Epilepsy is a chronic neurological disease that causes attacks of varying intensity in patients. With epilepsy, cognitive, sensory, and autonomic functions are impaired. The question of whether epilepsy is a hereditary disease is relevant for couples planning a pregnancy, as well as for people who have been diagnosed with this disease.
When making a diagnosis, neurologists at the Yusupov Hospital analyze the patient’s pedigree and identify the presence of epilepsy in his relatives. Cooperation between the Yusupov Hospital and large research institutes makes it possible to conduct genetic research and identify the nature of inheritance of the disease.
Types of inheritance of epilepsy
The development of epilepsy can occur due to various reasons. Clients often come to the neurology clinic of the Yusupov Hospital with the question of whether epilepsy is inherited. Every person wants to have healthy children, so this issue is relevant both for epileptics and for people who do not suffer from this disease.
Depending on the causes of development, the following types of epilepsy are distinguished:
- symptomatic, or acquired form, is associated with diseases of the cardiovascular, nervous systems, and various injuries;
- bdiopathic, or genuine, has a primary origin, which is caused by genetic disorders. In this case, epilepsy is inherited;
- The riptogenic form is characterized by unknown causes.
Genuine epilepsy can be transmitted as a dominant or recessive trait. An example of inheritance by a dominant trait is Rolandic epilepsy. Transmission of the disease in this case occurs through one sex and a direct line through one generation. So, if epilepsy is inherited from a father, then his child will be healthy, but his grandson will have this disease.
When inheriting a recessive trait, for example, juvenile myoclonic epilepsy, it is necessary that each parent is a carrier of this disease. In this case, epilepsy may not manifest itself in parents.
It is important for a neurologist to determine whether epilepsy is inherited, since the treatment tactics for epilepsy depend on its form. The epilepsy treatment program is drawn up by specialists at the Yusupov Hospital, taking into account the results of examinations and data collected by a neurologist.
Clinical picture
The course of hereditary epilepsy is no different from the course of acquired pathology. It is characterized by:
- fainting;
- convulsions;
- foaming at the mouth during an attack;
- short-term loss of consciousness.
In some cases, a patient who has already had a series of attacks can anticipate the onset of a new one several days in advance. This happens:
- disturbance of night sleep;
- headache and excessive irritability appear;
- decreased appetite;
- the appearance of a stereotypical aura and other symptoms by which the patient understands the approach of the inevitable.
After the appearance of the aura (lasting several seconds), loss of consciousness is possible with the patient falling to the floor, which is very often accompanied by a scream. Breathing movements slow down, the veins in the neck swell. The facial coverings turn pale, the jaws clench tightly. Tonic convulsions appear, and this state continues for approximately 20 seconds. The duration of this phase is about three minutes.
For Rolandic epilepsy, the characteristic time of occurrence is mainly at night (80% - the first half of the night, 20% - while awake). The convulsive state is more short-term in nature.
The first appearance of attacks for the myoclonic form is typical at the age of 10-19 years. Mental disorders act as precursors. Seizures are observed either daily, or at intervals of several months, or even less frequently.
The correct diagnosis is established by a qualified specialist. Only about 8% of sick people have a history of this pathology in their relatives.
Diagnosis of hereditary epilepsy
A neurologist at the Yusupov Hospital will be able to answer the patient’s question about whether epilepsy in this case is a hereditary disease only after a thorough examination. For diagnostic purposes, the patient is prescribed MRI and EEG. The absence of functional lesions of brain structures may indicate genetic factors in the development of epilepsy.
Genetic testing can determine whether epilepsy is inherited from the father or mother. The main indications for this procedure are:
- burdened heredity;
- suspicion of monogenic epilepsy;
- combination of epilepsy with mental disorders, congenital defects and other pathologies;
- exclusion from several types of genetic epilepsies.
The Neurology Clinic of the Yusupov Hospital is equipped with high-precision European equipment, which reduces the processing time of results and increases their reliability. An important advantage of examination at the Yusupov Hospital is the absence of queues and visits to specialists at a time convenient for the patient.
Signs
It is not epilepsy itself that is inherited, but a predisposition to it. If one of the parents or loved ones suffers from this disease, then it is not at all necessary that the child will also suffer from epilepsy. Although this probability is very high. In any case, children, even in the absence of clinical manifestations, will be carriers of pathologically altered genes.
