory encephalopathy.

A favorable prognosis can be made in the case when the state of the vascular system of the head is satisfactory, and the treatment tactics are adequate and effective. Much depends on how the patient follows medical recommendations.

Prevention

The following measures will help prevent the onset of the disease or slow its development:

1. Diet. It is necessary to abandon white bread, sausages, fatty, fried and smoked, canned food. It is worth eating more low-fat cottage cheese, sour berries, garlic, seafood, tomatoes.
2. Quit smoking and monitor the amount of alcohol consumed so that it does not exceed the norm, it is natural.
3. Reduce salt intake.
4. Exercise moderately.
5. Control blood pressure.
6. Do not sit in one position for a long time.
7. Sleep and sit on a comfortable surface.
8. Avoid stress.
9. Walk more outdoors, swim more.

VBN is a serious syndrome, but with timely treatment and prevention, its sad consequences can be avoided.

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Bradycardia: symptoms, treatment

Violations in the occurrence and conduct nerve impulse, which provides contraction of the heart, leads to changes in the heart rhythm - arrhythmias. One of the varieties of such pulse deviations is bradycardia - a decrease in the number of heartbeats to less than 55-60 beats per minute in adults and adolescents over 16 years old, 70-80 in children and 100 in children under one year old. This cardiac arrhythmia is not independent disease. As a symptom, bradycardia can occur at the most various ailments or appears as a protective physiological reaction in response to external stimuli.

In this article, we will introduce you to the physiological and pathological causes, manifestations, methods for diagnosing and treating bradycardia. This information will help you make the right decision about the need to see a doctor to identify and treat diseases that provoke this symptom.

The reasons

Physiological bradycardia is often found in well-trained individuals.

Changes in the pulse rate can cause both natural external factors and diseases of internal organs and systems. Depending on this, bradycardia can be physiological and pathological.

Physiological bradycardia

Such a slowdown in the pulse is a variant of the norm, is not dangerous to human health and can occur after exposure to the following external factors and stimuli:

• moderate hypothermia or stay in conditions of high humidity and temperature - the body in such conditions goes into a "saving mode" of energy resources;
• age-related changes - after about 60-65 years, islands of connective tissue appear in myocardial tissues (age-related cardiosclerosis) and the metabolism as a whole changes, as a result, body tissues need less oxygen, and the heart does not need to pump blood with the same blood as before , intensity;
• stimulation of reflex zones - pressure on the eyeballs or pressure on the bifurcation of the carotid arteries when wearing a tie or shirt with a tight-fitting collar affects the vagus nerve and causes an artificial slowing of the pulse;
• good physical preparation ("training") - in athletes or during physical labor, the left ventricle increases in volume and is able to provide the body with the necessary amount of blood and with fewer contractions;
• night sleep - the body is at rest and does not need frequent heartbeats and a large amount of oxygen;
• physical or psycho-emotional overwork - the body, when tired, goes into a “saving mode” of energy resources.

Another type of physiological bradycardia is idiopathic. In such cases, examination of the patient does not reveal any reason for the slowing of the pulse. A person does not go in for sports or physical labor, does not take medications, does not feel the effects of other contributing factors, and his well-being does not suffer from bradycardia in any way, because. it is successfully compensated by the body itself.

Sometimes a decrease in heart rate is considered a physiological norm when taking certain drugs that have a similar side effect. But the slowing of the pulse is considered the norm only in cases where the patient does not feel worse and the drug is not taken for a long time. In other situations, it is advisable to reduce the dosage, cancel or replace the drug with another one.

In the cases described above, the slowing of the pulse is not dangerous to health and does not cause a decrease in the blood supply to the brain and other organs. Treatment to eliminate physiological bradycardia is not required, because. it passes on its own after the exclusion of an external stimulus. However, with prolonged slowing of the pulse that occurs in athletes or people over 60-65 years old, it is recommended dispensary observation by a cardiologist for the timely detection of possible deviations in the state of health.

Pathological bradycardia

Such a slowdown in the pulse is not a variant of the norm, it affects the state of human health and may occur under the influence of the following reasons:

• heart pathology - a slowdown in the pulse can be provoked by coronary disease, myocardial infarction, focal or diffuse cardiosclerosis, inflammatory diseases(endocarditis, myocarditis), Morgagni-Adams-Stokes syndrome, etc.;
• taking medications (especially Quinidine, beta-blockers, cardiac glycosides, calcium channel blockers, Morphine, Amisulpride, Digitalis and Adenosine) - usually slowing the pulse is caused by improper dosing and taking such drugs, affects the general well-being and can threaten the patient's life;
• poisoning with toxic substances (lead compounds, nicotinic acid and nicotine, narcotic and organophosphorus substances) - under the influence of these compounds, the tone of the parasympathetic and sympathetic nervous system changes, various organs and systems are affected (including the cells of the conduction system of the heart, and myocardial cells);
• increased tone of the parasympathetic nervous system - such a reaction can be caused by certain diseases and pathological conditions (neurosis, depression, peptic ulcer, tumors in the mediastinum, traumatic brain injury, hemorrhagic stroke, increased intracranial pressure, neoplasms of the brain, edema after surgical interventions on the neck, head or mediastinal area);
• some infectious diseases- usually infections contribute to the development of tachycardia, but typhoid fever, some viral hepatitis and severe sepsis can cause a slow pulse, in addition, bradycardia can be observed in severe and prolonged infectious diseases leading to exhaustion of the body;
• hypothyroidism - a decrease in the level of thyroxine and triiodothyronine (hormones thyroid gland) leads to a change in the tone of the nervous system, disruption of the heart and slowing of the pulse, attacks of bradycardia in such conditions occur sporadically at first, and then become permanent.

In the cases described above, the slowing of the pulse is dangerous to health and causes a decrease in the blood supply to the brain and other organs. Such bradycardias are a symptom of pathology and require treatment of the underlying disease.

Symptoms

One of the manifestations of bradycardia is dizziness.

The slowing of the pulse affects the general well-being only with pathological bradycardia. In addition to the signs of the underlying disease, the patient has symptoms that indicate a decrease in heart rate, and their severity will depend on the pulse rate.

Almost all signs of bradycardia occur due to oxygen starvation of the organs and tissues of the body. Usually they occur episodically, but even their periodic appearance significantly affects the quality of life and indicates the presence of a disease that needs treatment.

Dizziness

A significant slowdown in the pulse leads to the fact that the heart cannot maintain blood pressure at the proper level. Due to its decrease, the blood supply to many systems and organs is disrupted. First of all, the brain begins to suffer from ischemia and oxygen starvation, and that is why dizziness becomes one of the first signs of bradycardia. Usually this symptom appears episodically and after the stabilization of the number of heart contractions is eliminated.

fainting

The appearance of such a symptom of bradycardia is caused by the same cause as dizziness. The degree of its severity depends on the level of lowering blood pressure. With severe hypotension, the brain seems to be temporarily turned off, which manifests itself in the form of a pre-fainting state or fainting. Especially often, such symptoms occur against the background of mental or physical overwork.

Weakness and fatigue

These symptoms are caused by reduced blood supply to the skeletal muscles that occurs when the heart rate slows down. Muscle cells due to lack of oxygen are not able to contract with the usual force, and the patient feels weakness or reduced tolerance to physical activity.

Pale skin

When the pulse slows down, blood pressure drops and insufficient blood flows to the skin. In addition, it is the skin that is a kind of "depot" of blood, and if there is not enough of it, the body mobilizes it from the skin into the bloodstream. Despite this replenishment of blood vessels, the skin, due to hypotension and slowing of the pulse, continues to suffer from circulatory failure and becomes pale.

Dyspnea

With bradycardia, the blood in the body is pumped more slowly and its stagnation in the lungs can be observed. During physical exertion, the patient develops shortness of breath, because. the vessels of the pulmonary circulation cannot provide a full-fledged gas exchange. In some cases, a dry cough may appear in parallel with respiratory failure.

Chest pain

Severe bradycardia is always accompanied by disturbances in the work of the heart and a deterioration in the blood supply to the myocardium. With a significant slowdown in the pulse, the tissues of the heart muscle do not receive enough oxygen, and the patient develops angina pectoris. Chest pain with bradycardia occurs after physical, psycho-emotional stress or a decrease in heart rate to 40 or less beats per minute.

