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Epilepsy is a brain disorder that causes recurrent seizures or convulsions. It is observed worldwide at all ages regardless of gender, race, social and economic status. About 50 million people suffer from epilepsy worldwide, with 80% of them in the developing world. In Greece, it is estimated that there are 86,700 epileptic patients.

How is an epileptic seizure caused?

The cells in our brain send and receive messages from all areas of our body. These messages are transmitted through a continuous electrical impulse that travels from cell to cell. Epilepsy disrupts this rhythmic electrical impulse. Instead, bursts of electrical energy, like an unpredictable lightning storm, occur between cells in one or more areas of the patients’ brains. This electrical disturbance causes changes in their perception, sensations, emotions, or muscle movements.

What are the symptoms of epilepsy?

Symptoms vary depending on the type of epilepsy. Some patients lose consciousness and have convulsions. Others stop responding to external stimuli and stare into space. Some patients may smell an unpleasant odor that is not there or hear sounds that are not there. It is not uncommon for them to have automatic movements such as swallowing, chewing, or rubbing their hands. Some patients experience jerks or involuntary movements of their arms or legs, and others may simply suddenly experience fear, unexplained anxiety, or déjà vu. The type of epileptic seizure is different for each patient depending on the type of epilepsy.

What are the types of epilepsy?

Epilepsy is classified according to the type of seizure.

If the seizure starts in a specific area of ​​the brain, it is called a “focal seizure.” If the seizure starts in many parts of the brain at the same time, it is called a “generalized seizure.” Of course, there are also cases where it is not possible to distinguish where an epileptic seizure starts. In these cases, the seizures are called “of unknown onset.”

Accordingly, epilepsies are classified as:

1. Generalized epilepsy

2. Focal epilepsy

3. Combination of generalized and focal epilepsy

4. Epilepsy of unknown onset

What are the causes of epilepsy?

Most of the time (70% of cases), the cause of epileptic seizures is not known. The most common causes are:

• Genetic: Some types of epilepsy (such as juvenile myoclonic epilepsy) are more likely to occur in families. Although there is evidence that specific genes are involved, it is believed that other factors are involved in the manifestation of the disease.
• Hippocampal sclerosis: This is a scar that forms in the inner part of the temporal lobe which can cause focal seizures.
• Traumatic brain injuries – Strokes: Head injuries that can be caused by traffic accidents, falls or any blow to the head.
• Brain infections: such as meningitis, encephalitis.
• Developmental disorders (in children): Congenital abnormalities in the anatomy and function of the brain.

What is the treatment for epilepsy?

The treatment for epilepsy can be pharmaceutical and/or surgical.

Antiseizure medications can control seizures in 60%-70% of patients. The remaining 20%-30% have drug-resistant epilepsy that can be treated surgically. Surgical options include surgical resection, stereotactic radiosurgery, or implantation of neuromodulation devices. These devices send electrical impulses to the brain with the goal of reducing seizures over time. Treatment is individualized for each case.

Conclusion

Epilepsy is a fairly common condition. There are many treatment options, including antiseizure medications, special surgeries, and devices to prevent seizures. The goal is to manage seizures as best as possible. In some cases, epilepsy is a lifelong disease, while in others, it can be controlled with appropriate medication. Most patients have a normal life, with normal activities. The Neurological Clinic of the Medical P. Faliros, with its specialized team, offers a holistic approach to the diagnosis, treatment and monitoring of patients suffering from epilepsy.