International Epilepsy Care Day: What happened in the patient's brain? June 28, 2019 Source: Science everyone Author | Fang Tie Beijing Children's Hospital Director of Functional Neurosurgery, Deputy Director of Epilepsy Center, Director of Cerebral Palsy Clinic, Deputy Chief Physician, Member of China Youth and Young Neurosurgery Exchange Association, Member of Precision Medicine Branch of the Association for the Promotion of Chinese Medicine, Member of China Anti-Epilepsy Association, Member of the American Anti-Epilepsy Association, a special expert on the micro-medicine platform There is such a group of people, the last second may still be talking to you and laughing, suddenly fainting to the ground, limbs twitching, loss of consciousness, foaming at the mouth, and even incontinence... No signs, frequent or horrible symptoms have seriously affected their lives, devastating their hearts, causing them to feel pain, even despair, and let their families feel nervous and nervous! They are people with epilepsy! Perhaps you are unfamiliar with epilepsy, but epilepsy is one of the most common diseases in neurology. The incidence rate is as high as 1%, that is, 100 people have epilepsy. June 28 is the "International Epilepsy Care Day". At present, there are 900 to 10 million epilepsy patients in China, most of whom are children and adolescents. The incidence of epilepsy ranks second among nervous system diseases. Why do the claws of fate reach out to them? Let them make a move that makes outsiders look so weird? What happened in the brain of patients with epilepsy? Abnormal discharge of brain neurons in patients with epilepsy The brain, as the chief commander of our body, gives orders to our bodies, and every part of our body is coordinated by it and managed by it. Although the brain position is high, it must also have "people" to supervise management, otherwise it may "abuse power" because of excessive excitement. Under normal circumstances, the excitability and inhibition of brain neurons are balanced, the two can live in harmony, and our bodies can work normally. But for some reason, the brain is too excitatory, the two are in an unbalanced state, and the brain is arbitrarily giving orders and abnormal discharge of neurons, which will cause epilepsy. Epilepsy produces a syndrome, it is not a single symptom, the symptoms of epilepsy are more complicated, and what areas of the brain are discharged, the corresponding function of the region will produce corresponding performance. For example: in the sports area discharge, epileptic patients will behave as convulsions! If the sensory area is discharged, it will feel numb! There are also more complex areas of neurological function that may produce more complex symptoms, some may be gibberish, and some may have hallucinations! The most common symptoms of epilepsy are the symptoms of generalized tonic-clonic seizures, limb convulsions, foaming at the mouth, gaze to one side of the eyes, closed jaws, incontinence, etc., which is what everyone calls the "sexual epilepsy" episode. . Why does epilepsy occur from time to time? What is the abnormal discharge of neurons? We can think of it as a volcanic eruption! When the volcano erupted, epilepsy occurred and the corresponding symptoms occurred. The volcanic eruption, the excess energy is released, and the volcano begins to enter a dormant period. Correspondingly, the performance of patients with epilepsy is no different from ordinary people at this time. But in the process of dormancy, these problematic places began to gradually accumulate energy. Once these energy exceeds a certain limit, they will erupt again. Therefore, epilepsy is a kind of intermittent, paroxysmal disease, and there is no incentive to see from the surface. Can epilepsy be completely cured? Most epilepsy can now be completely cured! It can work and live like a normal person. Although there is no specific statistics, in general, 90% of epilepsy can get a good therapeutic effect. However, these treatment methods actually do not reach the "frontier" that the public calls. From the perspective of the medical practitioner, the treatment effect is more important. Many treatment methods a hundred years ago are still very effective, and for the patients, Is the best. Medical progress can be divided into two parts, some of which are epoch-making. It used to be treated like this, and now it is not treated like this. It has completely changed. It is epoch-making; part of it is the original traditional treatment. Epilepsy treatment actually does not talk about it. On the epoch, most patients are treated in the traditional way. The treatment of epilepsy is divided into three main categories, drugs, surgery and other treatments (such as diet, biofeedback, etc.), the most important of which are drugs and surgery. 70% of patients can be effectively controlled through drug treatment, and then slowly reduce the drug, after a few years, the final withdrawal. Epilepsy drugs have new drugs every year, but it is not epoch-making. The therapeutic effect is not much different from the original drugs, but the side effects are relatively small. We call it a small change. Now the new drugs for epilepsy treatment are all imported from abroad. There are no new epilepsy drugs developed in China. We are indeed far behind in drug research. Including the cannabis, which is very hot in foreign countries, we are waiting to see when we can get into the country. It does have good effects on some epilepsy that have not been cured, including some epilepsy syndromes. In terms of the entire medical treatment, we still have a certain gap with other countries. They use more new drugs, and we will be relatively less. More than 30% of patients now have refractory epilepsy, that is, if the drug is not used, then we need surgery. The so-called traditional surgery, craniotomy trauma is relatively large, the risk is relatively large. At present, the so-called epilepsy frontier treatment is based on the original