In most cases, the cause is unknown, although some people suffer from epilepsy as a result of brain injury, stroke, brain cancer, and drug and alcohol abuse, among others. Epileptic seizures are the result of the activity of cortical neurons excessive and abnormal in the brain. The diagnosis is usually included getting rid of other conditions that may cause similar symptoms (such as syncope) and find out if there are immediate causes. Epilepsy can often be confirmed by electroencephalography (EEG).
Epilepsy can not be cured, but attacks can be controlled with treatment in about 70% of cases. For those who attack do not respond to treatment, surgery, nerve stimulation or changes in food intake could be considered. Not all symptoms of epilepsy lasts a lifetime, and a large number of people have improved even until treatment is not needed anymore. Epilepsy as well as tuberculosis treatment should be completed, although it had healthy. In epilepsy treatment was stopped one year after the last attack.
Approximately 1% of world population (65 million) suffer from epilepsy, and nearly 80% of cases arise in developing countries. Epilepsy is becoming more common with the passing of age. In developed countries, the early symptoms of new cases appear most frequently among children and the elderly; in developing countries most often appear among children of older and younger adults, due to differences in the frequency of underlying causes. Approximately 5-10% of all people will experience a seizure without cause before reaching the age of 80, and the possibility of having a second attack ranged between 40 and 50%. In many regions of the world, those who suffer from epilepsy are limited in driving or not allowed at all, but most can be re-driving after a certain period of free attack.
Someone who bite the tip of his tongue when epilespi attack.
Epilepsy is characterized by long-term risk of recurrent attacks. This attack can occur in several ways depending on what part of the brain is involved and the age of the patient.
Attack.
Types of epileptic seizures are the most common (60%) are convulsions / seizures. Of these attacks, two-thirds begin with focal seizures (which then can be common) while the third started with generalized seizures. The remaining 40% of other types of attacks are non convulsions. Examples of this type is attack absences, which showed a decrease in the level of consciousness and usually lasts about 10 seconds.
Focal epileptic seizures are often preceded by a certain experience, which is known as an aura. This could include: sensory phenomena (viewer, listener or smell), psychic, autonomic, or motor. Spasms can start with a particular muscle group and spread to the surrounding muscle groups known as Jacksonian seizures. Automatism may occur; This is a movement that is not recognized and most simple repetitive movements such as playing a lip or a more complex movements like trying to take something.
There are six main types of general epileptic seizures: tonic-clonic, tonic, clonic, myoklonik, absences, and Atonik attack. Everything involving loss of consciousness and usually occurs without warning. Tonic-clonic attacks occur with limb contraction followed by extension along with the back arched back that lasts for 10-30 seconds (tonic phase). Screams may sound because the pectoral muscle contraction. This is then followed by a simultaneous movement of the body (the clonic phase). Tonic attacks causes continuous muscle contraction. Sufferers often turn blue due to respiratory terhenti.Dalam clonic attacks limbs moving in unison. After the motion stops, the patient may take 10-30 minutes to get back to normal; This period is called "phase postiktal".
Loss of control of bowel movements or urination can occur during an attack epilesi. End or side of the tongue can be bitten during epilespi attack. In tonic-clonic seizures, bites on the side of the tongue is more common. Bite the tongue is also quite common in psychogenic non-epileptic attack.
Myotonic attacks involving muscle spasms in some or in all areas. Absence attacks (sudden loss of consciousness) can be disguised with only the head turned slightly or eye blinking. People do not fall and get back to normal after the attack stalled. Atonik attacks involve loss of muscle activity for more than one second. It usually occurs on both sides of the body.
Approximately 6% of patients with epileptic seizures are often triggered by specific events and is known as reflex attack. Reflex epileptic seizures are only triggered by specific stimuli. Common triggers include flashing lights and sounds suddenly. In certain types of epilepsy, attacks occur more frequently during sleep, and in other types of attacks occur almost only bedtime.
Postiktal.
After an active attack is usually a period of confusion called postiktal period prior levels back to normal consciousness. It usually lasts for 3 to 15 minutes but can last for hours. Other common symptoms include: feeling tired, headaches, difficulty talking, and abnormal behavior. Psychosis after an attack quite frequently, occurs in 6-10% of patients. Patients often do not remember what happened during this time. Local weakness, known as Todd paralysis, can also occur after focal epileptic seizures. If there is, it usually lasts for a few seconds to minutes but rarely occurred during one or two days.
