Encyclopedia of Epilepsy for Patients

Epileptica

Absence seizures previously were called attacks of "petit mal" ("small attacks"). Attacks of this type begin in childhood and adolescence. As a rule, they do not occur in other age groups. The appearance of absence seizures in adults requires the exclusion of focal seizures (as sometimes focal seizures can resemble absence seizures its external manifestations). With the development of the attack the patient suddenly stops, the gaze seems empty, missing (simple absence seizure);

perhaps the tremor of the eyelids, swallowing and throwing back the head or drop the head on the chest, redness or pallor of the face, automatic movements (complex absense). The attacks are very short (lasting several seconds), and how the patient and the surrounding, can not see them. Adults can interpret these episodes as a bad habit, personality, the distraction of the child; as they may be called “ideas” (the child often thinks), etc.

Sometimes absence seizures are detected by chance during examination of the child regarding the decline in school performance. This is due to the fact that frequent absences lead to a violation of concentration, and because of the frequent “blackouts” the child misses the training material, despite the fact that he is in the classroom. If absence seizures on EEG revealed very characteristic changes (a generalized peak-wave discharges with a frequency of 3 Hz). They can be provoked by hyperventilation (deep rhythmic breathing) during EEG recording. The described picture corresponds to the typical absence seizures. Attacks of this type occur in forms of epilepsy with a good prognosis. In General, the intelligence of these children is not reduced.

Atypical absences are less sudden start and end, the consciousness is broken, but not completely disabled, the child looks inhibited. Changes in EEG during the attack also differ from those in typical absences (irregular slow peak-wave activity of less than 2.5 Hz, generalized, but usually asymmetric). Atypical absences are characteristic of severe forms of epilepsy with poor prognosis, such as Lennox-gasto syndrome.

Anti-epileptic drugs

In the treatment of epilepsy, drugs are used that act on one or more targets in the brain (i.e., affecting the function of certain ion channels, changing the level of neurotransmitters — affecting the receptors of neurotransmitters, transport proteins or enzymes involved in the exchange of neurotransmitters, they cause a decrease in the level of excitatory or increase in the content of inhibitory mediators). Such drugs are called antiepileptic drugs (abbreviated AEP). Other names of drugs of this class — anticonvulsants, antiepileptic drugs, anticonvulsants. Some of the antiepileptic drugs act only on one target, others have many mechanisms of action-usually these drugs are effective in many types of epileptic seizures. Despite the fact that the new drugs were created with an eye to a certain clear target, in the future it turned out that the real mechanisms of their action are different from the originally stated. And some drugs have been found mechanisms of action, in addition to the originally intended. These additional mechanisms of action (or a combination of mechanisms of action) explain the wide range of anticonvulsant activity of some AES.