Epilepsy: symptoms, diagnosis and treatment. International Epilepsy Day
(Madrid. Lucila Rodríguez)
Around 50 million people suffer from epilepsy worldwide (400,000 in Spain), making this brain disease one of the most common neurological disorders in existence. However, despite being as old as mankind, no cure has yet been found.
The most characteristic symptoms of epilepsy are recurrent seizures, crises caused by abnormal discharges of neuronal electrical activity that prevent the normal control of different brain functions such as memory, consciousness, attention, sensitivity, sight, taste, movement, smell or visceral function.
These episodes usually last a few seconds, maximum a few minutes, but in order to speak of epileptic seizures, one must have suffered at least two unprovoked seizures in less than 24 hours; have, after the appearance of these two, an unprovoked seizure and a probability of presenting another one during the next 10 years similar to the general risk of recurrence; and receive a diagnosis of an epileptic syndrome.
“Epilepsies are usually mild and are controlled with medication or remit after some time. Most require pharmacological treatment, but some, such as the self-limited focal epilepsies of childhood, usually evolve well without the need for medication,” explains Dr. Irene García Morales, neurologist and physician in the Epilepsy Unit of the Hospital Ruber Internacional.
Precisely in the Unit, led by Dr. Antonio Gil-Nagel, special attention is paid to the diagnosis of epilepsy because it can condition the evolution of the disease. For this purpose, a clinical interview is carried out to help guide the diagnostic process in an individualized manner, as well as a brain MRI, prolonged video EEG monitoring, or a genetic study.
In addition, the center is a pioneer in the use of the ESI technique, which consists of the implantation of more than 72 surface electrodes in patients admitted for a week to precisely determine the location of the brain area where epileptic seizures originate.
Treatment of epilepsy
Once diagnosed, epilepsy can be treated surgically or pharmacologically. In fact, the World Health Organization (WHO) estimates that with an adequate regimen of anticonvulsant drugs, up to 70% of people with epilepsy could live seizure-free.
However, sometimes it is necessary to resort to surgery. ” The Epilepsy Unit of the Ruber International Hospital is a reference center in the surgical treatment of drug-resistant epilepsies that are difficult to locate, and it is also a pioneer in the use of stereo-electroencephalography, a neurophysiological technique that consists of the implantation of deep intracerebral electrodes to locate the area that generates the seizures,” explains Dr. Rafael Toledano, neurologist and assistant physician of the unit.
These procedures manage to improve patients’ lives, although despite diagnostic and therapeutic advances, it is necessary to continue encouraging and promoting research into new mechanisms of action to control crises, modify the course of the disease and, most importantly, achieve a cure.