Psychosocial.
Epilepsy can have a detrimental effect on the social and psychological well-being of a person. These effects can include social isolation, stigmatization, or incompetence. These effects can lead to lower educational achievement and employment are worse. Learning difficulties commonly found in people with epilepsy, and especially in children with epilepsy.
The stigma of epilepsy may also affect the patient's family.
Certain disorders occur more frequently among patients with epilepsy, partly depending on existing epilepsy symptoms. This can include: depression, anxiety disorders, and migraine. Attention-deficit hyperactivity disorder (ADHD) or Mind Centering Disorder / Hyperactivity (GPPH) affects children with epilepsy are three to five times more often than children in the general population. GPPH and epilepsy have important consequences on behavior, learning and social development of children. Epilepsy is also more common in those with autism.
Cause.
Epilepsy is not a single disease, but a symptom that can be generated by a number of different disorders. By definition, epileptic seizures occur spontaneously and without any direct cause such as the acute illness. The underlying causes of epilepsy can be identified as a genetic problem, structural, or metabolism, but 60% of cases of epilepsy is not known why. Genetic, congenital birth defects, and developmental disorders more common among younger people, whereas a brain tumor and stroke are more likely in older people. Attacks can also occur as a result of other health problems; if the attack happened right after their particular cause, such as stroke, head injury, consumption of toxic materials, or metabolic problems, this attack called acute symptomatic seizures, including seizures and in the broader classification-related disorder not epileptic seizures. Many of the causes of acute symptomatic seizures which can also lead to seizures latter, ie secondary epilepsy.
Genetic.
Genetic believed to be involved in most of the cases, either directly or indirectly. Some of epilepsy caused by a single gene defect (1-2%); largely the result of the interaction of multiple genes and environmental factors. Each single gene defect is rare, with more than 200 have been described. Several genes involved affect ion channels, enzymes, GABA, and receptor-related protein G.
In identical twins, if one suffers from epilepsy, there is a possibility of 50-60% other twin also suffered from epilepsy. In non-identical twins, the risk is 15%. This risk is greater in patients with generalized seizures than focal seizures. If both twins suffer from epilepsy, most (70-90%) have the same epilepsy syndrome. Other close relatives of people with epilepsy have a five times greater risk than those who do not. Between 1 and 10% of people with Down syndrome and Angelman syndrome 90% of patients suffering from epilepsy.
Secondary.
Epilepsy can occur as a result of a number of other conditions that include: tumors, stroke, head injury, infection of the central nervous system earlier, genetic abnormalities, and as a result of brain damage during birth. For those who have a brain tumor, nearly 30% of patients suffering from epilepsy, which are calculated in 4% of cases the cause of epilepsy. The greatest risk is in tumors located in the temporal lobe and slowly growing tumors. Other lesions such as cerebral cavernous malformations mass as arteriovenous malformations and has a risk of 40Templat: Endash 60%. Those who have had a stroke, as much as 2-4% have epilepsy later in life. In the UK, the stroke is responsible for 15% of cases of epilepsy and this is believed to be responsible for 30% of cases of epilepsy in the elderly. Between 6 to 20% of cases of epilepsy are believed to be caused by a head injury. Mild brain injury increases the risk approximately doubled, while severe brain injury increases the risk of up to seven-fold. In those who had suffered a gunshot wound to the head of the high strength, the risk reaches nearly 50%.
The risk of epilepsy after meningitis or meningitis is less than 10%; The disease usually causes seizures during the infection itself. At the risk of herpes simplex encephalitis seizure is about 50% accompanied by a high risk of later onset of epilepsy (25%). Infections caused by the pork tapeworm, which can cause neurosistiserkosis, is responsible for more than half the cases of epilepsy in the areas where these parasites are found. Epilepsy can also occur after other brain infections such as cerebral malaria, toxoplasmosis, and Toxocariasis. Chronic alcohol use increases the risk of epilepsy: those who drank six units of alcohol per day had a two and a half times the risk. Other risks include Alzheimer's disease, multiple sclerosis, tuberous sclerosis, and autoimmune encephalitis. Vaccination increases the risk of epilepsy. Malnutrition is a risk factor that is often found in developing countries, although it is not clear whether this factor is a direct cause or simply no relationship.
Syndrome.
