The relevance of this topic is that mental illness is much more widespread than is commonly believed. And the thing is that many mentally ill people do not consider themselves as such, and even if they guess about some disadvantage, they are panically afraid to see a psychiatrist. All this, of course, has to do with outdated traditions: psychiatry has long been one of the methods of intimidating and restraining both the sick and the dissenters. For many centuries, people's ideas about mental disorders have been shaped by mystical and religious sources. The natural-scientific understanding of mental illnesses as diseases of the brain was originally expressed by ancient Greek philosophers and doctors, but it long coexisted with superstitious beliefs. In ancient Rome, for example, insanity was believed to be sent by the gods, and in some cases was seen as a sign of chosenness (for example, epilepsy was called a sacred illness). In medieval Europe, psychosis was considered a spawn of the devil. Treatment of the mentally ill by "exorcism" was performed by clergymen. Some of the mentally ill were burned as witches and sorcerers. The first houses of mercy for the mentally ill were created at monasteries, and the sick were kept in straitjackets and chains "for curbing the devil. In Russia the mentally ill were called both "possessed" (by the devil) and "blessed" (from the word "good"); there were many mentally ill among the fools. The priesthood of the mentally ill also took place in monasteries, while the treatment, the "exorcism," took place in the church.
In the modern world the science, or field of clinical medicine, which studies the causes, signs and course of mental illnesses, as well as developing methods of their prevention, treatment and restoration of the mental abilities of the diseased person, is called psychiatry.
Psychiatry as a medical discipline emerged in the late 18th century. At that time, doctors began to speak out against cruelty to the disturbed sick, began to use medication, began to study the natural causes of illness, and from the various manifestations of mental disorders, distinguished groups of symptoms belonging to a particular disease. Psychiatry has made considerable progress over the past century. Many forms of mental illnesses are treatable, including those previously considered incurable. Methods have been developed to restore the social status (family, profession) of persons who suffered severe psychoses, which previously led to permanent disability. The appearance of psychiatric hospitals has changed - they have nothing in common with the "madhouses" repeatedly described in fiction. However, despite the progress of psychiatry, for some mental illnesses, it is still only able to reduce the intensity of painful disorders, to slow down their development, but not to cure the disease. This is explained by the fact that the nature of mental processes in norm and pathology has not yet been fully disclosed.
In this article three types of mental diseases will be considered in detail, namely: epilepsy, schizophrenia, manic-depressive psychosis. The choice of these particular diseases depended on those characteristic features peculiar to the mentally ill. It seems interesting to consider each disease separately, as well as all three in comparison, concluding that all three diseases are completely opposite. The main symptoms of mental illnesses, possible treatment options, as well as types and first aid techniques for an epileptic seizure will also be presented. The main conclusions will be summarized in the conclusion.
The problem of mental disorders is one of the most important problems in the world today. According to the World Health Organization (WHO), the number of people suffering from mental disorders averages 200-300 million, and is constantly growing. Thus, psychologists are faced with the problem of studying abnormal behavior and how it differs from the norm. In Russia, this issue gained popularity several years ago, which is associated with the change of political and social system. Mental illness (mental illness, psychosis) - is an illness that is characteristic only for humans. They are manifested by a variety of disorders of mental activity, as productive, i.e. occurring in excess of the usual mental activity, and negative (loss or weakening of mental activity), as well as general personality changes. Mental illnesses, or disorders of human mental activity, whatever their nature, are always caused by disorders of the brain. But not every disorder leads to mental illness. It is known, for example, that in some nervous diseases, despite the fact that the damaging process is localized in the brain, mental disorders may not be.
The Popular Medical Encyclopedia, edited by B. V. Petrovsky, indicates that the causes of mental disorders are varied. Among them, a significant role is played by hereditary factors, in particular in the origin of oligophrenia, psychopathy, manic-depressive psychosis, epilepsy and schizophrenia. However, the occurrence and development of psychosis in a number of cases is caused by a combination of hereditary predisposition and adverse external factors (infections, traumas, intoxications and traumatic mental situations).
The cause of mental illnesses also includes intoxications, head injuries, diseases of internal organs, and infections. For example, chronic alcoholism and drug addiction are connected with intoxications; among infectious diseases causing psychoses are encephalitis, brain syphilis, brucellosis, toxoplasmosis, typhus, some forms of flu.