The disease first manifests itself in childhood or adolescence with characteristic clonic-tonic convulsions, which involve almost all muscle groups. Against the background of convulsions, consciousness is lost, tongue biting and involuntary urination are often noted. As the disease progresses, the personality of such patients changes - their intelligence decreases, they become angry, petty, and irritable.
Treatment of hereditary epilepsy at the Yusupov Hospital
Modern experts have discovered that epilepsy is inherited in certain cases. When patients come to the Yusupov Hospital with complaints of epileptic attacks, neurologists determine what factors determine the development of the disease. This information is necessary not only for making a diagnosis, but also for choosing adequate treatment tactics.
The methods currently used in medicine to treat epilepsy achieve remission in more than 70% of cases. Drug therapy for epilepsy is leading, but it is successfully combined in the neurology clinic with other methods.
The technologies used at the Yusupov Hospital make it possible to determine whether epilepsy is transmitted in a particular case, and what is the mechanism of its manifestation. At the Neurology Clinic, real medicine is successfully combined with high-quality patient care. To receive specialist advice and quality treatment for epileptic seizures, make an appointment by calling the Yusupov Hospital.
Causes of the disease
Multiple sclerosis is a demyelinating autoimmune disease that is chronic in nature, in which the human immune system produces special antibodies that consistently destroy nerve cells by affecting the myelin layer of nerves.
The cause of this disease is the simultaneous confluence of certain conditions or factors. These conditions can be divided into:
- Are common.
- Direct.
Common ones contribute to the appearance of the disease and there may be several of them. These include:
- Belonging to the European race.
- The presence in the family of a person suffering from multiple sclerosis, and this person is a close blood relative.
- Belonging to the female gender.
- Changes in living conditions.
Direct factors are specific and are identified during diagnosis. These include:
- The effect of certain viruses and bacterial infections on the body, such as the herpes virus or streptococcal infection.
- Chronic processes in the body.
- Diet and daily routine.
- Physical and emotional stress.
- Hereditary predisposition.
- Taking oral contraceptives increases the risk of multiple sclerosis.
What is "epilepsy"?
For many decades, epilepsy was considered a single disease.
Currently, the concept of epilepsy has changed significantly. According to modern concepts, epilepsy is a group of different diseases, the main manifestation of which is repeated, spontaneously occurring epileptic seizures. It is important to note that there are both benign forms of epilepsy and prognostically unfavorable ones. Epilepsy is a chronic brain disease characterized by repeated, spontaneous (unprovoked) seizures in the form of disturbances in motor, sensory, autonomic, mental or mental functions, resulting from excessive neuronal discharges in the cerebral cortex.
Several important conclusions follow from this definition:
- Single seizures , regardless of their clinical manifestations, are not considered epilepsy. The diagnosis of “epilepsy” can only be established if the patient has repeated (at least two) epileptic seizures.
- Only spontaneous , unprovoked seizures require a diagnosis of epilepsy (the exception is reflex forms of epilepsy, for example, photosensitivity epilepsy). Seizures caused by certain influences, for example, fever (febrile convulsions), metabolic disorders, and occurring against the background of acutely developed brain diseases (encephalitis, stroke), are not considered as epilepsy.
- Epileptic seizures can be varied in nature. In addition to generalized tonic-clonic seizures (formerly called “grand mal” and traditionally associated with the concept of “epilepsy”), many different types of seizures have been described that may not always be noticeable to others (for example, seizures in the form of visual impairment, short-term memory impairment , sensations of fear, violent thoughts, etc. without loss of consciousness and not accompanied by convulsions), and do not always raise suspicion of their epileptic genesis (for example, attacks in the form of abdominal pain, suffocation, fainting, etc. with temporal lobe epilepsy).
How likely is the disease to be passed on by inheritance?
It was found that approximately 8% of children suffer from epilepsy, of which 4% are sisters and brothers and 4% are nieces and nephews of those individuals who have been diagnosed with idiopathic epilepsy. True epilepsy (genuine), which is based on metabolic disorder processes, manifests itself in various kinds of deviations from the norm in 50% of affected children. Dementia, pathological personality changes, neuropathy, and mental disorders are observed.