There are a number of epilepsy syndromes are usually grouped according to age at the time of beginning the attack, namely: the neonatal period, childhood, adulthood, and attack without a close relationship of age. In addition, there are groups with a specific set of symptoms, the group due to metabolic causes or specific structural, and a group of unknown cause. The classification of causes of epilepsy in a particular syndrome is more common in children. Some types include: Roland benign epilepsy (2.8 per 100,000), epilepsy Absence children (0.8 per 100,000) and juvenile myoclonic epilepsy (0.7 per 100,000). Febrile seizures and neonatal seizures is not the type of epilepsy.
Mechanisms.
Normally, the brain's electrical activity is non-synchronous. In epileptic seizures, due to structural problems or function in the brain, a group of neurons / nerve cells begin to release the electric charge is abnormal, excessive, and in sync. This results in a depolarization wave called paroxysmal depolarization shift.
Normally, after the excitatory nerve cells release an electrical charge, nerve cells become more resistant to re-release the electric charge during a certain period. This is caused by the effects of nerve cells inhibitorik, electrical changes in the excitatory nerve cells, and the negative effects of adenosine. In epilepsy, the resistance of excitatory nerve cells to re-release the electric charge during this period is reduced. This can occur because of changes in ion channel inhibitors or nerve cells do not function properly. Then, this resulted in the emergence of certain areas that may arise therefrom seizures, known as the "seizure focus". Another mechanism is the possibility of the occurrence of epilepsy excitatory circuits increase or reduction in the number of inhibitory circuits after brain injury. Secondary epilepsy as this occurs through a process called epileptogenesis. The failure of the blood brain barrier can also be a cause for this failure mechanism allows the substances in the blood entering the brain.
Focal seizures begin in one hemisphere of the brain, while generalized seizures began at both hemispheres. Some types of seizures can change the structure of the brain, while other types seemed to have little effect. Gliosis, nerve cell loss and atrophy of certain areas of the brain associated with epilepsy, but it is unclear whether the epilepsy causes these changes, or whether these changes lead to epilepsy.
Diagnosis.
EEG can help find the focus of seizures in patients with epilepsy.
The diagnosis of epilepsy is usually done based on the description of the events surrounding the seizure and seizure. Electroencephalogram and neuroimaging or imaging of nerve cells usually also become part of the medical examination. Despite efforts to find a specific epilepsy syndromes often do, this is not always possible. Video monitoring and long-term EEG may be useful in difficult cases.
Definition.
In practice, epilepsy is defined as two or more epileptic seizures, which are separated by more than 24 hours, for no apparent reason; while, epileptic seizures are defined as signs and symptoms of transient generated by abnormal electrical activity in the brain. Epilepsy can also be viewed as a disorder in which a person has experienced at least one epileptic seizure with ongoing risk for subsequent attacks.
International Forum Against Epilepsy and the International Bureau for Epilepsi- as a collaboration partner of the World Health Organization (WHO) -mendefinisikan epilepsy in a joint statement in 2005 as "a brain disorder characterized by persistent predisposition that generate epileptic seizures and by the consequences of neurobiological, cognitive, psychological, and social for this condition. The definition of epilepsy requires the occurrence of at least one epileptic seizure. "
Classification.
The attacks in people with epilepsy should be classified according to the type of attack, the underlying cause, epilepsy syndrome, and events for and about the attack. This type of attack are arranged according to whether the source of the attack is localized (focal seizures) or distributed (generalized seizures) in the brain. Generalized seizures are divided based on their impact on the body, among others: seizures, tonic-clonic (grand mal), attack Absence (petit mal), myoclonic, clonic, tonic, and Atonik. Some seizures are epileptic spasm is a type of epilepsy that is unknown. Focal seizures (formerly known as partial seizures) used to be divided into simple partial seizures or complex partial. This division is no longer recommended, and instead preferred to describe the symptoms that occur in the event of a seizure.
Laboratory examination.
For adults, the examination of electrolytes, blood sugar and calcium levels are very important to get rid of this problem as the cause. Electrocardiogram examination can rule out problems related to heart rhythm. Lumbar puncture may be used to diagnose infection of the central nervous system but not always necessary. In children, additional checks may be required, for example biochemical urine and blood tests for the presence of metabolic abnormalities.
High blood prolactin levels in the first 20 minutes after the seizure is an important sign to confirm the epileptic seizures and psychogenic rather than non-epileptic seizures. Serum prolactin levels are less useful in detecting partial seizures. If the levels are normal then epileptic seizures is still a possibility and serum prolactin does not distinguish between epileptic seizures with syncope (fainting). This examination is not recommended as a routine examination for the diagnosis of epilepsy.