Complications

The prolonged presence of bradycardia and the delay in the treatment of the underlying disease can cause the following complications:

• the formation of blood clots, which increases the risk of myocardial infarction, ischemic stroke and the development of thromboembolism;
• heart failure, which increases the likelihood of developing coronary heart disease and the onset of myocardial infarction;
• chronic attacks of bradycardia, causing weakness, dizziness, deterioration of concentration and thinking.

Diagnostics

The doctor will detect bradycardia by measuring the patient's pulse or by auscultation (listening to sounds) of the heart

Even the patient himself can find out about the presence of bradycardia. To do this, it is enough to feel the pulse on the wrist (radial artery) or on the neck (carotid artery) and count the number of beats per minute. With a decrease in the number of heartbeats according to age norms, it is necessary to contact a general practitioner for a detailed clarification of the causes of bradycardia and treatment.

To confirm the diagnosis, the doctor will conduct the following examinations:

• listening to heart sounds;
• phonocardiography.

To detect pathological bradycardia, the doctor performs the following test: the patient is offered exercise stress and the pulse is measured. Its frequency in such cases increases slightly or the patient has an arrhythmia attack.

When pathological bradycardia is confirmed, the following laboratory and instrumental methods diagnostics:

• clinical and biochemical blood tests;
• clinical and biochemical analysis of urine;
• blood test for hormones;
• analyzes for toxins;
• bacteriological studies of blood, urine or feces;
• Echo-KG, etc.

The scope of the examination is determined individually for each patient and depends on the accompanying complaints. After making a preliminary diagnosis, the patient may be recommended to consult a cardiologist, neuropathologist, gastroenterologist, endocrinologist or other specialized specialists.

Urgent care

With a sharp slowdown in the pulse and arterial hypotension, the patient may develop a pre-fainting state or faint. In such cases, he needs to provide first aid:

1. Lay the patient on his back and raise his legs, resting them on a cushion or pillow.
2. Call an ambulance.
3. Remove or unfasten clothing that restricts breathing.
4. Ensure the flow of fresh air and optimal temperature conditions.
5. Try to bring the patient to consciousness: sprinkle his face with cool water, rub auricles and face soaked in cold water towel, lightly pat him on the cheeks. If the measures provided are not enough, then let the patient inhale a remedy with a pungent odor: onion juice, cotton wool soaked in vinegar or ammonia. Remember that with a sharp inhalation of ammonia vapors, bronchospasm or respiratory arrest may develop. To prevent such a complication, cotton wool with ammonia should be brought at a distance from the respiratory tract.
6. If the patient regained consciousness, then you should measure the pulse and give him a drink of warm tea or coffee with sugar. Try to find out what medications he is taking and give them if possible.
7. After the arrival of the ambulance team, tell the doctor about all the circumstances of fainting and the actions performed.

Treatment

Treatment for pathological bradycardia is aimed at treating the underlying disease, leading to a slowing of the pulse. It can be conservative or surgical. Patients with acute forms of bradycardia require hospitalization.

Conservative therapy

In some cases, to eliminate bradycardia that occurs due to an overdose or long-term use of drugs, it may be sufficient to stop taking the drug or reduce its dosage. For other reasons for slowing the pulse, the treatment plan is drawn up depending on the severity of the underlying disease.

To eliminate bradycardia, such drugs can be used to increase the number of heartbeats:

• ginseng extract - tincture of ginseng, Farmaton vital, Gerbion ginseng, Gerimaks, Doppelgerts ginseng, Teravit, etc.;
• Eleutherococcus extract - Eleutherococcus tincture, Eleutherococcus P (tablets), Eleutherococcus plus (dragee);
• preparations based on belladonna extract - thick or dry belladonna extract, belladonna tincture, Corbella, Becarbon, etc .;
• Atropine;
• Isadrin;
• Isoprenyl;
• Caffeine;
• Eufillin;
• Ephedrine;
• Ipratropium bromide;
• Alupent.

As a rule, taking medication to eliminate bradycardia is recommended when the heart rate drops to 40 or less beats per minute and fainting occurs. The choice of means, its dosing and duration of administration is determined individually for each patient. Self-medication with such drugs is unacceptable, because. their incorrect intake can lead to severe arrhythmias.

In addition to these drugs, patients are prescribed drugs for the treatment of the underlying disease: antibiotics for infections, thyroid hormones for hypothyroidism, drugs for the treatment of heart disease, peptic ulcer, poisoning, tumors, etc. It is the therapy of the root cause of bradycardia that can more effectively eliminate the symptom itself and those unpleasant manifestations that it causes.

In addition to drug treatment, patients with such pulse disorders should give up bad habits. This is especially true for smoking, because. It is nicotine that significantly affects the heart rate.

With pathological bradycardia, diet is also important. When compiling the menu, patients should be guided by the following principles:

• restriction of products with animal fats;
• exclusion of alcoholic beverages;
• introduction to the diet vegetable oils and nuts rich in fatty acids;
• the calorie content of food should correspond to energy costs (1500-2000 kcal, depending on the work performed);
• reducing the amount of salt and fluid volume (as recommended by a doctor).

Surgery

Surgical operations to eliminate bradycardia are performed if conservative treatment is ineffective and the underlying disease is accompanied by a pronounced hemodynamic disorder. The technique of such interventions is determined by the clinical case:

• with congenital malformations of the heart - corrective cardiac surgery is performed to eliminate the anomaly;
• with tumors of the mediastinum - interventions are performed to eliminate the neoplasm;
• with severe bradycardia and the ineffectiveness of drug treatment, a pacemaker is implanted (a device for normalizing the number of heartbeats).

ethnoscience

As an addition to the basic plan of drug therapy, the doctor may recommend taking the following folk remedies:

• radish with honey;
• decoction of rose hips;
• decoction of yarrow;
• garlic with lemon juice;
• walnuts with sesame oil;
• tincture of pine shoots;
• tincture of Chinese lemongrass;
• infusion of immortelle flowers;
• decoction of the Tatar, etc.

When choosing a traditional medicine, possible contraindications and individual intolerance to the components of the recipe must be taken into account.

Bradycardia can be physiological or pathological. This symptom requires treatment only in cases where it is accompanied by a deterioration in well-being and is caused by various diseases or poisonings. The tactics of therapy for pathological bradycardia depends on clinical case and is determined by a pathology that causes a slowing of the pulse. Treatment of such diseases can be medical or surgical.

Union of Pediatricians of Russia, pediatric cardiologist M.A. Babaykina talks about bradycardia in children:

Watch this video on YouTube

Cardiologist D. Losik talks about bradycardia:

Watch this video on YouTube

Intracranial hypertension: symptoms, causes and treatment

Probably every person, at least sometimes, suffered from headache attacks, whether as a result of fatigue and overwork, or as a symptom of colds. But not everyone knows that the main cause of headache is intracranial hypertension.

If the pain is episodic and its cause is more or less known, then there is no reason to worry. But if the head hurts more than it does not hurt, then you should consult a doctor in order to avoid the progression of a much more serious pathology than the common cold.

Mechanism of headache

Our cranium contains, in addition to the brain itself, blood vessels, cerebrospinal fluid, interstitial substance. The cause of intracranial hypertension is the presence of factors in which the volume of at least one component of the brain system increases.

A healthy person produces up to 600 ml of cerebrospinal fluid (CSF) per day, which performs protective, nutritional and communicative functions between brain regions. With edema, enlarged areas of the brain compress the space filled with cerebrospinal fluid and, accordingly, intracranial pressure increases.

If the outflow of cerebrospinal fluid is disturbed or a hematoma forms due to cerebral hemorrhage, hypertension is also observed. The main reasons include neoplasms or inflammation of the brain tissue, which create abnormal pressure in the cranium. And because of the discrepancy between the pressure of different parts of the brain, there is a violation of the function of the central nervous system.

When hypertension occurs not due to some other disease, but due to the influence of objective factors, such as obesity, side effects from taking medications, then they talk about benign intracranial hypertension. It is also called a false brain tumor. This condition can also occur in children when taking corticosteroid drugs, drugs of the tetracycline group or containing an increased dose of vitamin A are discontinued.

The normal functioning of the brain is provided by the following components:

• unhindered passage of cerebrospinal fluid between the membranes of the brain and through its ventricles;
• good absorption (absorbability) of cerebrospinal fluid into the venous network of the brain;
• full venous outflow of blood from the brain.

