Status epilepticus can be treated with diazepam given as an injection or through someone's rectum. An alternative treatment is a medication called buccal midazolam. This comes in liquid form and it is administered by trickling the liquid onto the inside of your cheek. It is then absorbed into your bloodstream.
You do not have to be a healthcare professional to do this, but you do need the correct training as well as permission from the person who has epilepsy. These are called non-epileptic seizures. Other conditions, such as diabetes , heart conditions and psychological conditions, can cause seizures. Not all seizures are epileptic. Epilepsy can have a number of causes.
The brain is a delicate mix of neurons brain cells , electrical impulses and chemicals, known as neurotransmitters. Any damage has the potential to disrupt the workings of the brain and cause seizures. Where no apparent cause for epilepsy can be found, many researchers have suggested that small genetic changes in the brain could be the cause of epilepsy.
Current research is looking for defects in certain genes that may affect electrical transmission in the brain. Many people with epilepsy find that certain circumstances or substances can trigger a seizure. The commonest cause of breakthrough seizures is missing doses of medications. Some women may be more prone to seizures just before, during or after their period. This is because the hormones released by the body during that time can affect the chemicals in the brain, making seizures more likely.
Most people with epilepsy have a seizure threshold. This is the point at which the brain's natural resistance to seizures is passed, triggering a seizure. People with a high seizure threshold experience less frequent seizures and triggers will have less effect on them. Epilepsy can be difficult to diagnose because many other conditions, such migraines and panic attacks, can cause similar symptoms.
If you have had a seizure, you will be referred to a specialist in epilepsy, normally a neurologist a doctor who specialises in conditions that affect the nervous system. It may be useful to talk to anyone who witnessed your seizure and ask them exactly what they saw, especially if you cannot remember the seizure. The doctor should be able to make a diagnosis of epilepsy from the information you give, but they may run further tests. You may need an electroencephalogram EEG , which can detect unusual brain activity associated with epilepsy. Or you may have a magnetic resonance imaging MRI scan , which can spot any defects in the structure of your brain.
An EEG test measures the electrical activity of your brain through electrodes placed on your scalp. During the test, you may be asked to breathe deeply or close your eyes, as these actions could reveal unusual brain activity associated with epilepsy. You may also be asked to look at a flashing light, but the test will be stopped immediately if it looks like the flashing light could trigger a seizure.
At the moment, there is no cure for epilepsy. Anti-epileptic drugs AEDs are usually the first choice of treatment. Usually, AED treatment will not begin until after you have had a second seizure. In some cases, treatment will begin after a first seizure if:. If drug treatment fails to control seizures, surgery may be an option. If surgery is not an option, an alternative may be to implant a small device under the skin of the chest.
The device sends electrical messages to the brain. Sometimes, a special diet is used for children whose seizures are difficult to control and do not respond to drug treatment. Most people with epilepsy can be successfully treated with medicines known as anti-epileptic drugs AEDs. AEDs do not cure epilepsy, but they can prevent seizures from occurring. There are many different AEDs.
This reduces the chance of a seizure.
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The drugs used to treat epilepsy are often referred to as first-line and second-line drugs. This does not mean that one type of drug is better than the other, but it refers to when the drugs were first introduced. First-line drugs are older and have treated epilepsy for decades.
Second-line drugs are much newer. The older first-line AEDs, which include sodium valproate, carbamazepine, phenytoin, phenobarbital and primidone, may be tried first to control seizures, but more frequently, newer AEDs are recommended instead of the older drugs,because of their side effect profile and tolerability. It is particularly important to avoid using Valproate if you are thinking of having a baby now or sometime in the future. Newer AEDs include gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate and vigabatrin.
The level of Lamotrigine in the bloodstream will fall if the oral contraceptive pill is used and this will affect seizure control. Talk to your doctor or epilepsy nurse if you are planning a pregnancy or if you plan to start using the oral contraceptive pill. Levetiracetam is not recommended for children, but the others are recommended if older AEDs do not benefit children with epilepsy.
Your specialist will start you on a low dose of the AED, then gradually increase it within safe limits until your seizures stop. If one AED does not control seizures, another will be tried by gradually introducing the new drug and slowly reducing the dose of the old drug.
