Jacksonian epilepsy: causes, symptoms and signs, methods of diagnosis and treatment

Epilepsy is one of the most common diseases of the nervous system, in which periodic seizures of a relatively stereotypical nature occur.

Seizures can be either the only or the dominant symptom of epilepsy. The disease is chronic and, in addition to seizures, can manifest itself in convulsions and loss of consciousness.

Jacksonian epilepsy is a type of this disease, the main feature of which is that seizures begin in the muscle tissue on one side of the body and then spread to the opposite area.

Description of the disease and code according to ICD-10

This disease has the following ICD-10 code: G40.2. This includes epilepsy of a localized symptomatic nature, as well as epileptic syndromes accompanied by complex partial seizures. It is characterized by attacks during which the patient’s consciousness changes.

Jacksonian epilepsy is also called focal epilepsy. A separate area or zone of the cortex in the cerebral hemispheres is affected. This determines that the cortical localization of the seizure corresponds to its clinical manifestation.

The most serious type of the disease is a focal motor seizure, in which the spasms affect the same muscle groups. If localization is found in the sensory cortex, the patient usually feels heat, scratching and numbness in the same areas.

With auditory or visual manifestations, the spasm affects neighboring areas (for example, it can spread from sensitive areas to motor areas).

In most cases, focal motor seizures develop into generalized ones. Since the manifestations of epilepsy indicate the localization of the primary focus, this disease is called symptomatic.

Causes and risk factors

The risk of developing the disease in adults may increase due to the reasons described below:

1. Intracerebral tumors (and generally neoplasms anywhere in the body).
2. Traumatic brain injuries.
3. Brain surgeries that were unsuccessful.
4. Abnormalities of vascular activity in the brain.
5. Inflammation that begins in the membrane and substance of the bone marrow. A disease called meningoencephalitis negatively affects the functions of the cerebral cortex, leading to seizures.
6. Infectious lesions.
7. Congenital diseases.

It should be noted that due to the hereditary nature of the disease, it manifests itself in childhood and, as a rule, disappears by the age of 25 (relapses are possible in old age).
The factors described below increase the likelihood of epilepsy in a child from birth:

1. Fetal hypoxia.
2. Injuries to a newborn during childbirth.
3. Insufficiency of fetoplacental type.
4. Intrauterine infections.
5. Increased convulsive readiness of the mother's brain.

Clinic of the disease

Studying this type of epilepsy, doctors around the world note that most of their patients are conscious, while their body shakes from convulsions.

The characteristic signs of the disease described above allow us to conclude that the cause of the disease lies not in the part of the body itself affected by the spasm, but in the brain.

A person who has fallen into an epileptic seizure can stand, move, reason soberly and even sing, if he so desires.

The clinical picture of the disease is such that a patient who goes to the doctor with seizures can get up and walk away freely after a few minutes, which indicates how fleeting a seizure can be.

The onset of convulsions can stop as suddenly as they appear.

It is somewhat easier for young people suffering from this form of epilepsy to tolerate its manifestations, since in old age, after the cessation of muscle contractions, temporary post-ictal paralysis may occur.

The presence of paralysis also indicates that there is inflammation in the motor zone of the cerebral cortex.

Symptoms of the disease

Seizures usually begin in the front part of the brain.

After this, they impulsively appear in the affected area of ​​the body.

If a cramp affects a finger on the left hand, then with a high probability it can spread to the same finger on the right hand. Thus, the seizure does not spread to a large area (for example, the entire arm), but moves to a section located parallel to it.

Among Jacksonian seizures, the following forms can be distinguished:

1. “March” - seizures come one after another with a small interval.
2. The seizure affects the facial muscles.
3. A seizure occurs in the muscles of a specific part of the body.

You can tell that a patient is having a seizure by tingling in the fingers of both limbs (much less often the entire limb cramps).
Some people may experience clouding of consciousness, leading to fainting.

Jacksonian seizures: causes, symptoms and signs. Treatment of Jacksonian seizures in Moscow

The peculiarity of such epilepsy is its one-sided nature; if convulsions once occurred in the left leg, then they will subsequently recur in the same place at the same time.

