Epileptic seizure can be defined as conscious, motor and sensory symptoms that occur as a result of abnormal discharge of a group of brain cells due to various reasons affecting the brain. The human brain has the potential to experience an epileptic seizure due to various reasons such as head trauma and fever. It is known that approximately 5% of people experience a single epileptic seizure at some point in their lives. The patient who has a single seizure is not epileptic. Most epilepsy patients are completely healthy except for seizures that last only a few minutes.
What are the causes of epilepsy?
The cause cannot be determined in approximately 2/3 of epilepsies. The cause of seizures cannot be demonstrated in physical examinations and laboratory studies, including brain imaging methods, of this group of patients. Genetic causes play an important role in epilepsy. In some types of epilepsy, the probability of seizures occurring in children may be approximately 9-12%. In epileptics whose cause can be determined, congenital anomalies, birth traumas, head trauma, cerebrovascular diseases, tumors, brain inflammations and alcohol are among the causes. Birth injuries, genetic causes in childhood, trauma and tumors in middle age, and cerebrovascular diseases in older ages come to the fore. Although alcohol is an important cause of epilepsy in Western societies, alcohol-related epilepsy cases are not common in our country. It is known that insomnia, menstrual periods, excessive alcohol and some medications increase the frequency of seizures in epilepsy patients. Again, in some epilepsy patients, bright lights and television may facilitate seizures to a degree of stress.
What is the prevalence of epilepsy in our society? Does the incidence rate vary depending on gender?
The frequency of epilepsy is reported to be five per thousand in developed countries and ten per thousand in developing countries. In South American countries, figures such as 49 per thousand have been reported due to parasites affecting the brain. In a study conducted in Silivri in 1994, the frequency of epilepsy in this region was found to be ten per thousand. Based on this information, it can be said that there are approximately 650,000 epilepsy patients in Turkey. There is no difference in the frequency of epilepsy between men and women.
Are there types of epilepsy?
There are many different types of epileptic seizures. Their differences are related to the brain regions involved. A patient may have only one type of seizure, or more than one type of seizure may occur in the same patient. A patient's recurring seizure or seizures are generally similar to each other. The most well-known and dramatic ones that we see from time to time are major epileptic seizures in which the arms and legs first contract and then struggle, there is cyanosis on the face, foaming from the mouth, urinary incontinence, and then we watch with surprise for a long time. It is a 5-10 second period in which the child's writing and speaking are suddenly stopped, which is defined as "absorption" by families and teachers in childhood. Another example is absence seizures, in which there is a complete lack of response for a period of time and then the activity is resumed from where it left off. The most common seizures in adulthood are the type of seizures that people describe as "confusion". In these seizures, patients' eyes suddenly become fixed or they search with their eyes. There may be automatic movements in his lips and hands, he does not respond or speaks incoherently, he can walk, after a minute or two the patient comes to his senses and cannot remember that period. bun Apart from the movements, sudden jumps in the arms and legs are another example. Many examples can be given. All these seizures are very short-lived and more than one may recur in the same patient at different times.
How to help a patient having an epileptic seizure?
In some of the seizures, the patient realizes that a seizure is coming very soon and creates a confident position. In some major seizures, the patient suddenly loses consciousness and falls to the ground. Injuries mostly occur in such seizures. The purpose of assistance to the patient in seizures where consciousness is retained is to protect the patient. In major seizures, the patient is laid flat on the floor with his head in his lap, the head is turned to the side to prevent the tongue from slipping back and covering the trachea, and the seizure is waited for. During this period, there is no point in making the patient smell onions or applying cologne. There is no need to take the patient to the hospital for short-term seizures. Hospital treatment is required only in cases of prolonged seizures or in cases where seizures recur one after the other.
What are the diagnostic methods used in epilepsy?
The diagnosis of epilepsy is made by the specialist neurologist from the patient and their relatives. It is placed with the information it receives regarding the . Since patients are unconscious during some seizures, information obtained from people who see the seizure is important. Laboratory methods used in epilepsy are aimed at supporting the diagnosis made by the physician, determining the type of seizure and understanding the cause. Blood tests, electroencephalography (EEG), Magnetic Resonance (MR), Computed Tomography (CT), PET are the applied methods.
What are the treatment methods for epilepsy?
The treatment of epilepsy is mainly medication. The drugs used do not eliminate the disease and only They provide an effect to prevent seizures or reduce their frequency. Epilepsy disease continues its course. In some patients, this treatment is lifelong; for some seizures in childhood, it may be sufficient to continue treatment until the age of 15-20. In many patients, it is not known in advance how long the treatment will continue. In drug treatment, it is essential to use the drug(s) very regularly. In approximately 70% of patients, seizures can be controlled with medications, and in 30%, the frequency of seizures does not change despite all kinds of drug treatment. Surgical treatment is applied to a part of this group defined as "treatment-resistant epilepsy". Very detailed studies are required before deciding on surgical treatment. An increasing number of surgical treatments have been performed around the world for 15 years. Surgical treatment of epilepsy is successfully performed in a few centers in our country.
Are there any side effects of the drugs used in epilepsy?
The treatment of epilepsy patients is generally carried out with the drugs used for this purpose. Seizures can be controlled in approximately 70% of patients. Medicines used to treat epilepsy also have side effects. Some of these side effects are seen at the beginning of treatment and disappear over time, and do not require discontinuation of the drug. In some cases, the treatment must be discontinued and another group of drugs must be used. In most patients, treatment can be continued successfully with regular check-ups. In case of side effects, the patient should consult his physician.
How should families of children with epilepsy act?
The basis of epilepsy treatment is regular use of medication. In most patients, the reason for recurrence of seizures is forgetting or discontinuing the medication. Sleep should be regular. insomnia ne It increases my betting frequency. Educational institutions of children with seizures should be informed about this issue and what can be done during the seizure should be explained. The patient should avoid situations where it is difficult to protect himself during a seizure, such as swimming or being at high altitudes. Practices such as not locking the door while taking a bath and not taking a bath by filling the bathtub are simple protective practices.
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