In the origin of neuroses and reactive psychosis a major role is played by mental trauma, which sometimes only provoke a hereditary predisposition for the disease.
In the origin of mental diseases, a certain role is played by a combination of causal factors with the individual characteristics of the person. For example, not all individuals suffering from syphilis develop syphilitic psychosis, and only a small number of patients with atherosclerosis of cerebral vessels develop dementia or hallucinatory delusional psychosis. The development of mental illness in these cases may be promoted by preceding the underlying disease brain trauma, domestic intoxication (from alcohol), some diseases of internal organs, hereditary aggravation of mental illness.
Gender and age also have a certain value in the development of mental illness. For example, mental disorders in men are more common than in women. At the same time, traumatic and alcoholic psychoses are more frequently observed in men, and manic-depressive psychosis and involutionary (pre-aging) psychoses and depressions are more common in women.
The forms and types of mental illnesses are as varied as the action of causative factors. Some of them arise acutely and have a transient character (acute intoxication, infectious and traumatic psychoses). Others develop gradually, and progress chronically, with an increase and aggravation in the severity of disorders (some forms of schizophrenia, senile and vascular psychoses). Others, having been detected in early childhood, do not progress; the pathology they cause is stable and does not change essentially during the life of the patient (oligophrenia). A number of mental illnesses proceed in the form of attacks or phases ending in complete recovery (manic-depressive psychosis, some forms of schizophrenia).
There is one more group of illnesses that are not truly mental illnesses. They include neuroses (chronic nervous system disorders caused by stresses) and accentuations (i.e. aggravation or protrusion of certain traits) of character. The difference between psychopathies and character accentuations is that the latter have a less pronounced character, which allows for adaptation in society, over time accentuated character traits may flatten out. Character accentuations most often develop during character formation ("acute" character traits in adolescents are not surprising to anyone).
Thus, the existing prejudice about the fatal outcome of mental illnesses is not sufficiently grounded. These diseases are not homogeneous in diagnosis and prognosis; some of them are favorable and do not lead to disability, others are less favorable, but still, with timely treatment, produce a significant percentage of complete or partial recovery. It is necessary to warn against the idea that mental illnesses are shameful phenomena to be ashamed of. It is with these misconceptions that accidents with the mentally ill are connected, as well as the manifestation of neglected forms of psychosis that are difficult to treat.
Symptoms of mental illnesses
The most common symptoms of mental illnesses are hallucinations, delusions, obsessions, affective disorders, disorders of consciousness, memory disorders, and dementia.
Hallucinations. One of the forms of disturbance of perception of the surrounding world. In these cases, perceptions occur without a real stimulus, a real object, have sensory brightness and are indistinguishable from objects existing in reality. Visual, auditory, olfactory, gustatory and tactile hallucinations are encountered. Patients at this time really see, hear, smell, but do not imagine, do not imagine. Popular Medical Encyclopedia. Moscow: Sovetskaya Encyclopedia, 1987. С. 529.
Illusions. These are distorted perceptions of real-life objects. They are subdivided into visual, auditory, olfactory, tactile and gustatory. Examples of visual illusions are the following phenomena: a robe hanging in a room is mistaken for a person, a bush in the woods is mistaken for an animal. Auditory illusions include, for example, the phenomenon in which the noise of falling drops is perceived as individual words or phrases. They occur mainly in patients with infectious diseases, at poisoning, and also in physically weak people. Morozov G.V., Romasenko V.A. Nervous and mental diseases. Moscow: Medicine, 1987. С.170-171.
Delusion. This is a false judgment (inference) arising without an appropriate reason. It cannot be dissuaded, in spite of the fact that everything contradicts reality and all previous experience of the patient. Delusion opposes any valid reason, which distinguishes it from simple errors of judgment. According to the content of delirium, a distinction is made between delirium of grandeur (wealth, special origin, invention, reformation, genius, falling in love) and delirium of persecution (poisoning, accusation).
Compulsive states. Involuntary and irresistible arising thoughts, visions, fears, memories, doubts, cravings, movements, which painful character is realized, critically assessed, with some the subject constantly struggles. Characteristic of patients with schizophrenia.
Affective disorders. These are disorders associated with mood disorders. They are divided into manic and depressive states. (See Manic-depressive psychosis).