surgery, using minimally invasive surgery to change the original major surgery into minor surgery to reduce trauma. Although the risk is now small, from the perspective of curative effect, it is not improved than traditional treatment. Anything is a double-edged sword. While reducing trauma, the therapeutic effect may also decrease. If it has any advantages, it is epoch-making, then the so-called traditional treatment will die out, and the current minimally invasive treatment has not achieved epoch-making effects. Robot-assisted epilepsy surgery has also emerged. The so-called robotic aid refers to the integration of the navigational surgery plan with the robotic arm, which is a stereotactic navigation technique that doctors can use more easily. Preoperatively integrate the neurological imaging data of the child to make the structure and blood vessels of the brain endoscopic layer clearly visible. The doctor can customize the electrode implantation plan according to the specific conditions of the child, simplify the operation mode, and do not need to install the positioning head frame in the awake state. Can alleviate the suffering of children. But robot-assisted surgery is not fully automated, it does not implement artificial intelligence. Auxiliary procedures and surgical plans require a doctor to design the input. The surgery requires a semi-manual operation by the doctor, so in a strict sense, it cannot be called a "robot". It is actually an auxiliary system. Traditional treatments and minimally invasive treatments have their own advantages and disadvantages, depending on the parents' choices. Some parents want to choose minimally invasive treatment, but we will talk to them, the effect of minimally invasive treatment may be a little worse, and the cost of surgery is also higher, but it has great advantages, the trauma is very small, immediately after the operation Can be discharged from the hospital, and the risk is small. The surgical treatment of epilepsy in China is still closer to the international level, because its surgical methods and surgical equipment are better introduced into the country. The laser thermal coagulation used in the United States has not been available in China, and it may be introduced in the next few years. There are still some children who can't do intracerebral surgery. Now there are some nerve electrical stimulation treatments, which are relatively new. These new treatments can change the fate of some patients. But in the end, there are still some patients who can't cure it. The proportion in our country is almost 10%. Now, whether it is developed countries, China, or other countries, they are trying to find ways to change patients who could not be treated. How to get a first aid when you have a seizure? Epilepsy first aid is not like cardiac first aid, cardiopulmonary resuscitation. Our doctor hopes that everyone can master it, because it is indeed a common disease, and cardiac arrest needs immediate first aid, otherwise it will miss the best rescue time. For epilepsy, most of the epileptic seizures, breathing, heartbeat and other aspects of life indicators are stable, so we hope that parents do not operate on their own, the best way is to send the child to the hospital as soon as possible. Just do the following simple things at home: 1. Keep the patient's respiratory tract unobstructed, and let the patient be in a lateral position. Do not let the sputum or the like block the nose and mouth. Be careful not to squat, don't put your hand in the patient's mouth, otherwise it will be easily bitten. If you are worried that the patient will bite the tongue, you can use a small hard object to open your teeth. Use chopsticks and spoon, but do not use towels or towels. Easy to block the respiratory tract. 2. Try to keep the patient in the lateral position, put it on the door panel and take it to the doctor. Pay attention not to hold or carry it, and to move the patient repeatedly. If you find a patient suspected of epilepsy convulsions on the road, it is recommended to call 120 emergency calls, and then put this person in a lateral position to keep the airway open. Because ordinary people can't recognize epilepsy in general, to confirm whether it is epilepsy, doctors need to be diagnosed by EEG. Why do children get epilepsy? The etiology of epilepsy is very complicated. The main causes of epilepsy in children are these major causes: Genetic problems: Some children, whose genes from parents are problematic, have epilepsy genes, but this proportion is relatively low, and more genetic problems are acquired genetic mutations. Hundreds of genes are known to be associated with epilepsy. Problems in the development of the fetus: such as congenital developmental malformations, benign tumors of embryonic development, and genetic metabolic diseases. Problems during childbirth: such as hypoxia, premature delivery, combined birth injury with cerebral hemorrhage or cerebral hypoxia damage during childbirth. The incidence of epilepsy is related to age. The incidence of neonatal epilepsy is about 1%. It is generally considered that the prevalence rate is the highest within 1 year old and gradually decreases after 1~10 years old. Many parents will ask, my child was still good before, how did he suddenly get epilepsy? As mentioned above, during the volcanic eruption and dormancy period, the accumulation of energy is a process. Maybe the child's brain is damaged early, but the brain's excitement and inhibition are not completely out of balance, so he will not immediately develop epilepsy. He may need In a few months or even years, this balance will produce an imbalance. But in fact, this lesion may have already existed, such as premature infants, pathological jaundice, these children may begin to develop epilepsy after a few years, but the cause of epilepsy may be related to these problems. Some children's epilepsy is caused by brain tumors. When the tumor begins to grow, there may be no symptoms of epilepsy. As