What causes seizures, and how can we treat them? - Christopher E. Gaw

翻译人员: Sammi Wang 校对人员: Helen Chang

Nearly three millennia ago,

接近三千年前，

a Babylonian tablet described a curious illness called miqtu.

一座巴比伦的石碑描述了一种 名为“miqtu”的疾病。

Said to cause symptoms ranging from facial twitching to full body convulsions,

那疾病据说会引起症状 包括面部抽搐到全身抽搐，

the Babylonians believed those afflicted were possessed by evil spirits,

巴比伦人认为那些受苦的人 是被恶魔附身，

and the only treatment was divine intervention.

而唯一的治疗方法是神的介入。

Today, we know the symptoms of miqtu by another name,

现在我们认识的是“mique”疾病的 另一个名字，

and modern medicine has developed numerous treatments

并且现代医学已经发明出 多种治疗方法

for those experiencing seizures.

给那些经历癫痫发作的人。

But these ancient afflictions still hold a surprising number of secrets.

但这些古老的痛苦 还包含着数量惊人的秘密。

Doctors define a seizure as any set of symptoms

医生将癫痫定义为任何一组

resulting from excess electrical activity in the brain.

包括大脑过度电活动症状的疾病。

Outside this shared feature, there is a massive range of seizure symptoms,

除了这一共同特征之外， 还存在大范围的癫痫症状，

and researchers have identified a variety of different seizure types.

并且研究人员已经确定了 各种不同的癫痫类型。

But regardless of the underlying conditions that cause them,

但不管是什么潜在原因导致的，

every seizure begins here.

每一次癫痫发作都从这里开始。

Hippocrates identified the brain as the source of seizures around 400 BCE.

希波克拉底在公元前400年左右 确认大脑是癫痫发作的源头。

However, this insight didn't immediately lead to better treatments.

然而这一发现并没有 立即带来更好的治疗。

Generally, ancient Greeks prescribed medicinal herbs and alterations in diet.

一般来说，古希腊人 会开药方和改变饮食。

If they believed the seizure was caused by bleeding in the skull,

如果他们认为癫痫 是因颅骨出血引起的，

they sometimes employed a technique called trepanation.

他们有时会运用一种 称为钻孔的技术。

This early surgery involved drilling a hole in the skull to let blood escape

这个早期手术包括在颅骨上 钻一个洞让血液流出

and relieve pressure on the brain.

并减轻大脑的压力。

Trepanation had... sizable risks.

钻孔技术有... 相当大的风险。

But it wasn’t until the 19th century that scientists would make

但直到19世纪， 科学家才在癫痫治疗方面

the next leap forward in seizure treatment.

取得了新的飞跃。

In 1870, two German researchers discovered that using electricity

在1870年，两名德国 研究人员发现用电

to stimulate specific areas of a dog’s brain could move parts of its body.

刺激狗的大脑的特定区域 可以使其身体的某些部位移动。

Around the same time, other scientists discovered the brain and nervous system

大约在同一时间，其他科学家 发现大脑和神经系统

were connected via a network of cells called neurons

是通过一个叫做神经元的细胞网络 连接起来的，

that transmitted electrical signals throughout the body.

这些细胞在全身传递电信号。

This established the brain as the control center for nerve impulses

这使大脑成为决定我们思想和运动的

that determine our thoughts and movement.

神经冲动的控制中心。

Better yet, this model made it clear that seizures were due to errors

更好的是，这个模型 清楚地表明癫痫发作

in that control center,

是因为控制中心的差错，

such as misfiring neurons or excess electrical activity.

像神经元失效或过度电活动.

Early experiments even suggested that different patterns of misfiring

早期试验甚至表明 不同神经元失效模式

could account for different seizure types and symptoms.

可以解释不同种类的癫痫和症状。

So if seizures were due to neurons misfiring,

所以如果癫痫发作是因为神经元失效，

how could doctors stop this from happening?

医生怎么可以阻止这种情况发生？

Physicians like Sir Charles Locock hypothesized that sedative drugs

像查尔斯·洛科克爵士这样的医生

假设镇静药物可能会 平息过度的大脑活动，

might calm overactive brain activity,

a theory he confirmed by treating seizures

他用一种名为溴化钾的药物治疗癫痫

with a medication called potassium bromide.

证实了这一理论。

Others like Sir Victor Horsley

其他像维克多·霍斯利爵士这样的人

suspected that removing damaged parts of the brain might stop a patient's seizures.

认为切除受损的大脑部分 可能会阻止病人的癫痫发作。

In 1886, he performed a craniotomy,

在1886年，他主刀了一项开颅手术，

temporarily removing part of a patient's skull to extract scarred brain tissue.

暂时切除了一个病人的部分头骨， 以去除伤痕累累的脑组织。

Not only did his patient survive, but his seizures improved,

他的患者不仅活了下来， 而且癫痫发作也得到了改善，

launching further research in surgical treatments.

让他在外科治疗方面 展开了进一步的研究。

Over the next two centuries, seizure treatments advanced rapidly.

在接下来的两个世纪里， 癫痫治疗有了迅速发展。

And today, there are dozens of available seizure medications

现在，有数十种可用的治疗癫痫药物

that work with unprecedented specificity.

具有前所未有的独特性。

Some newer medications are able to focus on specific proteins

一些较新的药物能专注于 神经元中的特定蛋白质

in the neuron to help manage electrical activity.

以帮助管理电运动。

And advanced brain imaging techniques can sometimes allow doctors to pinpoint

而先进的脑成像技术有时可以让医生

exactly what parts of the brain are causing an individual's seizures.

精确地指出大脑的哪些部分 是导致癫痫发作的原因。

Surgeons then use this information to perform targeted surgeries.

外科医生利用这些信息 去进行更有针对性的手术。

These various treatments help doctors manage the majority of seizure cases,

这些不同的治疗方法 帮助医生处理大部分的癫痫病例，

allowing most people with seizures to live healthy and comfortable lives.

让大多数癫痫患者 过上健康又舒适的生活。

But the underlying pathology of many seizures remains elusive.

但许多癫痫发作的潜在原因 仍然让人难以捉摸。

In cases without clear brain damage or certain types of pre-existing conditions,

在没有明显脑损伤 或某些类型的先决条件的情况下，

it's incredibly difficult to determine what causes neurons to misfire.

很难确定是什么导致神经元失效。

It's also not always clear why some treatments are effective.

同时也不清楚为什么某些治疗有效。

And even more mysterious are cases where seizures are resistant

更为神秘的是有些癫痫发作病例

to existing treatments that work on similar seizure types.

抗拒现有的对类似癫痫发作 有效的治疗方法。

Scientists are still working on these questions,

科学家们还在努力解答这些问题，

but there are clear answers for what to do

但对于如果你遇到癫痫发作的人 该怎么做有明确的答案 。

if you encounter someone experiencing a seizure.

You should never hold a seizing person down,

你不应该把人放躺在地上，

put objects in their mouth, or perform CPR.

不要把东西放进他们的嘴里， 也不要做心肺复苏术。

Instead, try to keep the person safe from falling or bumping their head,

而是尽量不要让这个人 跌倒或撞到头，

shift them onto their side to keep airways open,

将身体侧身保持呼吸道畅通，

and stay with them until medical help arrives.

并陪伴他们直到医疗帮助到达。