Introduction
Epilepsy is one of the most common chronic neurological diseases of a person, manifested in the predisposition of the body to the sudden occurrence of convulsive attacks. These seizures are manifested in the form of brief involuntary seizures in any part of the body (partial seizures) or throughout the body (generalized convulsions) and are sometimes accompanied by loss of consciousness and loss of control over the functions of the intestine or bladder. The diagnosis is made if the seizures are repeated and accompanied by other symptoms characteristic of epilepsy. In most cases, epilepsy affects children and the elderly, but can be observed in young and adulthood.
In addition to physical trauma, which a patient of epilepsy risks to get during an attack, the illness reflects on his psychological state, self-awareness. At the same time, the more pronounced convulsive component of seizures and the frequency of their occurrence, the more sensitive the patient is (sensitive) and wounded in comparison with patients suffering from an unconvulsive form of paroxysms. Psychological studies have shown that the most disadaptive nature of personality reactions to the disease is much more pronounced in patients with secondary generalized complex partial seizures, with predominantly temporal localization of foci, personally altered, with a long duration of the disease and, especially, with a high incidence of seizures. It is in such patients that emotional-affective disorders predominate: melancholic, anxious, hypochondriac, neurasthenic, apathic, sensitive, egocentric and dysphoric patterns of attitude towards the disease.
In patients with infrequent primary generalized generalized seizures, a harmonious (relatively realistic) type of attitude toward the disease predominates; more pronounced ergopathic (leaving for work) and anosognoscopic (lack of a critical assessment of their illness) tendencies. This indicates the vulnerability, frustration (a state of tension associated with the inability to realize one’s need and achieve what was desired and planned) by illness, about the experiences of the patients due to their social dissimilarity in others (outside the seizures, these patients are usually practically healthy , which they try to demonstrate to others), stigmatization by the very fact of the diagnosis of “epilepsy”.
Formation of the internal picture of epilepsy, as well as of any other illness (the patient having a holistic image of his disease) goes through the following stages:
1) the initial – in which the sensory tissue of the disease is formed, that is, the bodily sensations caused by it. At this stage, sensations are poorly reflexed (realized) and verbalized (lend themselves to verbal description);
2) the primary meaning – in him the sensory tissue of the disease is mediated by a certain categorization, a system of meanings, universals. This changes the nature of bodily sensations: they lose their indeterminacy, they receive modality, intensity. The primary sign can be exercised either by the patient himself or by others;
3) secondary meaning is the correlation of one’s own state of health with stereotypes existing in a given society about systems of values in which the experience of a given society is expressed about health or illness. At this stage, sensations become symptomatic. The secondary sign depends on the notions of infectiousness, the curability of the disease, in accordance with the myth about the disease and its treatment that exists in a given society;
4) the generation by the individual of the meaning of the disease – the correlation of the meaning of the disease with its own system of values, motives. The personal significance of the disease can be different: hard, – receiving benefits and – have conflicting meaning (to facilitate the receipt of certain motives and interfere with others).
In spite of the fact that the majority of patients with epilepsy are intellectually preserved and no changes in their personality take place, the medieval notions of this disease still stigmatizing (stigmatizing) its carrier are still alive in the public mind. This problem is found all over the world, what can we say about today’s Russia, where everyday cruelty in both children’s and adult groups has become almost the norm. A person with epilepsy can often refuse to work if they find out his diagnosis. Children can not take in kindergarten, school. Disease brings to the person not only painful somatic sensations, but also affects the basis of his existence as a person. Qualitative information, as well as psychological support, can significantly and positively affect the process of forming an internal picture of the disease. This is exactly what psychologists are working on. Thesis statement: Epilepsy is a neurological disorder causing unexpected electrical activity throughout the brain, affecting the temporal, occipital, and frontal lobe.
Analysis
How and why is the temporal lobe affected?
. The temporal lobe of the brain, lobus temporalis, is the anterior section of the cerebral hemispheres containing gray and white matter (nerve cells and conductive fibers between them). Their surface is tubercular with convolutions, the lobes are endowed with certain functions and control various parts of the body. The temporal lobes of the brain are responsible for thinking, motivating actions, motor activity and speech building. With the defeat of this department of the central nervous system, motor disorders, speech and behavioral disorders are possible.
The temporal lobes of the brain are the anterior section of the central nervous system, which is responsible for complex nervous activity, regulates mental activity aimed at solving actual problems. Motivational activity is one of the most important functions. Main goals of these lobes are thinking and integrative function, control of urination, motivation, speech and handwriting, coordination of movements and behavior monitoring.
What is the temporal lobe of the brain responsible for? It controls the movements of limbs, facial muscles, the semantic construction of speech, and also for urination. Neural connections in the cortex develop under the influence of upbringing, gaining experience in motor activity, and writing. This part of the brain is separated from the parietal region by a central groove. They consist of four convolutions: vertical, three horizontal. In the back there is an extrapyramidal system consisting of several subcortical cores regulating movements. The oculomotor center is located next to, it is responsible for turning the head and eyes towards the irritant.