The aim is to achieve maximum seizure control with minimum side effects, using the lowest possible dose of a single drug. Trying a different type of AED is preferable to taking more than one AED, although a combination of drugs may be necessary to control seizures. Side effects are common when starting treatment with AEDs. However, they are short term and usually pass in a few days. Some side effects, which produce symptoms that are similar to being drunk, occur when the dose of AEDs is too high.
They include:. If you experience any of these symptoms, contact your GP or epilepsy specialist immediately so that your dosage can be revised. Never suddenly stop taking an AED because doing so could cause a seizure. While taking AEDs, do not take any other medicines, including over-the-counter OTC medicines or complementary medicines such as St John's Wort, without first speaking to your GP or epilepsy specialist.
Other medicines could have a dangerous interaction with your AEDs and cause a seizure. Your epilepsy specialist can discuss with you the best way to safely stop taking your AEDs. If, after you have tried various types of AED, your epilepsy is still poorly controlled, vagus nerve stimulation VNS therapy may be recommend. This involves surgically implanting a small electrical device, similar to a pacemaker, under your skin, near your collarbone.
The device has a lead that is wrapped around one of the nerves in the left side of your neck, known as the vagus nerve. This can help reduce the frequency and severity of seizures. If you feel the warning sign of a seizure coming on, you can activate an extra 'burst' of stimulation, which can often prevent the seizure from occurring.
How and why VNS works is not fully understood, but it is thought that stimulating the vagus nerve alters the chemical transmissions in the brain. A ketogenic diet was one of the treatments used before AEDs were available, but it is no longer recommended for adults with epilepsy. A ketogenic diet is high in fats and low in carbohydrates and protein, and it may make seizures less likely by altering the chemical composition of the brain. But a high-fat diet is linked to serious health conditions, such as diabetes and cardiovascular disease, so it is not generally recommended.
A ketogenic diet is sometimes advised for children with seizures that are difficult to control and have not responded to AEDs. The diet has been shown to reduce the number of seizures in some children. It should only be used under the supervision of an epilepsy specialist with the help of a dietitian. If your epilepsy is still poorly controlled after two years of treatment, you may be referred to a specialist epilepsy centre to see if you are suitable for brain surgery.
This involves having various types of brain scans to find out where the epilepsy is focused. Memory and psychological tests are also conducted to gauge how you are likely to cope with the stress of surgery and how it might affect you. As with all types of surgery, this procedure carries a risk. About one person in has a stroke after surgery, and about five in experience memory problems.
Before having the procedure, your surgeon will explain to you the benefits and risks of the surgery. Most people normally recover from the effects of surgery after a few days, but it could be two to three months before you are fully fit and able to return to work. There are several complementary therapies that some people say work for them. However, none has been shown conclusively in a study to reduce seizures. Withdrawing anti-epileptic medication without medical specialist supervision may result in seizures.
Treat with caution any advice from therapists to reduce or stop taking your anti-epileptic medication. Herbal remedies should be used cautiously because some of their ingredients can interact with anti-epilepsy drugs. St John's Wort, a herbal remedy used for mild depression, is not recommended for people with epilepsy because it can affect the blood levels of anti-epilepsy drugs and may affect seizure control. Ayurvedic herbal medicines are also not recommended. For some people with epilepsy, stress can trigger seizures.
Stress-relieving and relaxation therapies such as exercise, yoga and meditation may help. There are no rigid guidelines for living with epilepsy, as everyone's condition is different. However, there are some general points that can help. The more you know about the things that trigger your seizures and how to avoid them, the less debilitating your epilepsy will be.
Keep a seizure diary to help you work out if you have any triggers. Working with your specialist to find the medication that suits you best, and taking it exactly as prescribed, is probably the most effective way to live well with epilepsy. You will have regular reviews of your epilepsy and treatment. This is usually carried out by your GP, but sometimes by your neurologist and their team. If your epilepsy is not well controlled, you may have more frequent reviews.
Self-care is an integral part of daily life. It involves taking responsibility for your health and wellbeing with support from those involved in your care. Self-care includes what you do every day to stay fit and maintain good physical and mental health, prevent illness or accidents and care more effectively for minor ailments and long-term conditions.
People with long-term conditions can benefit enormously from being supported to self care. They can live longer, experience less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent. Regular exercise and a healthy diet are recommended for everyone, not just people with epilepsy. They can help prevent many conditions, including heart disease and many forms of cancer.
