Epilepsy is neurological disorders that occur as a result of abnormal electrical discharges that occur from time to time in the brain. Except for the type called status epilepticus, it is short-lived, lasting seconds or minutes. The term convulsion is used to describe severe contractions during a seizure. However, there are many types of seizures without contractions.
There may or may not be a change in consciousness during an epileptic seizure. It is known that 2-5% of the population has a seizure once in their lifetime. In more than half of patients, seizures begin at the age of 4-5 years.
CAUSES OF EPILEPIA
1-Heredity: Hereditary factors play a role in most spontaneous epilepsies.
2-Lesions in the brain: Birth trauma, head trauma, brain hemorrhages, brain tumors cause oxygen deprivation of the brain, brain infections, cerebrovascular diseases, epilepsy.
3- Systemic Diseases: Metabolic diseases, poisonings, thyroid gland diseases, vitamin B6 deficiency and some drugs cause epileptic seizures in susceptible individuals.
According to the region of origin of the brain, seizures may appear as unconsciousness or loss of consciousness, symmetrical contractions and relaxations in one half of the body or bilaterally, hallucinations with or without shape, hearing abnormal sounds, screaming, or bouts of absent-mindedness lasting only a few seconds.
Epileptic seizures are divided into 2 groups.
1-Partial seizures: They are divided into 2
-Simple partial seizures: There is only one finding when the patient is having seizures. Involves one part of the body. For example, there are jerks in a foot or arm. In this type, the seizure may stay where it started or may progress to involve one half of the body. For example, contractions that start in the face may progress and spread to the arm on that side and then to the leg. There may be weakness after the seizure has passed. In addition, in this type of seizure, sensory seizures such as numbness, burning, tingling, and rarely pain can be seen in the hand, arm and leg. In addition, there are partial seizures accompanied by skin flushing, fading, hearing certain sounds, and changes in blood pressure.
-Complex Partial Seizures: When the above-mentioned seizures are accompanied by impaired consciousness, they are called complex partial seizures.
2-Generalized Epileptic Seizures: Seizures often begin with sudden loss of consciousness and continue with bilaterally symmetrical movements (contraction and contractions). This is called the grand seizure (Grand Mal). Sometimes there is only a brief period of absent-mindedness, that is, consciousness being affected. There are no abnormal movements or contractions. Minor seizure (Petit Mal)
Diagnosis: Not all fainting is epilepsy. The definitive diagnosis of epilepsy is most definitely by observing the seizure by a specialist neurologist or neurosurgeon
Epilepsy (epilepsy) can often be confused with nervous fainting Differences
1- In epileptic seizure, the patient falls without choosing a place. injuries may occur. In nervous fainting, the patient usually falls on soft floors or safe places without injuring himself.
2-In epilepsy, if the patient’s eyes are open or closed, it is not difficult to open them.
3-In epilepsy, the patient does not hear the people around, but in neural hearing, the patient hears the people around.
4- Epileptics wake up dizzy from seizures, wake up crying in nervous fainting
5- In epileptic fainting, the patient may miss his urine, bite his tongue, these are not present in nervous fainting.
Brain MRI is normal in the vast majority of patients.
Seeing epileptic brain waves in the examination showing the electrical activity of the brain called EEG is valuable in diagnosing the disease.
The condition of successive epileptic seizures without a normal period between them is called status and urgent medical attention is required to stop these successive seizures.
In accordance with the definition of epilepsy under normal conditions, antiepileptic treatment is started in patients who have at least one more seizure within a year following the first epileptic seizure. The drug to be used is selected according to the seizure type. . The blood level of the drug is important in the treatment. Some drugs may take several weeks to reach adequate blood levels. Seizures may occur during this period, and the drug should not be discontinued as it is considered ineffective. Sometimes a single drug may be insufficient to stop the seizure, in which case two or three drugs can be used together. The main purpose of treatment is to stop seizures and a high rate of seizures is stopped with the drug treatment given. In patients whose seizures have completely stopped, treatment can be continued with the same drug for an average of 3-5 years. For this reason, the drug should not be discontinued without the doctor’s advice. At the end of this period, there is a risk of seizure again after the drug is stopped. If the epileptic seizure is no longer present after discontinuation of the drug, the drug is discontinued. In the first weeks after starting to use the drug, some symptoms such as redness of the skin, excessive sleepiness, and drowsiness may be seen in the body due to the drug. Since the drugs may have negative side effects on blood formation, a doctor should be consulted for the control of complete blood count and liver function tests several times within the first month of treatment.
Surgical treatment of epilepsy: If epilepsy is due to a pathology in the brain (tumor, abscess, vascular clump, etc.), surgery is performed to eliminate the cause. However, seizures may continue despite the removal of the lesion causing epilepsy. On the other hand, the brain region that causes epileptic discharges by interfering with the brain region that causes epilepsy is removed.