Disturbances of consciousness. These are transient, short-term (hours, days) disorders of mental activity which are characterized by partial or full disconnection from surroundings, various degrees of disorientation in a place, time, surrounding persons, thinking disorders with partial or full impossibility to make correct judgments, complete or partial remembrance of events occurring during a period of disturbed consciousness.
Memory disorders. This is expressed as a decrease in the ability to remember, retain and reproduce facts and events. A complete lack of memory is called amnesia. Popular medical encyclopedia. Moscow: Sovetskaya Encyclopedia, 1987. С. 529-530.
Thinking disorders. Some types are distinguished: Acceleration (thinking is so accelerated that patients do not have time to express their thoughts in words, manic-depressive psychosis), slowing down (some idea lingers in the mind for a long time, manic-depressive psychosis), viscosity (detailed description of unnecessary details, delay in getting to the point, epilepsy), resonance (unnecessary reasoning, idle pondering, schizophrenia), disconnectedness (separate words or parts of phrases).
Types of mental illnesses. Schizophrenia
Schizophrenia is a common mental illness in psychiatric practice with increasing emotional impairment and thought disorder with formally preserved memory. Reference Book for Medical Surgeons. Moscow: Medicina, 1975. С. 439. the name of illness "schizophrenia" in translation from Greek means "cleavage" of mentality.
In different countries, the number of patients with schizophrenia varies from 0.15% to 1-2%. The complexity of distinguishing schizophrenia is explained by the variety of clinical picture of the disease. The cause of schizophrenia is still unknown. There is convincing evidence of the importance of hereditary predisposition. There is significance of weakness of nerve cells, which develops as a result of poisoning by products of impaired metabolism (mainly protein metabolism). Morozov G.V., Romasenko V.A. Nervous and mental diseases. Moscow: Medicine, 1987. С. 243.
Clinical picture. Depending on the form of schizophrenia, different manifestations of mental disorders - delirium, hallucinations, agitation, immobility and other persistent changes that progress as the disease progresses - are observed.
The first symptoms are not quite specific: similar disorders may be present in other mental illnesses. However, in the subsequent stage, there are persistent mental changes or, as they are called differently, personality changes. They are characteristic of schizophrenia. Nevertheless, their degree of intensity depends on the form, the stage (early or late) of illness, the rate of its development and whether the illness proceeds continuously or with improvements (remissions).
At the earliest stages of illness, as a rule, even before pronounced manifestations of psychosis appear, these persistent and ever-growing mental changes are expressed in the fact that patients become taciturn, uncommunicative, withdraw into themselves and lose interest in their work, studies, life and activities of their relatives and friends. Patients often surprise others by the fact that they seize interest in areas of knowledge and activities to which they have not previously felt any attraction (philosophy, mathematics, religion, construction). They become indifferent to many of the things that earlier excited them (family and business affairs, illness of relatives), and, on the contrary, heightened sensitivity to trifles. Some patients stop paying attention to their toiletries, become unkempt, sluggish, and sink; others are tense, fidgety, going somewhere, doing something, thinking intently about something, not sharing with relatives what is occupying them at this time. Quite often the questions put to them are answered with long rambling speculations, ethereal speculation devoid of concreteness. Such changes occur quickly in some patients and gradually in others. In some patients, these changes, accruing, constitute the main part of the picture of the disease, while others are more likely to have other symptoms, i.e. to develop various forms of the disease.
Given the variety of manifestations of the disease, only a psychiatrist can make a diagnosis of schizophrenia. Timely diagnosis is necessary for correct and successful treatment and creation of sparing conditions for the patient.
Treatment. Although the cause of the disease is unknown, it is treatable. Modern psychiatry has a wide choice of treatment methods (medication, psychotherapy, occupational therapy) which allow to influence on schizophrenia. The combination of these methods with a system of measures to restore the ability to work and the ability to lead an active life in the community makes it possible to achieve long-term absence of manifestations of the disease. Patients with schizophrenia outside exacerbations retain ability to work, can live in a family and are under regular observation by a psychiatrist. Only a physician can monitor the patient's condition, the possibility of outpatient treatment or the need for hospitalization, and the length of hospital stay. The evaluation of the patient's condition, both by himself and his relatives, is often erroneous. Popular Medical Encyclopedia. Moscow: Sovetskaya Encyclopedia, 1987. С. 662-663.
