CAMAGÜEY.- To Dr. Demetrio J. Carbonell Perdomo, 2nd specialist. Degree in Clinical Neurology, Assistant Professor of that specialty, of the Ana Betancourt maternal and child hospital in this city, I appreciate the time he dedicated to me, little as that of most of our doctors, who finish their consultations and without a break respond to a questionnaire, without previous presentation.

He announced that epilepsy is a neurological disease caused by episodic and recurrent brain dysfunction due to abnormal neuronal discharge.

— What are its causes?

—They are multiple, but in children, the most frequent ones are idiopathic (unknown). However, it may be related to asphyxiation at birth, a previous meningoencephalitis, a head trauma, or a stroke, among others. In children, we find it more often in the first mentioned causes and it is thought to have a hereditary basis, without ruling out asphyxiation (hypoxia at birth) and meningoencephalitis. Psychiatric disorders are associated mainly with the temporal lobe, without epilepsy being the cause of psychiatric disease.

— How do the crises appear?

—In various ways. We find them localized or focal and generalized, sometimes they cannot even be well classified.

“In the focal type, a certain area of ​​the brain participates and the generalized one consists of complete neuronal dysfunction. It may happen that it starts as focused and spreads throughout the brain. ”

— Does the patient know when he will suffer from these crises?

— In the focal ones yes, because of a smell, cramp, discomfort in one arm, it's like a warning, they call it the epileptic aura; while in generalized ones the person falls sharply to the floor and then does not remember what happened.

— What are the most common ages of onset?

— In childhood at any age, although the one known as absences occurs in the school stage, children stay staring, it is called as absence or small evil crisis, it comes from a hereditary base with a very good prognosis; and in elderly age, although it can be seen in all ages.

— Can it be curable?

— Yes, especially in children with absence, with idiopathic focal epilepsies and in adults with undetermined causes, about two years go by without it, electroencephalograms are normal, we begin to decrease the medication and often never repeat. In the children with absence, it usually disappears in adolescence.

"Other people have to maintain the treatment for many years or even for a lifetime, and they are those with a brain injury because it is another disease that causes it."

— How is it diagnosed?

— People give too much value to the electroencephalogram and it does not stop having it, but this can be abnormal in up to 20% of the cases examined, or perhaps more, without being epileptic and I say it from my experience and in someone who does either, it is possible that this is normal. This means that the most important thing is the clinical evaluation.

"It is exceptional in a child who debuted with seizures suffering from a brain tumor injury, while in adults suffering from acute seizures and not due to meningoencephalitis, imaging studies should be indicated to rule out, for example, tumors and cerebral infarction" .

— Does it have favorite sex or race?

—In neither case; nevertheless, without an exhaustive scientific study, but for my years in the specialty, I have seen it more in men.

— Does it intervene in intelligence?

— Great personalities have been epileptic, such as: Alexander the Great, Julius Caesar, Napoleon Bonaparte, and Fiódor Mikhailovich Dostoyevsky. Intelligence is affected if epilepsy is secondary to another condition such as meningoencephalitis that caused a mental retardation, or a child with asphyxiation at birth and was left with a disability, and as I stated before the idiopathic epilepsy in children has an excellent prognosis without compromising intelligence.

— Do the neurons experience damage before epilepsy crisis?

— That is questionable because there are serious and benign epilepsies. Children with absence crisis are indicated treatment, are controlled and this does not happen. In the past, without the current medications, the boys suffered an uncontrolled crisis over and over, and neurons deteriorated.

— What warning signs should be known to go to the doctor and discard or not this ailment?

—The presence of attacks, that is the abrupt and sudden fall with convulsive shocks, the appearance of behavioral disorder, when it seems to be absent at times, sometimes they stay with headaches, or irritable after the crisis, there are children who change in their school performance. Others convulse during sleep and in this situation assist to the specialist in Neurology to define if it is epilepsy or a sleep disorder, and we also have sleepwalking, talking asleep, sleep paralysis, jumping while sleeping, and all this should be assessed by the doctor. And adults usually when they convulse in an apathetic way.

— Events in a pregnant woman can cause this disease to her future son?

—Yes, virus infections such as simple genital herpes, cytomegalovirus (a common virus that can infect any person and once infected, the body retains it for life), alcoholism in the mother can lead the child to be very small, seizures, high blood pressure or eclampsia or preeclampsia can cause it or another brain problem.

— If the person is epileptic in adulthood, are there habits that make it worse?

— Alcoholism and drugs, and less mixing medications with these substances.

— Any advice?

—Before the described symptoms go to the doctor and never give medication without being indicated by him, he is the only one equipped to diagnose and treat the patient.

Translated by Linet Acuña Quilez