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Convulsões



O cérebro controla as respostas motoras através de mensagens de origem electroquímica que percorrem os nervos até às células motoras. Observamos no dia-a-dia que movimentos como levantar um braço e flectir uma perna são realizados de forma consciente pela maioria das pessoas, o que pressupõe a existência de uma actividade eléctrica cerebral normal. As convulsões surgem quando ocorre uma súbita alteração da actividade eléctrica cerebral normal. Dependendo da causa e da área lesada do cérebro, as convulsões podem ser de diversos tipos. São designadas por convulsões focais ou parciais quando afectam apenas uma parte do cérebro e generalizadas quando o cérebro está envolvido na sua totalidade. As convulsões caracterizam-se pelo movimento descontrolado de um ou vários segmentos do corpo pelo que observando os segmentos envolvidos é previamente possível enquadrar a convulsão num dos dois tipos acima referidos. Além de poderem ser focalizadas ou generalizadas, a pessoa pode estar consciente ou não aquando a sua ocorrência, pelo que se designam respectivamente por convulsões simples ou complexas. Qualquer pessoa saudável pode vir a sofrer uma convulsão sob algumas condições contudo, os primeiros episódios de convulsão devem implicar uma avaliação médica. Geralmente têm pouca duração; sempre que possuam duração superior a 5min ou não exista uma recuperação de consciência por parte da pessoa entre vários episódios constituem uma emergência médica. Nas pessoas que sofrem de epilepsia é frequente a ocorrência de convulsões. Contudo, nem todas as pessoas que sofrem uma crise convulsiva são epilépticas.


Quais as causas possíveis:
- Epilepsia;

- Traumatismo craniano;

- Infecção do Sistema Nervoso Central (abcesso cerebral, encefalite e meningite);

- Tumor cerebral;

- Hemorragia cerebral;

- Trombose cerebral;
- Eclampsia (convulsões que ocorrem no terceiro trimestre de gravidez associadas à hipertensão).


Algumas outras situações médicas que “irritem” as células cerebrais podem originar uma convulsão:

- Alterações metabólicas (ex: baixa de açúcar, insuficiência renal, excesso de produção de hormona da tiróide);

- Alguns medicamentos ou drogas (alguns antibióticos, drogas estimulantes, cocaína);

- A abstinência súbdita de consumo de bebidas alcoólicas em indivíduos alcoólicos;

- Febres elevadas (sobretudo em crianças).


O que fazer face a uma convulsão?

A maior parte das convulsões é auto-limitada, ou seja, pára sem qualquer intervenção e não deixa sequelas permanentes. Contudo podem surgir algumas complicações durante a crise:

- Traumatismos devidos a alguma queda e aos movimentos convulsivos;

- Aspiração de vómito, comida, objectos ou líquido para os pulmões;

- Incapacidade para respirar adequadamente e assim receber oxigénio de forma adequada.


Perante uma pessoa em convulsão, deve-se:

- Tentar manter a calma;

- Prestar atenção ao que se passa com a pessoa para depois poder descrever ao pessoal da equipa de emergência e aos médicos;

- Não tentar segurar/prender impedindo os movimentos convulsivos;

- Não colocar nenhum objecto ou os dedos entre os dentes da vítima em convulsão;

- Não tentar mover a pessoa, a não ser que esta esteja em local ou condição perigosa;

- Não tentar obrigar a pessoa a parar a convulsão;

- Tentar proteger a pessoa, evitando possíveis traumatismos, afastando móveis e objectos que possam magoar a vítima e se possível colocá-la de lado;

- Tentar cronometrar o tempo de duração da convulsão;

- Não tentar dar nada pela boca até que a convulsão tenha parado e a pessoa esteja totalmente consciente.

- Não se deve impedir a pessoa de descansar após a crise, esta poderá apresentar sinais de inquietação e de desorientação durante a fase de recuperação.



Quando levar ao hospital?

Caso uma pessoa, que já possua uma história conhecida de epilepsia, tenha uma convulsão de curta duração e em que não decorra nenhum traumatismo importante ou aspiração de vómito, não é necessário conduzir essa pessoa para o hospital, contudo, o médico responsável pelo tratamento da epilepsia do doente deve ser notificado para que possam ser feitos os ajustes necessários à medicação.


Sempre que:

- Seja o primeiro episódio de convulsão;

- A crise seja prolongada (>5min);

- A pessoa se mantenha confusa ou desorientada num período superior a 10-15min após terminar a convulsão;

- Não ocorra recuperação do estado de consciência após a crise;

- Se manifestem sinais de dificuldade em respirar;

- A pessoa sofra algum traumatismo durante a convulsão.


(ligar 112)


Avaliação Hospitalar:

Para além da história clínica e do exame físico do doente, é de esperar que o médico que procede à avaliação do paciente procure obter informações sobre o tipo de convulsão (se o doente esteve ou não consciente durante a crise, que partes do corpo se moveram compulsivamente, onde começaram os movimentos convulsivos, qual a duração da crise, quantas crises, etc). Diversos estudos poderão ter que ser efectuados, como: análises sanguíneas, TAC cerebral, electroencefalograma, punção lombar. O tratamento dependerá do tipo de convulsão e das causas subjacentes.


Prognóstico:

Depende da causa da convulsão e também da resposta ao tratamento do indivíduo. A maioria das convulsões devidas a medicamentos, drogas e traumatismos cranianos ligeiros não carece de tratamento especifico e não implica que a pessoa passe a padecer de epilepsia. A maioria das outras causas de convulsões pode ser tratada de forma eficaz recorrendo a diversos fármacos actualmente disponíveis e sempre que possível ao tratamento da causa subjacente. São raras as situações em que as crises convulsivas são difíceis de controlar com os medicamentos disponíveis.

