A. Understanding Epilepsy
Epilepsy is a disorder of the central nervous milk (CNS) characterized by the occurrence of the resurrection (seizure, fit, attact, spell) which is spontaneous (Unprovoked) and periodic. Arousal can be interpreted as a modification of brain function that is sudden and passing, which came from a large group of brain cells, the dominant of the inhibition process. Changes in afferent excitation, disinhibition, a shift of extracellular ion concentrations, voltage-gated ion-channel opening and
strengthening the synchrony of neurons are very important in terms of initiation and propagation of epileptic activity generation. Neuronal activity regulated by the concentration of ions in the extracellular and intracellular space, and by the movement of ions in and out through the membrane of neurons.Epilepsy is difficult to control medically or pharmacoresistant, because the majority of patients with epilepsy are resistant, most often affected are the head first. Antiepileptic drugs that can calm the standard. Related to the complexity of biomolecular basis. Headache that is very difficult to attack the caravan to be treated as pharmacological, despite optimal antiepileptic drug was administered, approximately 30-40% of patients affected by epilepsy, patients usually perform surgery to relieve pain temporarily. However, symptoms of epilepsy will occur occasionally, because epilepsy is difficult to remove the head pain attack.
Every person has a risk of one in 50 to have epilepsy. The use of narcotics and alcohol drinkers have a higher risk. Drug users may get a first seizure due to use of narcotics, but then it will probably continue to have seizures despite being separated from the narcotic. In the UK, one person among the 131 people menyindap epilepsy. So at least 456 000 penyidap epilepsy in the UK.
Epilepsy can strike children, adults, parents and even newborns, the incidence of epilepsy is higher in men than in women, which is 1-3% of the population will suffer from epilepsy for life. In the United States, among the 100 population (1%) of the population affected epilepsy and uses of approximately 2.5 million had been undergoing treatment in the last five years. According to the World Health Organization (WHO approximately 50 million people worldwide have epilepsy (2004 Epilepsy, com).
B. Symptoms of Epilepsy
• Grand Mal Epilepsy
Grand mal epilepsy is characterized by the emergence of escape from the excessive electric charge around the area of the brain-neurons in the cortex, and even inside the cerebrum in the brain stem and thalamus, grand mal seizures last for 3 or 4 minutes.
• Epilepsy Peti mal
Epilepsy is usually marked the emergence of unconscious circuitry or impairment of consciousness for 3 to 30 seconds, during which time some of these attacks the patient felt like a jolt of muscle contraction (twitch-like), usually in the head area, particularly pengedipan eye.
• Focal Epilepsy
Focal epilepsy can involve almost any part of the brain, for local regoi in the cerebral cortex or more structures in the cerebrum and brain stem. Focal epilepsy caused by a local organic sage or functional abnormalities.
Nervous system is a communication network (communication network). The brain communicates with the organs of the body through the nerve cells (neurons). In normal conditions, nerve impulses from the brain electrically like going under the neurotransmitter GABA (gamma-aminobutiric acid) and glutamate through 9neuron nerve cells) to the organs of the body.
Trigger factor for epilepsy:
• Pressure
• Lack of sleep or break
• Sensitive to bright light (photo sensitive), and
• Drinking alcohol
• incidence of paroxysmal
Differential diagnosis for paroxysmal events are included sinkrop, migraine, TIA (Transentlschaemic Attack), periodic paralysis, gastrointestinal disorders, movement disorders and breath holding spesll. This diagnosis is fundamental
• Simple Partial Epilepsy
Diagnosis includes TIA, migraine, hyperventilation, tics, myoclonus and spasmus hemifasialis. TIA can occur with sensory symptoms are indistinguishable with partial epilepsy sederhan. Both paroksimal, generation may be lost sight of for a moment and experience of older people.
• Complex partial Epilepsy
Differential diagnosis is related to the rate of loss of consciousness, from the drop anttacks up with a complex pattern of behavior. In general, this diagnosis include sinkrop, migraines, sleep disorders, non-epileptic resurrection, narcolepsy, metabolic disorders and transient global amnesia.