The common combination of dementia and epileptic seizures, according to neurologists, is not so much the result of genetic interaction between these diseases, but rather the selective marriage of the genes of their carriers from generation to generation.
Separately, we need to talk about the influence of heredity on the course of the disease.
It has been proven that heredity has a weaker effect the older the patient who started having seizures. In addition, the earlier the first seizure was noted, the higher the likelihood of inheriting epilepsy. Most often, those children who develop epilepsy are those whose siblings died in the first months of life from the seizures themselves or complications caused by them.
When aggravated by family heredity, the disease begins to manifest itself at about 4 years, and in the absence of an unfavorable family history - at 13-15 years. In describing the course of inheritance, it is necessary to say about the prevailing recessiveness.
Epilepsy: is it treatable?
First you need to determine the type of disease:
- Symptomatic – against the background of inflammation, skull injury;
- Hereditary;
- Idiopathic – without an established etiology.
When a person has hereditary epilepsy, it is not difficult to determine whether it will be passed on to children. The main thing is to establish the genetic factors that determine the clinical symptoms of the disease. There are several localities that cause pathology of brain tissue. In patients with hereditary forms, the first attacks occur at 14–16 years of age. Early onset of symptoms (in adolescence) indicates poor heredity. This form cannot be cured forever, but with proper treatment, doctors can reduce the number of epileptic seizures to one within 1–2 years.
A rare recurrence allows a person to lead a normal lifestyle and perform professional activities, but it is recommended to periodically do electroencephalography and avoid warning signs. Elimination of provoking factors increases the timing of repeated relapses. In some epileptics, with careful monitoring of precursors, secondary attacks of loss of consciousness and muscle twitching do not occur.
With a hereditary type of epilepsy, there is no cure, but with proper therapy it is possible to control the course of the disease. Patients with this type are able to perform normal work activities. Restrictions in pathology exist only when performing work with increased mental load.
What diseases should epilepsy be distinguished from?
In the newborn period, motor restlessness and tremor (shaking) may resemble symptoms of seizures.
In children, it is necessary to distinguish from epileptic seizures: pseudoepileptic (“hysterical”) seizures, fainting, migraines, tics (and other hyperkinesis), non-epileptic myoclonus, night terrors, somnambulism (sleepwalking), some diseases of the gastrointestinal tract (gastro-esophageal reflux) , benign paroxysmal dizziness, metabolic disorders (hypocalcemia).
Under the “mask” of epilepsy in adulthood, pseudoepileptic seizures, fainting, migraines, transient ischemic attacks, attacks of obstructive sleep apnea, narcolepsy, catalepsy, panic attacks, and hypoglycemia can occur.
The differential diagnosis of epilepsy in the elderly includes cardiac arrhythmias, transient ischemic attacks, metabolic disorders and sleep apnea.
Treatment
What to do if a person has their first seizure? Proper treatment of epilepsy is strongly related to diagnostic performance. It is necessary to determine what stimulates the occurrence of a seizure, so the patient should be closely monitored.
There are several main treatment methods:
- Elimination of concomitant diseases that can provoke the development of an epileptic focus.
- Taking special anticonvulsant drugs to relieve seizures.
- Creating comfortable conditions in which negative effects on the patient’s body and stimulation of seizures are eliminated.
Regular observation by a doctor and medical history are also necessary. The person’s loved ones need to be taught how to behave correctly during an attack in order to provide first aid and stop it.
Potential Complications
The disease is dangerous with a large number of complications. So, during an attack, a person can harm himself and sometimes others. There are many concomitant diseases that can appear during epilepsy:
- Brain swelling.
- Stroke of hemorrhagic or ischemic type.
- Thrombosis of the veins of the skull.
- Injury to the body.
- Cardiogenic shock.
And these are just some of the potential problems you may encounter. Seeing a doctor, treatment and prevention are very important.
Prevention
It is important to understand that a person with epilepsy can live a normal life. The main thing is to maintain the body in normal condition and follow the recommendations:
- Regular exercise, maintaining a balance between work and rest.
- Elimination of factors that provoke seizures.
- Taking a set of medications described by your doctor.
- Normal sleep pattern.
- Reducing stress.
- Refusal of strong drinks and alcohol.
- Eliminating the possibility of overheating or hypothermia of the body.
In many cases, seizures can be completely eliminated. It is also important to visit a doctor regularly and monitor your health.
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