EEG.
An electroencephalogram (EEG) can help give you an idea of brain activity that indicates an increased risk of seranga. This examination is recommended only to those who showed epileptic seizures as a symptom. In the diagnosis of epilepsy, electroencephalography may help distinguish the type of seizure or syndrome that existed at the time. In children usually only required after the second seizure occurrence. This check can not be used to exclude the diagnosis, and may lead to false positive mark on those who do not suffer from this disease. In certain situations it is helpful to check is performed when the patient is asleep or in a state of sleep deprivation.
Imaging.
Diagnostic imaging using CT scans and MRI is recommended after non-febrile seizure first to detect any structural problems in and around the brain. MRI is generally a better imaging tests unless suspected bleeding, where CT is more sensitive and easier to do. When someone walks into the emergency room with seizures but recovered quickly, imaging tests can be done later. Whereas in the past, a person has been diagnosed with epilepsy imaging examination, imaging studies are not necessary despite repeated back spasms.
Differential diagnosis.
Diagnosis of epilepsy can be difficult, and can often misdiagnosed (occurs in 5 to 30% of cases). Some conditions may indicate the characteristics and symptoms similar to epilepsy, including: syncope, hyperventilation, migraines, narcolepsy, panic attacks and psychogenic non-epileptic seizures (PNES). Approximately one in five people who are suffering from PNES and epilepsy clinic of those with PNES approximately 10% also suffer from epilepsy. Separating the two is based on episodes of seizures without further examination is generally difficult.
Children can have an attitude that is easily mistaken for epileptic seizures, when in fact it is not. These include: breath-holding spells (hold your breath condition which can not be controlled by a child), bedwetting, sleep terrors, tick and Shudder attacks (movement of the baby or child suddenly). Gastroesophageal reflux can cause arched back and stiff neck and terpelintirnya sideways in infants, which then can one be considered as a tonic clonic seizures.
Prevention.
Although many cases are not preventable, efforts to reduce head injuries, with good handling for the area around the head at birth, and pressing environmental parasites such as tapeworms can deliver effective results. Steps taken in one of the Central American region weeks to reduce the level of tapeworm infection has been successful in reducing new cases of epilepsy up to 50%.
Management.
Epilepsy is usually treated with medication every day when it has raised a second seizure, but for patients with high risk, treatment can be started immediately after the first seizure. In some cases it may be necessary to a special diet, implantation of neurostimulator, or neurosurgery.
First aid.
Positioning the tonic clonic seizures patients with active at resting position on the side of the body and the recovery position will help prevent fluid into the lungs. Put a finger, bite or tongue depressor box in the mouth is not recommended because it can cause the patient to vomit or cause helper bitten. No efforts should be made so that patients do not injure yourself. Precautions spinal cord injury is usually not necessary.
If the seizure lasts more than 5 minutes or two or more seizures occurred within one hour without recovery to a normal state of which the state is considered a medical emergency known as status epilepticus. This condition requires medical attention so that the airway remains open and protected; nasopharyngeal airway will be very helpful in this situation. For the home, the initial treatment given to seizures with long duration is placed in the mouth of midazolam. Diazepam may also be given rectally in dosage forms. At the hospital, intravenous lorazepam administration is preferred. When two doses of benzodiazepines are not effective, the use of other drugs that are recommended are phenytoin. Epileptiku convulsive status that do not respond to initial treatment usually requires treatment in the emergency room and treatment with more potent compounds such as thiopentone or propofol.
Treatment.
Anticonvulsants.
Handling mainstay for epilepsy is the anticonvulsant drug delivery, with the possibility of granting a lifetime. Selection of anticonvulsant use depends on the type of seizures, epilepsy syndrome, other treatments are used, other health problems, and the age and style of life of patients. At first recommended a single treatment; if not effective, it is recommended to switch to a single treatment sharing. Two types of treatment once only recommended when a single treatment is not working properly. In approximately half, the first agent effective; The second single agent to help around 13% and the third one or two agents at the same time may provide additional help as much as 4%. Approximately 30% of patients continue to have seizures despite treatment with anticonvulsants get.
