It is estimated that 70% of people with epilepsy could live seizure-free if accurately diagnosed and treated.
Epilepsy is a chronic brain condition affecting around 50 million people worldwide. Epilepsy is characterized by recurrent seizures (brief episodes of involuntary movements of the body). Seizure episodes result from excessive electrical discharges in a group of brain cells.
It is estimated that up to 70% of people with epilepsy could live seizure-free if accurately diagnosed and treated.
Types of seizures include:
Focal seizures (just one area of your brain is involved during a seizure) are of 2 types depending on the degree of consciousness during the seizure activity, which include
- Without loss of consciousness
- With impaired awareness
Generalized seizures (when all areas of the brain are involved during a seizure) are of 6 types which include:
- Absence seizures typically occur in children and are characterized by staring into space with or without subtle body movements like eye blinking or lip smacking.
- Tonic seizures cause stiff muscles and may affect consciousness.
- Atonic seizures or drop seizures cause a loss of muscle control, mainly in the legs.
- Clonic seizures are characterized by repeated or rhythmic jerking muscle movements.
- Myoclonic seizures are sudden, brief jerks or twitches and usually affect the upper body, arms, and legs.
- Tonic-clonic seizures, known as grand mal seizures, can cause an abrupt loss of consciousness and body stiffening, twitching, and shaking.
What are the symptoms of epilepsy?
Symptoms may vary depending on the type of seizure. Some of the common signs and symptoms include:
- Temporary confusion
- Uncontrollable jerking movements (arms and legs)
- Stiff muscles
- A staring spell
- Loss of consciousness or awareness
- Disturbances in sensation (including vision, hearing, and taste)
- Psychological symptoms such as fear, anxiety, or depression
What Can Cause Epilepsy?
Certain factors that contribute to epilepsy include:
- Genes that cause epilepsy run through families. There is a high chance that people born in those families inherit those specific genes.
- Head trauma from a car accident or other traumatic injuries can cause epilepsy.
- Brain abnormalities such as brain tumors or vascular malformations can cause epilepsy.
- Stroke is a major cause of epilepsy in adults.
- Infections such as meningitis, HIV, viral encephalitis, and some parasitic infections can cause epilepsy.
- Prenatal injury is the injury to the brain before birth due to an infection, or oxygen deficiencies or nutritional deficiencies may result in epilepsy.
- Developmental disorders such as autism can cause epilepsy.
Complications of Epilepsy
Having a seizure at certain times can lead to dangerous and life-threatening circumstances, such as
- Falling
- Drowning
- Car accidents
- Pregnancy complications
- Emotional health issues
- Permanent brain damage
- Sudden unexpected death in epilepsy (SUDEP)
People with frequent tonic-colonic seizures or whose seizures are not controlled by medications may be at higher risk of SUDEP.
Diagnosis
A doctor makes an epilepsy diagnosis based on symptoms, physical signs, and the results of tests such as an electroencephalogram (EEG), computed tomography (CT or CAT scan), or magnetic resonance imaging (MRI).
Treatment of Epilepsy
Medication
Doctors begin epilepsy treatment with certain anti-seizure medications. Up to 70% of people living with epilepsy could become seizure-free with the appropriate use of anti-seizure medicines.
If medications do not treat the condition, doctors may propose surgery or another type of treatment.
Surgery
Surgery can be an option when medications fail to provide adequate control over seizures.
Surgery for epilepsy can reduce the frequency or intensity of seizures or even stop them completely.
Most surgical procedures involve removing the area of the brain where seizures occur or implanting a device in the brain.
Neurosurgical treatment is not suited for every patient with epilepsy.
Who Is the Right Candidate for Epilepsy Surgery?
Surgical options are available for every patient with severe, intractable epilepsy.
You may be a candidate for surgery if:
- Epilepsy causes severe seizures that impact your quality of life and cannot be controlled by medicines.
- An injury or malformation causes epilepsy in an area of your brain that can be removed surgically.
Types of epilepsy surgery include:
Open surgery
The surgeon makes an incision through your scalp and creates a hole in the skull (craniotomy). They locate the area of the brain causing seizures and remove it.
Temporal Lobectomy
Temporal lobectomy is another open surgery and the most successful form of epilepsy surgery. It requires an incision through your scalp and skull, and the procedure removes the temporal lobe.
Laser Interstitial Thermal Therapy (LITT)
The procedure is a less invasive way to treat intractable epilepsy. The surgeon uses magnetic resonance imaging (MRI) to target the area of your brain causing seizures. With the help of a thermal laser, the targeted area is destroyed, leaving surrounding areas undamaged.
Pacemaker Implantation
A pacemaker is a small, battery-powered device implanted in the skull, with wires that lead from the device into your brain. A pacemaker is placed using minimally invasive surgery, which takes about three or four hours.
The device monitors brain activity and records seizures. Using this data, the surgeon can program the pacemaker to send an electrical signal whenever it detects an oncoming seizure disrupting and preventing the seizure.
What to Expect from Epilepsy Surgery?
- All epilepsy surgeries come with a few risks.
- Post-surgery you may have trouble with language, memory, or other cognitive skills.
- All epilepsy surgeries are performed under general anesthesia (complete loss of consciousness).
- Each procedure can take a minimum time between three and eight hours.
- Open brain surgeries require extended hospital stays, and it may take three or four weeks to return to your normal activities after surgery.
Your doctor will help you decide which type of treatment may be the most effective for you.
