Epilepsy is a group of chronic neurological disorders caused by excessive and rapid bioelectric discharges in nerve cells. It’s one of the most common diseases of the nervous system, with an estimated 1% of the world’s population affected. In most cases, the cause of epilepsy is unknown, but depending on age, the cause may vary.
Symptoms
Epilepsy can vary in severity – both as brief and imperceptible, and as strong and long shocks. There are several types of seizures, depending on the damaged part of the brain and the age of the patient.
The most common type of epilepsy that everyone associates with epilepsy is convulsive seizures (in 60% of patients) however, the second type is non-convulsive seizures (40%).
Convulsive seizures are characterised by loss of consciousness, body distension, convulsions, cyanosis, tongue biting and uncontrollable urination. This type of seizure lasts from several seconds to 2-3 minutes. After the seizure ends, the patient may feel drowsiness, headache, muscle pain and general tiredness. Before an epileptic seizure, some patients have what is known as an aura, which is a specific symptom that announces an epileptic seizure.
Non-convulsive seizures involve a momentary loss of consciousness (a few – tens of seconds) which, for example, in children can look like a momentary reverie, making it difficult to diagnose the disease.
Generalised epileptic seizures are divided into 6 types:
Causes and risk factors
Epilepsy can manifest itself at any stage of life, but depending on the region of the world, the causes of the disease and the age group varies. About 80% of people suffering from epilepsy live in developing countries, where the disease is mainly seen in teenagers and young adults. In developed countries, cases of epilepsy are more prominent in infants or people over 65.
Epilepsy in childhood is usually associated with other congenital diseases (usually related to congenital brain defects), genetic diseases, and infectious diseases during pregnancy or problems during childbirth (such as hypoxia).
The likelihood of developing epilepsy increases with age. In adults, epilepsy can be a symptom of a brain injury or tumour, encephalitis or meningitis. Sometimes an epileptic attack can be triggered by other factors, such as alcohol abuse or drug use. In patients over 65, epilepsy can be caused by stroke or degenerative diseases, such as Alzheimer’s disease.
Diagnosis and treatment
The main diagnosis is to rule out other diseases with similar symptoms and determine the cause of symptoms, if possible. The main tests to confirm the presence of epilepsy are an electroencephalogram (EEG) and a computed tomography (CT) scan.
Unfortunately, so far no method has been developed to cure people with epilepsy, but in most cases epileptic seizures can be controlled pharmacologically. Usually anticonvulsant drugs are administered throughout the patient’s life, depending on the type of epilepsy. In about 30% in which anticonvulsants don’t work (drug-resistant epilepsy), a ketogenic diet, vagus nerve stimulation or surgical treatment is used.
It’s also important to impart knowledge to the patient and their loved ones about appropriate behaviour during an epileptic seizure.
Current clinical trials for epilepsy are exploring new treatments, both pharmacological and for patients with drug-resistant epilepsy. Although epilepsy is not fully curable, appropriate treatment can control symptoms, and in some patients, after a few years, withdrawal of the drugs used can be considered.