Try to eat a balanced diet, containing all the food groups, to give your body the nutrition it needs. Heavy drinking can cause seizures, as well as interact with anti-epileptic drugs AEDs , making them less effective. Heavy drinking is also associated with disrupted sleep patterns, and this can increase the risk of having a seizure. Drinking no more than the recommended limits will reduce any potential side effects. The recommended limits for alcohol consumption are 17 standard drinks for men and 11 for women.
A standard drink of alcohol is equal to about half a pint of beer, a small glass of wine or a pub measure of spirits. Some anti-epileptic drugs AEDs can reduce the effectiveness of some types of contraception, including:. If you are sexually active and you want to avoid pregnancy, ask your GP or epilepsy specialist whether your AEDs could affect any of these methods of contraception. You may need to use another form of contraception such as a condom or coil. Some AEDs have also been known to make the emergency contraceptive pill less effective.
If you require emergency contraception, you may need an IUD. Your GP, family planning clinic or pharmacist should be able to advise you. There is no reason why women with epilepsy cannot have a healthy pregnancy. However, it is always preferable if the pregnancy is planned. This is because there is a slightly higher risk of complications developing during pregnancy.
However, with forward planning, these risks can be minimised. The main risk is that some AEDs are known to increase the chances of a serious birth defect occurring, such as spina bifida, cleft lip or a hole in the heart. The risks depend on the type of AED and the dosage you are taking. It can also be contacted at Freephone If you are planning a pregnancy, talk to your epilepsy specialist. It may be possible to change the AED you are taking to minimise any risks. Taking 5mg of a folic acid supplement a day can also help reduce risks of birth defects.
If you discover you are pregnant, do not stop taking your medicine. The risks to your baby from uncontrolled seizures are far higher than any risks associated with your medicines. There are no risks associated with breastfeeding while taking an AED if the baby had been exposd in utero. Others may need some extra support to get the most out of their time at school. Make sure your child's teachers know about their condition and the medication they need to control it. Epilepsy is more common among children with learning disabilities and special educational needs.
These children are entitled to extra help to overcome their difficulties. How are meningitis and encephalitis diagnosed? How are these infections treated? Can meningitis and encephalitis be prevented?
What is the prognosis for these infections? What research is being done? Where can I get more information? Infections and other disorders affecting the brain and spinal cord can activate the immune system, which leads to inflammation. These diseases, and the resulting inflammation, can produce a wide range of symptoms, including fever, headache, seizures, and changes in behavior or confusion.
In extreme cases, these can cause brain damage, stroke, or even death. Inflammation of the meninges, the membranes that surround the brain and spinal cord, is called meningitis ; inflammation of the brain itself is called encephalitis.
Myelitis refers to inflammation of the spinal cord. When both the brain and the spinal cord are involved, the condition is called encephalomyelitis. Infectious causes of meningitis and encephalitis include bacteria, viruses, fungi, and parasites. For some individuals, environmental exposure such as a parasite , recent travel, or an immunocompromised state such as HIV, diabetes, steroids, chemotherapy treatment are important risk factors. Bacterial meningitis is a rare but potentially fatal disease.
Several types of bacteria can first cause an upper respiratory tract infection and then travel through the bloodstream to the brain. The disease can also occur when certain bacteria invade the meninges directly. Bacterial meningitis can cause stroke, hearing loss, and permanent brain damage. Other forms of bacterial meningitis include Listeria monocytogenes meningitis in which certain foods such as unpasteurized dairy or deli meats are sometimes implicated ; Escherichia coli meningitis , which is most common in elderly adults and newborns and may be transmitted to a baby through the birth canal; and Mycobacterium tuberculosis meningitis , a rare disease that occurs when the bacterium that causes tuberculosis attacks the meninges.
europeschool.com.ua/profiles/xuriqoh/fyc-busco-mujeres.php Viral, or aseptic, meningitis is usually caused by enteroviruses—common viruses that enter the body through the mouth and travel to the brain and surrounding tissues where they multiply. Enteroviruses are present in mucus, saliva, and feces, and can be transmitted through direct contact with an infected person or an infected object or surface. Other viruses that cause meningitis include varicella zoster the virus that causes chicken pox and can appear decades later as shingles , influenza, mumps, HIV, and herpes simplex type 2 genital herpes.