Venous intracranial hypertension occurs due to improper outflow of venous blood from the intracranial system due to thrombosis or blockage of the venous ducts, emphysema, or mediastinal tumors that provoke increased pressure in the chest.

The manifestation of the disease in children and adults

How the syndrome of intracranial hypertension manifests itself depends entirely on the local location of the causative focus and the rate of development of the disease.

The main signs of intracranial hypertension in adults are headache, most often occurring before lunch, nausea and vomiting during meals, visual disturbances with pain in the eyeballs, up to loss of consciousness. The intensity of the pathology can vary from mild lethargy to falling into a coma.

Symptoms of intracranial hypertension of a moderate course are muffled consciousness, when interest in life is lost, bifurcating objects in the eyes, heart sounds that become rare, as in bradycardia. This state is especially pronounced with a decrease in pressure in the atmosphere. In addition, sleep disturbance, possible nosebleeds, chin trembling, marbling of the skin, and changes in behavior indirectly complement the signs of intracranial hypertension in adults.

In women, as a rule, this is associated with the upcoming menopause or pregnancy, in which there are changes in the cycles of menstruation, as well as with obesity or taking certain medications.

The syndrome of intracranial hypertension in children can be caused by such reasons:

• increased size of the children's skull due to excessive production of cerebrospinal fluid by the body due to hydrocephalus or dropsy of the brain;
• consequences of birth trauma;
• an infectious disease transmitted by the mother during pregnancy.

Intracranial hypertension in infants is diagnosed with developmental delay, too convex frontal part of the head. At the same time, the child does not react in any way to bright light, often rolls his eyes. The place of the fontanel on the head is either tense or swollen, the eyeballs are bulging.

In older children, these manifestations are increased sleepiness, constant or frequent headache, possible strabismus and the inability to catch a visual picture that escapes and is not fixed by sight.

Intracranial hypertension in children, which lasts for a long time, can cause pathological changes in the development of the brain. Therefore, when identifying the focus of the disease, it is necessary to urgently take all measures to further treatment child to avoid a worse prognosis.

Treatment methods

Depending on which component of the overall system of brain functioning is out of order, the symptoms and treatment of intracranial hypertension in adults and children depend.

So, in order to reduce the amount of cerebrospinal fluid produced, urinary agents are prescribed, and the corresponding set of exercises developed by specialists is designed to reduce intracranial pressure. A special diet and dosage of water consumed per day is compiled for the patient. Attracting a manual specialist and getting acupuncture sessions helps to normalize the amount of CSF.

If the case is severe and the above procedures do not produce the desired effect, resort to the surgical method. It lies in the fact that by means of trepanation of the skull, a hole is made in it through which a special drainage system is implanted. With the help of this system, excess fluid is removed from the cranium.

These methods significantly improve the patient's health, eliminating the signs of intracranial hypertension syndrome in just a few days from the start of treatment. However, it is possible to successfully cure the disease only if the cause of hypertension is completely eliminated.

Treatment of intracranial hypertension in a child's body can be carried out both conservatively and radically. The choice of treatment method depends entirely on the cause that gave rise to the disease.

If the pathology is diagnosed in a newborn, then such babies should be observed by a neurologist from birth, who, if necessary, will correct the treatment at a certain stage in order to avoid serious complications.

In order to eliminate the consequences of the pathology of pregnancy and the severe course of labor, it is necessary to breastfeed the baby for as long as possible, punctually observe the daily regimen and, especially, sleep, constantly be in contact with the child both emotionally and contactly in order to avoid nervous stress regularly take walks outside in any weather.

At the same time, the child should take drugs designed to calm the nervous system, improve the circulatory, urinary system, as well as vitamin preparations to strengthen immunity.

For older children, the doctor prescribes procedures from the category of physiotherapy, they help well in curing the disease of swimming.

Any anatomical anomalies that interfere with the outflow of cerebrospinal fluid from the brain are solved surgically.

From folk methods, as a supplement to the main treatment, one can single out rubbing lavender oil into the temporal part of the head before going to bed. This tool not only calms the nervous system, but also promotes sound healthy sleep, which significantly speeds up recovery.

Video about intracranial hypertension:

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(lat. Epilepsia - seized, caught, caught) - one of the most common chronic neurological diseases a person, manifested in the predisposition of the body to the sudden onset of convulsive seizures. Other common and commonly used names for these sudden attacks are an epileptic seizure, "falling." Epilepsy affects not only people, but also animals, such as dogs, cats, mice. Many great ones, namely Julius Caesar, Napoleon Bonaparte, Peter the Great, Fyodor Dostoevsky, Alfred Nobel, Joan of Arc, Ivan IV the Terrible, Vincent van Gogh, Winston Churchill, Lewis Carroll, Alexander the Great, Alfred Nobel, Dante Alighieri, Fyodor Dostoevsky , Nostradamus and others suffered from epilepsy.

This disease was called "God's mark", believing that people with epilepsy are marked from above. The nature of the appearance of this disease has not yet been established, there are several assumptions in medicine, but there is no exact data.

The popular belief that epilepsy is an incurable disease is wrong. The use of modern antiepileptic drugs can completely eliminate seizures in 65% of patients and significantly reduce the number of seizures in another 20%. The basis of treatment is long-term daily drug therapy with regular follow-up studies and medical examinations.

Medicine has established that epilepsy is a hereditary disease, it can be transmitted through the mother's line, but more often it is transmitted through the male line, it may not be transmitted at all or it may manifest itself through a generation. There is a possibility of epilepsy in children conceived by parents in a drunken state or with syphilis. Epilepsy can be an "acquired" disease, as a result of severe fright, head injury, mother's illness during pregnancy, due to the formation of brain tumors, cerebrovascular malformations, birth trauma, infections of the nervous system, poisoning, neurosurgical operation.

An epileptic seizure occurs as a result of the simultaneous excitation of nerve cells, which occurs in a certain area of ​​​​the cerebral cortex.

Epilepsy is classified into the following types based on its occurrence:

1. symptomatic- it is possible to detect a structural defect of the brain, for example, a cyst, a tumor, a hemorrhage, malformations, a manifestation of organic damage to brain neurons;
2. idiopathic- there is a hereditary predisposition, and there are no structural changes in the brain. The basis of idiopathic epilepsy is channelopathy (genetically determined diffuse instability of neuronal membranes). There are no signs of organic brain damage in this variant of epilepsy; the intelligence of patients is normal;
3. cryptogenic- the cause of the disease cannot be identified.

Before each epileptic seizure, a person experiences a special condition called an aura. The aura manifests differently in each person. It all depends on the location of the epileptogenic focus. The aura can be manifested by fever, anxiety, dizziness, the patient feels cold, pain, numbness of some parts of the body, strong heartbeat, feeling bad smell, the taste of some food, sees a bright flicker. It should be remembered that during an epileptic attack, a person not only is not aware of anything, but also does not experience any pain. An epileptic seizure lasts for several minutes.

Under a microscope, during an epileptic seizure, swelling of cells, small areas of hemorrhages are visible in this place of the brain. Each seizure facilitates the next one by forming permanent seizures. That's why epilepsy needs to be treated! Treatment is strictly individual!

Predisposing factors:

• change in climatic conditions,
• lack or excess of sleep,
• fatigue,
• bright daylight.

Epilepsy symptoms

Manifestations of epileptic seizures vary from generalized convulsions to changes that are barely noticeable to others. internal state patient. There are focal seizures associated with the occurrence of an electrical discharge in a certain limited area of ​​​​the cerebral cortex and generalized seizures, in which both hemispheres of the brain are simultaneously involved in the discharge. With focal seizures, convulsions or peculiar sensations (for example, numbness) in certain parts of the body (face, arms, legs, etc.) can be observed. Also, focal seizures can be manifested by short attacks of visual, auditory, olfactory, or gustatory hallucinations. Consciousness during these attacks can be preserved, in which case the patient describes in detail his feelings. Partial or focal seizures are the most common manifestation of epilepsy. They occur when nerve cells are damaged in a specific area of ​​one of the hemispheres of the brain and are divided into:

1. simple - with such seizures there is no disturbance of consciousness;
2. complex - seizures with a violation or change in consciousness, are caused by areas of overexcitation that are diverse in localization and often turn into generalized ones;
3. Secondary generalized seizures - characterized by the onset in the form of a convulsive or non-convulsive partial seizure or absence, followed by a bilateral spread of convulsive motor activity to all muscle groups.

