Seizures are abnormal abnormal behavior arising due to abnormal electrical activity in the brain, and the recurrence of these seizures means epilepsy. Fortunately, epilepsy is currently treated in Turkey.
What is a seizure and what is epilepsy?
Seizures: abnormal abnormal behavior arising from unusual electrical activity in the brain, which arises from the effects of epilepsy. But not all people who have seizures have epilepsy, and epilepsy: a group of related disorders characterized by a tendency to have recurring seizures.
Non-epileptic seizures (called false seizures) are not accompanied by abnormal electrical activity in the brain and may be caused by psychological problems or stress. However, non-epileptic fits look like true seizures, making diagnosis more difficult. The fact that the electroencephalogram is normal with no response to epilepsy medications are evidence that these seizures are non-epileptic. These types of seizures can be treated with psychotherapy and psychiatric medications.
Aroused seizures are single episodes that may occur as a result of shock, low blood sugar (hypoglycemia), hyponatremia, high fever, or alcohol or drug abuse. Fever-related seizures may occur during infancy but usually clear up by the age of six. After careful assessment to estimate the risk of recurrence, patients who experience a single episode may not need treatment.
Seizure disorder is a general term used to describe any condition in which seizures are a symptom. Seizure disorder is a general term that is often used in place of the term "epilepsy".
Who is affected by epilepsy?
Epilepsy is a relatively common condition, affecting up to 1.2% of the population. In the United States alone, about 3.4 million people have epilepsy and about 9% of Americans will have at least one seizure in their lifetime.
What causes epilepsy?
Epilepsy is caused by abnormal electrical activity that originates in the brain. Brain cells communicate with each other by sending electrical signals in an orderly pattern. In epilepsy, these electrical signals become abnormal, resulting in an "electrical storm" that triggers seizures. These storms may be within a specific part of the brain or generalized to other parts of the brain, depending on the type of epilepsy.
types of epilepsy
People with epilepsy may have more than one type of seizure. This is because seizures are only symptoms. Therefore, it is essential that your neurologist diagnose the type of epilepsy you have, not just the type of seizure you have.
How is epilepsy treated in Turkey / Istanbul?
The majority of epileptic seizures are controlled with drug therapy. The diet can also be used with medication.
For 70% of epilepsy patients, medications can control seizures. However, they cannot cure epilepsy, and most people will need to continue to take medications.
For an accurate diagnosis of the type of epilepsy (and not just the type of seizure, since most seizure types occur in different types of epilepsy) a person has great importance in choosing the best treatment. The type of medication prescribed will also depend on several factors specific to each patient, such as tolerable side effects, other illnesses they may have, and the acceptable method of delivery.
Instructions for epilepsy medication
It may take several months before the best medication and dose for you is determined. During this time, you will be carefully monitored with frequent blood tests to measure your response to the medication.
It's very important to keep follow-up appointments with your doctor to reduce your risk of serious side effects and prevent complications.
In some cases where medications and diet don't work, surgery (vagus nerve stimulation) may be used. The type of treatment prescribed depends on several factors, including the frequency and severity of attacks, as well as the person's age, general health, and medical history.
An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment.
What is epilepsy surgery?
Medications can control seizures in most people with epilepsy, but they don't work for everyone. About 30% of people who take medications cannot tolerate the side effects. In some cases, brain surgery may be an option.
Brain surgery can control seizures and improve your quality of life. Surgery has three main goals:
- Removal of the area in the brain that causes seizures (removal of the brain).
- Disrupting the nerve pathways that transmit impulses through the brain.
- Implantation of a device for the treatment of epilepsy.
Who undergoes epilepsy surgery?
Surgery is only an option if:
- Your doctor can clearly identify the area of the brain where the seizures begin, which is called the focus of the seizure.
- The area to be removed does not control a critical function such as language, sensation, or movement.
If you meet these criteria, surgery works best when:
- Your seizures are disabling.
- The medicine does not control your seizures.
- Medication side effects are severe and affect your quality of life.
People with other serious medical problems, such as cancer or heart disease, aren't usually considered for this treatment.
What are the options?
The type of surgery you'll have depends on the type of seizures you're having and the area where the attacks began.
The largest part of your brain, the cerebrum, is divided into four sections called lobes: the frontal, parietal, occipital, and temporal lobes. Temporal lobe epilepsy, in which the focus of the seizure is within the temporal lobe, is the most common type in adolescents and adults. In a temporal lobe resection, brain tissue in this area is cut to remove the focus of the attack. Extracorporeal resection involves removing brain tissue from areas outside the temporal lobe.
Excision of the lesion:
This surgery removes brain lesions — areas of injury or defects such as a tumor or abnormal blood vessels — that cause seizures. The attacks usually stop once the lesion is removed.
Cut the corpus callosum:
The corpus callosum is a group of nerve fibers that connect the two hemispheres of the brain. In this procedure, sometimes called split-brain surgery, your doctor cuts the corpus callosum. This stops communication between the two hemispheres and prevents seizures from spreading from one side of your brain to the other. It works best for people with severe and uncontrollable forms of epilepsy, and for those with severe seizures that can lead to violent falls and serious injury.