How is the frontal lobe effected and why?
The frontal lobes of the brain are responsible for: Perception of reality. There are centers of memory and speech. Emotions and strong-willed sphere. With their participation, the sequence of actions of one motor act is monitored. Manifestations of lesions are called frontal lobe syndrome, which occurs with various brain injuries: craniocerebral injury, alzheimer’s disease, pick’s disease, frontal lobe dementia and Oncological diseases. When the nerve cells and the pathways of the lobus frontalis of the brain are damaged, a motivation violation, called abulia, occurs. People suffering from this disorder show laziness, conditioned by the subjective loss of the meaning of life. Such patients often sleep all day. When the frontal lobe is damaged, the thinking activity aimed at solving problems and problems is disrupted. The syndrome also includes a violation of perception of reality, the behavior becomes impulsive. Planning actions occurs spontaneously, without weighing the benefits and risks, possible adverse consequences.
Violated the focus on a particular task. The patient, suffering from the syndrome of the frontal lobe, is often distracted by external stimuli, unable to concentrate. At the same time, there is apathy, loss of interest in those occupations that the patient previously enjoyed. In communication with other people, there is a violation of the sense of personal boundaries. Perhaps impulsive behavior: flat jokes, aggression associated with satisfying biological needs. The emotional sphere also suffers: the person becomes unreceptive, indifferent. Euphoria is possible, which is sharply replaced by aggressiveness. Injuries to the frontal lobes lead to a change in personality, and sometimes a complete loss of its properties. You can change your preferences in art, music. With the pathology of the right divisions, there is hyperactivity, aggressive behavior, talkativeness. Left-sided lesion is characterized by general inhibition, apathy, depression, propensity to depression.
Symptoms in case of damage include grasping reflexes and oral automatism, violation of speech include motor aphasia, dysphonia and cortical dysarthria, abulia includes loss of activity motivation. Neurological manifestations includes the suffocating reflex of Janiszewski-Bekhterev is manifested when the skin of the hand is irritated at the base of the fingers. Reflex Shuster: grasping objects that are in sight. Hermann’s symptom: extension of the toes with irritation of the foot skin. Symptom Barre: if you give the hand an uncomfortable position, the patient continues to support it. Symptom Razdolskogo: when irritated with a hammer front of the lower leg or the iliac crest, the patient involuntarily performs flexion-retraction of the hip. Duff’s symptom: constant rubbing of the nose.
The Bruns-Yastrovits syndrome is manifested in disinhibition, swagger. The patient does not have a critical attitude towards himself and his behavior, control it, in terms of social norms. Motivational violations are manifested in ignoring the obstacles to meeting biological needs. At the same time, focusing on life’s tasks is fixed very weakly.
Speech in the defeat of the centers of Brock becomes hoarse, disinhibited, control of it is carried out poorly and possible motor aphasia, manifested in violation of articulation. Motor disorders manifest themselves in the disorder of the handwriting. The sick person has disrupted the coordination of motor acts, which are a chain of several actions that begin and stop one after another and possible loss of intelligence, complete degradation of personality. The interest to professional activity is lost. Abulian-apathetic syndrome manifests itself in inhibition, drowsiness. This department is responsible for complex neural functions. The defeat of it leads to a change in personality, speech and behavior, the appearance of pathological reflexes.
What causes Epilepsy
Note that under the name “epilepsy” hides a whole group of more than 60 diseases with various clinical manifestations. The variety of clinical manifestations of epilepsy often makes diagnosis difficult. What are the symptoms and signs of epilepsy in children, what should parents be pricked up?
Generalized seizures are the same seizures that epilepsy is often associated with. At the beginning of the attack, there is a tension of all muscles and a short-term stop of breathing. Then convulsions begin, which can last from 10-20 seconds to 10-20 minutes. During an attack, spontaneous emptying of the bladder often occurs. Cramps stop by themselves, after which the child falls asleep. Non-convulsive generalized seizures Or absences (from absence – absence), flow less noticeably. During such attacks the child suddenly freezes, the sight becomes empty and absent. Sometimes a slight eyelid tremor is noticeable, the child can close his eyes or tilt his head. At this moment the child ceases to react to others, his attention can not be attracted. After the attack, the child returns to the interrupted occupation. Such seizures last very briefly, only 5-20 seconds, and adults most often do not notice them or pay no attention to them, accepting for usual absent-mindedness. Absence epilepsy usually begins at the age of 5-7 years, and girls suffer from this form of epilepsy about twice as often as boys. Absence epilepsy can last several years, before puberty. Then the seizures either gradually come to naught, or epilepsy passes into another form. Atonic seizures Atonic seizures in children are characterized by sudden loss of consciousness with relaxation of all muscle groups. Such an attack looks like a usual faint.