The duration of partial seizures is usually no more than 30 seconds.

There are states of the so-called trance - outwardly ordered actions without consciousness control; upon the return of consciousness, the patient cannot remember where he was and what happened to him. A kind of trance is sleepwalking (sometimes not of epileptic origin).

Generalized seizures are convulsive and non-convulsive (absences). For others, the most frightening are generalized convulsive seizures. At the beginning of an attack (tonic phase), there is a tension of all muscles, a short-term cessation of breathing, a piercing cry is often observed, biting of the tongue is possible. After 10-20 sec. the clonic phase begins, when muscle contractions alternate with their relaxation. Urinary incontinence is often observed at the end of the clonic phase. Seizures usually stop spontaneously after a few minutes (2-5 minutes). Then comes the post-attack period, characterized by drowsiness, confusion, headache and the onset of sleep.

Non-convulsive generalized seizures are called absences. They occur almost exclusively in childhood and early adolescence. The child suddenly freezes and gazes intently at one point, the look seems to be absent. Covering the eyes, trembling of the eyelids, slight tilting of the head can be observed. Attacks last only a few seconds (5-20 seconds) and often go unnoticed.

The occurrence of an epileptic seizure depends on a combination of two factors of the brain itself: the activity of the convulsive focus (sometimes also called epileptic) and the general convulsive readiness of the brain. Sometimes an epileptic seizure is preceded by an aura (a Greek word meaning "breeze", "breeze"). The manifestations of the aura are very diverse and depend on the location of the part of the brain whose function is impaired (that is, on the localization of the epileptic focus). Also, certain conditions of the body can be a provoking factor in an epileptic seizure (epileptic seizures associated with the onset of menstruation; epileptic seizures that occur only during sleep). In addition, an epileptic seizure can provoke a number of environmental factors (for example, flickering light). There are a number of classifications of characteristic epileptic seizures. From the point of view of treatment, the classification based on the symptoms of seizures is most convenient. It also helps to distinguish epilepsy from other paroxysmal conditions.

Types of epileptic seizures

What are the types of seizures?

Epileptic seizures are very diverse in their manifestations - from severe general convulsions to an imperceptible blackout. There are also such as: a feeling of a change in the shape of surrounding objects, twitching of the eyelid, tingling in the finger, discomfort in the stomach, short-term inability to speak, leaving home for many days (trances), rotation around its axis, etc.

More than 30 types of epileptic seizures are known. Currently, the International Classification of Epilepsy and Epileptic Syndromes is used to systematize them. This classification distinguishes two main types of seizures - generalized (general) and partial (focal, focal). They, in turn, are divided into subspecies: tonic-clonic seizures, absences, simple and complex partial seizures, as well as other seizures.

What is an aura?

Aura (a Greek word meaning "breeze", "breeze") is the state that precedes an epileptic seizure. The manifestations of the aura are very diverse and depend on the location of the part of the brain whose function is impaired. They can be: fever, anxiety and restlessness, sound, strange taste, smell, change in visual perception, discomfort in the stomach, dizziness, "already seen" (deja vu) or "never seen" (jamais vu) states , a feeling of inner bliss or longing, and other sensations. The ability of a person to correctly describe his aura can be of great help in diagnosing the localization of changes in the brain. The aura can also be not only a harbinger, but also an independent manifestation of a partial epileptic seizure.

What are generalized seizures?

Generalized seizures are seizures in which paroxysmal electrical activity occurs in both hemispheres of the brain. A additional research the brain is not detected in such cases focal changes. The main generalized seizures include tonic-clonic (generalized convulsive seizures) and absences (short-term blackouts). Generalized seizures occur in about 40% of people with epilepsy.

What are tonic-clonic seizures?

Generalized tonic-clonic seizures (grand mal) are characterized by the following manifestations:

1. turning off consciousness;
2. tension of the trunk and limbs ( tonic convulsions);
3. twitching of the trunk and limbs (clonic convulsions).

During such an attack, breathing may be held for a while, but this never leads to suffocation of a person. Usually the attack lasts 1-5 minutes. After an attack, sleep, a state of stupor, lethargy, and sometimes a headache may occur.

In the event that an aura or a focal attack occurs before an attack, it is regarded as partial with secondary generalization.

What are absences (fading)?

Absences (petite mal) are generalized seizures with a sudden and short-term (from 1 to 30 seconds) loss of consciousness, not accompanied by convulsive manifestations. The frequency of absences can be very high, up to several hundred seizures per day. They are often not noticed, believing that the person was thinking at that time. During an absence, movements suddenly stop, the gaze stops, and there is no reaction to external stimuli. Aura never happens. Sometimes there may be eye rolling, twitching of the eyelids, stereotyped movements of the face and hands, and discoloration of the skin of the face. After the attack, the interrupted action resumes.

Absences are typical for childhood and adolescence. Over time, they can transform into other types of seizures.

What is juvenile myoclonic epilepsy?

Adolescent myoclonic epilepsy begins between the onset of puberty (puberty) and 20 years of age. It is manifested by lightning-fast twitches (myoclonus), as a rule, of the hands while maintaining consciousness, sometimes accompanied by generalized tonic or tonic-clonic seizures. Most of these attacks occur within 1-2 hours before or after waking up from sleep. The electroencephalogram (EEG) often shows characteristic changes, and there may be an increased sensitivity to light flicker (photosensitivity). This form of epilepsy responds well to treatment.

What are partial seizures?

Partial (focal, focal) seizures are seizures caused by paroxysmal electrical activity in a limited area of ​​the brain. This type of seizure occurs in about 60% of people with epilepsy. Partial seizures can be simple or complex.

Simple partial seizures are not accompanied by impaired consciousness. They can manifest as twitching or discomfort in certain parts of the body, turning the head, discomfort in the abdomen, and other unusual sensations. Often these attacks are similar to an aura.

Complex partial seizures have more pronounced motor manifestations and are necessarily accompanied by one or another degree of change in consciousness. Previously, these seizures were classified as psychomotor and temporal lobe epilepsy.

In partial seizures, a thorough neurological examination is always performed to rule out underlying brain disease.

What is rolandic epilepsy?

Its full name is "benign childhood epilepsy with central-temporal (rolandic) peaks." Already from the name it follows that it responds well to treatment. Seizures appear in the younger school age and stop in adolescence. Rolandic epilepsy usually presents with partial seizures (eg, unilateral twitching of the corner of the mouth with salivation, swallowing) that usually occur during sleep.

What is status epilepticus?

Status epilepticus is a condition where epileptic seizures follow each other without interruption. This condition is life threatening. Even with the current level of development of medicine, the risk of death of the patient is still very high, so a person with epileptic status must be taken to the intensive care unit of the nearest hospital without delay. Seizures recurring so frequently that between them the patient does not regain consciousness; distinguish epileptic status of focal and generalized seizures; very localized motor seizures are termed "permanent partial epilepsy".

What are pseudo-seizures?

These states are deliberately caused by a person and outwardly look like seizures. They can be staged in order to attract additional attention to themselves or to avoid any activity. It is often difficult to distinguish a true epileptic seizure from a pseudoepileptic one.

Pseudo-epileptic seizures are observed:

• in childhood;
• more often in women than in men;
• in families where there are relatives with mental illness;
• with hysteria;
• in the presence of a conflict situation in the family;
• in the presence of other brain diseases.

In contrast to epileptic seizures, pseudoseizures do not have a characteristic post-seizure phase, return to normal very quickly, the person smiles often, there is rarely damage to the body, irritability rarely occurs, rarely more than one seizure occurs during short span time. Electroencephalography (EEG) can accurately identify pseudoepileptic seizures.

Unfortunately, pseudoepileptic seizures are often misdiagnosed as epileptic seizures, and patients begin to receive treatment. specific drugs. Relatives in such cases are frightened by the diagnosis, as a result, anxiety is induced in the family and hyper-custody is formed over a pseudo-sick person.