In a hemispherectomy, the doctor removes all of your brain. In a functional hemispherectomy, the doctor leaves the hemisphere in place but separates it from the rest of your brain. Thus only a limited area of brain tissue is removed. This surgery is mostly done for children under the age of 13 who have a hemisphere that isn't working the way it should.
Subtibial multiple resection (MST):
This procedure can help control seizures that begin in areas of your brain that cannot be safely removed. The surgeon makes a series of superficial cuts (called cuts) in the brain tissue. These wounds impede the flow of seizures, but do not disturb normal brain activity. This leaves your abilities intact.
Vagus nerve stimulation (VNS):
A device placed under your skin sends an electronic jolt to the vagus nerve, which controls activity between your brain and major internal organs. Thus, it reduces seizure activity in some people with partial seizures.
Responsive Neurostimulation System (RNS):
Doctors place a small nerve stimulator in your skull, just below your scalp. They attach one or two wires (called electrodes) that they place either in the part of your brain where seizures begin or on the surface of your brain. The device detects abnormal electrical activity in the area and sends an electrical current. It can stop the process that leads to a seizure.
Deep Brain Stimulation:
Doctors place electrodes in a specific area of the brain. get up stimulating the brain directly to help stop the spread of seizures in adults who have not responded to medication and are not candidates for further surgery.
How does epilepsy surgery work in Turkey?
It depends on the type of surgery. Some people never have seizures after surgery. But others still have these seizures, but less often. You will then need to continue taking anti-seizure medications for a year or more after that. Once your doctor knows your seizures are under control, you may be able to cut back on your medications or even stop taking them.
Are there risks?
Before having surgery to treat epilepsy, your doctor will discuss the pros and cons with you. Some of the risks are:
- Infection and bleeding as well as the possibility of an allergic reaction to the anesthetic. (This is common in any operation).
- Making existing problems worse or creating a new problem in the way your mind works. You may lose vision, speech, memory, or movement.
- Return seizures.
If you have a seizure immediately after surgery, your doctor may suggest a second surgery (called re-surgery). This does not mean that the operation did not work. This usually means that the surgeon has not removed all of the brain tissue that causes the seizures.
Coping with epilepsy
Educational, social and psychological treatment, all of which are part of the comprehensive treatment plan for epilepsy. The most important step you can take is to seek help as soon as you feel less able to cope. Epilepsy is best managed by a team of physicians who can provide medical, psychological, social, and educational support. If you have a problem with school, work, finances, relationships or daily activities, it is important that you discuss it with a member of the epilepsy team.
Taking action early will enable you to understand and deal with the many effects of epilepsy. Learning to manage your stress will also help you maintain a positive physical, emotional, and spiritual outlook on life.
Vagus nerve stimulation
What is vagus nerve stimulation (VNS)?
Vagus nerve stimulation is one of the ways to treat epilepsy in Turkey. Your doctor places a small device similar to a pacemaker in your body to stimulate the vagus nerve that runs from your brain to your trunk. This organ serves many organs, including the larynx, lungs, heart, and digestive system.
How to stimulate the vagus nerve
Your doctor puts you to sleep under general anesthesia. They insert a device, about the size of a silver dollar, under the skin in the upper part of your chest. Next, they pass a wire under your skin from the stimulator to an electrode connected to the vagus nerve, which they can access through a small cut in your neck.
After it's inserted, the stimulator is programmed to send electrical impulses at regular intervals, depending on your condition. Your doctor can adjust the settings and slowly raise the current.
The doctor will also give you a hand magnet. When you bring it close to the stimulator, it generates a current of electricity to stop the seizure as it occurs or to make it less severe.
VNS is an add-on therapy, which means you use it in addition to another type of treatment. You will continue to take seizure medications. But you may be able to lower your dose over time.
How does VNS work?
Doctors don't know exactly how it works. They know that the vagus nerve is an important pathway to the brain. They also believe that stimulating this nerve sends electrical energy to a wide area of your brain. This, in turn, disrupts the unusual brain activity that causes seizures. Another theory is that stimulating the nerve causes your brain to send out special chemicals that reduce seizure activity.
Why is the vagus nerve stimulated?
Medications called anticonvulsants or anti-seizure medications work for most people, but some can't handle the side effects.
Surgery to remove the part of the brain that's causing the seizures is another option. But not everyone should have this surgery.
Maybe your seizures are happening all over your mind, or the medications you're taking can't control them. This is when VNS might be a good option.
Risks of vagus nerve stimulation
VNS can lead to complications including:
- Injury to a nerve or nearby blood vessels, including the carotid artery and jugular vein
- Allergic reaction to anesthesia
VNS . side effects
Side effects usually only occur when the nerve is stimulated. It is usually mild and tends to go away over time. The most common ones include:
- Throat pains
- Tingling in the neck
- difficulty swallowing
- shortness of breath
- sleep problems
Vagus nerve stimulation results
VNS is not a cure. It's rare for seizures to go away completely, and most people still need to take epilepsy medication after the procedure. But many people with VNS note that their seizures are less severe and occur 20% to 50% more often. You may also need less time to recover from an attack.
People who have had VNS may also notice an improvement in their mood and quality of life. But it may take months, a year, or more on VNS before you notice much of a difference.