Fungal infections can affect the brain. The most common form of fungal meningitis is caused by the fungus cryptococcus neoformans found mainly in dirt and bird droppings. Cryptococcal meningitis mostly occurs in immunocompromised individuals such as those with AIDS but can also occur in healthy people. Some of these cases can be slow to develop and smolder for weeks. Although treatable, fungal meningitis often recurs in nearly half of affected persons. Parasitic causes include cysticercosis a tapeworm infection in the brain , which is common in other parts of the world, as well as cerebral malaria.
There are rare cases of amoebic meningitis, sometimes related to fresh water swimming, which can be rapidly fatal. Encephalitis, usually viral, can be caused by some of the same infections listed above. However, up to 60 percent of cases remain undiagnosed. Several thousand cases of encephalitis are reported each year, but many more may occur since the symptoms may be mild to non-existent in most individuals.
Most diagnosed cases of encephalitis in the United States are caused by herpes simplex virus types 1 and 2, arboviruses such as West Nile Virus , which are transmitted from infected animals to humans through the bite of an infected tick, mosquito, or other blood-sucking insect, or enteroviruses. Lyme disease, a bacterial infection spread by tick bite, occasionally causes meningitis, and very rarely encephalitis.
Rabies virus, which is transmitted by bites of rabid animals, is an extremely rare cause of human encephalitis. Herpes simplex encephalitis HSE is responsible for about 10 percent of all encephalitis cases, with a frequency of about 2 cases per million persons per year. More than half of untreated cases are fatal. About 30 percent of cases result from the initial infection with the herpes simplex virus; the majority of cases are caused by reactivation of an earlier infection. Most people acquire herpes simplex virus type 1 the cause of cold sores or fever blisters in childhood.
HSE due to herpes simplex virus type 1 can affect any age group but is most often seen in persons under age 20 or over age This rapidly progressing disease is the single most important cause of fatal sporadic encephalitis in the United States. Symptoms can include headache and fever for up to 5 days, followed by personality and behavioral changes, seizures, hallucinations, and altered levels of consciousness.
Brain damage in adults and in children beyond the first month of life is usually seen in the frontal lobes leading to behavioral and personality changes and temporal lobes leading to memory and speech problems and can be severe. Type 2 virus genital herpes is most often transmitted through sexual contact.
Many people do not know they are infected and may not have active genital lesions. An infected mother can transmit the disease to her child at birth, through contact with genital secretions. In newborns, symptoms such as lethargy, irritability, tremors, seizures, and poor feeding generally develop between 4 and 11 days after delivery. Outside the United States, Japanese encephalitis is one of the most common causes of encephalitis worldwide. It is widespread in Asia and is transmitted by a mosquito. A vaccine is available so travelers to at-risk areas should discuss this with their healthcare provider.
Powassan encephalitis is rare but is the only well-documented tick-borne arbovirus in the United States and Canada. Symptoms are noticed days following the bite most people do not notice tick bites and may include headache, fever, nausea, confusion, partial paralysis, coma, and seizures. It is also possible to develop encephalitis that has non-infectious or autoimmune causes. NMDA-Receptor encephalitis is a type of autoantibody-mediated encephalitis and is being increasingly recognized; it was the most documented form of non-bacterial meningitis reported in the long-term study and follow-up of participants in the California Encephalitis project.
Anyone—from infants to older adults—can get encephalitis or meningitis. People with weakened immune systems, including those persons with HIV or those taking immunosuppressant drugs, are at increased risk. Some forms of bacterial meningitis and encephalitis are contagious and can be spread through contact with saliva, nasal discharge, feces, or respiratory and throat secretions often spread through kissing, coughing, or sharing drinking glasses, eating utensils, or such personal items as toothbrushes, lipstick, or cigarettes. For example, people sharing a household, at a day care center, or in a classroom with an infected person can become infected.
College students living in dormitories—in particular, college freshmen—have a higher risk of contracting meningococcal meningitis than college students overall. Children who have not been given routine vaccines are at increased risk of developing certain types of bacterial meningitis. Because these diseases can occur suddenly and progress rapidly, anyone who is suspected of having either meningitis or encephalitis should immediately contact a doctor or go to the hospital.
The hallmark signs of meningitis include some or all of the following: sudden fever, severe headache, nausea or vomiting, double vision, drowsiness, sensitivity to bright light, and a stiff neck. Encephalitis can be characterized by fever, seizures, change in behavior, and confusion and disorientation.