Epilepsy: Seizure Types, Symptoms and Treatment Methods

Epilepsy is a neurological disease originating from the central nervous system. It is a medical condition that can cause unusual behavior, sometimes loss of consciousness, especially seizures. It is seen in approximately 1% of the world’s population. Experts state that for a diagnosis of epilepsy, seizures without an identifiable trigger must occur at least twice, at least 24 hours apart.

What is Epilepsy?

To understand epilepsy, the concept of seizure must first be understood correctly. A seizure is a medical condition that creates a sudden and unexpected change in movement, behavior, sensation, or consciousness as a result of a disturbance in the normal function of the brain’s electrical activity. Seizures can have many causes. Since seizures occur with uncontrolled electrical waves, individuals may experience muscle spasms, confusion, loss of consciousness, and uncontrolled body movements. Although it is not possible to predict exactly how long seizures will affect the individual, they usually end on their own within seconds or minutes.

Epilepsy is the condition in which these seizures occur repeatedly. It is not correct to define every seizure as epilepsy. seizures; It can also develop due to many factors such as diseases that cause high fever, severe head trauma, and lack of oxygen. In addition, epilepsy is a disease that affects the electrical connections in the brain and may continue throughout life. It is not possible to cure it completely, but it can be controlled with the help of medical treatments and medications.

Types of Epilepsy Seizures

• Simple Partial Seizure: In simple partial seizures, consciousness is completely clear, but the individual cannot control the seizure. A seizure occurs as a result of activity in a small part of the brain. How a person is affected depends on which part of the brain the seizure occurs in. For example, if the seizure occurs in the occipital lobe, which is related to visual function, the individual may experience symptoms affecting the visual field.

• Complex Partial Seizures: In this type of seizure, consciousness is affected. The person may not remember the seizure or may experience temporary memory loss. Chewing, licking, swallowing, and confused looks may be observed during the seizure.

• Generalized Seizures: During this seizure, which affects the entire brain, violent movements occur that are beyond the person’s control. The person first experiences contractions and falls to the ground, then the entire body muscles contract and relax, one after the other.

• Absence Seizures: These seizures, which spread throughout the brain, are mild, but if repeated too frequently, they can affect life. During the seizure, the person’s appearance is as if he or she is immersed in a dream. During this time, the person experiences a short-term loss of consciousness and cannot perceive the stimuli from the environment. It is mostly seen between the ages of 6-12. Its incidence is higher in girls. If these seizures are not noticed, learning difficulties at school, hearing the beginning of the sentence but not the end, and reluctance to participate in activities may occur.

What are the symptoms of epilepsy?

The symptoms of epilepsy depend on which area of ​​the brain the seizures occur in.

Symptoms of seizures originating from the temporal lobe:

• Sudden Fear, Panic
• Inability to make connections between events, not being able to remember events that have happened, thinking that there are events that did not happen
• Thinking that you know people you don’t know, not being able to recognize people you know
• Smells and tastes that upset the stomach

Symptoms of seizures originating from the frontal lobe:

• Movement problems, weakness
• sudden turning of the head
• Involuntary lifting of the arm
• Jumping contraction and relaxation in the limbs
• interruptions in speech
• Speech becomes imperceptible
• short-term paralysis

If the left side of the person is affected during the seizure, it means that the seizure originates from the right frontal lobe.

Symptoms of seizures originating from the parietal lobe:

• Sensory strange sensations
• Temporary numbness, numbness

Symptoms of seizures originating from the occipital lobe:

• Flash-like light that affects vision
• Seeing different colors in the field of vision than they should be

It is extremely important to understand in which area of ​​the brain seizures develop in the diagnosis and treatment of epilepsy. For this reason, seizures should be closely observed by the patient’s relatives and reported to physicians in detail.

How to Diagnose Epilepsy?

Epilepsy is diagnosed by neurologists. A detailed medical history of the individual should be taken and a detailed neurological examination should be performed by the doctor. To diagnose epilepsy, the individual must undergo some tests. Some testing methods used are:

• Electroencephalography (EEG): It is a method used to detect abnormal electrical activities in the brain. It was developed by Dr. Hans Berger in 1929. Electrical methods are used, but since no electric current is given to the individual, it is unlikely that the person will feel pain or pain. Thanks to the electrodes placed on the scalp, the pattern of electrical activity is detected and recorded. The test is performed by an EEG technician in a room in the hospital with special equipment for this procedure. During the test, the person lies flat on his back, and discs are placed on his head with the help of a paste and connected to a recording machine with cables. The recording machine records brain signals and these signals create a wavy line-like image. When examining the recording, malfunctions in the brain can be detected based on deviations from normal. The individual is asked to remain still, as movement may change the test result. The individual may be asked to remain awake at night to examine the activity in brain waves during sleep. For children, the doctor may ask the child to be sleep deprived the night before or medication may be given before the test.
• Magnetic Resonance Imaging (MRI): Magnetic resonance imaging is a medical imaging method that uses magnetic fields and radio waves to reveal detailed images of tissues and organs in the body. To diagnose epilepsy, an image of the brain is taken. Unlike radiography, which uses X-rays, MRI imaging uses the magnetic properties of atoms. An MRI machine is actually large, tube-shaped magnets. This powerful magnet in the machine creates an intense magnetic field around the body, and some hydrogen atoms in human tissue align with this field. In short, MRI momentarily realigns water molecules in the body. As a result, signals are generated and pictures of the body part are created. It is also possible to capture 3D images with MRI.
• Positron Emission Tomography (PET): It is a medical imaging technique used to evaluate the energy activity of the brain. For scanning, radiopharmaceutical drugs containing radioactive tracers that show intense chemical activity and can be absorbed by organs and tissues are administered to the patient’s body. When used for brain diseases, tracers in drugs prepared for PET scans attach to glucose and similar compounds. In this way, the scanner displays the radioactive glucose and determines which part of the brain uses the most glucose. PET images are programmed to display different colors or brightness levels depending on the rate of glucose used. Thus, for epilepsy, the possible area where the seizure occurs can be recognized in the brain tissue because it will look different from other areas.

Epilepsy Treatment Methods

Epilepsy treatment should be determined on an individual basis. It is important to create a treatment plan based on the cause. Its basic treatment has been carried out with antiepileptic drugs that prevent the development of seizures for many years. Drug treatment is effective in the majority of patients. Stimulating treatments and epilepsy surgery can also be applied for patients who do not respond to medications.

Ketogenic diets can also be used as medical nutrition therapy for drug-resistant epilepsy. The ketogenic diet is a diet model that contains high amounts of fat and low amounts of carbohydrates. In this treatment, the anticonvulsant effects of high ketone bodies, high fatty acids and low glucose levels are used. The ketogenic diet has many different applications and must be planned individually. It is important that the treatment is carried out by a dietician who is an expert in this field and the patient is kept under follow-up.