Laugh frequently

Introduction There is a seizure that can't be controlled by self-control, and it can be swayed 3 to 5 times a day. Each duration lasts from a few seconds to tens of seconds. The attack time is irregular, and there is no obvious aura before the attack.

Cause

Western medicine is divided into two categories according to the etiology of epilepsy: idiopathic epilepsy and secondary (symptomatic) epilepsy. The former refers to the brain disease of such patients does not explain the structural changes or metabolic abnormalities of the symptoms, but has a close relationship with genetic factors. Symptomatic epilepsy is caused by a variety of brain lesions and metabolic disorders, such as congenital diseases, prenatal and perinatal diseases (production injury is a common cause of epilepsy in infancy), febrile seizures, trauma, infection, poisoning, Intracranial tumors, cerebrovascular diseases, nutritional metabolic diseases, etc. The production of epilepsy is associated with abnormal discharge of neurons. When the human body is resting, the discharge frequency of a cerebral cortical pyramidal cell is generally maintained between 1 and 10 times/second, while in epileptic foci, a group of diseased neurons can discharge at a frequency of up to hundreds of times per second.

High-frequency repetitive discharge of epileptogenic cell populations, the neurons directly associated with their axons produce a large post-synaptic potential, resulting in continuous transmission until inhibition (including sebaceous peripheral inhibitory neuronal activity, colloid The recovery of excitatory substances by the cells, as well as the involvement of the extracancerous inhibition mechanism, terminates the seizure. Various forms of seizures are caused by different routes and ranges of transmission. Epileptic activity may only involve the cerebral cortex of a region and no longer spread, causing a partial partial seizure; excitement is transmitted to adjacent neurons through the increase of extracellular potassium ions in the anterior central or posterior central gyrus, resulting in Jackson ( Jackson) Epilepsy; epileptic activity is often transmitted from the cerebral cortex through the descending projection fibers to the thalamic and midbrain reticular formation, causing loss of consciousness, which is then transmitted to the entire cerebral cortex by the diffuse thalamic projection system, producing a secondary generalized tonic. attack.

an examination

Related inspection

Brain CT examination blood routine

The patient often laughs for no reason, sometimes smiling and sometimes "haha" laughing, each laugh lasts about 3 to 5 minutes. When you laugh, you have no expression, or have a strange expression. There is no normal and happy emotion. The laughter is high and rough, and the tone is not normal. It is like laughing and laughing. "The smile is not laughing." The laughter is inconsistent with the scene at the time. In other words, in most cases there are no factors that cause laughter. After the attack, there is no memory for the laughing process, and there is no pleasant emotional experience. The intermittent period of the disease is completely normal and the onset is irregular. During the examination, the clinical episode was captured. When the laughter was seen, the EEG had a persistent high-pointed, slow-slung, slow-synchronous wave. After the laughter stopped, the slow-sounding, slow-synchronous complex wave disappeared.

Differential diagnosis

First, the body is strong - clonic attack (big attack)

Suddenly, consciousness is lost, followed by a strong temperament. Often accompanied by screaming, complexion bruising, urinary incontinence, tongue bite, foaming or foaming at the mouth, dilated pupils. After a tens of seconds or minutes, the seizure naturally stops and enters a state of drowsiness. After waking up, there is a short period of dizziness, irritability, and fatigue, which cannot be recalled during the attack. If the episode continues, those who have been in a coma state say that the episode is in a state of constant attack and often endangers life.

Second, absence of seizures (small episodes)

Sudden mental activity is interrupted, loss of consciousness, may be associated with myoclonus or autonomic syndrome. A seizure of a few seconds to more than ten seconds. EEG appears 3 times / sec slow or sharp slow wave synthesis.

Third, simple partial seizures

A local or one-sided limb with a stiff, clonic attack, or a paroxysmal episode, which is short-lived and clear-minded. If the range of attack extends to other limbs or the whole body along the movement, it can be associated with loss of consciousness. It is called Jack. After the attack, the affected limb may have temporary paralysis, called Todd paralysis.

Fourth, complex partial seizures (psychomotor episodes)

Psychosensory, psychomotor, and mixed seizures. There are varying degrees of disturbance of consciousness and obvious mental, sensory, emotional and psychomotor disorders. There may be autopsy symptoms such as snoring and night snoring. Sometimes, under the control of hallucinations and delusions, violent acts such as wounding and self-injury can occur.

Five, autonomic seizures

There may be headache type, abdominal pain type, limb pain type, syncope type or cardiovascular attack.

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