The causes of epilepsy are a combination of factors that either served or could have caused the development of the first epileptic seizures and the subsequent development of the symptoms of the disease. The disease itself is a chronic pathology arising from the pathological activity of the neurons of the human brain. Nerve cells must transmit signals between themselves in the brain using electrical impulses, but in the case of epilepsy, the strength of such impulses is exceeded and the processes of their normal transmission are disrupted. This leads to the emergence in the human cerebral cortex of the strongest electrical discharge, similar in principle to the action of a short circuit in electrical wires. Sometimes such a discharge concerns only the chosen part of the brain, then the epileptic seizure on the whole body will not spread. With the spread of impulses throughout the cerebral cortex, a generalized attack occurs with a widespread prevalence in the body.
Etiology of the disease
Finding out the specific cause of epilepsy is very difficult in each individual case of the disease. In 60% of cases, there are simply no such reasons, and this gives rise to idiopathic epilepsy with an unknown origin. Most often, experts suggest that idiopathic epilepsy occurs due to genetic predisposition.
When establishing the causes that cause epileptic seizures, the disease is called symptomatic. However, almost any influence on the human brain can be considered the cause of epilepsy, if this causes the destruction of nerve cells. Sometimes intrauterine brain injury can cause this pathology. Also, birth injuries (lack of oxygen during the passage of the birth canal, for example) can trigger seizures in the future.
The most common known causes of epilepsy are head injuries of absolutely any origin, at any age. Also, quite often, brain tumors and strokes can trigger the disease. In elderly people, epileptic seizures may occur against the background of Alzheimer's disease or other pathologies in which there is a progression in the damage of brain activity.
Also, various infectious processes in the human body can cause epilepsy. The most common diseases that cause epilepsy include encephalitis, meningitis, or viral infections. With the development of such diseases it is necessary to take timely measures to treat them in the early stages. If you do not allow severe forms of infections and their complications, epilepsy after the infection process will not occur. Also a very frequent and obvious cause of epilepsy is a long and incurable alcoholism.
Why do children suffer from epilepsy
The main cause of epileptic seizures in children are perinatal complications. Birth and prenatal injuries associated with the occurrence of hypoxia in the human brain (oxygen starvation), lead to the development of seizures. I am glad that modern obstetric practice allows minimizing the possibility of such injuries, which reduces the number of cases of perinatal epilepsy. However, statistics show that up to 20% of all detected cases of the disease can be attributed specifically to this category of causes.
In 5-10% of cases of epilepsy in children, all kinds of head injuries are to blame. Sometimes post-traumatic convulsions begin to manifest immediately after an injury, sometimes they may develop some time after that. Head injuries can be caused to children by negligence, cruel treatment, through the fault of a firearm, as a result of an accident. Doctors believe that if the child received a brain injury that led him to a prolonged unconscious state, the risk of epilepsy will increase sharply.
After minor injuries, epilepsy rarely occurs, so standard children's falls and bruises are not a reason to worry too much and constantly protect the child from normal activity and development. However, sometimes even very active motion sickness of a baby can harm its physical and mental development, cause the development of epilepsy in the future.
If you experience cramps in a child immediately after a head injury, you shouldn’t worry much - these conditions rarely have a recurrence.
But if the convulsions began after months after the injury - this is a reason to go to the doctor and examine the baby, because post-traumatic convulsions may occur for the first time even 25 years after the accident occurred. This will be evidence of epilepsy.
Repeated epileptic seizures can occur in various infectious pathologies, cerebral palsy, and brain cancer. Also a common cause of childhood epilepsy is vascular disease. And in 15% of patients, epileptic convulsions occur as a sign of the development of systemic lupus erythematosus.
It is customary to talk about idiopathic epilepsy if no one can assume the primary pathology that provoked the attack. This group includes generalized seizures, myoclonic seizures of the juvenile period, generalized nocturnal seizures, some forms of myoclonic-astatic focal epileptic seizures. Cases of the disease, which could not be detected with the help of modern diagnostic procedures - electroencephalography, computed tomography, indicate this phenomenon. Scientists suggest that in this case it is a question of chemical changes in the human brain that have not yet been studied.
When diagnosing epilepsy in one of the parents, the probability of the child becoming ill is 6%. If both parents have epilepsy, then the risk of incidence of a baby is already from 10 to 12%.
Most often, epilepsy is transmitted through inheritance, with the generalized nature of the pathology of the parents. It is important to understand that it is not epilepsy that is inherited as a disease, but the propensity of the brain to stimulate, inhibit, paroxysmal reactions to external and internal factors.
