Epilepsy is a neurological condition that causes unprovoked and recurrent seizures. February 12th is International Epilepsy Day, and Instituto Clavel wants to raise awareness of epilepsy by sharing useful information about this brain disease.
Epilepsy is one of the most common neurological diseases. It affects about 70 million people, that is, 0.8% of the world's population. The likelihood of suffering epilepsy varies depending on the socioeconomic conditions of the population, with a higher incidence in developing countries.
According to the EPIBERIA study, the current prevalence of epilepsy in Spain would be 5.79 cases per 1,000 inhabitants. According to Spain’s National Institute of Statistics (INE), prior to the coronavirus pandemic, the population of Spain was 46,748,775 inhabitants, which would mean that more than 270,000 people currently suffer from epilepsy in Spain.
Epilepsy can place a heavy burden on both the patient and their family, especially when it cannot be controlled with medication. Problems faced by people with epilepsy can include significant medical and social problems related to recurrent seizures or the side effects of medication, as well as social stigma and discrimination. They often suffer from intellectual and emotional difficulties, or have a hard time fitting in socially, which can cause problems in school, difficulty in getting or keeping a job, and lead to feelings of isolation.
In the following, we explain more about types of epilepsy and their treatment options.
What is epilepsy?
Epilepsy is a disease of the nervous system characterized by spontaneous (unprovoked) and repeated seizures over time. In epilepsy, the electrical rhythms of the brain tend to become unbalanced, resulting in recurrent seizures. A person is diagnosed with epilepsy when he or she has had at least two seizures at separate times, or one seizure and a high risk of developing another.
Epileptic seizures, caused by an increase in the quantity and synchronicity of electrical discharges in the brain, are the main symptom of epilepsy. Seizures usually last for a period of seconds to minutes.
Types of epilepsy
There are two main types of epilepsy:
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Partial (or focal): the seizures originate in a specific area of the brain. Partial seizures may manifest as unusual sensations the patient feels while remaining conscious (such as tingling, visual hallucinations, psychological sensations such as déjà vu), movements such as shaking of a part of the body, or the patient may appear to be blanked out, with a fixed gaze and automatic movements.
- Generalized: the entire brain is affected during the seizures, of which there are six types: absence, atonic, tonic, clonic, tonic-clonic, myoclonic.
If you want to know more about the different types of epilepsy, we recommend the following article:
Types of epilepsy and seizures
What causes epilepsy?
Some partial seizures are related to brain injuries or lesions such as cardiovascular accidents or tumors, but, in many cases, the cause is unknown. Partial seizures are also classified according to whether the patient’s consciousness (the ability to respond and remember) is affected or not during the seizure.
In people who are prone to seizures, there are risk factors that make seizures more likely to occur, such as stress, lack of sleep or fatigue, fever, excessive use of alcohol or drugs, or failing to take prescribed anti-seizure medication.
Treatment of epilepsy
Anti-epileptic drugs are the first-line treatment in epilepsy. However, up to one-third of patients continue to suffer seizures despite medication. These patients are said to suffer from drug-resistant epilepsy. The International League Against Epilepsy (ILAE) defines drug-resistant epilepsy as “failure of adequate trials of two tolerated and appropriately chosen AED schedules (whether as monotherapies or in combination) to achieve seizure freedom."
For patients with drug-resistant epilepsy, there is the possibility that other treatments, including surgery, neurostimulation, ketogenic diet, or a combination of these treatments, may help control their seizures and improve their quality of life.
Epilepsy surgery is performed in order to cut out or disconnect the epileptogenic zone, when it can be done without causing neurological deficits unacceptable to the patient or the medical team. Surgery can successfully control drug-resistant seizures in 60% of patients, if they are rigorously selected and depending on the cause of the epilepsy.
Despite its potential benefits and safety, epilepsy surgery continues to be underutilized. In Spain, it is estimated that there are about 24,000 patients with drug-resistant epilepsy who could benefit from surgical treatment.
Micro-neurosurgery and advances in minimally invasive techniques, such as laser surgery, have increased the safety and efficacy of the most common epilepsy surgeries.
The doctors at our Brain Pathology Unit at Instituto Clavel, are Dr. Mar Carreño, neurologist specialized in epilepsy, and Dr. Jordi Rumià, neurosurgeon specialized in epilepsy surgery.
On International Epilepsy Day, we at Instituto Clavel want to help educate people about epilepsy, in addition to offering medical care and access to information about treatments for epilepsy. If you have any questions, do not hesitate to contact us.
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