Epilepsy is one of the most common disorders of the nervous system, characterized by repeated seizures. In this article, Dr. Mar Carreño answers the most frequently asked questions about this neurological condition.
What is epilepsy? An epileptic seizure is manifested by the sudden alteration of behavior due to a temporary change in the electrical functioning of the brain. The brain's electrical rhythms tend to become unbalanced in patients with epilepsy, resulting in recurrent seizures. These seizures can range in severity from brief, barely noticeable episodes, to severe seizures that affect consciousness and muscle control.
Patients who suffer from epilepsy, or are in the process getting a diagnosis to see if they have it, often have many questions about what it is, how it will affect them, and how it can be treated. Dr. Mar Carreño, neurologist specializing in pediatric and adult epilepsy at Instituto Clavel, offers answers to these questions.
What types of epilepsy are there?
Epilepsy is classified into different types based on its clinical presentation and the regions of the brain that are affected:
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Focal epilepsy, formerly known as partial epilepsy, which affects a specific part of the brain. There are two types of focal seizure: focal onset aware seizures (simple partial seizures) and focal onset seizures with altered consciousness (complex partial seizures).
- Generalized epilepsy, which involves both hemispheres of the brain and often causes seizures with loss of consciousness. We distinguish six different types of these seizures: absence, atonic, tonic, clonic, tonic-clonic, and myoclonic.
If you want to know more about each type of seizure, you can read all the information in this article:
What are the main causes of epilepsy?
The causes of epilepsy vary and can range from genetic predispositions to acquired brain injuries. The most common causes are:
- Genetic causes: Certain genetic or inherited mutations can lead to epilepsy.
- Structural causes: Some brain injuries can alter the electrical activity of the brain, increasing the likelihood of seizures.
- Infectious causes: Brain infections, such as meningitis, can damage brain tissue and disrupt its normal function.
- Autoimmune causes: Chronic inflammation of the brain can cause epilepsy.
There are also many cases of idiopathic epilepsy, in which it is not possible to clearly determine the cause. In these cases when the causes are unknown, treatment will focus on controlling the seizures so that the patient can have the best quality of life.
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How can epilepsy be treated?
Epilepsy treatments focus primarily on controlling seizures to improve the patient’s quality of life. These treatments differ depending on the type of epilepsy, and the frequency and severity of the seizures. In addition, the needs of each individual are also taken into account.
The most common treatments for epilepsy are:
- Antiepileptic drugs (AEDs). Medications to help control seizures that are prescribed according to the type of epilepsy and the characteristics of each patient.
- Vagal nerve stimulation (VNS). Through surgery, a device is implanted that stimulates the vagus nerve with an electric shock.
- Stimulation of the anterior nucleus of the thalamus. A surgical procedure in which electrodes are implanted in the anterior nucleus of the thalamus. Electrical stimulation will reduce the frequency and severity of seizures.
- Ketogenic diet. A low-carbohydrate, high-fat diet has been shown to be good at reducing seizures in some cases of patients with epilepsy.
- Epilepsy surgery. This can be considered for some types of epilepsy that do not respond to medication.
In which cases epilepsy surgery is recommended?
In some cases, patients who suffer from drug-resistant epilepsy, meaning that their seizures cannot be controlled despite being treated with epilepsy medication, can be candidates for epilepsy surgery that can reduce the seizures or, in some cases, control them completely.
In order to determine whether this surgery may be used for a specific case, a series of studies must be carried out to identify the area of the brain in which the seizures originate, as well as tests to find out which brain functions can be affected if surgery is performed in that area.
In the article below in “Alimente,” Dr. Pablo Clavel, neurosurgeon and Director of Instituto Clavel, explains more about epilepsy surgery, for this disease that affects both men and women and can appear at any age:
Is it safe to exercise and play sports if you have epilepsy?
Many patients with epilepsy are hesitant to exercise or play sports for fear of having an epileptic seizure, or increasing the frequency of their seizures. But playing sports has been shown to provide both physiological and psychological benefits for people suffering from this neurological disease.
Doctors are often the ones who make a difference by providing the right information to address patients' fears. Depending on each patient’s individual case and situation, the doctor can recommend which type of physical activity is most suitable.
People with epilepsy can safely practice most types of exercise and sports, with the precaution of avoiding overexertion, high temperatures, or dehydration. Some sports, however, such as diving, skydiving, or rock climbing should be avoided by patients with uncontrolled seizures, as they require full concentration and an episode of loss of consciousness while practicing them can lead to serious injury.
If you would like to find out more about epilepsy, the Brain Unit at Instituto Clavel will be happy to answer all your questions. You can request an appointment here:
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