Therefore, if your child becomes unconscious from time to time without reason, this is a reason to be seriously worried. Children’s spasm This is involuntary bringing the hands to the chest, tilting the head or the entire body forward and straightening the legs. Most often, such attacks occur in the morning, immediately after awakening. Attacks last for several seconds. Sometimes they capture only a small group of neck muscles – then the spasm is expressed in an involuntary nodding of the head. Usually they suffer from children 2-3 years old, by the age of 5 it passes completely, or, as in the case with absences, passes into another form of epilepsy. Other signs of epilepsy in children In addition to the more or less obvious signs described above, there may be other reasons to think about going to the doctor. Such signs of epilepsy are very difficult to notice and associate with a serious disease. Of course, and terrible dreams, and headaches are in all children, they do not always signal the presence of epilepsy. But if these events are repeated too often, you need to seek the advice of a neurologist who can make an accurate diagnosis. All described manifestations are not always associated with epilepsy, they may have other causes. The main methods of diagnosing epilepsy include brain electroencephalography and computer or magnetic resonance imaging.
Psychological treatments for Epilepsy
The treatment of epilepsy differs from the therapy of other diseases due to the peculiarities of its manifestations and course. Therefore it is necessary to observe the basic principles and rules:
1. When establishing the diagnosis of epilepsy, it is deemed necessary to begin treatment immediately, in order to avoid the progression of the disease and prevent subsequent seizures.
2. The patient and his relatives need to explain the purpose, meaning and characteristics of therapy.
3. Taking medication should be regular and lengthy. Arbitrary cancellation of drugs can cause a sharp deterioration of the condition.
4. Drugs are prescribed depending on the nature of seizures and other mental disorders.
5. The dose of drugs depends on the frequency of seizures, duration of the disease, age and weight of the patient, as well as individual drug tolerance.
6. The dose is regulated in such a way that, with a minimum set of funds and minimal doses, achieve the maximum therapeutic effect, i.e., the complete disappearance of seizures or their significant decrease.
7. In case of ineffective treatment or pronounced side effects, the drugs are replaced, however, this is done gradually, preferably in a hospital setting.
8. With good results of treatment, reduce the dose of drugs, do it carefully, under the control of an electroencephalographic study.
9. It is necessary to follow not only the mental, but also the physical condition of the patient, regularly check blood tests, urine tests.
10. In order to prevent attacks, the patient should avoid the influence of factors and situations provoking seizures: alcohol intake, overheating in the sun, bathing in cold water (especially in the river, at sea), stagnant, humid atmosphere, physical and mental overexertion.
Treatment for epilepsy is usually complex and involves the appointment of various groups of drugs: directly anticonvulsants, psychotropic, vitamins, nootropics, injections of aloe, vitreous, biyohinola. To reduce intracranial pressure, intravenous infusions of sulfurous magnesia with glucose, diacarb are used.
In the treatment of large seizures, phenobarbital (luminal), benzonale, hexamidine, chloracon, primidone (milepsin, lysanthil), sodium valproate are used. To treat small seizures and absences, hexamidine, difenine, trimethine, sulex (picnolepsin) is recommended. Practically for all types of paroxysms, including twilight consciousness and dysphoria, finlepsin (tegretol) is effective. In recent years, widely usedtransquilizers that have a muscular-relaxing effect (seduxen, phenazepam, clonazepam).
With pronounced dysphoria, neuroleptics (aminazine, sonapax, nuleptil) are added.
Treatment of epilepsy should be supplemented by the correct mode of work and rest, observance of the diet with water, salt, sharp meals, complete elimination of alcohol.
Conclusion
It has also been established that the fewer patients are satisfied with their physical and emotional state, the more they are concerned about various social and situational circumstances complicating life activity, for example, “personal relationships”, “dependence on drugs”, “security”, etc., the more clearly the tendency to avoid (or oust) the solution of problems.
It is important to emphasize that in patients with epilepsy there is no global disturbance of the value system in comparison with healthy people. They retain a completely high identification of themselves with micro- and macrosocial environments. This applies primarily to the values-goals of life. Instrumental values, seen as means of achieving goals, are changing to a greater extent. Relatively safe value system – value consciousness is probably the real mechanism of active life of patients, despite the life difficulties (or contrary to them) caused by the disease, which probably reflects the phenomenon known in epileptology – hypersocial tendencies, that is, the desire of patients to social hypernormativity as a specific, but not always a conscious way of protecting the individual from those restrictions that are not always reasonably formulated by society in relation to patients with epilepsy.
References
Pietrangelo, A. (n.d.). Epilepsy: Causes, Symptoms, Treatment, and More. Retrieved April 09, 2018, from https://www.healthline.com/health/epilepsy
Epilepsy. (2018, March 10). Retrieved April 09, 2018, frohttps://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/drc-20350098
What You Need to Know About Epilepsy and Seizures. (n.d.). Retrieved April 09, 2018, from https://www.hopkinsmedicine.org/healthlibrary/conditions/nervous_system_disorders/epilepsy_and_seizures_85,P00779
