This year, June 28 is the 18th International Epilepsy Awareness Day, and the theme of this year's "Caring Day" is "Pay Attention To The Comorbidities of Epilespy".
Epilepsy, commonly known as "sheep epilepsy", is a chronic brain disease characterized by recurrent seizures, in which the balance between nerve cells in the brain is disrupted and neurons are suddenly discharged abnormally. Seizures occur when excessive synchronized discharges propagate through the brain.
1. What are the predisposing factors of epilepsy?
Lack of sleep, excessive physical exertion, excessive mental stress, strenuous physical activity, hunger, oversatiety, drinking a lot of water at one time, constipation, drinking alcohol, drinking strong tea, eating foods containing a lot of caffeine (such as chocolate, etc.), nervousness, sadness, sorrow, emotional impulses, colds, fever, menstrual periods in women, and various transient metabolic disorders and allergic reactions can trigger seizures in epilepsy patients. Transitional ventilation is effective in absences, in tonic-clonic seizures, and in myoclonus.
2. What are the clinical manifestations of seizures?
According to the 2017 classification criteria for seizures, seizure forms such as tonia, clonus, myoclonus, atonic force, epileptiform spasm, and tonic-clonic are seen regardless of focal or global origin.
3. How to deal with seizures?
1. The movements of grand mal seizures are generally more intense, and the first witness is generally nervous, but the seizures usually end on their own after a few minutes, so there is no need to panic too much. It is advisable to give the patient enough space to remove hard or sharp objects from the surrounding area.
When it is safe to do so, untie the patient's collar, do not lift the patient's limbs, do not try to press the patient or stop them from convulsing, and it is not recommended to stuff something into the patient's mouth, even if the tongue is bitten during the attack, it is generally relatively mild, and forcing something into the mouth may injure the patient's teeth or be bitten by the patient.
2. After the seizures stop, tilt the head to one side or let the patient lie on the side to avoid suffocation caused by aspiration, and closely observe the condition, epilepsy will have repeated seizures, do not take it lightly.
3. For petit mal seizures, because the patient's movements are not so intense, there may only be manifestations such as impaired consciousness or limb shaking. Steer the patient away from dangerous places, such as bathrooms, stairs, or water's edge, and do not leave the person who has a seizure until the person is fully awake (able to communicate normally). When the patient is awake, inform the patient of what has just happened and do not give the patient anything to eat or drink during the attack.
4. What should I do if I have a seizure in a public place or at home?
1. Stay calm and take it in stride. Leave the tics to time, and most of the seizures will stop naturally after 3-5 minutes.
2. Strengthen protection to avoid injury. Avoid falls, burns, and accidental injuries, and remove all hard or sharp objects that may injure the patient; Guide people with small seizures away from dangerous places such as roads, water, and fires.
3. Pay attention to your breathing to prevent aspiration. After the seizure is terminated, the patient's head is tilted to one side or lying on his side, the collar is unfastened, and the dentures are removed; Remove mouth and nasal secretions and keep the airway open; Do not feed water or medicine to avoid choking and aspiration.
4. Reduce irritation and avoid compression. reduce undesirable irritation to the patient; Do not forcibly place objects in your mouth, do not pinch people; Do not attempt to help the person stand, sit up, or compress the limbs to avoid fractures.
5. Protect the patient until he or she is awake. Don't be in a hurry to make a phone call, don't leave the patient, and don't leave until the patient is fully awake.
6. Refuse to be onlookers and respect patients. 2-3 people can help solve the problem, refuse to watch; Avoid causing unnecessary psychological burden to patients.
7. Record carefully and take pictures calmly. Carefully observe seizure manifestations to help doctors determine the diagnosis and type of seizure; Pay attention to the patient's state of consciousness, facial expressions, limb posture, eye squint direction, head deflection direction, pronunciation, speech, etc. Under the condition of ensuring the safety of the patient, calmly take out the mobile phone to shoot a video with the right angle and light, which is more important than pinching people!
8. Seek medical attention promptly if necessary. It is recommended to seek medical attention promptly if the first seizure, seizure duration exceeds 5 minutes, continuous seizure, failure to recover consciousness after the seizure is terminated, injury during the seizure, and other diseases such as heart disease or diabetes.
5. How to treat it correctly?
Rational use of antiepileptic drugs is by far the most effective method for treating seizures.
The choice of antiepileptic drugs should be based on the type of seizure (e.g., grand mal seizures, absence seizures, tonic spasms, etc.). Consultation with a medical professional is recommended.
Here are a few tips to take note of when taking your medication:
1. Start with a small dose and gradually increase to an effective dose;
2. Try to use drugs alone as much as possible to avoid interactions and adverse reactions caused by combination drugs;
3. When changing the drug, the original drug should be gradually reduced after taking the new drug for a period of time;
4. After stopping the seizure for 1~3 years, reduce the dose to stop using as appropriate;
5. Take it regularly to maintain a stable concentration of drugs in the body, and monitor blood concentrations if necessary;
6. Regularly check the blood and urine routine and liver and kidney function to prevent toxic and side effects of drugs.
Author: Yao Guangming
Source: Shenyang Red Cross Hospital
Editor: Huang Di
Proofreading: Huang Aili, Chen Zeming
Preliminary review: Xue Bing
Review: Xu Jiang