Epilepsy is commonly known as "epilepsy". How much do you know about it? It is believed that such a scene will emerge in everyone's mind: the patient falls down, convulsions all over, unconsciousness, and even foaming at the mouth. This is the most intuitive understanding of "epilepsy", but would you be surprised to say that "one in 100 people may be epileptic"?

Shanghai is densely populated, and people come and go on the streets. Maybe there will be epilepsy patients passing by you. "People don't know enough about epilepsy. Most people think that epilepsy is' goat crazy '. In fact, epilepsy also has no cramps, and a large proportion of people do not cramp. Even if they are around you, you may not be aware of them." In the interview, Professor Xu Jiwen, director of the Neurosurgical Epilepsy Diagnosis and Treatment Center of Renji Hospital affiliated to Shanghai Jiaotong University, said.

Professor Xu Jiwen stressed that from the perspective of age, epilepsy has two peaks, one is childhood (before the age of 18), especially adolescence, and the other is old age. "If children with epilepsy are found and treated early, 80% of them can be cured by taking medicine," said Professor Xu Jiwen.

The editor interviewed Professor Xu Jiwen on a series of issues concerning "infantile epilepsy". The interview was about 10 o'clock in the morning. It was drizzling. The editor rushed to Renji Hospital and contacted Professor Xu by phone. "There is the last patient who will come after reading. Sorry, wait a moment." Professor Xu's voice was calm and calm, but there was no sense of distance. He said sorry to me again and again. In fact, I arrived 20 minutes early.

Introduction to famous doctors: Xu Jiwen, male, chief physician, professor, doctor of medicine, member of the Chinese Expert Committee on Functional Neurosurgery, and member of the first council of China Anti epilepsy Association.

He has participated in the preparation of many academic monographs, especially in functional neurosurgery, such as epilepsy, Parkinson's disease, mental illness, pain, etc. He is one of the experts who have earlier comprehensively intervened in the field of functional neurosurgery in China, and has achieved satisfactory results in the operation of epilepsy and Parkinson's disease that has been carried out. In epilepsy surgery, we have rich experience in the treatment of intractable epilepsy, intractable epilepsy caused by intracranial tumors and brain trauma. Recently, Professor Xu Jiwen has devoted himself to the research of minimally invasive surgery for the treatment of intractable epilepsy, hoping to gain the maximum therapeutic effect with the smallest surgical trauma. Professor Xu Jiwen's meticulous, serious and responsible work style has won praise from patients and their families.

One in 100 people may be epileptic

Reporter: Hello, Professor Xu! First of all, thank you for accepting the interview of "reporter" in your busy schedule. For "epilepsy", it seems that people have few opportunities to contact it in life, and many people's understanding of epilepsy is only superficial. What is the actual situation?

Professor Xu Jiwen: People don't know enough about epilepsy. Most people think that epilepsy is "crazy sheep". In fact, there are some seizures that don't cramp, and many of them don't cramp. Even if they are around you, you may not be aware of them. The general routine physical examination can not detect whether the patient has epilepsy. Even if the EEG is done, if the outpatients show normal performance and do not have seizures during the visit, then the EEG can not be detected.

Reporter: Is the incidence of epilepsy high?

Professor Xu Jiwen: A large-scale survey has been conducted in China. The incidence of epilepsy is about 7 per 1000, which means that there is nearly one epilepsy patient in 100 people.

Reporter: It's already quite high.

Professor Xu Jiwen: Yes. In recent years, people have paid more and more attention to epilepsy. In the past, due to the serious lack of awareness of epilepsy, many patients like those in rural areas would not go to the hospital to see a doctor. Now they gradually pay attention to it. It seems that the number of patients coming to see a doctor has increased.

Reporter: The base number has not changed, but there are more discoveries?

Professor Xu Jiwen: Yes. What we mainly do is intractable epilepsy. Patients seek surgical treatment when the medical treatment effect is not good, but not necessarily every patient is suitable for surgery.

Reporter: In terms of age, do children often suffer from epilepsy?

