Epilepsy
Can epilepsy be cured? Everything about the causes, symptoms, and treatments for the different types of epileptic seizures.
Symptoms and Causes
Epilepsy is a disease that increases the predisposition of the neurons in the cerebral cortex to excessive activity. As a result, epileptic seizures occur, characterized by recurrent convulsions that deteriorate health and negatively affect social relationships.
Not everyone who experiences convulsions suffers from epilepsy, as it is diagnosed when these seizures occur more than once within a 24-hour period. Although this disease is more common in children and the elderly, it can affect people of all ages.
In most cases, the seizures are controlled with medication or surgery, and patients can lead normal lives. Occasionally, epilepsy disappears on its own over time, especially when it first appears during childhood.
Symptoms
The main symptom of epilepsy is the spontaneous onset of seizures that usually last between one and five minutes. These episodes cause both convulsions and motor and sensory disturbances.
In addition, other symptoms occur depending on the type of epilepsy the patient has and are classified into two main groups depending on where they originate:
- Generalized epilepsy: seizures affect the entire brain.
- Absence seizures: usually manifest in childhood. The person has a fixed gaze, is disconnected, and does not respond; sometimes, there is slight body movement like blinking. They are usually brief, but if they occur multiple times a day, they can cause a loss of consciousness.
- Tonic seizures: cause muscle rigidity.
- Atonic seizures: cause a loss of muscle control.
- Myoclonic seizures: manifest as small spasms in the arms or legs.
- Tonic-clonic seizures: cause sudden loss of consciousness, followed by body rigidity and shaking of the limbs, loss of bladder control, or tongue biting.
- Focal epilepsy: occurs in a specific area, but often extends to other parts of the brain.
- Focal seizures without loss of consciousness: cause tingling, dizziness, spasmodic movements, and the perception of flashing lights.
- Focal seizures with loss of consciousness: characterized by a lack of response to external stimuli or the performance of repetitive movements.
Causes
Epilepsy can be caused by various factors:
- Structural epilepsy: results from trauma, injury, inflammation, malformation, infection, or stroke.
- Genetic epilepsy: results from alterations in genes or chromosomes that generate a susceptibility to developing epileptic seizures.
- Infectious epilepsy: caused by damage to brain structures from brain infections.
- Immune-related epilepsy: caused by damage to brain structures from antibodies.
- Idiopathic epilepsy: has no known cause, although it is assumed to be caused by genetic factors. One well-known type is photosensitive epilepsy, triggered by certain light and dark contrasts. Rolandic epilepsy, which causes numbness in the face, usually in the morning or at night, is common in children and often disappears on its own.
Risk Factors
Some factors that increase the risk of developing epilepsy include:
- Age: children and the elderly are more likely to develop this disease.
- Family history.
- Brain trauma, injuries, or tumors.
- Strokes.
- Brain surgery.
Complications
Seizures resulting from epileptic attacks can lead to falls, accidents, sleep problems, or memory loss. In addition, individuals affected by epilepsy often experience depression or anxiety due to the side effects of medication or the symptoms themselves. In extreme cases, loss of consciousness can lead to death.
Prevention
There is no way to prevent epilepsy. However, diagnosed patients are advised to maintain a healthy diet, get enough sleep, and avoid drugs and alcohol to reduce the likelihood of having a seizure.
Which doctor treats epilepsy?
Epilepsy is diagnosed by specialists in neurology. Treatment is carried out by experts in neurosurgery, neurophysiology, and pediatric neurology.
Diagnosis
Epilepsy diagnosis is made by studying the medical history and analyzing information provided by people who have witnessed the seizures. To confirm the diagnosis, one or more of the following tests are usually performed:
- MRI: helps visualize anomalies or lesions in the brain that cause the seizures.
- EEG: helps analyze brain activity.
- PET or SPECT brain scans: show the area where the disease originates.
Treatment
The treatment of epilepsy varies depending on the characteristics of each person and the type of epilepsy. The first step in controlling seizures is changing lifestyle habits, as patients are advised to avoid toxic substances and manage their sleep routine.
The preferred treatment to alleviate epileptic seizures is antiepileptic drugs. This treatment is usually long-term, so it should be reviewed periodically to ensure it is effective and does not cause too many side effects.
Refractory epilepsy refers to epilepsy that does not respond to medication. In these cases, other techniques are used, such as:
- Resective surgery: only applicable in cases of focal epilepsy. This involves removing the part of the brain causing the seizures. In most cases, the attacks are reduced or even disappear completely.
- Functional surgery: disconnects the areas of the brain where the seizures originate, or implants a device that decreases activity with electrical impulses.
- Neurostimulation: controls seizures with few side effects by inserting a device that produces electrical stimulation when a seizure is about to occur.
- Deep brain stimulation: helps reduce seizures by implanting an electrode in the thalamus that receives regular electrical impulses from a generator placed in the chest.
- Vagus nerve stimulation: sends electrical signals directly to the vagus nerve to inhibit seizures, though medication must continue.
