Epilepsy is a chronic brain disease in which patients are susceptible to repeated seizures. This is due to an excessive and abnormal increase in brain electrical activity, resulting in a wide variety of symptoms, such as strange sensations, uncontrollable movements of a part of the body, falls, loss of consciousness, blinking, seeing lights, unreal perceptions, etc.
It should be noted that epilepsy can begin at any age, without the need to have had previous episodes.
Causes of epilepsy and triggering factors
A large percentage of epilepsy cases are diagnosed in childhood or adolescence, often with a genetic cause. In the adult population, and especially in the elderly, seizures are usually caused by brain injury due to cerebral infarction, cranial trauma or tumors.
Although most epileptic patients do not relate seizures to clear triggering factors, some situations may favor certain epileptic seizures, such as:
– Lack of sleep
– Recreational drugs
– Alcohol (and, fundamentally, its deprivation after chronic consumption).
– Stress
– Bright and repetitive lights
– Menstruation (in some women)
Recommended treatment for epilepsy
Treatment is aimed at preventing the onset of epileptic seizures. In some cases, such as benign childhood epilepsies, it is not necessary to apply pharmacological therapies, since they are self-limiting processes with age.
On the other hand, if after a first epileptic seizure an increased risk of new seizures is identified (when certain syndromes are detected, or certain alterations in the MRI or EEG), treatment can be started immediately. Antiepileptic drugs (AEDs) are the first choice of treatment, being able to control 3/4 of patients. There are many types of AEDs available, so the choice is determined on an individual basis, taking into account the type of seizure, patient preferences and side effects. The function of AEDs is to balance neurotransmitter levels at the brain level, so they require strict and controlled adherence with regular check-ups by the neurology specialist. The aim of the medication is to enable the patient to lead as independent and active a life as possible.
Surgery for epilepsy is an option available in patients who do not respond adequately to AEDs. These patients should be evaluated in a specialized unit, where they will undergo video-EEG monitoring (simultaneous EEG and video recording) and other advanced complementary tests (including structural and functional neuroimaging and neuropsychological analysis), in order to identify the regions affected by the disease. If, after all the examinations, it is considered that the patient may be a good candidate for surgery, he/she will be referred to a neurosurgeon with experience in this pathology.
In cases where this option is not considered, there are palliative treatments such as brain stimulators or the ketogenic diet, which can significantly improve the quality of life of patients with epilepsy.