Characteristics of the personality of patients. Schizophrenic patients are characterized by a loss of unity of mental activity: aspirations, actions, feelings lose their connection with reality, inadequacy of feelings arises, giving way to a decrease in emotionality, coldness and obtuseness. Detachment from reality, immersion into the world of one's own experiences appears. Gradually, the patients become inactive, inactive, sluggish, lacking initiative, sometimes showing activity and the initiative directed by painful experiences. Sloppiness, crankiness, selfishness, cruelty increase. There arises an emotional emaciation with indifference towards relatives, own destiny, former interests and affections disappear. The patients are forced to interrupt their studies, become inert at work, and often have a decreased ability to work and increased apathy. In remote stages of the disease delirium appears in the form of delusions of invention, reformism, jealousy, sometimes combined with elements of persecution ideas; there are also absurd delusions of grandeur of fantastic content.
Manic-depressive psychosis is a periodic psychosis manifested by bouts (stages) of mania or depression.11 The Popular Medical Encyclopedia. Moscow: Soviet Encyclopedia, 1987. С. 348. The etiology of the disease is poorly elucidated. The importance of hereditary aggravation of the disease is thought, and predisposing factors include mental trauma and somatic illness. The disease usually occurs at a mature age, and women are more often affected. The paramedic's handbook. Moscow: Medicine, 1975. С. 429.
Clinical picture. One of features of this illness is the recurrence of manic and depressive attacks. These attacks can proceed and be repeated in various variants. Manic attacks can alternate with depressive ones, without a bright interval, or there can be a bright interval between manic and depressive attacks, lasting from several days to several years. The duration of the seizures varies widely. They can last from 2 to 10 months. More often, the illness begins with a depressive attack. Sometimes only manic or only depressive attacks predominate in the clinical picture.
The second peculiarity is that the light interval between phases is characterized by recovery of mental health. Patients usually behave as they did before the disease.
The third feature is that no matter how severe the attacks are, no matter how often they recur, personality degradation never develops.
Manic phase. Patients have a cheerful mood and a heightened desire for activity. They take up everything, interfere in all affairs, make courageous projects, aspire to carry them out, achieve appointments with "responsible persons. Quite often, patients overestimate their capabilities, for example, having nothing to do with medicine, offer their own methods of treatment. Sometimes this overestimation takes on the character of delusional statements.
Patients in the manic phase are characterized by heightened sexuality. While outside the hospital, they often engage in casual relationships. Also in the manic phase, patients talk a lot, but it is not always possible to understand them. Due to the accelerated flow of the presentations, speech sometimes becomes so fast that it can outwardly give the impression of being disjointed: patients miss individual words and phrases. They themselves say that their language does not have time to express all their thoughts. This is why the patients talk a lot, their voice becomes husky. The annoyance of such patients irritates those around them.
Often there is an increased distraction of attention. Patients do not finish any of their work; they sleep very little, sometimes 2-3 hours a day, and feel absolutely no fatigue. Their mood is usually cheerful, but sometimes they are angry and easily involved in conflicts.
Depressive phase. Depressed patients perceive everything in gloomy tones and constantly experience a feeling of melancholy. They usually speak slowly, in a low voice, most of the time sit with their head down and their movements are sharply slowed down.
The patients' attitude toward their relatives and friends changes. Delusional statements are possible, most often a delirium of self-accusation. The patients claim that all of their acts were only a deception that caused irreparable harm to everyone. Sometimes patients conclude that they should not live, attempt suicide and refuse to eat.
In recent decades, the clinical picture of manic-depressive psychosis has undergone certain changes, in particular, depressive states have become predominant and manic ones are relatively rare. Along with typical depressive states, the so-called masked depressions are often encountered. They are characterized not so much by a melancholy, but rather by a depressed, despondent mood, occurrence of a set of somatic complaints (uncertain pains in heart, a gastrointestinal tract), insomnia, sleep without a feeling of rest. Morozov G.V., Romasenko V.A. Nervous and mental diseases. Moscow: Medicine, 1987. С. 255-259.
Treatment. Upon detection of signs of the disease, urgent hospitalization is necessary, where treatment is performed with medications prescribed by a specialist.
