There are several disease attended with spasms of the muscles of the body resulting in various contortions of the features and limbs. When such spasms are attended with loss of consciousness, they are epileptic. Many children have fits of this kind, due to various causes, such as the irritation of teething or unsuitable diet. These may never recur, and then the disease is not called epilepsy, proper, but only if there is a periodical return of the attacks.
Hysterical attacks are sometimes mistaken for epilepsy, but in these the loss of consciousness is never complete, and as they occur in young women who are generally known to be hysterical, there is not much difficulty in distinguishing between them. Sometimes fright will send a person into convulsions, either hysterical or truly epileptic. There may never be a second attack, but not infrequently the patient has become epileptic form that moment, and subject to fits all the rest of his life.
Diagnosis.-Epilepsy is easily distinguished from apoplexy in general. In the latter there is no struggling, and in many cases there is no loss of consciousness; but in the worst forms of the two there may be difficulty. When patients fall down unconscious and lie still with congested face it may be impossible to decide between the two. If there is a history of previous epileptic attacks this will make the case clear. When there is no such history the event will have decide.
In Children.-General Treatment.-Put the legs of the child up to the knees in water as hot as can be borne. Let them remain in five or ten minutes, or until the fit appears to be gone off. Wipe perfectly dry and wrap the child warmly after. This may be repeated shortly if no relief follows the first time, or if the returns. Whilst the feet are in the bath cold water may be applied to the head. If the attack is traceable to the presence of an irritating substance in the stomach or bowels, an emetic or an injection of warm water should be given to bring it away if possible.
Medicines.-(To be given just as the fit is gone off; or, if long continued and frequently recurring, immediately and repeated every ten or fifteen minutes, according to urgency.
If there is no recurrence the medicine should be repeated two or three times a day for a few days.)
If the child is cross, and especially if teething and if there is convulsive jerking of limbs, twitching of face and eyelids, constant moaning, craving for drink, one cheek red the other pale.
Starting suddenly when asleep or staring about wildly; dryness and burning heat of forehead and palms; involuntary discharge of urine after the return of consciousness.
Sudden and violent starting from a light sleep with loud screaming and trembling of the whole body; spasms of a single limb or single muscles.
When there are worm symptoms, itching at the nose and anus, and wetting of the bed.
From indigestible food, as unripe fruit.
When due to fright; loud screaming, tossing of the limbs; or an unconscious state as if stunned.
When following repelled eruptions.
During the attack no treatment should be attempted. Tight garments may be loosened, and a tooth-brush handle may be inserted between the teeth to prevent biting of the tongue. When the conditions which induce an attack are known, such as indiscretions in diet, these should be avoided. The medical treatment should, when possible, be undertaken by a medical man.
Medicines.-(Two or three times a day.)
Convulsions violent; followed by mental disturbance.
Calcarea 6.-In pale lymphatic subjects with cold, damp feet.
When the fit occurs in sleep; heavy drowsy condition; constipation; when the fits are a consequence of fright, reproach, violent scolding, or taking offence.
In unhealthy-looking subjects who suffer from constipation.
Fits occurring about the full moon. In constitutions of the Sulphur type, subject to eruptions, to flushes of heat and fainty spells, when there is a “sinking” sensation at the pit of the stomach, worse in the forenoon. Hysterical. See HYSTERIA.