Professor Xu Jiwen: There are many children. Epilepsy has two high incidence periods, one is in childhood (under 18 years old), especially in adolescence. The other is old age, which is relatively small.

　 Benign infantile epilepsy generally recovers after treatment

Reporter: Is the high incidence of puberty related to the growth of children?

Professor Xu Jiwen: There are several reasons. First, the nervous system of a child is the organ with the latest development in the whole body. The nervous system of a newborn child is very imperfect. Unlike other organs, such as the digestive system, it has been fully developed since birth. During the development of nervous system, many diseases will occur, including epilepsy. In fact, epilepsy is not a real disease, it is abnormal brain function. Many diseases may cause epilepsy, such as brain tumors, cerebrovascular diseases, congenital encephalopathy, inflammation, and trauma. These diseases can all be uniformly manifested as epilepsy. Because epilepsy is only an external manifestation caused by the excitement of local cells in the brain or the excitement of the whole brain. In addition, the congenital brain is not well developed. If it is serious, the baby will die at the age of two or three at most. This is serious epilepsy. There is also a child with high fever and febrile convulsions. One febrile convulsion does not matter, but two febrile convulsions may lead to epilepsy.

Because there are many primary diseases in children, most of them are in the process of brain development, which leads to the peak of epilepsy in children. However, there are also benign epilepsy in children. During the development process, brain waves have typical abnormalities, but with the improvement of development, they will recover in adulthood. Benign epilepsy in children is not rare, typical small seizures, brain waves discharge 3 times per second, very regular. It is characterized by loss of mind, such as taking something out, but not knowing it, and not cramping. We call it a typical paroxysm. Benign epilepsy will generally recover after treatment.

Reporter: As you just mentioned, children with benign epilepsy are in the development stage and are constantly learning. Will such benign epilepsy have a great impact on children's intellectual learning?

Professor Xu Jiwen: It will have an impact. Convulsions, one is not good-looking; Second, if there is no treatment, repeated severe brain discharge will cause excessive discharge of normal neurons in the brain, apoptosis of nerve cells, decrease of the total number of cells, cause memory decline, and even affect the child's intellectual development. Such as inattention and emotional excitement. If the child has attacks more than twice a year, he must go to the hospital for treatment. It doesn't matter if it happens only once a year.

　　 Parents and parents lack awareness of childhood epilepsy

Reporter: When a child gets sick, the child will certainly not realize that it is epilepsy. The first discovery must be the parents. Now, do parents know enough about epilepsy in children?

Professor Xu Jiwen: Parents' understanding is also gradually improving. Especially those who have epilepsy in their family and have seen it in their friends, they will be very alert. This is a good thing! If parents find a problem, the child can get medical treatment as soon as possible, and the effect will be better. But some parents and children are ill, and they don't know it yet. In particular, infantile spasms have no symptoms in infancy, such as nodding, bowing and bowing. Many people do not know it, but it is serious. It attacks several times a day. Some of the mental development was originally step-by-step, such as learning to walk, called Mom and Dad. After these nervous systems were disrupted, they could not sit, could not stand up, and could not walk. If you find your child has such symptoms, you should take him to the hospital immediately for EEG examination.

Reporter: EEG examination?

Professor Xu Jiwen: Yes. EEG examination is not a routine clinical examination. Many people think that EEG examination is useless, unlike changes in ECG, which can show myocardial infarction, ischemia, etc. In fact, the EEG shows great changes. It is impossible for professional doctors to understand the EEG. At present, there are few doctors who are really good at EEG in Shanghai.

Reporter: You should have a professional doctor to check?

Professor Xu Jiwen: There must be one in Renji Hospital, because we have to look at EEG. Without EEG, we can't locate, so we can't operate.

Careful operation for epilepsy in children

Reporter: After the discovery of epilepsy in children, can surgery be performed?