Most often, with a hereditary type of transmission of pathology, epilepsy in a child will manifest itself before it has developed in his parents. In identifying seizures in the mother at the age of fifteen, it is worth waiting for the occurrence of seizures in her child at the age of 5 years. However, you should not treat this problem as a sentence, because with the right therapy, you can stop the development of seizures and prevent their further occurrence.
The mechanism of occurrence of epilepsy
Some forms of epilepsy are more likely to occur at night during sleep. Although at night, all varieties of this pathology can theoretically arise. Some patients suffer from a series of nocturnal epileptic seizures, and some may have seizures at any time of the day.
Epileptic seizures behave differently at different stages of sleep. Most convulsive seizures occur during shallow sleep immediately after falling asleep, either on the eve of waking up in the morning or at night. Night attacks most often occur when the epileptic focus is located in the temporal part of the human brain.
Until the end of the night cases of seizures have not yet been studied, but it has already been proven that brain activity at night provokes the activation of epileptic seizures. Certain nocturnal seizures will always occur during identical periods of the carotid phase.
In the process of wakefulness, brain wave activity is usually constant, but it can change when it falls asleep. If you wish to fall asleep, the brain activity migrates from the waking state to a sleepy state, first to a stage of shallow sleep, and then to a deep dream in which the motor activity of the eyeball occurs. Such a cycle at night is usually repeated up to 4 times.
Convulsions can occur during any phases of sleep, but, as a rule, they tend to occur more often during the first two shallow stages.
This means that there are periods with more frequent paroxysmal nocturnal conditions:
- first hour or two after falling asleep;
- on waking up one or two hours earlier than usual;
- an hour after waking up;
- the whole period of night and day sleep after eating.
Night seizure begins with the awakening of the patient from the sensation of discomfort. This can manifest as chills, tremors, nausea, headache. Sometimes there is spasm of the laryngeal, facial muscles, which will lead to impaired speech function. Some patients will become in a certain position at the same time (for example, knee-elbow). Such paroxysmal phenomena usually last from 10 seconds to 7 minutes. The long hypertonus of muscles can be replaced by short spasms. After experiencing nighttime paroxysms, many patients do not remember them. Evidence of a night attack can be traces of dried saliva in the mouth, the smell of urine from the bed.
Sometimes nightly paroxysms occur without convulsions. The patient awakens excitedly, is tormented by fear, the pupils dilate, the person begins to look at one point. In addition to convulsions in a patient with nocturnal epilepsy, manifestations of sleepwalking are possible, which he will not recall in the morning. In childhood, such sleepwalking is often accompanied by nightmares and enuresis.
The causes of epileptoid nocturnal paroxysms can not be called science. As a rule, they are not observed during the daytime. Sometimes experts suggest that this phenomenon is caused by a patient’s incomplete sleep, abrupt awakenings from loud noise, frequent sleep deprivation, and intermittent sleep at night. All this can provoke an increase in the frequency of attacks.
The second reason for night epilepsy, experts believe alcoholism, drug addiction, mental and physical overload of the body.
Bouts after alcohol
Alcoholic epilepsy is a symptomatic type of this disease, resulting from the frequent and excessive abuse of alcoholic beverages. Usually, this form of the disease is peculiar to 2-3 stages of alcoholism, but sometimes it can occur with the occasional use of large amounts of alcohol.
Attacks after alcohol may include several different pathological conditions, which are accompanied by a convulsive and non-convulsive course. Most often, this form of epilepsy occurs in men aged 30–40 years and is characterized by a direct relationship between drinking and convulsions with a high incidence of non-convulsive seizures and the absence of epileptic indicators during electroencephalography.
The main cause of alcoholic epilepsy is cellular damage to the human brain due to toxic alcohol effects. The likelihood of seizures increases with often recurring long periods of hard drinking and the use of low-quality liquor. In the modern international classifier of diseases (ICD) there is no concept of "alcoholic epilepsy", it more often refers to intoxication processes accompanied by convulsive seizures or withdrawal accompanied by seizures. However, in the medical literature, the concept of alcohol withdrawal can combine several pathological conditions at once - an epileptic reaction, an epileptic syndrome and directly alcoholic epilepsy.
An epileptic reaction is defined as the occurrence of one-time or recurrent seizures due to the occurrence of one-time alcohol abuse in people who, in principle, do not suffer from alcoholism. Such a reaction occurs, as a rule, the next day after taking large doses of alcohol and lasts exactly until the hangover.