Convulsive focus

The convulsive focus is the result of organic or functional damage to a part of the brain caused by any factor (insufficient blood circulation (ischemia), perinatal complications, head injuries, somatic or infectious diseases, brain tumors and abnormalities, metabolic disorders, stroke, toxic effects various substances). At the site of structural damage, a scar (which sometimes forms a fluid-filled cavity (cyst)). This place may occasionally occur acute edema and irritation of the nerve cells of the motor zone, which leads to convulsive contractions of the skeletal muscles, which, in the event of generalization of excitation to the entire cerebral cortex, end in a loss of consciousness.

Convulsive readiness

Convulsive readiness- this is the probability of an increase in pathological (epileptiform) excitation in the cerebral cortex above the level (threshold) at which the anticonvulsant system of the brain functions. It can be high or low. With high convulsive readiness, even a small activity in the focus can lead to the appearance of a full-blown convulsive attack. The convulsive readiness of the brain can be so great that it leads to a short-term loss of consciousness even in the absence of a focus of epileptic activity. In this case, we are talking about absences. Conversely, there may be no convulsive readiness at all, and, in this case, even with a very strong focus of epileptic activity, partial seizures occur that are not accompanied by loss of consciousness. The reason for increased convulsive readiness is intrauterine cerebral hypoxia, hypoxia during childbirth or hereditary predisposition (the risk of epilepsy in the offspring of patients with epilepsy is 3-4%, which is 2-4 times higher than in the general population).

Diagnosis of epilepsy

In total there are about 40 various forms epilepsy and various types of seizures. At the same time, each form has its own treatment regimen. That is why it is so important for a doctor not only to diagnose epilepsy, but also to determine its form.

How is epilepsy diagnosed?

A complete medical examination includes the collection of information about the life of the patient, the development of the disease and, most importantly, a very detailed description of the attacks, as well as the conditions that precede them, by the patient himself and by eyewitnesses of the attacks. If seizures occur in a child, then the doctor will be interested in the course of pregnancy and childbirth in the mother. Necessarily carried out a general and neurological examination, electroencephalography. Special neurological studies include nuclear magnetic resonance imaging and computed tomography. the main task examinations are the identification of current diseases of the body or brain that could cause seizures.

What is electroencephalography (EEG)?

Using this method, the electrical activity of brain cells is recorded. This is the most important test in the diagnosis of epilepsy. An EEG is performed immediately after the onset of the first seizures. In epilepsy, specific changes (epileptic activity) appear on the EEG in the form of discharges of sharp waves and peaks of higher amplitude than ordinary waves. In generalized seizures, the EEG shows groups of generalized peak-wave complexes in all areas of the brain. With focal epilepsy, changes are detected only in certain, limited areas of the brain. Based on the EEG data, a specialist can determine what changes have occurred in the brain, clarify the type of seizures, and, based on this, determine which drugs will be preferable for treatment. Also, with the help of EEG, the effectiveness of the treatment is monitored (especially important for absences), and the issue of stopping treatment is decided.

How is an EEG performed?

An EEG is a completely harmless and painless test. To conduct it, small electrodes are applied to the head and fixed on it with the help of a rubber helmet. Electrodes are connected by wires to an electroencephalograph, which amplifies the electrical signals of brain cells received from them by 100 thousand times, writes them down on paper or enters readings into a computer. During the examination, the patient lies or sits in a comfortable diagnostic chair, relaxed, with his eyes closed. Usually, when taking an EEG, the so-called functional tests(photostimulation and hyperventilation), which are provocative loads on the brain through bright light flashing and increased respiratory activity. If an attack begins during the EEG (this is very rare), then the quality of the examination increases much, since in this case it is possible to more accurately determine the area of ​​\u200b\u200bthe disturbed electrical activity of the brain.

Are EEG changes grounds for the detection or exclusion of epilepsy?

Many EEG changes are nonspecific and provide only supporting information for the epileptologist. Only on the basis of the detected changes in the electrical activity of brain cells, one cannot speak of epilepsy, and, conversely, this diagnosis cannot be ruled out with a normal EEG if epileptic seizures occur. EEG activity is regularly detected in only 20-30% of people with epilepsy.

Interpretation of changes in the bioelectrical activity of the brain is, to some extent, an art. Changes similar to epileptic activity can be caused by eye movement, swallowing, vascular pulsation, respiration, electrode movement, electrostatic discharge, and other causes. In addition, the electroencephalographer must take into account the age of the patient, since the EEG of children and adolescents differs significantly from the electroencephalogram of adults.

What is a hyperventilation test?

This is frequent and deep breathing within 1-3 minutes. Hyperventilation causes pronounced metabolic changes in the brain substance due to the intensive removal of carbon dioxide (alkalosis), which, in turn, contribute to the appearance of epileptic activity on the EEG in people with seizures. Hyperventilation during EEG recording allows revealing latent epileptic changes and clarifying the nature of epileptic seizures.

What is photostimulation EEG?

This trial is based on the fact that flashes of light can cause seizures in some people with epilepsy. During the EEG recording, a bright light flashes rhythmically (10-20 times per second) in front of the eyes of the patient under study. Detection of epileptic activity during photostimulation (photosensitive epileptic activity) allows the doctor to choose the most correct treatment tactics.

Why is an EEG with sleep deprivation performed?

Sleep deprivation (deprivation) for 24-48 hours before the EEG is performed to detect latent epileptic activity in cases of epilepsy that are difficult to recognize.

Sleep deprivation is a fairly strong trigger for seizures. This test should only be used under the guidance of an experienced physician.

What is an EEG in sleep?

As is known, in certain forms of epilepsy, changes in the EEG are more pronounced, and sometimes only able to be perceptible during a study in a dream. EEG recording during sleep makes it possible to detect epileptic activity in most of those patients in whom it was not detected in the daytime even under the influence of conventional provocative samples. Unfortunately, such a study requires special conditions and preparedness of medical personnel, which limits wide application this method. It is especially difficult to carry it out in children.

Is it right not to take antiepileptic drugs before an EEG?

This should not be done. Abrupt discontinuation of drugs provokes seizures and can even cause status epilepticus.

When is video-EEG used?

This very complex study is carried out in cases where it is difficult to determine the type of epileptic seizure, as well as in the differential diagnosis of pseudo-seizures. A video EEG is a video recording of an attack, often during sleep, with simultaneous EEG recording. This study is carried out only in specialized medical centers.

Why is brain mapping done?

This type of EEG with computer analysis of the electrical activity of brain cells is usually carried out for scientific purposes. The use of this method in epilepsy is limited to detecting only focal changes.

Is EEG harmful to health?

Electroencephalography is an absolutely harmless and painless study. EEG is not associated with any effect on the brain. This study can be done as often as necessary. The EEG only causes a slight inconvenience associated with the wearing of a helmet on the head and slight dizziness, which may occur during hyperventilation.

Do the EEG results depend on the device used for the study?

EEG devices - electroencephalographs manufactured by various firms, do not fundamentally differ from each other. Their difference is only in the level of technical service for specialists and in the number of registration channels (electrodes used). The results of the EEG largely depend on the qualifications and experience of the specialist conducting the study and analysis of the data obtained.

How to prepare a child for an EEG?

The child must be explained what awaits him during the study, and convinced of his painlessness. The child before the study should not feel hungry. The head must be clean. With young children, it is necessary to practice on the eve of putting on a helmet and staying still with your eyes closed (you can stage a game of an astronaut or a tanker), as well as teach you to breathe deeply and often under the “inhale” and “exhale” commands.

CT scan

Computed tomography (CT) is a method of examining the brain using radioactive (X-ray) radiation. During the study, a series of images of the brain is taken in different planes, which, unlike conventional radiography, allows you to get an image of the brain in three dimensions. CT allows to detect structural changes in the brain (tumors, calcifications, atrophies, hydrocephalus, cysts, etc.).

However, CT data may not be informative when certain types seizures, which include:

any epileptic seizures for a long time, especially in children;

generalized epileptic seizures with no focal EEG changes and no evidence of brain damage on neurological examination.

Magnetic resonance imaging

Magnetic resonance imaging is one of the most accurate methods for diagnosing structural changes in the brain.

Nuclear Magnetic Resonance (NMR)- This is a physical phenomenon based on the properties of some atomic nuclei, when placed in a strong magnetic field, to absorb energy in the radio frequency range and radiate it after the cessation of exposure to the radio frequency pulse. By their own diagnostic capabilities NMR is superior to computed tomography.

