All About Epilepsy

The treatment of epilepsy is based mainly on the administration of drugs. More than 50% of patients who are treated for the first time with an antiepileptic treatment have good results.

Epilepsy is a chronic disease that affects the central nervous system. It appears in the form of unexpected and spontaneous crises that are produced by excessive electrical activity of a group of hyperexcitable neurons.

For a patient to be diagnosed as epileptic, they need to have suffered at least two seizures. This data is important because, in approximately half of the people that have suffered a first seizure, it’s spontaneous, so it can’t be diagnosed as epilepsy.

In addition, it must be taken into account that epileptic seizures by themselves are not epilepsy, but are a symptom or a disorder motivated by several factors that produce irritation and a malfunction of neurons.

On the other hand, the prevalence of epilepsy affects, according to epidemiological studies carried out, a percentage of between 0.4% and 0.8% of the general population. In other words, 8 out of every 1000 people are epileptic.

Epilepsy is the second most common neurological disease after headaches. It can affect anyone and at any age. However, it affects more people at extreme ends of the age scale, that is, during the first year of life and in people over 65 years of age.

Causes of epilepsy

Epilepsy has no identifiable cause in almost half of the people with the disease. In the other half of patients, they can occur due to various factors, among which we can mention:

• Genetic factors: Some types of epilepsy are inherited. Researchers have established a relationship between some types of epilepsy and specific genes. However, heredity is only part of the factors that cause the disease.
• Head trauma
• Brain diseases, such as tumors or strokes.
• Infectious diseases: Such as meningitis, AIDS, or viral encephalitis.
• Prenatal injuries: Before birth, babies are sensitive to brain damage that can be caused by different reasons, such as an infection in the mother, poor nutrition, or oxygen deficiency.
• Developmental disorders, such as autism or neurofibromatosis.

Types of seizures

Epileptic seizures can be classified into two large groups: partial or focal seizures and generalized seizures.

Focal epileptic seizures

In this type of epilepsy, the discharge begins in a specific area of the brain. 60% of epileptic seizures are focal. The patient experiences a combination of motor, sensory, sensory, psychic, and vegetative symptoms and signs.

Among the different types of symptoms that the patient may suffer we find:

• Changes in skin color, such as paleness or redness
• Increased blood pressure
• Tachycardia or bradycardia
• Burning sensation
• Language disorders

Generalized seizures

This type may or may not be accompanied by seizures. Loss of consciousness occurs from the first moment of the attack and the patient frequently falls to the ground and is injured.

If generalized seizures are accompanied by seizures,  they’re classified into different types of seizures:

• Tonic
• Clonic
• Tonic-clonic
• Atonic seizures

On the contrary, if they aren’t accompanied by seizures, they’re called absence seizures. In this case, they’re classified as:

• Typical absence seizures
• Atypical absence seizures

On the other hand, it’s worth mentioning another type of epilepsy: the continuous seizure. It’s also known as status epilepticus. This name is given to a crisis that lasts more than 30 minutes and that may or may not be convulsive.

How can it be treated?

The treatment of epilepsy is based mainly on the administration of drugs. More than 50% of patients who are treated for the first time with an antiepileptic treatment have good results.

However, there’s another percentage in which it’s necessary to make a dose adjustment or combine several medications. There’s also another proportion of patients whose cases are uncontrollable and they require surgical treatment.

Antiepileptic drugs are intended to fully control seizures. To do this, they try to inhibit the excitation of neurons. These medications must be administered gradually and it’s of utmost importance that the guidelines set by the doctor are strictly adhered to. If you don’t comply with the treatment properly, it may not be as effective.

On the other hand, surgical treatment, which will be assessed when the patient doesn’t respond to the pharmacological treatment, consists of the total or partial removal of the abnormal brain tissue responsible for the seizures. However, for surgery to be carried out, the epilepsy must be focal in type.

Finally, there’s another treatment option which is the implantation of an electrode to stimulate the vagus nerve. This nerve is believed to connect to many areas of the brain that are often involved in epilepsy.