Epilepsy is a chronic disease characterized by seizures, certain personality changes, sometimes progressing to dementia. Epilepsy as a disease was already known in ancient Egypt, as well as in the ancient world. Hippocrates in his treatise "On the Sacred Disease" gave a vivid description of the epileptic seizure and its precursors (aura), and also noted the inheritance of the disease. He suggested a connection between epilepsy and brain damage, and objected to the widespread opinion of the time about the role of mysterious forces in the origin of the disease.
In the Middle Ages the attitude to epilepsy was ambivalent - on the one hand epilepsy caused fear as a disease that could not be cured, on the other hand - it is often associated with possession, trances observed in the saints and prophets. The fact that many great men (Socrates, Plato, Julius Caesar, Caligula, Petrarch, etc.) suffered from epilepsy was a prerequisite for the spread of the theory that epileptics are people of great intelligence. However, later in the eighteenth century, epilepsy often became identified with insanity and epileptic patients were hospitalized in psychiatric hospitals.
Only in 1849 and then in 1867 in England and Germany were organized the first specialized clinics for patients with epilepsy.
At a later time in our country, Russian psychiatrists S.S. Korsakov (1893), P.I. Kovalevsky (1898, 1902), A.A. Muratov (1900) and others paid much attention to epilepsy, and in recent decades epilepsy has been studied by scientists very widely and multilaterally, using modern epidemiological, genetic, neurophysiological, biochemical research methods, as well as methods of modern psychology and clinical psychiatry.
Epilepsy in Different Age Groups
Today, epilepsy is considered one of the most common diseases in neurology. The incidence of epilepsy is 50-70 cases per hundred thousand people, the prevalence is 5-10 cases per thousand people (0.5- 1%). At least one seizure during life is carried by 5% of the population, in 20-30% of patients the disease is lifelong.
Epilepsy in 70% of patients begins in childhood and adolescence and is rightly considered one of the major diseases of pediatric neuropsychology. The highest incidence rates are in the first year of life, the lowest between 30-40 years of age, and then increases again later in life. The prevalence of epilepsy in adults is 0.1-0.5%.
In 75% of patients the first seizure of epilepsy develops before the age of 18 years, in 12-20% of cases seizures are familial in nature. Obviously, this is due to the peculiarities of the structure and function of the brain of children and adolescents, with tension and imperfect regulation of metabolism, lability and tendency to irradiate excitation, with increased vascular permeability, hydrophilicity of the brain, etc.
There are no significant differences in the frequency of epilepsy in men and women.
Origin, etiology and pathogenesis
According to the definition of the World Health Organization (hereinafter WHO) epilepsy - is a chronic disease of the brain, characterized by recurrent seizures, accompanied by various clinical and paraclinical manifestations.
The interaction of hereditary predisposition and brain lesions is of primary importance in the origin of epilepsy. In most forms of epilepsy there is polygenic heredity, and in some cases it is of greater and in others of lesser importance. When analyzing heredity it is necessary to take into account, first of all, the obvious signs of the disease, giving some importance to such its manifestations as stuttering, consider the characteristic features of the personality (conflicted, spiteful, pedantic, obnoxious). Predisposing factors include organic cerebral defects of perinatal or acquired (after neuroinfections or craniocerebral trauma) character.
Such conditions occur as a result of provocative causes, such as high fever, in long-term chronic alcoholism - convulsive withdrawal seizures, or in chronic drug addiction - convulsions caused by drug deficiency.
From this we conclude that only 20% of all people who have had at least one seizure in their lives have epilepsy.
It is very difficult to get accurate figures of epilepsy due to the lack of unified accounting, and the fact that this diagnosis is often deliberately or erroneously not established and goes under the guise of other diagnoses (episyndrome, seizure syndrome, various paroxysmal states, seizure readiness, some types of febrile seizures, etc.) that are not considered general statistics on epilepsy.
In most cases, epilepsy is regarded as a polyetiological disease. Patients are significantly more likely than the population average to have a history of abnormal pregnancies and maternal births, severe infectious diseases, head trauma, and other exogenous difficulties. W. Penfield and T. Erickson (1949) considered craniocerebral trauma as the main cause of epilepsy, A.I. Boldyrev (1984) found a large number of cases caused by infectious diseases. At the same time, it is not always possible to establish a direct link with any exogenous factor, since the onset of the disease may be delayed from the primary brain lesion by several months or even years. Moreover, in a large percentage of cases, even severe brain injuries occur without subsequent development of epileptic symptoms, making it impossible to relate the severity of organic brain damage to the likelihood of epilepsy. It is important to note that, even with the most thorough collection of the anamnesis, in at least 15% of cases, it cannot be established.