Posted by Immuniselectrun at 07:53

Hall of fame

Louis Pasteur

Birthday date: 27th December, 1822

The truth is surprising: as young, Louis Pasteur was a lazy student. His teachers never thought he was quite clever, as ahead he would show.

He studied physics and chemistry in Paris and chemistry was even the discipline in which we got a lower grade. Despite of that, later, He became a wise teacher and was one of the bigger scientists of ever, a genius of science. Only through one huge thirst of knowledge and an inexhaustible will of work the immortality was conquered and the death was defeated.

Facing all the expectations, the success arrived much early. With twenty six years he discovered the secret of crystals and a few time later he realized that the air we breathe it’s full of very small beings, He called them the invisible giants. Perhaps Pasteur already knew that these beings, apparently armless, were responsible for much part of the diseases shown in living beings. For sure he knew that the microorganisms used to enter in our organism with the purpose of unleash diseases. It was not easy to prove such theory in a time when all scientists thought that microorganisms were fruit of our own organism and not from outside. He wouldn’t give up anyway, He even bottled air to prove it, under the laugh of his colleagues , of course they didn’t even guess that what he was doing would become indispensable to his theory: none living being, including microorganisms, can appear in the world without descend from at least other of the same specie. In the course of his experiences, Pasteur could show up that microorganisms live in the air and reproduce themselves, entering in our body when they “feel” we are weakened and is the best shot to take. This was a very important discovery but his greatest feat, vaccine, would take more time to be created.

Before it, he helped the French farmers, solving a big problem: the quick sourness of wine. He observed microscopically the wine and found some kind of very short vegetation, called yeasts. Therefore, the yeasts were spoiling the wine, making it vinegary. Pasteur understood that wasn’t possible to take out those little creatures, they had to be killed and the only possible way: heat them up. The problem lied in the fact that the wine couldn’t heat up to high temperatures because it would change its quality. Persistent, Pasteur made a lot of experiences and found the solution: it was only necessary rise the wine’s temperature about sixty degrees centigrade to kill the microorganisms. These experiences gave rise to a much known process called pasteurization.

Pasteur was, undoubtedly, a chemistry genius and started to be called to solve the riddles that more nobody could. There was even a time when he was asked to find the origin of a plague which was killing thousands of silkworms. Pasteur, after some research, figured out that the butterfly was transmitting to her own eggs the disease and hence died so many of them. It was necessary to exterminate all larvae, butterflies and eggs which weren’t healthy. He had saved the French Industry of Silk and now, he’s stories of success were told not only in France but also abroad.

Modest, simple and not vain, Pasteur used to say that he only worked to help mankind. But, the fact of two of his sons have died with typhoid fever explain the dedication to Medicine and to studies about diseases caused by microorganisms.

Carbuncle was one of the first diseases studied by Pasteur. In that time, were dying many animals, mostly sheep due this disease. He discovered the responsible microorganism and made an experience: vaccinated twenty five sheep with the germ which caused the disease and left other twenty five sheep for vaccinate. Then he infected them all with the microorganism which made they feel sick. Happened that all vaccinated sheep survived and the others died. This was the first success of vaccination. However, he refused money to patent the medicine.

He wondered if would be worthwhile try to apply the same principles in the cure of human diseases. About 1880 Pasteur started to study the rage disease (affect animals, especially dogs, and normally is transmitted to humans by a nibble). Firstly, he discovered the rage virus. Then he used its “good” part to create an antidote and transformed it into a vaccine. Later, He started to inoculate it in the dogs but he didn’t have the courage to do the same in humans, until when on 6th July, 1885, a woman knocked on his door. She was carrying a boy with nine years old that was bitten by a dog fourteen times. The mother begged him to heal her son but the scientist didn’t want to experiment the serum in the kid named Joseph Meister because so far he never had used the vaccine in humans. However, once there was no other solution, eventually the kid would die with or without the inoculation, he applied the first of twelve anti-rage vaccines. During many weeks, the scientist and boy’s family feared the worst but in the end, Joseph Meister survived. From that time, people that had been bitten by raged dogs started to go to his laboratory asking for help. They came from different places of France and even from abroad although doctors didn’t recognize the worthwhile of Pasteur, what’s unthinkable, even because before his investigations, the only medicine available against rage was a spike in hot coal to burn the dog’s bite.

The vaccines were a huge triumph to medicine. Without them it’s difficult even think in survival.

Pasteur Institute:

The success of anti-rage vaccine was so enormous that the French Academy of Sciences decided to build one Institution dedicated only to laboratorial investigation. The Pasteur Institute was established in 1888 and is nowadays one of the most known centers of scientific investigation.

Curiosity – The HIV virus was isolated for the first time in these laboratories. This Institution without profitable ends was presided by Louis Pasteur until his death (28th September, 1895) and has a team of scientists that globally has eight Nobel Prizes in Medicine.

Microscope:

Nobody knows for sure who created it. Generally, its invention is attributed to Hans Janssen, Dutch glasses manufacturer, and his son Zacarias, in the year of 1590. However, will have been the Dutch Anton van Leeuwenhoek, that lived between 1632 and 1723, who made the first microscopic observations. He was a textile trader that used to mount lends. It was precisely through curved glasses that he mounted in a rudimental microscope that he saw little creatures which were walking along the drops of rain, vinegar and saliva. He was not a scientist but woke up the interest of scientific community. The first microscope had only one lend and so it couldn´t amplify very much.