There are various treatments available. Phenytoin, and valproate carbamazepin seem to give the same effect and a common focal seizures. Controlled release of carbamazepin also seems to work well as direct release carbamazepin, and may only give a few side effects. In the UK, or lamotrigine carbamazepin recommended as first-line treatment for focal seizures, with levetiracetam and valproate as a second line on the consideration of the issue of cost and side effects. Valproate is recommended as first-line treatment for seizures in general with lamotrigine as second-line treatment. In patients who are not accompanied by seizures, recommended the use of Ethosuximide or valproate; Valproic generally effective for myoclonic seizures and tonic seizures or Atonik. When seizures have been controlled well with certain handling, usually not always necessary routine check drug levels in the blood.
More economical type of anticonvulsant is phenobarbital at a price of about 60,000 a year. The World Health Organization (World kesehata Organization) making recommendations on the first line of the developing countries and very common there. Access to get it may be difficult because some countries classify them as drugs with control.
Adverse effects of this drug have been reported in 10 to 90% of patients, depending on the method and source of the data collected. Most of the adverse effects associated with a given dose level and its light weight. Some examples of these include mood swings, drowsiness, or unstable gait. A number of drug side effects that are not related to dose such as rash, liver toxicity, or bone marrow suppression. Up to a quarter of patients discontinued treatment because of adverse effects. A number of treatments associated with the occurrence of birth defects when used during pregnancy. Valproate also feared like this, especially during the first trimester. However, the treatment is continued when already provide an effective response, because of the risk of epilepsy that is not handled properly will be more dangerous than the risk arising from the treatment itself.
Stopping treatment can be performed slowly in patients who had not had a seizure for two to four years, however, one-third of patients experiencing back spasms, usually during the first six months. Discontinuation of treatment is possible in approximately 70% of children and 60% adults.
Surgery.
Epilepsy Surgery may be an option for those who suffer from focal seizures that did not improve after he passes other countermeasures. Another handling test includes at least one or two types of treatment. Target surgery is complete control over the seizures experienced by the patient and can be successfully implemented in 60-70% of cases. The procedures are commonly taken include: cutting the hippocampus via the anterior temporal lobe resection, tumor removal, and removal of part of the neocortex. Some procedures such as kalosotomi corpus done in an effort to reduce the number of seizures rather than cure the condition of the patient. After surgery, treatment can often be reduced gradually.
Nerve stimulation could be an alternative option for patients who can not undergo surgery. There are three types that have been shown to be effective in patients who show no response to treatment: stimulation of the vagus nerve, anterior thalamic stimulation, and stimulation of responsive bight closed.
Other.
A ketogenic diet (high fat, low carbohydrate, adequate protein) seems to reduce the number of seizures by half in approximately 30-40% of pediatric patients. Approximately 10% successful diet for a few years, 30% had constipation, and other adverse effects are common effects. Diet is not as hard as it is more easily tolerated and may also be effective. Unclear why the diet works. Sports activities have been put forward as something that might be useful in preventing the occurrence of seizures and the statement is supported by a number of data.
Aversion therapy is an attempt to minimize or eliminate the triggers. For example, in patients who are sensitive to light is a good idea to use a small sail television, avoid video games, or wear sunglasses. Some argue that the seizure responders dog, terrier waiter, can predict seizures. However, the evidence is insufficient to support it. Feedback bodily-based operand by the waves of EEG showed some efficacy in patients who do not respond to treatment. However, the method should not be used as a substitute for psychological treatment.
Alternative medicine [edit | edit source]
Alternative medicine, including acupuncture, psychological interventions, vitamins, and yoga, have no reliable evidence to be able to support its application in epilepsy. The use of cannabis is not supported by the evidence. Melatonin is not supported by sufficient evidence.
Epilepsy can not be cured, but treatment can only be effective in controlling seizures in approximately 70% of cases. In patients with generalized seizures of more than 80% can be well controlled with medication, but the percentage of patients with focal seizures is only reached 50%. One predictor of long-term outcome is the number of seizures that occur within the first six months. Other factors that increase the risk of poor outcomes are: low response to initial treatment, generalized seizures, family history of epilepsy, psychiatric problems, and waves in the EEG which represent general epileptiformik activity. In the developing world, 75% of patients not treated or get less appropriate treatment. In Africa, 90% did not receive treatment. This is partly due to appropriate treatment is not available or the cost is too high.
Mortality.
