What are the signs before the onset of epilepsy?

Written by Yuan Jun Li
Neurology
Updated on November 16, 2024
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Before the onset of epilepsy, most patients do not exhibit any signs and can suddenly experience an epileptic seizure. Different types of epilepsy have different symptoms. For example, during a major seizure, symptoms can include limb twitching, eyes rolling upwards, frothing at the mouth, clenched teeth, loss of consciousness, and abnormal blood pressure, which can lead to severe falls and injuries. During a minor seizure, the patient mainly shows transient loss of consciousness, objects in hand may suddenly drop, unresponsiveness when called, and a vacant stare. Most patients do not fall, and the symptoms generally last for only a few seconds to tens of seconds. If autonomic epileptic seizures are considered, symptoms may include nausea and vomiting. Psychotic symptom seizures can present with hallucinations and delusions.

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What is an effective treatment for epilepsy?

To effectively treat epilepsy, it is crucial to adhere to the principles of medication use and cessation. First, epilepsy medication should generally be administered for one to two years without seizures before gradually reducing the dose. If seizures reoccur after dose reduction, or if there is significant worsening on electroencephalography (EEG), the dosage should be restored. If switching medications, take both medications concurrently for about a week, then gradually reduce the original medication to cessation while increasing the new medication to an effective dose. These are the principles of medication exchange and use. Then, consider the principles for attempting medication cessation. Generally, medication should not be ceased any earlier than one year and abrupt cessation should be avoided to prevent epilepticus status. If there is clear organic brain disease, persistent positive neurological signs, or continuous mental disorders with abnormal EEG readings, lifelong medication may be necessary. Some suggest that individuals older than 30 should be cautious about stopping medication. Since the recurrence rate upon cessation can exceed 50%, lifelong medication may be necessary.

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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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Neurology
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Can patients with epilepsy eat mangoes?

Epilepsy patients can eat mangoes. Mangoes are rich in vitamins and can supplement the essential nutrients needed by the human body. However, some people may be allergic to mangoes, and generally should not consume them. There are no specific dietary restrictions for epilepsy patients, but they should try to eat less spicy and greasy food, avoid mental stimulation, which can provoke seizures. Additionally, patients should eat more fresh vegetables and fruits to supplement the necessary vitamins and nutrients. They should also have a balanced diet, including lean meat, fish, poultry eggs, soy products, and some milk. It is important to have a regular lifestyle, sleep and wake up on time, and ensure sufficient sleep duration and quality.

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Neurology
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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.

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What are the symptoms of epilepsy in children?

Seizures in children manifest in various forms, but they all share characteristics of sudden onset, sudden cessation, and periodic occurrence. Common types include grand mal seizures, absence seizures, and benign childhood epilepsy. During a grand mal seizure, the child suddenly loses consciousness, stops breathing, turns blue-purple, pupils dilate, limbs stiffen, hands clench into fists, followed by spasmodic convulsions, foaming at the mouth, with the episode generally lasting 1-5 minutes. Absence seizures in children present as sudden loss of consciousness, interruption of activity, staring or rolling of the eyes, but without falling down or convulsing, lasting 1-10 seconds, with consciousness quickly returning after the episode. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, or tongue, possibly accompanied by abnormal sensations in the area, inability to speak, drooling, generally with clear consciousness, with episodes occurring more frequently at night.