There are many reasons for Jackson's epilepsy, so to establish them you will need to undergo a thorough examination. Main reasons:

1. Severe head injuries that led to brain injury or brain surgery.
2. Anomalies of cerebral vessels.
3. Malignant tumors of the brain and other internal organs.
4. Meningoencephalitis, i.e., inflammation of the membranes of the bone marrow. The disease interferes with its normal functioning, which leads to Jacksonian seizures.
5. Congenital diseases. Seizures usually occur in early childhood and resolve by age 25.

Among the risk factors that lead to this disease are:

• birth injuries;
• hypoxia;
• infection of the fetus.

There are three types of Jacksonian seizures:

1. Epileptic. It primarily affects the facial muscles.
2. Convulsive. Epilepsy affects a specific part of the body.
3. Jackson's March. Seizures occur at a certain interval one after another.

In Jacksonian epilepsy, seizures affect the arms, legs, or face. They then spread to other parts of the body. For example, a cramp in the arm moves from the hand to the forearm, shoulder, which leads to raising the arm. In this case, the face tilts to the side of the raised hand.

A cramp in the lower extremities causes the foot to flex, then it moves up the lower leg, thigh and affects the muscles of the body. Facial spasms distort the face and confuse the mouth.

With the development of the Jacksonian march, muscle paralysis and loss of consciousness occur. This condition is typical when the central nervous system is damaged.

In most cases, seizures affect the front part of the brain and then spread throughout the body.

Typically, epileptic seizures affect a specific area of ​​the body, and then spread further. This symptom is called the Jacksonian March. The disease manifests itself in three types: sensory, motor and sensorimotor.

Diagnosis of Jackson's disease

In order to make a final diagnosis, the neurologist sends the patient for a full examination of the entire body, and, accordingly, the brain.

The final diagnosis is made only after reviewing the results of all tests. The primary diagnosis can be made by the pattern of seizures the patient describes, as well as disturbances caused by head injuries or sensory disorders.

In order to distinguish the disease from other forms of epilepsy and neurological disorders, a psychiatrist and an epileptologist may be involved in making a diagnosis together with a neurologist.

A method such as electroencephalography is used to detect discharges of epileptic activity.

Using it, you can register focal discharges of epiactivity in the cortex caused by light or sound.

The following methods are also used:

• EEG video monitoring;
• MRI of the brain;
• CT scan of the brain (used if the patient has contraindications to MRI).

Treatment and first aid for an attack

Therapy for Jacksonian epilepsy should include the following components:

• antiepileptic therapy itself;
• treatment of the underlying disease (without it it is impossible to overcome epilepsy).

Typically, anticovulsant treatment is monotherapy. In the case of complex treatment, the following drugs are used:

• Phenobarbital;
• Primidone;
• Lamotrigine;
• Benzoarbital;
• valproic acid;
• means for dehydration (they are prescribed in parallel). These include furosemide, acetazolamide, and hydrochlorothiazide;
• absorbable drugs (aloe, hyaluronidase).

If epilepsy has developed due to a tumor, you should consult a neurosurgeon, with whom the option of treating the disease surgically will be discussed.
If you are dissatisfied with the operation due to the lack of a therapeutic effect, a focal resection may be prescribed, in which the areas of the cerebral cortex responsible for seizures are simply removed.

It should be borne in mind that after surgery, the limb for which the activity of the remote area of ​​the cortex was responsible may stop working.

Despite the fact that muscle strength in a given limb may reappear over time, certain manifestations of paresis in it may persist until the end of life.

Official medicine does not guarantee that epileptic seizures will not recur even after such a radical method (the intervention in any case leads to the formation of scars).

If the patient has a seizure, then its symptoms can be relieved by relief (compression or massage). This action on the muscle is necessary in order to prevent further spread of the cramp.

If a cramp has seized the leg, then squeeze it tightly with both hands or make confident but gentle massage movements. This method is applicable to any part of the body.

Find out more about other types and forms of epilepsy:

• congenital and acquired, alcoholic;
• pharmacoresistant and nocturnal, generalized and cryptogenic;
• idiopathic and partial, absence and myoclonic;
• Rolandic and temporal, Kozhevnikov epilepsy.