People with epilepsy have a higher risk of death. This increased risk ranging from 1.6 to 4.1 times higher than the normal population and are often associated with: the basic cause seizures, status epilepticus, suicide, trauma, and non-expected death in epilepsy (SUDEP). Deaths due to status epilepticus mainly caused by an underlying problem instead passed his medication dosage. The risk of suicide increased from two to six times in people with epilepsy. The cause of this is not known with certainty. SUDEP seems mostly related to the frequency of generalized tonic-clonic seizures and the cause of approximately 15% of deaths related to epilepsy. How to reduce the risk is not known with certainty. The highest increase in mortality due to epilepsy occur among the elderly. Those who suffer from epilepsy due to an unknown cause only a small increased risk. In the UK an estimated 40-60% likelihood of death can be prevented. In the developing world, many cases of death caused by untreated epilepsy which then led to the fall of the patient or status epilepticus.
Epidemiology.
Epilepsy is one of the most serious neurological disorders commonly terjad affecting about 65 million people worldwide. It affects 1% of the population aged 20 years and 3% of the population at the age of 75 years. He is plural occurs in males than females, but the difference is quite small overall. Most patients (80%) live in the developing world.
Number of people with active epilepsy currently in the range of 5-10 per 1,000; active epilepsy is defined as patients with epilepsy who had experienced a seizure at least once in the past five years. Epilepsy begins each year in the 40-70 per 100,000 in developed countries and 80-140 per 100,000 in developing countries. Poverty is a risk and include both housed origin of a poor country and status as the poor relative to others in the same country. In developed countries, the most common epilepsy begins in young people or the elderly. In developing countries, the beginning of epilepsy is more common in children who were older and young adults because of the higher number of trauma and infectious diseases. In developed countries, the number of cases per year has decreased in children and an increase in older people between 1970 and 2003. This is partly contributed by post-stroke survival rate better in older people.
History.
The oldest medical records indicate that epilepsy has affected humans since the beginning of recorded history. Throughout ancient history, the disorder is suspected as the spiritual condition. Description of epileptic seizures are the oldest in the world are listed on the manuscript in Akkadian (the language spoken in ancient Mesopotamia), written about 2000 BC. People who are described in the text are diagnosed under the influence of the Moon god, and therefore the ceremony was organized exorcist (exorcism). In the Law of Hammurabi (about 1790 BC), epileptic seizures referred to as a legitimate reason for a bondsman must be returned with compensation, and Edwin Smith Papyrus (around 1700 BC) describe cases of patients with epileptic convulsions.
Detailed records of the oldest known about the disorder itself is listed in Sakikku, a Babylonian cuneiform medical texts dating back to 1067 Template: Endash1046 BC. The script calls the signs and symptoms, treatment and possible detail the results obtained, and describe many characteristics of various types of seizures. Because the Babylonians did not have an understanding of the nature of the disease biomedical, they also blame the evil spirits as the cause of seizures and attempt to deal with the condition by means of spirituality. Around 900 BC, Punarvasu Atreya describes epilepsy as conditions of loss of consciousness; The definitions used in the text Charaka Samhita Ayurveda (around 400 BC).
Hippocrates, a 17th century engraving by Peter Paul Rubens an antique bust.
The Greeks have contradictory views about this disease. They consider epilepsy as a form of spiritual possessed, but also associate this condition with genius and divinity. One of the nicknames given to this disease is the sacred disease. Epilepsy appears in Greek mythology: the Moon is associated with the goddess Selene and Artemis, who attacked people who annoy them. The Greeks suspected important figures such as Julius Caesar and Hercules suffer from this disease. A noteworthy exception to the spiritual and the divine view this is from a group of Hippocrates. In the fifth century BC, Hippocrates rejected the idea that the disease is caused by spirits. In his famous work On the Sacred Disease, he suggested that epilepsy is not from divine but a brain problem that can be treated medically. He accused those who connect to the sacred cause of this disease spreading ignorance to believe superstitions. Hippocrates suggested that heredity is important because, explain the worse outcomes if the disease appears at a young age, and make notes about the physical characteristics and social embarrassment associated with this disease. Rather than calling it a sacred disease, he uses the term severe disease, began the rise of the term moderngrand mall, which is used for generalized epilepsy. Although his work detailing the physical origin of this disease, his view was not accepted at that time. Blamed evil spirits remain until at least the 17th century.