The main disadvantages usually include:

1. low reliability of detection of calcifications;
2. high price;
3. the impossibility of examining patients with claustrophobia (fear of closed spaces), artificial pacemakers (pacemaker), large metal implants made of non-medical metals.

Is a medical examination necessary in cases where there are no more seizures?

If a person with epilepsy has stopped seizures, and the drugs have not yet been canceled, then he is recommended to conduct a control general and neurological examination at least once every six months. This is especially important for controlling the side effects of antiepileptic drugs. The condition of the liver, lymph nodes, gums, hair is usually checked, and laboratory tests blood and liver tests. In addition, sometimes it is necessary to control the amount anticonvulsants in blood. Neurological examination at the same time includes a traditional examination by a neurologist and an EEG.

Cause of death in epilepsy

Status epilepticus is especially dangerous due to pronounced muscle activity: tonic-clonic convulsions of the respiratory muscles, inhalation of saliva and blood from oral cavity, as well as delays and arrhythmias of breathing lead to hypoxia and acidosis. The cardiovascular system is experiencing exorbitant loads due to the gigantic muscular work; hypoxia increases cerebral edema; acidosis enhances hemodynamic and microcirculation disorders; Secondly, the conditions for brain functioning worsen more and more. With prolonged epileptic status in the clinic, the depth of the coma increases, convulsions take on a tonic character, muscle hypotension is replaced by their atony, and hyperreflexia by areflexia. Hemodynamic and respiratory disorders. Convulsions may completely stop, and the stage of epileptic prostration sets in: palpebral fissures and the mouth is half open, the gaze is indifferent, the pupils are wide. In this state, death can occur.

Two main mechanisms lead to cytotoxic action and necrosis, in which cellular depolarization is supported by stimulation of NMDA receptors and the key point is the launch of a destruction cascade inside the cell. In the first case, excessive neuronal excitation is the result of edema (fluid and cations enter the cell), leading to osmotic damage and cell lysis. In the second case, activation of NMDA receptors activates the flow of calcium into the neuron with the accumulation of intracellular calcium to a level higher than the cytoplasmic calcium binding protein can accommodate. Free intracellular calcium is toxic to the neuron and leads to a series of neurochemical reactions, including mitochondrial dysfunction, activates proteolysis and lipolysis, which destroys the cell. This vicious circle and underlies the death of a patient with status epilepticus.

Epilepsy prognosis

In most cases, after a single attack, the prognosis is favorable. Approximately 70% of patients undergo remission during treatment, that is, there are no seizures for 5 years. Seizures continue in 20-30%, in such cases, the simultaneous administration of several anticonvulsants is often required.

First aid

Signs or symptoms of an attack are usually: convulsive muscle contractions, respiratory arrest, loss of consciousness. During an attack, others need to remain calm - without showing panic and fuss, provide the correct first aid. These symptoms of an attack should go away on their own within a few minutes. To accelerate the natural cessation of the symptoms that accompany an attack, others most often cannot.

The most important goal of first aid in a seizure is to prevent harm to the health of the person who has had a seizure.

The onset of an attack may be accompanied by loss of consciousness and a person falling to the floor. When falling from the stairs, next to objects that stand out from the floor level, bruises of the head and fractures are possible.

Remember: an attack is not a disease transmitted from one person to another, act boldly and correctly, providing first aid.

Getting into an attack

Support the falling person with your hands, lower him here on the floor or seat him on a bench. If a person is in a dangerous place, for example, at a crossroads or near a cliff, raising his head, taking him under the armpits, move him a little away from the dangerous place.

The beginning of the attack

Sit next to the person and hold the most important thing - the head of the person, it is most convenient to do this by holding the head of the person lying between your knees and holding it from above with your hands. The limbs can not be fixed, they will not make amplitude movements, and if initially a person lies comfortably enough, then he will not be able to inflict injuries on himself. Other people are not required nearby, ask them to move away. The main phase of the attack. While holding your head, prepare a folded handkerchief or part of the person's clothing. This may be required to wipe saliva, and if the mouth is open, then a piece of this matter, folded in several layers, can be inserted between the teeth, this will prevent biting the tongue, cheeks, or even damage to the teeth against each other during cramps.

If the jaws are tightly closed, do not try to open the mouth by force (this most likely will not work and may injure the oral cavity).

With increased salivation, continue to hold the person's head, but turn it to the side so that saliva can drain to the floor through the corner of the mouth and does not enter the respiratory tract. It's okay if a little saliva gets on your clothes or hands.

Exit from attack

Remain completely calm, an attack with respiratory arrest can last several minutes, memorize the sequence of symptoms of an attack in order to describe them to the doctor later.

After the end of convulsions and relaxation of the body, it is necessary to put the victim in a recovery position - on his side, this is necessary to prevent the root of the tongue from sinking.

The victim may have medicines, but they can be used only at the direct request of the victim, otherwise criminal liability for causing harm to health may follow. In the vast majority of cases, the exit from the attack should occur naturally, and the right medicine or mixture of them and the dose will be selected by the person himself after leaving the attack. Searching a person in search of instructions and medicines is not worth it, as this is not necessary, but will only cause an unhealthy reaction from others.

In rare cases, the exit from the attack may be accompanied by involuntary urination, while the person still has convulsions at this time, and consciousness has not fully returned to him. Politely ask other people to move away and disperse, hold the person's head and shoulders and gently prevent him from getting up. Later, a person will be able to cover himself, for example, with an opaque bag.

Sometimes at the exit from an attack, even with rare convulsions, a person tries to get up and start walking. If you can keep spontaneous impulses from side to side of the person, and the place is not dangerous, for example, in the form of a road nearby, a cliff, etc., let the person, without any help from you, get up and walk with him, holding him tightly. If the place is dangerous, then until the complete cessation of convulsions or the complete return of consciousness, do not allow him to get up.

Usually 10 minutes after the attack, the person completely returns to his normal state and he no longer needs first aid. Let the person make the decision on the need to seek medical help; after recovering from an attack, this is sometimes no longer necessary. There are people who have seizures several times a day, and at the same time they are completely full members of society.

Often, young people are uncomfortable with the attention of other people to this incident, and much more than the attack itself. Cases of an attack under certain stimuli and external circumstances can occur in almost half of the patients; modern medicine does not allow to insure against this beforehand.

A person whose attack is already ending should not be made the focus of general attention, even if the person emits involuntary convulsive cries when exiting the attack. You could, holding the person's head, for example, talk calmly to the person, this helps reduce stress, gives confidence to the person coming out of an attack, and also calms onlookers and encourages them to disperse.

An ambulance should be called in case of a second attack, the onset of which indicates an exacerbation of the disease and the need for hospitalization, since further attacks may follow a second attack in a row. When communicating with the operator, it is enough to indicate the gender and approximate age victim, to the question "What happened?" answer “a repeated attack of epilepsy”, name the address and large fixed landmarks, at the request of the operator, provide information about yourself.

In addition, an ambulance should be called if:

• seizure lasts more than 3 minutes
• after an attack, the victim does not regain consciousness for more than 10 minutes
• attack occurred for the first time
• the seizure occurred in a child or an elderly person
• a seizure occurred in a pregnant woman
• during the attack, the victim was injured.

Epilepsy treatment

Treatment of a patient with epilepsy is aimed at eliminating the cause of the disease, suppressing the mechanisms of seizure development and correcting the psychosocial consequences that may occur as a result of the neurological dysfunction underlying the diseases or in connection with a persistent decrease in working capacity.

If the epileptic syndrome is the result of metabolic disorders such as hypoglycemia or hypocalcemia, then after recovery metabolic processes to a normal level, seizures usually stop. If a epileptic seizures are caused by an anatomical lesion of the brain, such as a tumor, an arteriovenous malformation, or a brain cyst, then removal of the pathological focus also leads to the disappearance of seizures. However, long-term even non-progressive lesions can cause the development of various negative changes. These changes can lead to the formation of chronic epileptic foci that cannot be eliminated by removing the primary lesion. In such cases, control is needed, sometimes surgical extirpation of the epileptic areas of the brain is necessary.

Medical treatment of epilepsy

• Anticonvulsants, another name for anticonvulsants, reduce the frequency, duration, and in some cases completely prevent seizures:
• Neurotropic agents - may inhibit or stimulate transmission nervous excitement in various parts of the (central) nervous system.
• Psychoactive substances and psychotropic drugs affect the functioning of the central nervous system, leading to a change in mental state.
• Racetams are a promising subclass of psychoactive nootropics.

