What causes epilepsy relapses?

Written by Tang Bo
Neurology
Updated on September 02, 2024
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Epilepsy is a clinical syndrome caused by highly synchronized abnormal discharges of brain neurons due to various reasons. Clinically, it is characterized by episodic, transient, repetitive, and stereotyped manifestations, making recurrence a characteristic of the disease itself. The location of the neurons with abnormal discharges and the range of the abnormal discharge waves vary, leading to different forms of seizure symptoms in patients. These can manifest in various ways, including sensory, motor, consciousness, psychiatric, behavioral, and autonomic nervous system dysfunctions, and may occur simultaneously. Each seizure and each type of seizure process is referred to as an epileptic seizure. Of course, a patient can experience one or several types of epileptic seizures, thus, recurrence is a characteristic of epilepsy itself.

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Written by Liu Shi Xiang
Neurology
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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.

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Written by Li Jiao Yan
Neonatology
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What are the early symptoms of epilepsy in children?

Epilepsy is a particularly common chronic disease in life. If the brain is underdeveloped and there are neurological disorders, it can cause epilepsy. What are the early symptoms of childhood epilepsy? The manifestations of a child's epileptic seizure are diverse, but all have the characteristics of sudden onset, sudden cessation, and periodic attacks. Common types in children include major seizures, absence minor seizures, and benign childhood epilepsy. During a major seizure, the child suddenly loses consciousness, breathing stops, the complexion turns cyanotic, the pupils dilate, the limbs stiffen, and the hands clench into fists, then switching to paroxysmal convulsions, foaming at the mouth, with the attack generally lasting 1-5 minutes. Children with absence seizures appear to suddenly lose consciousness, stop their activities, and stare upward or roll their eyes, but they do not fall down or convulse, lasting 1-10 seconds, with consciousness quickly recovering after the attack. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, and tongue, possibly accompanied by abnormal sensations in those areas, inability to speak, and drooling, typically with clear consciousness, and more frequently occurring at night.

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Written by Li Jiao Yan
Neonatology
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What are the symptoms of epilepsy in children?

Epilepsy is a chronic brain disorder caused by various etiologies, characterized by repetitive, episodic, and transient central nervous system dysfunction due to abnormal and excessively synchronized discharges of brain neurons. The clinical manifestations of childhood epilepsy are complex and varied, commonly including loss of consciousness, localized or generalized muscular rigidity or clonic convulsions, and sensory abnormalities; there may also be abnormal behaviors, emotional and perceptual disturbances, memory changes, and autonomic nervous system dysfunction.

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Written by Tang Li Li
Neurology
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What causes epilepsy in the elderly?

If a patient has no history of epilepsy but begins to experience epileptic seizures in old age, it is generally secondary epilepsy, also known as symptomatic epilepsy. All patients should have a clear cause, but with current diagnostic techniques, it is not always possible to find the cause. If the cause cannot be identified, it is called cryptogenic epilepsy. In such cases, it is generally necessary to improve diagnostic methods, such as cranial magnetic resonance imaging (MRI) and cranial magnetic resonance angiography. The most common causes of epilepsy in the elderly are generally cerebrovascular disease, brain trauma, or encephalitis, and in some cases, brain tumors. Any disease that causes brain cell damage can potentially cause symptomatic epileptic seizures. If all imaging examinations fail to reveal any abnormalities, regular follow-ups are necessary to monitor for early-stage tumors that may not be detectable on imaging tests. Meanwhile, antiepileptic treatment should be administered, and routine blood tests, liver, and kidney functions should be regularly monitored.

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Written by Yan Xin Liang
Pediatrics
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Precursors to epileptic seizures in children

The majority of childhood epilepsy seizures occur without any precursors, as they arise and cease suddenly with stereotyped movements. However, some seizures are preceded by prodromes, such as sudden onset of consciousness disturbances, or fainting symptoms. Other seizures can present with motor dysfunctions, displaying sudden weakness or fatigue in certain limbs, followed by an epileptic attack. Additionally, some may experience abnormal sensations, such as numbness in a specific area or visual disturbances, including sudden flashes or even visual distortions, leading to convulsive seizures.