the tumor grows and develops, some symptoms of epilepsy will gradually appear. Children with febrile seizures Vs epilepsy Many treasure parents may confuse epilepsy and febrile seizures, but in fact, febrile seizures and epilepsy are completely different concepts. Febrile seizures are not diseases, but some of the children's physiological response to fever, although it is also caused by multiple discharge of neurons, but it is a clear incentive, in the case of fever will produce paroxysmal convulsions. In general, children are not so sensitive to heat when they are five or six years old. It is natural to have febrile seizures. Epilepsy is a sudden convulsion without cause, and the law of onset cannot be found. Some epilepsy is a heat-related epilepsy. It is related to fever at first. It is usually smoked as soon as it is a fever. However, it is often characterized by very early onset. It usually appears within one year of age. Later, it gradually evolves into a fever without smoking. Regular, convulsions without cause, and then mental decline. But this is a heat-related epilepsy, not the same as febrile seizures. Why are older women more likely to have epilepsy baby? As a woman's egg grows with age, it is affected by the environmental environment, and the overall quality is gradually decreasing. Therefore, older women are prone to discharge mutant eggs, and mutant eggs are prone to genetic problems. Eggs with genetic problems, once combined with sperm to form fertilized eggs, are prone to various problems during the development of the fetus, including epilepsy. Therefore, older women are not only prone to epilepsy, but also have a high chance of having other problems. To prevent the birth of epileptic babies, it is important to achieve prenatal and postnatal care and prenatal care. In particular, older women with a family history of epilepsy must make detailed prenatal examinations and find relevant problems early. Although many epilepsy can not be screened before birth, the screening can screen children with severe birth defects, and the incidence of epilepsy will also decrease. For children with epilepsy and parents Although the misfortunes of life come to you, don't lose confidence. Most epilepsy can be completely cured. The child can finally live a normal life. I hope that you must have confidence. In addition to active treatment, life should also pay attention to, people with epilepsy, whether adults or children, need a healthy life, develop good habits, eating habits, exercise habits, which is more helpful for patients with epilepsy. Some parents ask me, "fat" such as mutton, fish, etc., can induce epilepsy? Can you give your child a meal? In fact, the so-called hair is explained from the perspective of Chinese medicine. From the perspective of Western medicine, there is no clear incentive for epilepsy. There are only some patients with epilepsy. When eating certain foods, it may aggravate the epileptic seizures. But this is different from person to person. If the parents usually find that the child eats certain foods, it is easy to cause the child's bad symptoms to occur, and try not to eat this food in the future. However, children with epilepsy are advised to try to have a balanced diet and a healthy diet. For mutton, fish and other foods, as long as the child has no obvious reaction symptoms, you can eat in moderation. Some parents are also worried that it is not correct to limit the child's movement because of the epileptic seizure caused by fatigue. Although overwork is not enough, but for most patients with epilepsy, normal exercise is OK, don't have the mentality that this dare not do, that dare not touch. However, the child's sleep must be guaranteed. When the person does not sleep enough, the corresponding health status is relatively poor, and the frequency of the disease will increase accordingly. Conceptually, epilepsy itself has no incentives. We are more concerned with the aggravating factors of epilepsy. Unhealthy lifestyles tend to aggravate epilepsy. Of course, some patients have special physiques, which are sensitive to certain things and cause the body. The situation is declining, and this will aggravate epilepsy, which is a factor that varies from person to person. But overall, we believe that for people with epilepsy, a positive attitude and a healthy lifestyle are the most important. In addition, I would like to say a few words to female friends with epilepsy. Most mothers with epilepsy can give birth to normal babies. Therefore, for fertility, don't give yourself too much psychological pressure. But before going to pregnancy, you must do a detailed genetic test in advance, because the genetic test can be clear, will not have a baby with epilepsy in the future. As for the mother of epilepsy in early pregnancy, it is recommended that the epilepsy doctor and obstetrician should be fully consulted when using epilepsy drugs. At the same time, prenatal examination should be done because many epilepsy drugs are teratogenic, like phenobarbital. The medicine has severe teratogenic effects, but drugs like levetiracetam have low side effects and can be eaten during pregnancy, but must be taken under the guidance of a specialist. Hope, every epileptic patient can get a cure! Manual Massage Foot Spa Massager A manual massage Foot Spa Massager is a device designed to provide a relaxing and therapeutic foot massage. It is a manually operated handheld device, which means it does not require electricity or batteries to operate. The massager is made up of several parts, including the handle, rollers, and knobs.
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Image source: Visual China 
Image source: 123RF genuine gallery 
Image source: 123RF genuine gallery 
Epilepsy resection (Source: Fang Tie) 
Robotic adjuvant therapy (Source: Fangtie)
Robotic adjuvant therapy (Source: Fangtie) 
Image source: 123RF genuine gallery 
Image source: 123RF genuine gallery
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