C. Causes of Epilepsy
Once the diagnosis is established the therapeutic action was held. All people who suffer from epilepsy, both idiopathic and non idiopathic, but the underlying pathological process is not as active as the progression of cerebral tumor, should receive medicinal therapy. Drug of choice for the eradication of epileptic attacks of any kind, except petit mal, is luminal or phenytoim. To determine the luminal dose should diketahuiumur patient, type of epilepsy, frequency of attacks and when it is treated to another doctor. Dose of the drug being used. For children luminal dose is 35 mg / kg / bw / day, while adults do not need that many doses. Adults need 60 to 120 mg / day. Dose of phenytoin (Dilatin, Parke Davis) for children is 5 mg.kg / bw / day for adults and 5-15 mg / kg / bw / day. Effects of phenytoin 5 mg.kg / bw / day (approximately 300 mg daily) has seen in five days. Then the direct effect to be achieved when the dose of 15 mg / kg / bw / day (approximately 800 mg / day) should be used.
Effects of anticonvulsants can be judged from the "follow up". People with common assault frequency circuitry 3 times a week is much easier to treat than patients who had a frequency of 3 times a year. On the visit of "follow up" to reported results are good, bad, or that can not be judged good or bad because of the frequency of attacks before and during the new therapy is still about the same. When the frequency is reduced by appeal, the dose being used needs to be raised slightly. When the frequency is fixed, but the epileptic attack assessed by parents or people with epileptic patients Jakson motor / sensory / 'march' as' light 'atau'jauh lighter', then the dose used may be continued or increased slightly. If the result is bad, the dosage should be increased or added to other anticonvulsant circuitry.
• Examination of brain imaging
MRI aims to look at the structure of the brain and EEG melengkapid ata. Useful to compare the left and right hippocampus. Besides it can also identify abnormalities of brain growth, small-sized tumors, certain vascular malformations and diseases of demyelination.
D. Prevention of Epilepsy
Evaluation of patients who are symptomatic paroxysmal circuitry, particularly the factor of unknown cause, require specialized knowledge and skills to be able to dig and find the relevant data. Diagnosis of epilepsy was based on anamnesis and clinical examination combined with the results of EEG and radiological examination. Patients Aqtau parents need to be questioned about a history of epilepsy the family. Then proceed with some tests, among others:
• The physical examination
This examination of the causes of sifting generation circuitry using the age and history of the disease as a handle. In old age auscultation in the neck region is important to detect vascular disease. In the children's views of slow growth, sebaceous adenoma (tuberous sclerosis) and organomegaly (srorage disease).
• Electro-ensefalograf
EEG patterns in epilepsy may help to nenetukan type and location of generation. Epileptiform waves originating from paroxysmal spontaneous outburst, which comes on a group of neurons that have a synchronous depolarization. Picture of the recorded EEG epileptiform anatarcetusan appeared and stopped suddenly, often times the typical morphology.
• Examination of brain imaging
MREI untukmelihat aims to complete the data structure of the brain and EEG. Useful to compare the left and right hippocampus. Besides it can also identify abnormalities of brain growth, small-sized tumors, certain vascular malformations and diseases of demyelination.
E. Treatment of Epilepsy
The first drugs most commonly used
(Such as sodium valporat, Phenobarbital and phenytoin).
- It is recommended for people with epilepsy new
- These medications will give side effects such as swollen gums, headaches, acne and body feathers (Hirsutisma), swollen glands and osteomalakia seeds.
Both drugs are commonly used:
(Such as lamotrigine, tiagabin and gabapetin)
- If there is no change in the patient's head after the first use of the drug, the medicine will be added to both drugs
- Lamotrigine has be passed as the first drug in Malaysia
- New drugs are introduced do not have side effects, especially in terms of disability during birth.
Posted in: disease
Related Post:
Widget by [ Iptek-4u ]
