Epilepsy is a chronic disease characterized by repeated epileptic seizures, which occur as a manifestation of uncontrolled neuronal discharge. In most cases the cause is unknown. However, epilepsy is associated with the following pathologies:
- Traumatic brain injuries.
- Anoxic encephalopathy
- Infectious processes
- Brain tumors
Type of seizures
There are different types of seizures that can be associated in the same patient. Seizures can be classified according to the alteration of the level of consciousness:
- Simple seizures: during the seizure the level of consciousness is maintained.
- Complex seizures: in this type of seizure there is an alteration of the level of consciousness.
They can also be classified according to the spread:
- Partial seizures: only a specific brain area is activated.
- Generalized seizures: both cerebral hemispheres are activated.
How are they diagnosed?
The diagnosis is made by means of a good clinical history of the patient that allows characterizing the type of seizure he/she suffers. In addition, there are other tests that can help identify the origin of the seizure, such as electrophysiological studies like the electroencephalogram (EEG) and imaging tests like magnetic resonance imaging (MRI). Currently, these tests are always performed when a seizure is suspected.
Treatment for epilepsy
In the first phase, medical treatment is necessary for primary epilepsies. In the case of lesional epilepsies and primary epilepsies with poor seizure control despite pharmacological treatment, surgical treatment may be indicated.
In primary epilepsy it will be necessary to perform an extensive preoperative study to locate exactly where the focus of epilepsy is located.
Types of surgery
- Lesionectomy: aims to remove the epileptogenic focus, either tumor or sclerotic. It is the most commonly used technique to treat epilepsy.
- Disconnection of the epileptogenic focus: in some cases the resection may cause post-surgical sequelae, so that the disconnection of that area from the surrounding brain may be the treatment of choice.
- Vagal stimulation: consists in the implantation of an electrical impulse generator to the vagus nerve, which generates electrical stimuli allowing seizure control.
The type of surgery that may be offered will depend on the location of the epilepsy. It can be said that epilepsy surgery is classified as follows:
- Temporal epilepsy surgery: the temporal lobe is the most frequent area where surgical epilepsy is located in adults.
- Extratemporal epilepsy surgery: frontal, occipital, parietal, insular, various lobes.