1, Daily prevention and health care of epilepsy
All along, doctors and epilepsy patients are very concerned, which has positive significance for some epilepsy patients, especially those with seizures, and can prevent or reduce seizures. Actively carrying out the daily prevention and health care of epilepsy can promote the rehabilitation of epilepsy patients and greatly improve their quality of life. So, what are the daily preventive health care of epilepsy that experts will take you to know?
Advocate prenatal and postnatal care
"Good prenatal and postnatal care" has been the call of family planning in China for many years. Only in this way can we reduce the occurrence of various diseases. When choosing a spouse, epileptic patients should avoid marrying people with family history of epilepsy, prohibit close relatives from marrying, and prohibit both men and women from marrying patients with primary epilepsy. Because they are married, the incidence of epilepsy has greatly increased. The first child born to an epileptic is an epileptic child. Don't have a second child. If female patients have a clear genetic history, fertility should be prohibited as much as possible. Doing the above will greatly reduce the incidence of epilepsy.
(b) Women should pay attention to health care during pregnancy.
After a woman is pregnant, don't take medicine blindly. If she suffers from epilepsy, she must take medicine carefully under the guidance of a doctor. Because some drugs have teratogenic effects, especially in the first three months of pregnancy, the teratogenic effects of drugs are particularly prominent. Don't be too exposed to radiation. All kinds of radiation (including X-rays, γ-rays and radiation from household appliances, televisions and computers) may cause congenital developmental defects to the fetus. Therefore, pregnant women should try to avoid working and living in high radiation environment. In addition, it is necessary to prevent various viral and bacterial infections during pregnancy and conduct regular prenatal examinations. If the fetal development is obviously abnormal by B-ultrasound, the pregnancy should be terminated in time. If the fetal umbilical cord is found around the neck, cesarean section should be performed in time. Try to reduce fetal hypoxia, asphyxia and birth injury during delivery, and try to avoid using forceps and fetal aspirator, which often leads to intracranial hemorrhage and brain injury of infants, leaving hidden dangers leading to epilepsy.
(3) Children (4 months to 5 years old)
Epilepsy patients should avoid fever caused by cold, tonsillitis, pneumonia and fright. If the body temperature is about 3℃ higher than normal, we should deal with the symptoms in time to avoid febrile convulsion. Repeated febrile convulsion can cause hypoxia in brain tissue and secondary brain injury, which is the pathological basis of epilepsy. According to domestic reports, the incidence of febrile convulsion turning into epilepsy is 3.8% ~ 20%. Therefore, if the child's fever temperature exceeds 38.0℃, parents of epileptic patients must pay attention to timely treatment and seek medical advice in time.
(d) In China, one of the common causes of epilepsy in adults is cerebral parasitic diseases.
With the development of society and the improvement of sanitary conditions, epilepsy caused by brain parasitic diseases has decreased, which is mainly prevalent in North China, Northeast China and Yunnan. Because of eating food or water contaminated by eggs, eggs enter the body and parasitize the cerebral cortex with blood circulation, causing seizures. Therefore, we should pay attention to the hygiene of diet and drinking water. If the patient has subcutaneous nodules and seizures, CT and MRI should be done as soon as possible to find the lesions and treat them as soon as possible.
(5) Pay attention to personal and traffic safety.
To prevent traumatic epilepsy caused by craniocerebral trauma, the incidence of post-traumatic epilepsy is 0.5% ~ 50%. The longer the coma time, the more serious the brain parenchymal injury and the higher the incidence. For example, the compression of intracranial hematoma in acute stage and intracranial hypertension caused by edema after brain parenchyma injury can all lead to seizures, and brain atrophy after brain surgery and brain contusion and laceration can lead to insufficient blood supply to the brain, dysfunction of brain cells, epilepsy and so on.
(six) to avoid epilepsy after alcoholism caused by heavy drinking.
Long-term heavy drinking can cause gastritis, pancreatitis, liver injury, arrhythmia, abnormal hematopoietic function and immune function, and the most important thing is nervous system toxicity, which makes the body lack vitamin B 1, causes brain tissue metabolic disorder, brain atrophy, seizures, and may also lead to low attention, memory loss and even dementia. Acute alcoholism can directly cause seizures. In addition, drunken accidents, fights or traffic accidents can cause craniocerebral trauma, and secondary epilepsy can be caused after trauma.
2, epilepsy surgery questions and answers
Q 1: it's too annoying to take medicine for a long time. Can you operate directly without taking medicine?
A: Epilepsy is a chronic brain disease, which means that no matter which treatment method is adopted, it is a long-term process. Drugs and surgery are two important weapons for us to deal with epilepsy. When we make a choice, there is no question of who will replace who. Just like the treatment of tumors, some patients need surgery, and some patients need surgery plus chemotherapy. Drugs are the basis of epilepsy treatment. If the drug treatment effect is good, we should insist on taking the drug for a long time and wait for the chance of cure. Only when the medication is still not well controlled, it is called drug-resistant epilepsy, and then it is evaluated to determine whether it is suitable for surgery. Therefore, it is absolutely not advisable to have an operation just because it is troublesome to take medicine.
Q2: What are the epilepsy operations?
A: Epilepsy surgery mainly includes excision of epileptogenic focus, hemispherectomy, multiple subdural transection and vagus nerve stimulation. The seizure-free rate after epileptogenic focus resection is relatively high, and the latter three operations mainly focus on reducing the seizure frequency.
Q3: What is the success rate of epilepsy surgery?
A: The degree of relief of epileptic seizures is the main index to judge the success of epileptic surgery, and it usually needs to be observed for at least 2 years after surgery. The surgical effect is mainly related to the type, etiology and accurate location of epileptic focus. For example, 90% of cavernous hemangioma has no seizure, and medial temporal sclerosis, local focal cortical dysplasia and some tumors are also relatively high, reaching more than 70%, while others are relatively low, less than 50%. Therefore, in order to evaluate the operation scientifically and accurately and treat the epilepsy operation rationally, we should not have unrealistic high expectations for the operation effect, but also avoid missing the appropriate operation opportunity because of too many conflicts.
Q4: Don't you need to take medicine after the operation?
A: As mentioned earlier, there is no conflict between surgery and taking medicine. Generally speaking, you need to take medicine for 2 years after operation, and then a specialist will evaluate it and decide whether to stop taking medicine slowly or continue to maintain it. Therefore, not all patients can completely stop taking drugs after surgery.
Q5: Why should we evaluate before operation?
A: The so-called surgical evaluation mainly does two things. First, it finds the brain region that causes seizures (epileptic region); Secondly, after locating the epileptogenic focus, we should also consider whether this part of the brain can be safely removed. After all, many areas of the human brain have important functions. When the epileptogenic focus happens to be located in these places, the operation will lead to paralysis, blindness and inability to speak. This is obviously something we should avoid.
Q6: How to evaluate epilepsy surgery?
A: Surgical evaluation refers to the process that doctors determine the location of epileptogenic focus and surgical risk through a series of comprehensive analysis. First of all, we will choose non-invasive examination, which generally includes remote video EEG monitoring, high-resolution magnetic resonance, neuropsychological test, PET and so on. If the epileptic focus cannot be determined by non-invasive means, doctors still think that surgery is more likely, so invasive assessment is needed, mainly referring to video monitoring of intracranial electrode EEG. Surgical evaluation is a test of patience and perseverance of patients, family members and doctors, especially video EEG monitoring. Because patients need to wait for frequent attacks, it is often boring to stay in the monitoring bed for more than ten days or even longer. But don't worry, as long as you are mentally prepared, most patients can complete it smoothly.