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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Written by Yan Xin Liang
Pediatrics
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What are the symptoms of epilepsy in children?

Common symptoms of epilepsy in children generally include sudden convulsions. During a convulsion, the typical manifestations are tightly closed or staring eyes, rolled-up eyeballs, clenched teeth, twitching at the corners of the mouth, frothing at the mouth, head and neck thrown back, and repetitive flexing or rigid shaking of the limbs. Generally, these can last for a few minutes, or vary from several seconds to ten minutes. Of course, there are also focal seizures, such as twitching of one side of the body, or absence seizures. Some infantile spasms are characterized by jackknife movements, occurring in clusters, with each display being different. The symptoms described earlier are typical of a generalized tonic-clonic seizure.

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Written by Liu Shi Xiang
Neurology
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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.

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Written by Tang Bo
Neurology
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What are the clinical manifestations of epilepsy?

Epilepsy is caused by abnormal discharges of brain cells, and the symptoms and clinical manifestations vary depending on the area of discharge. Main symptoms can include sudden loss of consciousness, rigidity followed by clonic convulsions, and may also involve cyanosis or purpling of the face, tongue biting, frothing at the mouth, urinary incontinence, dilated pupils, continuing for several seconds to minutes before stopping. This condition is called a generalized tonic-clonic seizure. Some patients may also experience sudden brief loss of consciousness and interruption of ongoing actions, with a blank stare and unresponsive to calls. They may perform simple automatic actions like swallowing or chewing. Generally, there is no falling, and the patient has no memory of the episode afterwards. This type of seizure is known as an absence seizure. Additionally, some may experience rigidity and clonic convulsions in one limb or a localized area, etc.

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Written by Tong Peng
Pediatrics
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What causes benign epilepsy in children?

There are multiple causes of benign epilepsy in children, with significant genetic factors often involved. It generally occurs during a specific developmental period in childhood due to localized diseases, and the prognosis is usually good. Such seizures in children may be caused by conditions like tuberous sclerosis, cerebral trigeminal angioma, and neurofibromatosis. Intracranial infections, such as viral encephalitis, bacterial meningitis, and tubercular meningitis, can also trigger benign epilepsy in children. Therefore, once diagnosed, early intervention treatments should be initiated to prevent the symptoms from worsening. Regular follow-ups with electroencephalograms are also necessary to understand the effects of epilepsy medications and treatments.

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Written by Liu Shi Xiang
Neurology
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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.