Rather contradictory points of view exist regarding hereditary transmission of epilepsy. It is known that the incidence among the closest relatives of patients with epilepsy is higher than in the population (about 4%). However, familial cases are rare. An example of familial inheritance is the syndrome of benign neonatal seizures. In fact, we can only talk about the transmission of hereditary predisposition to the disease. On average, the probability of having a child with epilepsy in healthy parents is only 0.5%.
The pathogenesis of the disease remains largely unclear. The relationship of seizures with local organic scarring in the brain ("epileptogenic focus") can be established only in partial seizures. In generalized seizures, foci in the brain cannot be found.
The occurrence of seizures is often associated with changes in the overall metabolic processes in the body and brain. Thus, the factors provoking seizures are considered to be accumulation of acetylcholine in the brain, increased concentration of sodium ions in neurons, increasing alkalosis. The effectiveness in epilepsy of drugs that increase the activity of gamma-aminobutyric acid receptors indicates the role of gamma-aminobutyric acid deficiency in the occurrence of seizures.
In recent years, a close relationship between the metabolism of gamma-aminobutyric acid, glutamic acid and the migration of sodium ions in the neuron is found, which allows us to consider disorders in this system as one of the causes of seizures.
One of the mechanisms of action of antiepileptic drugs is their ability to cause folic acid deficiency, but introducing folic acid from outside the body usually does not lead to increased frequency of paroxysms.
The clinical picture of epileptic disease is polymorphic. It consists of prodromal disorders, various seizure and non-seizure paroxysms, personality changes and psychosis (acute and chronic).
In epileptic disease, a distinction is made between the prodromal period of the disease and the prodrome of the paroxysmal state.
The prodromal period of the disease includes various disorders that precede the first paroxysmal state, i.e. manifestation of the disease in its most typical manifestation.
Usually several years before the first paroxysmal attack, episodic attacks of dizziness, headaches, nausea, dysphoric states, sleep disorders, asthenic disorders are observed. Some patients have rare absences, as well as pronounced readiness for seizure reactions to exposure to various exogenous hazards. In some cases, more specific for epilepsy symptomatology is revealed - the predominance of polymorphic variable non-convulsive paroxysmal states with a number of features. Most often these are short-term myoclonic twitches of individual muscles or muscle groups, little noticeable to others, often without changes in consciousness and timed to a certain time of day. These conditions are often combined with brief sensations of heaviness in the head, headaches of a certain localization, paresthesias, as well as vegetative and ideatorial non-convulsive paroxysms. Autonomic paroxysms are manifested by sudden difficulty in breathing, changes in the rhythm of breathing, heart palpitations, etc. Ideator paroxysms most often have the character of violent thoughts, acceleration or slowing down of thinking. As the disease progresses, the manifestations described in the prodromal period become more pronounced and more frequent.
Prodromal paroxysms immediately precede the development of an epileptic seizure. According to the majority of researchers, they occur in 10% of cases (the rest of patients develop seizures without obvious precursors). The clinical picture of the prodrome of seizures is nonspecific, with a wide range of symptoms. In some patients the duration of prodrome is a few minutes or a few hours, in others it is equal to a day or more. Usually prodrome includes asthenic disorders with irritable weakness and persistent headache, different in character, intensity and localization.
Paroxysms may be preceded by episode-like affective disorders: periods of mild or more pronounced depression with a touch of displeasure, irritability; hypomanic states or distinctly pronounced manias. Often, in prodrome, patients experience melancholy, a feeling of impending and unavoidable trouble and have no place to go. Sometimes these conditions are less distinct and are limited to the sensation of discomfort - patients complain of some uneasiness, heaviness in the heart, sensation that something unpleasant is going to happen to them. The prodrome of paroxysms may include senestopathic or hypochondriacal disorders. Senestopathic phenomena are expressed by vague and varied sensations in the head, various parts of the body, and internal organs. Hypochondriacal disorders are characterized by excessive hypochondria of patients, increased attention to unpleasant body sensations, their well-being and the body's functions. Patients, inclined to self-monitoring, by prodromal phenomena determine the approaching paroxysm. Many of them take precautions: stay in bed, at home, try to be among their loved ones, so that the seizure will pass in more or less favorable conditions.