Epileptic syndrome is affected much more often than directly alcoholic epilepsy. This is a specific condition in the case of chronic alcoholics of repeated nature, accompanied by somatic, mental disorders. Sometimes with such attacks there is an aura in the form of hallucinations or illusions. Alcoholic epilepsy itself is rare. Typically, this condition is provoked by a very long-term alcoholism (more than 10 years). It is diagnosed in 10% of all patients with epileptiform seizures during alcoholism. Attacks begin at the time of withdrawal and often end with alcoholic psychosis.
In true alcoholic epilepsy, the onset of illness and the ingestion of alcohol are very tightly interconnected and as natural as alcohol and subsequent hangover.
A seizure does not occur with active use, but shortly thereafter. Often convulsions occur within 2-4 days after the cessation of alcohol in the human body, which corresponds to the peak of abstinence.
Alcoholics have non-convulsive and convulsive seizures. The severity and nature of such attacks may vary and vary between short-term impairment of consciousness and serial tonic-clonic seizures or seizures resulting in an epileptic status. Non-convulsive seizures may occur more often, accompanied by disturbances in consciousness, motor automatisms, and episodes of severe dysphoria. In this case, polymorphism in this case will not be observed, the clinical picture with each new seizure will correspond to the one that arose once for the first time.
At the time of convulsions in a patient, the tonic phase lasts longer. Abscess, psychosensory and psychomotor attacks very rarely occur. Before a generalized convulsive seizure begins, the upper part of the body turns blue (pales) in a patient. When an attack develops, a person falls, throwing back his head, squeezing his jaws very strongly, may moan, bend his limbs. He may also have trouble breathing and involuntary urination.
Sometimes an epileptic seizure cannot be recognized by others, because its symptoms do not seem familiar to people in such a situation. For example, this often occurs when a sudden cessation of speech, pronouncing phrases off topic of the conversation, which the patient will not remember later. Sometimes attacks can form on the background of precursors (a sharp increase in anxiety, dysphoria, growing irritability), which many may take for the onset of alcohol withdrawal.
Very different and the behavior of patients in the period after a seizure. So, with the idiopathic form of epilepsy after an attack, the patient is sluggish, broken, tired. Less often, he experiences psychomotor agitation or his consciousness becomes gloomy.
When alcoholic epilepsy occurs in post-convulsive condition, insomnia occurs, emotional dreams occur. At the same time, half of the patients with insomnia develop delirium, which is accompanied by visual hallucinations with devils, aliens and other things. Over time, weighting of alcoholic seizures, unlike idiopathic, does not occur. At the same time, there are personal changes due to alcohol degradation, not associated with epilepsy.
From a medical point of view, during epileptic seizures, the nerve cells of individual brain areas are simultaneously over-excited. In this case, the body ceases to obey the person, his convulsions twist. From a psychosomatic point of view, all this testifies to a huge internal conflict that literally tears the patient apart.
Psychosomatics explains the onset of epilepsy by constant violence against one’s own self, a feeling of incessant struggle with the outside world, a sense of persecution, and a denial of one’s own right to live one's own way. The patient constantly confronts the world, and this is so strongly expressed in his subconscious that he begins to manifest himself also externally.
Such self-perceptions do not arise spontaneously, they take a very long time to form when a person crosses his own pride when communicating with others, which provokes discomfort, despair, anger in him.
It is also important to remember that the causes of many diseases can be identified in childhood. With epilepsy, it was possible that they wanted to break the child in the family, crush him as a person, constantly restrict him and prevent him from expressing his “I”.
To overcome the disease in question, it is necessary to carry out a huge amount of work on oneself, aimed at restructuring the world perception and cultivating a respectful attitude.
Spontaneous epilepsy can not be predicted. Their repetition and intensity is always impossible to explain. However, in medicine such a type of disease is known as reflex epilepsy, which can be triggered by certain specific stimuli, for example, a bright light, light music, a photo flash, the frequency of change of a picture in a video series, and so on.
Less likely to provoke a seizure, emotional overstrain, lack of sleep, poor nutrition, taking certain medications, alcohol, drugs or certain sounds can be a factor. Reflex epilepsy is always treated with the help of mandatory exclusion from the life of possible provoking factors.
Life with such a diagnosis requires self-discipline and control over yourself, primarily from the patient himself. Most external stimuli can be monitored, limited, and permanently eliminated so as not to provoke an exacerbation.
Specialty: pediatrician, infectious diseases specialist, allergist-immunologist.
Total experience: 7 years.
Education: 2010, SSMU, pediatric, pediatrics.
Experience infectious diseases more than 3 years.
He has a patent on the topic “A method for predicting a high risk of the formation of a chronic pathology of the adeno-tonsillar system in frequently ill children”. As well as the author of publications in the journals of the Higher Attestation Commission.