Epilepsy

Epilepsy, popularly known in Turkish as ‘sara’, is one of the most common clinical conditions; it can affect any age group and results from abnormalities in the electrical activity of brain cells.

It can occur in the form of seizures. Depending on the location and extent of the brain region where the electrical disturbance originates, seizures can be classified as partial or generalized. Some epileptic seizures involve loss of consciousness and uncontrolled body movements, while others may be so subtle that they go unnoticed. Seizures usually last one or two minutes. A significant proportion of partial seizures may present with numbness, clumsy behavior, strange tastes and smells, loss of the sense of time and place, speaking little and moving very slowly, or staring into space.

TYPES OF EPILEPTIC SEIZURES

• Simple Partial Seizure: Consciousness is preserved. Depending on the brain region where it originates, symptoms may include sudden fear, déjà vu (feeling that an event that has never happened before has already happened), unpleasant sensations, movement-related problems in some cases, flashes of light in the eyes and seeing different colors.
• Complex Partial Seizure: Consciousness is also affected, and symptoms may include repetitive chewing, lip licking, swallowing and tugging at clothing. When the attack passes, the patient may not remember anything.
• Generalized Seizure: There is a problem with electrical activity across a very wide area of the brain. The person stiffens and may fall to the ground. This may be followed by contraction and relaxation of all body muscles and loss of bladder and bowel control.

SYMPTOMS BEFORE A SEIZURE

If the seizure affects a small area of the brain, the patient may experience certain symptoms before the attack. The symptoms we call an aura include;

• Numbness,
• Changes in vision and hearing,
• Smelling unpleasant odors,
• Nausea,
• Sudden fear,

CAUSES OF EPILEPSY

• An imbalance in the chemical messengers (neurotransmitters) that carry signals between nerve cells in the brain
• Brain tumor,
• Stroke,
• Conditions that cause brain damage: These may be congenital or due to illness, surgical procedures or trauma.
• Infections: Meningitis and encephalitis,
• Hereditary epilepsy,
• Other conditions: Illegal drug use, alcohol or drug withdrawal, abnormal blood sugar and electrolyte levels

DIAGNOSTIC METHODS

• The physician evaluates the patient's detailed medical history; in this context, medication or alcohol use, head trauma, high fever or infection, and genetic abnormalities are important information.
• Blood Tests: Blood sugar, electrolytes and similar values should be evaluated.
• Radiological Brain Imaging: MRI, CT,
• EEG (Electroencephalogram): This is the most important diagnostic tool. It may sometimes need to be recorded during sleep.
• Lumbar Puncture (cerebrospinal fluid analysis): Helps detect intracranial pressure, infection and other problems.

TREATMENT APPROACHES
MEDICAL TREATMENT: Seizures can be stopped and brought under control with antiepileptic medications. When choosing a medication, the patient's age, the drug's side effects and ease of use are important. Medications must always be taken on time and exactly as prescribed. The treatment process is monitored with blood drug levels and EEG tests.

SURGICAL TREATMENT: This is preferred when medical treatment is insufficient. It is a complex surgical procedure.

VAGUS NERVE STIMULATION: A battery-powered device surgically implanted in the chest sends electrical impulses to the brain via the vagus nerve. Because of some significant side effects, it cannot be used in every patient.

IT IS NECESSARY TO LEARN TO LIVE WITH EPILEPSY.

• Medications must be taken regularly.
• Get enough sleep.
• Stay away from situations that trigger seizures.
• Have tests done as often as needed and consult your physician.

At İzmir Özel Can and Salihli Özel Can Hospitals, the neurology, cardiology, internal medicine, physical therapy and neurosurgery clinics work together in caring for our patients with epilepsy, which yields very positive results for patients and their families.