Antiepileptic drugs are chosen depending on the form of epilepsy and the nature of the seizures. The drug is usually prescribed in a small initial dose with a gradual increase until the optimal clinical effect appears. If the drug is ineffective, it is gradually canceled and the next one is prescribed. Remember that under no circumstances should you independently change the dosage of the medicine or stop treatment. A sudden change in dose can provoke a deterioration in the condition and an increase in seizures.

Non-drug treatments

• Surgery;
• Voight method;
• osteopathic treatment;
• Influence study external stimuli affecting the frequency of seizures, and the weakening of their influence. For example, the frequency of seizures can be influenced by the regime of the day, or it may be possible to individually establish a connection, for example, when wine is consumed, and then it is washed down with coffee, but this is all individual for each organism of a patient with epilepsy;
• Ketogenic diet.

Epilepsy and driving

Each state has its own rules for determining when a person with epilepsy can obtain a driver's license, and several countries have laws requiring physicians to report epilepsy patients to the registry and inform patients of their responsibility for doing so. In general, patients can drive a car if within 6 months - 2 years (with or without drug treatment) they have not had seizures. In some countries, the exact duration of this period is not defined, but the patient must obtain a doctor's opinion that the seizures have stopped. The doctor is obliged to warn the patient with epilepsy about the risks that he is exposed to while driving with such a disease.

Most patients with epilepsy, with adequate seizure control, attend school, go to work, and lead a relatively normal life. Children with epilepsy usually have more problems in school than their peers, but every effort should be made to enable these children to learn normally by providing them extra help in the form of tutoring and psychological consultations.

How is epilepsy related to sex life?

Sexual behavior is an important but very private part of life for most men and women. Studies have shown that about a third of people with epilepsy, regardless of gender, have sexual problems. Main reasons sexual disorders are psychosocial and physiological factors.

Psychosocial factors:

• limited social activity;
• lack of self-esteem;
• rejection by one of the partners of the fact that the other has epilepsy.

Psychosocial factors invariably cause sexual dysfunction in various chronic diseases, and are also the cause of sexual problems in epilepsy. The presence of seizures often leads to a feeling of vulnerability, helplessness, inferiority and interferes with the establishment of a normal relationship with a sexual partner. In addition, many fear that their sexual activity may trigger seizures, especially when the seizures are triggered by hyperventilation or physical activity.

Even such forms of epilepsy are known, when sexual sensations act as a component of an epileptic seizure and, as a result, form a negative attitude towards any manifestations of sexual desires.

Physiological factors:

• dysfunction of brain structures responsible for sexual behavior (deep structures of the brain, temporal lobe);
• hormonal changes due to seizures;
• increase in the level of inhibitory substances in the brain;
• a decrease in the level of sex hormones due to the use of drugs.

A decrease in sexual desire is observed in about 10% of people receiving antiepileptic drugs, and to a greater extent it is expressed in those taking barbiturates. A rather rare case of epilepsy is increased sexual activity, which is no less a serious problem.

When evaluating sexual disorders, it must be taken into account that they can also be the result of improper upbringing, religious restrictions and negative experiences of early sexual life, but the most common cause is a violation of relationships with a sexual partner.

epilepsy and pregnancy

Most women with epilepsy are able to carry an uncomplicated pregnancy and give birth to healthy children, even if they are taking anticonvulsants at this time. However, during pregnancy, the course of metabolic processes in the body changes, Special attention should pay attention to the levels of antiepileptic drugs in the blood. Sometimes relatively high doses have to be administered to maintain therapeutic concentrations. The majority of sick women, whose condition was well controlled before pregnancy, continue to feel satisfactory during pregnancy and childbirth. Women who fail to control seizures before pregnancy are at higher risk of developing complications during pregnancy.

One of the most serious complications of pregnancy, morning sickness, often presents with generalized tonic-clonic seizures in the last trimester. Such seizures are a symptom of a severe neurological disorder and are not a manifestation of epilepsy, occurring in women with epilepsy no more often than in others. Toxicosis must be corrected: this will help prevent the occurrence of seizures.

In the offspring of women with epilepsy, the risk of embryonic malformations is 2-3 times higher; this appears to be due to a combination of the low incidence of drug-induced malformations and genetic predisposition. Congenital malformations observed include fetal hydantoin syndrome, characterized by cleft lip and palate, heart defects, finger hypoplasia, and nail dysplasia.

The ideal for a woman planning a pregnancy would be to stop taking antiepileptic drugs, but it is very likely that in a large number of patients this will lead to a relapse of seizures, which will later be more detrimental to both mother and child. If the condition of the patient allows to cancel the treatment, then this can be done at a suitable time before the onset of pregnancy. In other cases, it is desirable to carry out maintenance treatment with one drug, prescribing it at the minimum effective dose.

Children exposed to chronic intrauterine exposure to barbiturates often have transient lethargy, hypotension, restlessness, and often signs of barbiturate withdrawal. These children should be included in the risk group for the occurrence of various disorders in the neonatal period, slowly removed from the state of dependence on barbiturates and carefully monitored for their development.

There are also seizures that look like epileptic seizures, but are not. Increased excitability in rickets, neurosis, hysteria, disorders of the heart, breathing can cause such attacks.

Affectively - respiratory attacks:

The child begins to cry and at the height of crying stops breathing, sometimes it even goes limp, falls unconscious, there may be twitches. Help with affective seizures is very simple. You need to take as much air as possible into your lungs and blow on the child's face with all your might, or wipe his face with cold water. Reflexively, breathing will be restored, the attack will stop. There is also yactation, when a very small child sways from side to side, it seems that he is rocking himself before going to bed. And who already knows how to sit, sways back and forth. Most often, yactation occurs if there is no necessary spiritual contact (it happens in children in orphanages), rarely - due to mental disorders.

In addition to the listed conditions, there are attacks of loss of consciousness associated with a violation of the activity of the heart, breathing, etc.

Influence on character

Pathological excitation of the cerebral cortex and seizures do not pass without a trace. As a result, the psyche of the patient with epilepsy changes. Of course, the degree of change in the psyche largely depends on the personality of the patient, the duration and severity of the disease. Basically, there is a slowdown in mental processes, primarily thinking and affects. With the course of the disease, changes in thinking progress, the patient often cannot separate the main from the secondary. Thinking becomes unproductive, has a concrete descriptive, stereotyped character; standard expressions predominate in speech. Many researchers characterize it as "labyrinth thinking".

According to the observational data, according to the frequency of occurrence among patients, character changes in epileptics can be arranged in the following order:

• slowness,
• viscosity of thinking,
• heaviness,
• short temper,
• selfishness,
• rancor,
• thoroughness,
• hypochondria,
• quarrelsomeness,
• accuracy and pedantry.

The appearance of a patient with epilepsy is characteristic. Slowness, restraint in gestures, reticence, lethargy of facial expressions, inexpressiveness of the face are striking, you can often notice a "steel" gleam in the eyes (a symptom of Chizh).

Malignant forms of epilepsy eventually lead to epileptic dementia. In patients, dementia is manifested by lethargy, passivity, indifference, humility with the disease. Viscous thinking is unproductive, memory is reduced, vocabulary is poor. The affect of tension is lost, but obsequiousness, flattery, hypocrisy remain. In the outcome, indifference to everything except one's own health develops, petty interests, egocentrism. Therefore, it is important to recognize the disease in time! Public understanding and comprehensive support are extremely important!

Can I drink alcohol?

Some people with epilepsy choose not to drink alcohol at all. It is well known that alcohol can provoke seizures, but this is largely due to the individual susceptibility of the person, as well as the form of epilepsy. If a person with seizures is fully adapted to a full life in society, then he will be able to find for himself a reasonable solution to the problem of drinking alcohol. Permissible doses alcohol consumption per day are for men - 2 glasses of wine, for women - 1 glass.

Can I smoke?

Smoking is bad, it's common knowledge. There was no direct association between smoking and seizures. But there is a risk of fire if a seizure occurs while smoking unattended. Women with epilepsy should not smoke during pregnancy, so as not to increase the risk (and already quite high) of malformations in the child.

Important! Treatment is carried out only under the supervision of a physician. Self-diagnosis and self-treatment are unacceptable!