There is no etiologically sound treatment for epilepsy, anticonvulsants are the basic therapeutic agents.
There are three main stages in the treatment of epilepsy:
- Selection and application of the most effective and well tolerated type of therapy;
- Establishment of therapeutic remission, its consolidation and prevention of any exacerbations of the disease;
- Checking the stability of remission by reducing the dose of drugs to a minimum or complete abolition of antiepileptic drugs.
It is believed that surgical intervention is primarily indicated in symptomatic epilepsy caused by local abnormalities, such as a tumor. Surgical treatment of so-called temporal lobe epilepsy is now quite common, especially when drug therapy is ineffective. Surgery has a positive effect if a clear focus is found, mainly in the anterior part of the non-dominant anterior lobe. The operation consists of excision of the anterior and medial part of the affected temporal lobe, amygdala nucleus, hippocampus, and is performed on one side only. In therapy-resistant cases of epilepsy, stimulation of the cerebellum through electrodes implanted in the anterior parts of its hemispheres is sometimes used.
Types and techniques of first aid during the development of an epileptic seizure
Epileptic seizures can be small or large.
A minor epileptic seizure is a momentary disturbance in the brain that results in a temporary loss of consciousness.
Signs and symptoms of a small seizure:
- Temporary loss of consciousness;
- Airway remains open;
- Breathing is normal;
- Pulse is normal.
In a minor seizure, there are also convulsive movements of individual muscles and "unseeing" gaze of the victim.
Such a seizure ends as suddenly as it began. At the same time, the victim may continue the interrupted activities without realizing that he/she has had a seizure.
First aid for minor epileptic seizures:
- If a hazard is present, remove it. Calm and reassure the victim.
- When the person regains consciousness, tell them what has happened because they may not be aware they are sick and it is their first seizure.
- If this is the first time the person has had a seizure, advise him or her to see a doctor. A grand mal seizure is a sudden loss of consciousness accompanied by violent convulsions of the limbs and whole body.
Signs and symptoms of a grand mal seizure:
- The onset of the seizure is the onset of near-euphoric sensations (unfamiliar smell, sound, taste); the end of the seizure is loss of consciousness;
- Airways are clear;
- Pulse is normal;
- Respiratory arrest is possible, but not long.
In most cases, the victim falls to the floor without feeling, his body begins to beat in convulsions. Loss of physiological control may occur. The face becomes pale, then livid. The tongue is bitten. The pupils lose their reaction to light. Foaming of the mouth may occur. A seizure may last from 20 seconds to two minutes.
First aid for a grand mal seizure:
- Try to keep the patient safe so that he or she does not injure himself or herself if he or she falls.
- Clear a space around the victim and put something soft under his head.
- Open clothing around the victim's chest and neck.
- Do not hold the victim. Do not try to unclench his teeth if they are clenched.
- When the convulsions stop, move the victim to a safe position.
- While administering first aid, treat any injuries the victim may have sustained during the seizure.
- Hospitalization of the victim after the seizure has stopped is necessary if: it was the first seizure; there have been several seizures in a row; the victim is injured; the victim did not regain consciousness for more than 10 minutes.
This paper has succeeded in revealing the concept of mental disorders. The most common symptoms of mental illnesses are hallucinations, delusions, obsessive states, affective disorders, disorders of consciousness, memory disorders. Separately, we have broken down the main mental illnesses, identified the causes and treatments. The causes of mental illness are varied: from hereditary predisposition to trauma. As diverse as the action of causal factors, so diverse are the forms and types of mental illnesses. Nowadays, psychiatry no longer deals with punitive functions, so do not be afraid to consult a psychiatrist, because he can really help the patient suffering from a mental illness.
Completely dismantled such a disease as epilepsy, its clinical features of the disease, as well as methods of treatment and prevention. Epilepsy occurs in many people and does not interfere with their productive and full life. A prerequisite for this is regular visits to the doctor, as well as compliance with the following prescriptions and regimen.
In conclusion, here are seven basic rules to help prevent and alleviate seizures:
- Making sure to see your doctor regularly;
- Keeping a seizure calendar at all times;
- Take your medications regularly;
- Getting enough sleep;
- Avoidance of alcohol consumption;
- Avoiding bright, flickering light sources
By: Dr. Seniha Inan