Professor Xu Jiwen: Yes, the operation of children should be careful. Because the child is in the period of growth and development, surgery will have an impact on the brain more or less. Some doctors are not very clear. They mistook children with benign epilepsy for intractable epilepsy. As a result, they had surgery, and the results are conceivable. I think the operation of children's intractable epilepsy must be jointly diagnosed and treated by three doctors, which three? Internal medicine, surgery and pediatrics. Because some problems are understood by surgeons, but not by physicians and pediatricians. There are some problems that they understand very well but we don't understand very well. The surgeon is very clear about the location and the monitoring of the cerebral cortex function during the operation, and we can do it very carefully. Physicians cannot do this work, but physicians are very clear about the classification, while surgeons are not very clear about it. What should we do? One is cooperation, the other is that surgeons must learn from them and attend pediatric conferences and internal medicine conferences.

Reporter: Do the three departments cooperate in many operations?

Professor Xu Jiwen: Many. In case of pediatric epilepsy, we will invite pediatric experts for consultation to see if surgery is needed. But for some diseases, such as infantile spasms, the effect of drug treatment must be very poor. Now we are also considering surgical treatment, and these works are also being done abroad. Some children have really improved greatly after treatment.

Reporter: The symptoms of epilepsy in children are relatively obvious.

Professor Xu Jiwen: The symptoms of epilepsy in children are very distinctive, so pediatricians can classify them clearly. There are cramps, abnormal movements, absences, all kinds of them. We often ask pediatricians to give us some lectures, tell us their new classifications, or help us understand them, which will greatly improve our surgical treatment.

Reporter: Will it recur after the operation?

Professor Xu Jiwen: Yes, surgical treatment is not a complete solution. We generally do not advocate the word "radical cure", because surgery is only one method of comprehensive treatment. Of course, medicine is the first choice, followed by surgery. Recently, we have also introduced a new method such as "electric stimulation therapy", which is between surgery and non surgery, and is relatively safe.

Reporter: But will the cost of this new treatment be more expensive?

Professor Xu Jiwen: Very expensive.

Reporter: Is it more expensive than surgery?

Professor Xu Jiwen: It's much more expensive. One treatment cost nearly 200000 yuan. But it is OK after one treatment, and there is no need to do it again.

80% of epilepsy in children can be cured by taking medicine

Reporter: Are there many cases of pediatric epilepsy caused by trauma?

Professor Xu Jiwen: Quite a lot. The incidence of post-traumatic epilepsy is about 10%~14%. Epilepsy can be divided into early epilepsy and late epilepsy. If you suffer serious trauma, you will cramp immediately. Some had seizures within three days, and some had epilepsy symptoms after three weeks. Generally speaking, the incidence of traumatic epilepsy in children is higher than that in adults. The child's brain development is not perfect, and is easily affected by the outside world, which is manifested as epilepsy. Therefore, if the child suffers from trauma, it must be treated with antiepileptic drugs.

Reporter: Do you need to use medicine all the time?

Professor Xu Jiwen: No, epilepsy caused by trauma can be cured in three months.

Reporter: Is home care important for children?

Professor Xu Jiwen: It's very important. If the child at home suffers from epilepsy, safety is the first priority. Because children are easy to fall, whether it is absentia attack or nervous attack, they are easy to fall. It is easy to hit the table and chair, and this kind of place should be wrapped with soft things; Also, children should not go out alone; Don't let children climb high and swim. Be careful. Moreover, children with epilepsy must go to a regular hospital for treatment, early detection, early treatment, 80% of patients can be cured simply by taking medicine. There is also a need to build confidence that epilepsy can be treated, but if drugs are not available, surgery can be used. If surgery is not available, there can be other non-surgical treatments.

Psychological care for epileptic children is equally important

Reporter: If a child has a seizure at school, will the child have a psychological shadow because the convulsions and other movements are ugly?

Professor Xu Jiwen: In this respect, teachers' work is the most important. First of all, teachers should not discriminate against children, and then take some more positive measures to tell other students that this student is not in good health and everyone should care about him, which will instead give more care to children. Parents should have knowledge, and teachers should also have knowledge.