It is a disease caused by paroxysmal abnormal discharge of neuronal groups in the brain due to various reasons, leading to episodic abnormalities in movement, sensation, consciousness, mental state, and autonomic nervous function.

bubble_chart Clinical Manifestations

According to clinical seizure types, it is classified into:

1. Generalized tonic-clonic seizures (grand mal): Sudden loss of consciousness, followed by tonic then clonic spasms. Often accompanied by screaming, cyanosis, urinary incontinence, tongue biting, frothing at the mouth or blood froth, and dilated pupils. The seizure naturally stops after tens of seconds or minutes, entering a state of lethargy. Upon waking, there is a brief period of dizziness, dysphoria, fatigue, and no memory of the seizure process. If the seizures continue without interruption, remaining in an unconscious state, it is called status epilepticus, which is often life-threatening.
2. Loss of vitality seizures (petit mal): Sudden interruption of mental activity, loss of consciousness, may be accompanied by myoclonus or automatisms. A single seizure lasts from a few seconds to more than ten seconds. The EEG shows 3 Hz spike-and-wave or sharp-and-slow wave complexes.
3. Simple partial seizures: Tonic or clonic seizures of a local or unilateral limb, or sensory abnormal seizures, lasting briefly with clear consciousness. If the seizure spreads along the motor area to other limbs or the whole body, it may be accompanied by loss of consciousness, known as Jacksonian seizures (Jack). Post-seizure, the affected limb may have temporary paralysis, known as Todd's paralysis.
4. Complex partial seizures (psychomotor seizures): Psychosensory, psychomotor, and mixed seizures. Mostly with varying degrees of consciousness impairment and significant thinking, perception, emotion, and psychomotor disorders. May have automatic behaviors such as fugue, somnambulism, etc. Sometimes, under the influence of hallucinations and delusions, violent behaviors such as harming others or self-harm may occur.
5. Autonomic seizures (diencephalic): May include headache type, abdominal pain type, limb pain type, syncope type, or cardiovascular type seizures.

bubble_chart Auxiliary Examination

1. EEG, BEAM, Holter (Electroencephalogram, Brain Electrical Activity Mapping, Dynamic Electroencephalogram Monitoring): Clear pathological waves, spike waves, sharp waves, spike-slow waves, or sharp-slow waves can be observed.
2. If it is secondary epilepsy, further examinations such as cranial CT, cranial MRI, MRA, DSA, etc., should be conducted to identify the corresponding lesions.
3. Lumbar puncture CSF examination may show changes.

bubble_chart Treatment Measures

1. Drug Treatment:

1. Select safe, effective, affordable, and easily accessible drugs based on the type of epilepsy seizure.
   1. For grand mal seizures, use Phenobarbital 90～300mg/d. Sodium Valproate 0.6～1.2/d, Carbamazepine 600～1200mg/d, etc.
   2. For complex partial seizures: Phenytoin Sodium 0.2～0.6/d, Carbamazepine 0.2～1.2/d.
   3. For loss of vitality seizures: Clonazepam 5～25mg/d, Diazepam 7.5～40 mg/d.
   4. For status epilepticus: Diazepam 10～20mg per dose intravenously is the first choice.
2. Start the drug dose from the lower limit of the usual dose, gradually increasing until the seizures are ideally controlled without severe side effects.
3. The frequency of administration should be determined based on the drug characteristics and seizure features.
4. Generally, do not change or interrupt the medication arbitrarily. Only after complete control of seizures for 2～3 years and normal EEG, can the dose be gradually reduced and the medication stopped.
5. Regular drug concentration monitoring should be conducted, and the drug dose adjusted timely.

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2. For epilepsy with a clear disease cause, in addition to effectively controlling seizures, the primary disease should be actively treated.

3. For drug-resistant epilepsy that does not respond to medication, stereotactic surgery to destroy brain areas related to epilepsy seizures, anterior callosotomy, or chronic cerebellar stimulation can be performed.

4. Treatment for generalized tonic-clonic seizure status

1. Actively and effectively control spasms:
   1. Diazepam: Adults 10～20mg, children 0.25～1mg/kg, slowly intravenously injected until spasms stop. Then, add 20～40mg to glucose solution and intravenously drip at a rate of 10～20mg per hour for 10～20 hours, with a total daily dose not exceeding 120mg.
   2. Amobarbital Sodium: Adults 0.5g dissolved in 10ml of injection water, slowly intravenously injected at a rate of 50～100mg/min until the seizure stops. Pay attention to changes in respiration and heart rate during injection. After seizure control, continue with nasogastric or oral antiepileptic drugs.
2. Manage complications: Keep the airway clear, use diuretics to reduce brain edema, correct acidosis, etc.