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17
Liu Shi Xiang
Neurology
About me
Associate Chief Physician, undergraduate education, has studied Neurology at West China Hospital of Sichuan University, member of the 8th Committee on Dementia and Cognitive Impairment of the Neurology Branch of Jiangxi Medical Association
Proficient in diseases
The diagnosis and treatment of neurological and geriatric diseases, especially in the field of cognitive dysfunction in the nervous system, have accumulated rich clinical experience.
Voices
How is epilepsy caused?
Epilepsy is generally caused by cerebrovascular diseases, brain trauma, intracranial tumors, and central nervous system infections, and some cases of epilepsy are due to congenital genetic factors. Patients with epilepsy need to undergo timely examinations and treatments in the department of neurology. Examination methods mainly include CT, MRI, EEG, transcranial Doppler ultrasonography, cerebral angiography, etc., among which video EEG or ambulatory EEG is the most important basis for diagnosing epilepsy. Once epilepsy is diagnosed, the treatment plan needs to be decided based on the individual condition of the patient. If it is the patient's first episode, medication may not be necessary initially, and regular follow-ups are sufficient. However, if the patient frequently experiences episodes, it is necessary to promptly administer antiepileptic drugs, commonly used drugs include carbamazepine, oxcarbazepine, gabapentin, levetiracetam, etc.
Can epilepsy patients drink water frequently in their daily life?
Patients with epilepsy can often drink water in their daily lives, but they should pay attention to the amount of water they drink and not consume too much at once. Drinking too much water in a short period can lead to increased urination, and an increase in the frequency of urination could potentially trigger a seizure. Additionally, patients should try to reduce their water intake during a seizure episode. Drinking water during a seizure can easily cause choking or even suffocation. Therefore, patients with epilepsy need to pay attention to adjusting their diet and lifestyle. Moreover, patients need to take long-term medication to prevent seizures, including commonly used drugs such as carbamazepine and sodium valproate. In hot weather, patients with epilepsy still need to hydrate appropriately; otherwise, dehydration and low blood pressure can occur, which can also easily trigger a seizure.
What are the initial symptoms of sleep-related epilepsy?
The initial symptoms of sleep-related epilepsy mainly include sudden opening of the eyes and panic symptoms at the onset of sleep. A few patients may exhibit aggressive behavior towards others, and some may experience movement disorders and abnormal muscle tone. For these patients, it is necessary to promptly receive examinations and treatment in neurology. Diagnostic methods mainly include video EEG, ambulatory EEG, cranial CT, and MRI, among others. Once diagnosed, timely intervention should be provided. For some patients, if it is the first seizure and not frequent, interventions through lifestyle and sleep adjustments can be implemented without immediately resorting to medication. If these adjustments are ineffective or if the patient frequently experiences seizures, appropriate medications should be administered in a timely manner, including drugs such as sodium valproate, carbamazepine, oxcarbazepine, and levetiracetam, among others. (Medication should be taken under the guidance of a doctor)
What causes epilepsy?
The causes of epilepsy mainly include some congenital factors, such as pathological changes during pregnancy or childbirth, which can lead to the occurrence of epilepsy in children. In adults, epilepsy is generally secondary to severe head trauma, cerebrovascular disease, intracranial tumors, encephalitis, etc. Therefore, for patients with epilepsy, it is first necessary to actively remove various inducements and then to treat according to the type of epileptic seizures. Epilepsy mainly includes generalized seizures and partial seizures. Patients with generalized epileptic seizures can take medications such as sodium valproate and diazepam for treatment. Patients with partial epileptic seizures can take medications such as carbamazepine, oxcarbazepine, gabapentin, and levetiracetam for treatment. Generally, the symptoms of epilepsy can be effectively controlled after patients follow a standardized medication treatment regimen.
The difference between facial neuritis and facial nerve paralysis
The difference between facial neuritis and facial nerve paralysis is that facial neuritis refers specifically to peripheral facial paralysis, while facial nerve paralysis is a broader concept. It includes peripheral facial palsy caused by facial neuritis, as well as central facial palsy caused by cerebrovascular diseases. Therefore, the two have different clinical concepts and symptoms. Facial neuritis can involve paralysis of the entire facial muscles, including the disappearance of forehead lines and the shallowing of the nasolabial fold below the eye slit, as well as deviation of the mouth corner. Facial nerve paralysis, in addition to the symptoms caused by facial neuritis, may also include central facial palsy caused by cerebrovascular diseases. Central facial palsy does not affect the facial muscles above the eye slit, but only causes paralysis of the facial muscles below the eye slit, including shallowing of the nasolabial fold and deviation of the mouth corner. Therefore, facial nerve paralysis is a more extensive concept.