In many cultures, people with epilepsy have been stigmatized, kept out, even imprisoned; in the Salpêtrière, the birthplace of neurology (neuroscience) modern, Jean-Martin Charcot find people with epilepsy are placed along the mentally ill, suffering from chronic syphilis, and the criminally insane. At the time of ancient Rome, epilepsy known as Morbus Comitialis ('disease assembly hall') and is regarded as the curse of the gods. In northern Italy, epilepsy has traditionally been known as St. Valentine's disease.
In the mid 1800s an effective anti-seizure medications first, bromide, was introduced. The first modern treatment, phenobarbital, developed in 1912, with phenytoin into use in 1938.
Society and culture.
Stigma.
General stigma experienced by people with epilepsy worldwide. It can affect people economically, socially, and culturally. In India and China, epilepsy can be used as a determinant for refusing marriage. People in certain areas still believe that people with epilepsy was cursed. In Tanzania, as in other parts of Africa, epilepsy is associated with an unclean spirit, magick, or poisoning as well as by many people believed to be contagious, that there is no proof. Before 1970 in the United Kingdom there is a law that prohibits people with epilepsy to marry. Existing stigma can make epileptics deny if they ever had seizures.
Economy.
Seizures caused direct economic costs amounting to about one billion dollars in the United States. Epilepsy cause economic costs in Europe around 15.5 billion euros in 2004. In India, the cost for epilepsy is estimated at approximately $ 1.7 billion or 0.5% of GDP. It is caused by about 1% emergency department visits (2% of pediatric emergency section) in the United States.
Vehicle.
People with epilepsy have a two times greater risk to be involved in motor vehicle collisions in various parts of the world so that they are banned from driving or only allowed to drive if several conditions are met. In some places, doctors are required by law to report to the publisher permission if someone suffers a seizure while in other places the doctor concerned was asked to advocate for self-reported condition. Countries that require doctors to report include: Sweden, Austria, Denmark, and Spain. State which requires the sufferer to report include: United Kingdom, and New Zealand and a doctor can report if it considers that has not yet reported. In Canada, the United States, and Australia for reporting requirements vary depending on the province or state. If seizures are well controlled in general people feel it is reasonable to be allowed to drive. The number of seizure-free period required for a particular person before they are allowed to drive differ depending on the country. Many countries require one or three years without seizures. In the United States without seizures time required depends on his state and ranged from three months to one year.
The people with epilepsy or seizures usually denied to get a pilot license. In Canada if someone had experienced no more than one seizure, they can be considered after five years to obtain a limited license if all other tests normal. The patient convulsions and seizures associated with drug may also be considered. In the United States, the Federal Aviation Administration does not allow people with epilepsy get a commercial pilot license. Rare, an exception may be granted to people who have seizures or convulsions isolated and remain seizure-free until well into adulthood without treatment. In the United Kingdom, the full national private pilot license requires the same standard as a professional driver's license. It requires ten years seizure-free without medication. For those who do not meet these requirements can obtain a limited license if it has been free of seizures for five years.
Support organizations.
There are a number of nonprofit organizations that provide support for people and families affected by epilepsy. In the United Kingdom this includes the Joint Epilepsy Council of Great Britain and Ireland. Purple Day was established in 2008 to raise awareness about epilepsy and appeared on March 28.
Another attempt to improve knowledge including campaign "Out of the Shadows", a joint venture held by the World Health Organization, the International League Against Epilepsy and the International Bureau for Epilepsy.
Research.
Seizure prediction refers to attempt to predict epileptic seizures by the EEG before it happens. In 2011, there is no effective mechanism for predicting the development of seizures. Kindling, namely repeated exposure to events that can cause seizures in the end make the seizures occur more easily, has been used to create animal models of epilepsy.
Gene therapy has been studied in certain types of epilepsy. Treatments that alter immune function, such as intravenous immunoglobulin, poorly supported by evidence. Stereotactic Radio Surgery non-invasive, in 2012, is currently being compared with standard surgery for certain types of epilepsy.
Other animals.
Epilepsy occurs in a number of other animals, including dogs and cats as well as a brain disorder that is most common in dogs. The disorder is usually treated with anticonvulsants such as phenobarbital or bromide in dogs and phenobarbital in cats. While a diagnosis of generalized seizures in horses quite easily enforced, it would be difficult to diagnose generalized seizures and EEG may help.
Thank you for reading this article. Written and posted by Bambang Sunarno. sunarnobambang86@gmail.com
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