What is needed to cure Jacksonian epilepsy

If you suspect the appearance of this pathology, you should undergo an examination by a specialist at our Leto mental health center. Hotline phone number: 8(969)060-93-93 . The call center is open 24 hours a day. Call us and the consultant on duty will give comprehensive answers to all your questions. The anonymity of the appeal allows you to talk about existing problems completely calmly. 24-hour consultation gives you the opportunity to make calls at any time convenient for you.

You can make an appointment with a doctor by telephone, and, if necessary, call a specialist to your home. If you need to transport a patient, we will provide conditions for a comfortable transfer.

In the inpatient department of the clinic, you can choose the most suitable ward for your stay.

We offer options:

• Standard (2-3-4 seats).
• Comfort for two people.
• VIP – for a stay of one person.

Attentive and qualified staff will monitor the patient around the clock.

Features of therapy in childhood

As in adults, epilepsy in children is treated with the correct selection of anticonvulsant drugs and their correct dosage. Compliance with a special diet, as well as the child’s stay in a special environment, also contributes to high-quality treatment.

It should be said that it is necessary to start treatment with anticonvulsants as early as possible, otherwise the risk of serious brain damage increases significantly. When choosing a drug, you should pay attention to the following: if you can achieve the full effect with it, then stop with it.

However, if the effectiveness is incomplete, a second drug is added to the therapy (this is explained by the fact that the drugs complement each other and enhance the therapeutic effect). If the second remedy does not live up to expectations, other drugs are used in treatment.

If there is a need to change the drug, it should be gradual - the dose of one is reduced, while the dose of the other is increased.

For treatment to work as a cure, it must be permanent.

Drug treatment is stopped only if the child, after recovery, does not notice epilepsy attacks for two years.

The withdrawal of treatment is carried out gradually (on average, the process takes up to three months), since the rapid withdrawal of drugs against convulsions can provoke their relapse.

It is necessary to constantly monitor both the child’s EEG data and blood and urine tests. All of the above also includes control over liver functions.

The best place to treat Jacksonian epilepsy in a child with medications is a hospital.

If the child is at home, parents should remember the following:

1. The child should not worry. The environment at home should be calm.
2. The body cannot stay in the sun for long.
3. A seizure can be triggered by television, so the child should not sit too long in front of it.
4. Unacceptably large amounts of salt in baby food.
5. Bicycling, swimming and gymnastics are prohibited, but you can attend school (if seizures are rare).

If a child has a seizure, a rubber tube is inserted into his mouth, not forgetting a handkerchief so that he does not accidentally bite his tongue.

Next, place the child on his side, raise his head and place it on the pillow. The pressure of tight clothing must be released (unbutton your shirt). In most cases, the seizure resolves spontaneously, however, if it persists, the child is given Diazepam or Chloral hydrate.

Forecast and preventive measures

The prognosis of treatment is determined based on the characteristics of another disease that caused Jackson's epilepsy, and the degree of effectiveness of the therapy used.

This disease does not pose a direct threat to human life and is an unpleasant illness that causes disturbances in consciousness and the loss of certain body functions.

If you consult a specialist in a timely manner, the disease can be cured.

However, it should be remembered that the path to full restoration of strength will take at least a year. If Jacksonian epilepsy is not started and treated in a timely manner, the number of seizures can be minimized and, ultimately, the disease can be overcome.

In order to ensure effective prevention of Jacksonian epilepsy, it is necessary to organize systematic treatment for patients. It is impossible to predict the onset of disorders of this nature!

In conclusion, it should be said that curing Jackson’s epilepsy is quite possible if a diagnosis is made in time and every effort is made to combat the disease.

In most cases, patients achieve full recovery after using modern treatment methods, drug therapy and other procedures prescribed by a qualified specialist.

Forecast

Jacksonian epilepsy has a good prognosis. The disease is highly treatable. There is no development of additional complications in the form of mental or functional abnormalities. This type of epilepsy is not a life-threatening or dangerous disease. But still, the disease is very unpleasant due to constant convulsive attacks and periodic loss of consciousness. And also due to the loss of certain body functions. But with timely consultation with a doctor, the number of seizures is significantly reduced. Treatment lasts at least a year.