Why does epilepsy occur at night?
Epilepsy that occurs at night is called sleep-related epilepsy. There are many reasons for this phenomenon, such as excessive fatigue, irregular sleep, menstrual onset, anxiety, depression, and more. Additionally, some patients exhale more carbon dioxide during sleep, causing hyperventilation and internal environmental imbalances, which can easily lead to abnormal discharges of brain neurons. When some patients experience symptoms of epilepsy at night, timely intervention and treatment are needed. First, patients should develop a good lifestyle, go to bed on time, get up on time, avoid staying up late, and avoid excessive fatigue. Furthermore, targeted medication should be given to prevent the onset of the condition. Common medications include lamotrigine, levetiracetam, carbamazepine, and sodium valproate. Besides, patients also need to maintain a good mindset and avoid tense and anxious emotions that could exacerbate symptoms.
What causes epilepsy in children?
The causes of epilepsy in children primarily include congenital factors and acquired factors. Congenital factors are mainly due to premature birth, difficult labor, umbilical cord around the neck, neonatal intracranial hemorrhage, drug factors, etc. Acquired factors mainly include brain trauma, central nervous system infections, cerebrovascular disease, intracranial tumors, and other causes. Therefore, when a child exhibits symptoms of epilepsy, it is necessary to promptly visit the department of neurology to conduct relevant examinations to determine the cause. The examination methods mainly include CT, MRI, EEG, cerebrospinal fluid analysis, etc. After identifying the cause, symptomatic treatment methods should be adopted to control the symptoms of epilepsy episodes. In clinical practice, controlling epilepsy is mainly achieved through drug treatment, with commonly used medications including carbamazepine, sodium valproate, gabapentin, etc. For some patients with refractory epilepsy, surgical treatments may also be used to control symptoms.
What are the prodromal symptoms of epilepsy?
The prodromal symptoms of epilepsy are diverse, generally involving movement, sensation, and mood. Some patients may experience transient numbness or weakness on one side of their body prior to a seizure, while others may have hallucinations and atypical mental or behavioral changes. However, these symptoms are not necessarily indicative of an impending seizure. When such symptoms occur, it is crucial to consider the possibility of an epilepsy attack, and patients should promptly visit the neurology department of a hospital for a thorough examination, including an electroencephalogram (EEG). If the EEG shows significant abnormalities such as spikes, sharp waves, slow waves, spike-and-wave complexes, or sharp-and-slow wave complexes, it suggests the potential for an epileptic seizure. In such cases, preventive medication should be administered promptly, such as carbamazepine or sodium valproate.
Early symptoms of Parkinson's disease
The early symptoms of Parkinson's disease primarily include weakness of limbs on one side, resting tremors, and bradykinesia, among others. As the disease progresses, patients will display typical Parkinson's symptoms, including a shuffling gait, reduced facial expressions, decreased sense of smell, orthostatic hypotension, anxiety and depression, cognitive decline, constipation, frequent urination, etc. Therefore, when these symptoms appear, the possibility of Parkinson's disease should be considered. Patients need to promptly visit the neurology department of a hospital for complete testing such as routine blood tests, urinalysis, MRI of the skull, and if necessary, cerebrospinal fluid analysis through lumbar puncture to confirm the diagnosis. Once diagnosed, treatment with anti-Parkinson's medication should be started as soon as possible. Commonly used medications include Levodopa, dopamine receptor agonists, monoamine oxidase inhibitors, Vitamin B6, and more.
What can severe epilepsy lead to?
Severe epilepsy can cause many complications, such as cerebral edema, brain herniation, upper gastrointestinal bleeding, etc. Therefore, severe epilepsy can seriously threaten the patient's life. If the patient's epilepsy is not controlled in time, it can easily lead to a state of status epilepticus. Status epilepticus is a very dangerous central nervous system disease. Patients may experience sudden respiratory and circulatory arrest and uncontrollable massive gastrointestinal bleeding. For severe epilepsy patients, it is necessary to promptly administer medications such as diazepam and sodium valproate to terminate the seizures. If status epilepticus occurs, the patient needs to be urgently sent to the ICU for observation and treatment, and effective interventions for various complications must be provided. For example, in the case of cerebral edema caused by epilepsy, medications such as mannitol and glycerol fructose are needed to dehydrate and reduce intracranial pressure. If epilepsy causes acute upper gastrointestinal bleeding, treatments to suppress acid, stop bleeding, and maintain blood pressure are required.