“Then suddenly, as it were, something opened up before him: an extraordinary inner light illumined his soul. This moment lasted maybe half a second; but he, however, clearly and consciously remembered the beginning, the very first sound of his terrible cry, which escaped from his chest by itself and which he could not stop by any force. Then his consciousness faded instantly, and complete darkness ensued.

This is a description of the state of Prince Myshkin, the protagonist of the novel by F.M. Dostoevsky "The Idiot" It is believed that this work is autobiographical, and in describing Myshkin's illness, Dostoevsky reflects own feelings. AT modern medicine there is even a term "Dostoevsky's epilepsy" - it describes seizures accompanied by pleasant sensations, euphoria. In one of his diaries, the writer says the following: “For a few minutes I experienced such happiness that it is impossible to feel in ordinary life, such delight that no one else understands. I felt in complete harmony with myself and with the whole world, and this feeling was so strong and sweet that for a couple of seconds of such bliss, I would have given ten or more years of my life, and maybe my whole life.

However, not everyone suffering from epilepsy is "lucky" like the famous writer. As a rule, an aura, i.e. the sensations that appear a few minutes before the convulsive seizure itself are of a different nature. There is photo- or phonophobia - fear of bright light and loud sounds, respectively; rejection of surrounding odors. There may also be a distortion of visual perception - this phenomenon is called "Alice in Wonderland syndrome": a person sees objects smaller than they really are (in medicine this is called micropsia). “Flies” or color spots appear before the eyes, and sometimes some field of vision “falls out” altogether.

The prevalence of epilepsy is very high. According to the World Health Organization, about 50 million people in the world suffer from epilepsy; in developed countries, there are 40 to 70 new cases per 100,000 people each year. This widespread pathology led to the creation of the Global Campaign against Epilepsy: Out of the Shadows by WHO and the International League Against Epilepsy (ILAE).

ancient disease

One of the first mentions of epilepsy refers to the times Ancient Greece and belongs to the pen of Hippocrates. He dedicated a whole treatise to this pathology, "On the Sacred Disease", in which he wrote the following: "The cause of this disease, like other great diseases, is the brain." And he was right. Modern scientists have come closer to finding out the cause of epilepsy, although much remains unclear so far. For some time, it was even believed that this was a disease of people with high intelligence, since, according to historical sources, Julius Caesar, Napoleon Bonaparte, Byron and others suffered from it. However, this assumption about the relationship between epilepsy and intelligence is unfounded.

In 1873, John Hughlings Jackson, an English neurologist, suggested that seizures were the result of spontaneous short electrochemical discharges in the brain. He also suggested that the nature of seizures is directly related to the location and function of the source of such activity in the brain. The twentieth century confirmed the scientist's thoughts. To date, it is known that different brain structures have different thresholds for convulsive readiness, i.e. in order for convulsions to occur, one structure requires less irritation. The hippocampus, a small paired structure responsible for memory and learning, has the lowest threshold for convulsive readiness. The most "stable" structures are the cerebellum, the striatal complex, and the sensorimotor cortex. If the focus of epileptic activity is in the hippocampus, then the seizure will be manifested by short-term amnesia, i.e. loss of memory, if in the sensorimotor cortex - an attack of twitching of the limbs or unpleasant sensations"Crawling ants."

What happens at the cellular level?

The brain has an inhibitory and an activating system. In a person suffering from epilepsy, the balance between these two systems is disturbed. If the excitatory nerve cells function normally, but the inhibitory ones do not function, an attack occurs. If we consider the pathology at the molecular level, it turns out that the work of the inhibitory and activating systems depends on the functioning potassium channels in the membranes of nerve cells. In 1997, a group of German scientists found an exact correspondence between the number of voltage-gated potassium channels in the cells of different brain structures. . Most of them were found in the hippocampus. Thus, the ideas put forward by Jackson in the 19th century turned out to be correct.

British-born American neurologist and neuropsychologist Oliver Sacks (1933-2015)

In addition to a seizure in its classical sense, i.e. convulsive attack with loss of consciousness, the so-called "grand mal", there are a huge number of manifestations of epilepsy. It can be bouts of unpleasant sensory sensations, visual impairment, taste, smell. The manifestation depends on in which part of the brain the epileptic focus is located - a group of neurons in which the activity-inhibition balance is disturbed. If it is localized in the temporal lobe, an attack of sudden amnesia may occur. Sometimes, with the same location of the focus, the seizure is manifested by a sensation of an unpleasant smell - this may be the smell of burnt hair, rotten fish, etc. When the focus is localized in the occipital lobes of the brain, deja vu arises - deja vu, - or, on the contrary, the feeling of the never seen - jamais vu. One of the unusual manifestations may be auditory or visual hallucinations, dreamy (oneiric) states. Here is how a patient of Oliver Sachs, a famous American neurologist and popularizer of medicine, described them: “I saw India - landscapes, villages, houses, gardens - and instantly recognized my favorite places of my childhood.”

Electroencephalogram of a patient with epilepsy.

There are many causes of epilepsy, and idiopathic epilepsy (i.e. without a clear cause) is just one of them. Epileptic seizures can be caused by head trauma, the development of a stroke or cerebral hemorrhage, and even a tumor. Therefore, for the diagnosis of epilepsy, the method of magnetic resonance imaging, MRI, is used, which allows, like an x-ray, to look at the state of the brain and exclude the above causes. Another way to confirm the presence of the disease is to conduct electroencephalography, EEG. This method is absolutely harmless to the body, however, it allows you to fairly accurately judge the localization of the pathological focus, as well as monitor the effectiveness of therapy.

Cure for no reason

Methods for the treatment of epilepsy can be divided into two classes - conservative and surgical. Today, there are a huge number of drugs that suppress pathological activity in the brain and prevent the development of seizures. One of them - barbituric acid - has been used since 1864, when this substance was discovered by Adolf von Bayer, a German chemist, laureate Nobel Prize in chemistry and founder of the pharmaceutical company Bayer, now one of the largest companies in the world with a turnover of billions of dollars.

In addition to medications, patients in a number of countries are put on a special ketogenic diet before radical treatments are considered. Its essence lies in the maximum exclusion from the diet of proteins and carbohydrates. At the same time, β-hydroxybutyrate is actively synthesized in the liver, which has an anticonvulsant effect.

DBS method. The electrode is installed in the area of ​​the brain determined by the neurosurgeon, the wire from the electrode is connected to a generator implanted in the region of the pectoralis major muscle.

However, in about 30% of patients, seizures do not respond to either drug therapy or the ketogenic diet. In March 2010, the journal Epilepsia published the results of a study on stimulation of the anterior thalamic nucleus in epilepsy, which concluded that deep brain stimulation (DBS - deep brain stimulation) is a new treatment option for patients whose seizures not docked conservative methods. The technique, first applied in the United States in 1997, is becoming a replacement for the neurosurgical treatment that preceded it, the essence of which was to physical removal focus of epilepsy from the brain. Deep stimulation looks like this: an electrode is inserted into a certain area of ​​\u200b\u200bthe brain, selected by a neurosurgeon, a wire from which is connected to a matchbox-sized generator placed between the pectoral muscles.The pulses generated by the electrode suppress the pathological activity and, as a result, prevent the development of an attack.In addition to epilepsy, DBS is used in the treatment of Parkinson's disease, chronic pain syndrome, dystonia, Tourette's syndrome and many other pathologies.

The technique of transcranial magnetic stimulation - TMS.

One of the newest (and so far experimental) techniques is transcranial magnetic stimulation of the brain. In 1985, a team of scientists at the University of Sheffield created the first magnetic stimulator capable of exciting the human motor cortex. The principle of its work was formulated in 1831 by Michael Faraday. The TMS apparatus is a coil. Electric current flowing through the coil produces a magnetic field perpendicular to the direction of the current in the coil. If a conducting medium, such as the brain, enters a magnetic field, then an electric current is induced in this medium. Depolarization of the membrane of nerve cells leads to the appearance of an action potential in them and its further distribution, which leads to the activation or suppression of neurons in various parts of the brain.

Treatment methods varying degrees a lot of efficiency has been invented. However, they are all symptomatic, they remove only the manifestation of the disease, and not its cause, which still remains unknown even thousands of years after the first description of the disease. The task of the future is to understand what leads to pathology in the brain. Then, perhaps, we can forget about this disease forever.

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