Cryptogenic epilepsy is the most common form of the disease, affecting approximately one in two patients.. A characteristic feature of the cryptogenic form is that it is impossible to establish the cause of the development of the disease.. Unidentified etiology creates certain difficulties in the selection of treatment, the basis of therapy for such patients is anticonvulsants.
When the cause of the occurrence of epileptic seizures cannot be identified, they speak of cryptogenic epilepsy. Epilepsy is one of the most common pathologies of the central nervous system; among adults and children, the prevalence of the disease is approximately 50-100 cases per 100 thousand. population.
Depending on the etiology, 3 forms of pathology are distinguished:.
symptomatic;
idiopathic;
cryptogenic.
Cryptogenic epilepsy is a disease with an unknown etiology, that is, the cause of the development of the disease is not clear, not identified. The diagnosis is established only after the exclusion of other forms.
For some reason, there is a predisposition of brain cells to the formation of excessive paroxysmal discharge. Such a discharge disrupts the normal functioning of neurons, which leads to clinical manifestations of epilepsy - loss of consciousness, convulsions, sensory and autonomic disorders..
In the cryptogenic form of the disease, focal changes are more often detected.. The focus of excessive activity may be localized in the frontal, temporal, parietal or occipital lobe. Less commonly, the discharge extends to both hemispheres of the brain.
How the disease manifests itself The main symptom of the disease is recurrent epileptic seizures.. They are of 2 types - partial (focal) and generalized. Frequent attacks can provoke irreversible changes in the brain, in which case some symptoms of the disease will persist even outside the attacks..
Cryptogenic focal epilepsy In the cryptogenic form of the disease, partial seizures are more common.. They are characterized by the appearance of a focus of excitation in a small area of \u200b\u200b\\u200b\\u200bthe brain. The symptomatology that occurs in this case directly depends on the localization of the focus of excitation (temporal, frontal, parietal, occipital lobe).
The patient usually anticipates an exacerbation due to the characteristic aura - mild symptoms that appear before the onset of an attack..
There are three types of partial seizures:.
simple - without loss of consciousness;
complex - with loss of consciousness;
with secondary generalization - a partial seizure turns into a generalized one.
The clinic of partial seizures is diverse and may include motor, sensory, autonomic and mental components.. All variants of partial seizures are united by one common property - paroxysmal character..
Type of partial seizure.
How does it manifest.
Motor (motor).
Motor partial seizure manifests itself in the form of rapid and rhythmic contractions of individual muscle groups.. Most often, convulsions are localized in the muscles of the face, left or right arm, leg.
Sensitive.
A partial seizure with sensory disturbances most often manifests itself in the form of unusual sensations in the body (burning, numbness, crawling). Olfactory, visual, auditory illusions and hallucinations occur less frequently.
Vegetative.
Attacks with a vegetative component are manifested by the following symptoms:.
sudden blanching or redness of the skin;
excessive sweating;
Feeling of a lump in the throat;
dizziness, ringing in the ears.
Mental.
The mental component manifests itself in the form of unusual thoughts, derealization, depersonalization, aggressive or strange behavior, fears..
Cryptogenic generalized epilepsy Generalized seizures in the cryptogenic form of the disease are much less common.. They are characterized by bilateral involvement of the brain, no focal symptoms. In most cases, generalized seizures manifest as a convulsive syndrome and are accompanied by loss of consciousness.. Allocate tonic-clonic, myoclonic seizures and absences.
Presence of seizures.
Type of generalized seizures.
Characteristic.
Convulsive.
Tonic-clonic.
The most common form of seizure. The patient does not anticipate his appearance, but suddenly loses consciousness. A tonic-clonic seizure consists of two phases - tonic and clonic.. In the first phase, strong muscle tension occurs, the body arches, the muscles become as if made of stone.. The patient falls, may bite his tongue, his breathing stops. Then comes the second phase - fast and rhythmic twitches of all muscle groups. Gradually, twitching stops, at the end of the second phase, involuntary urination may occur. On average, an attack lasts from 30 seconds to 3 minutes..
Myoclonic.
Occurs rarely, characterized by short-term non-rhythmic twitching of muscle groups.
non-convulsive.
Absence.
Absence occurs more often in childhood and is a non-convulsive form of a generalized seizure.. With the development of a typical absence, a person seems to freeze, but at the same time he can make automatic movements. Consciousness during absence is not turned off, but is disturbed. Seizures last a few seconds.
Symptoms in the interictal period Outside the attacks, non-specific symptoms may persist that are not directly related to the convulsive activity of the brain:.
depressed mood;
anger, resentment;
impaired memory and other cognitive functions.
Such symptoms usually appear with prolonged and frequent generalized seizures, which lead to temporary cerebral hypoxia..
Diagnostic methods Epilepsy is indicated by the appearance of two or more epileptic seizures, but only the clinical picture is not enough to make a final diagnosis.
Epilepsy of unknown origin is an exclusion diagnosis, i.e. other forms of the disease must be excluded to make a diagnosis.. There should be no history of traumatic brain injury, neuroinfections, strokes, brain tumors.
Additional studies are needed for a definitive diagnosis.. The main method for diagnosing the disease is electroencephalography (EEG), to exclude the symptomatic form of the disease, neuroimaging methods (MRI or CT of the brain) are prescribed..
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