Surgical methods are used in epilepsy, which is one of the diseases that can be seen at almost any age, negatively affects the daily life of people and usually takes a long time to treat. Surgical methods, which have been applied throughout history and have a deep-rooted history, have become common today, especially with the development of technology and medicine. Epilepsy surgery both reduces the risks considerably and makes it possible for people to continue their social lives normally.
What is epilepsy?
Epilepsy; It is a disease that causes sudden and involuntary contractions, closure of consciousness and emotional changes in people as a result of abnormal activities seen in brain neurons affecting the normal course. Epilepsy, which manifests itself in the form of tremors and seizures in general, is also known as epilepsy among the people.
Tremors, loss of consciousness and various body movements are seen in sudden and involuntary epileptic seizures. For diagnosis, these seizures should repeat more than once.
Although epilepsy, which is very common, manifests itself in all age groups, it is more common in individuals under the age of 18 and over the age of 65. Epilepsy is one of the most common neurological diseases especially in individuals under the age of 18.
Why Does It Happen?
Epilepsy is seen for many different reasons, depending on the person. In addition to the identified causes, some patients are diagnosed with epilepsy, but the cause of the disease is unknown. Some of the factors that cause epilepsy are:
genetic factors,
inherited diseases,
Inflammations such as brain tumors and meningitis,
Head trauma due to accidents and injuries,
Traumas developing in difficult births,
Damages affecting the nervous system, brain tissue and vessels.
What Are the Types of Epilepsy?
Epilepsy is divided into two as focal and generalized according to the area where the nerve cells are affected and the areas affected by the abnormal activities in the brain:
Focal Epilepsy
In focal epilepsy, also known as partial epilepsy, abnormal electrical activities seen in various parts of the brain are not seen simultaneously. Abnormalities that start in a certain area are limited to this area in some cases, while in some cases they can spread to the whole brain. This difference is the reason why focal epilepsy is divided into simple and complex seizures.
Simple focal seizures in which consciousness is clear may result from abnormalities in the frontal lobe, temporal lobe, or parietal lobe. These different regions cause people to show different symptoms during a seizure. The frontal lobe is associated with movement disorders, the temporal lobe is associated with sudden panic and deja-vu, and the parietal lobe is associated with drowsiness and visual difficulties.
In complex focal epilepsy, patients lose consciousness during seizures. Symptoms include constant swallowing and chewing desire, fixation of gaze and confusion. After the seizure, people often do not remember what they did during the seizure.
Generalized Epilepsy
Contrary to focal epilepsy, in generalized epilepsy, abnormal electrical activities are observed in all parts of the brain simultaneously or starting in one region and spreading to other regions. Epileptic seizure, which is also known as epileptic seizure and is quite severe, is evaluated in the generalized category. Symptoms include involuntary movements of the arms, legs and body, complete contraction of some or all parts of the body and then relaxation. In most generalized epileptic seizures, people are unconscious.
What Are the Symptoms of Epilepsy?
Epilepsy symptoms generally differ in simple and complex seizures. Although simple seizures are a real seizure, they can also be a precursor to a more severe seizure. In complex seizures, patients are usually unaware of what they are doing. The most important difference between the two types of seizures is whether consciousness is on or off. While the patients are conscious in simple seizures, the movements and sounds made in complex seizures are made unconsciously.
There are some symptoms called aura before the epileptic seizure and evaluated during the diagnosis. These symptoms are generally associated with abnormal bioelectrical activity in a certain and small part of the brain. Among these symptoms;
Sudden onset of anxiety and fear
Visual or hearing impairments
Nausea,
Numbness in some parts of the body,
feeling of fainting,
There are changes in the sense of smell.
Symptoms of epilepsy differ from person to person, depending on the part of the brain that is affected. In general, the symptoms seen during seizures are as follows:
Sudden contractions and tremors in the body,
Loss of consciousness
,
Involuntary movements in the arms and legs
repetitive head shaking movements
clenching of teeth,
foaming at the mouth,
Rapid and sudden eye movements
Fixing the gaze on one point,
Inability to speak and answer questions.
How Is Epilepsy Diagnosed?
Imaging methods are one of the primary methods used in the diagnosis of epilepsy. (EEG), (MR) and computed tomography are among the most commonly used imaging methods. EEG, which indicates the electrical activity of the brain, is especially important in the diagnosis of epilepsy. Thanks to EEG, regions of the brain with uncontrolled bioelectrical activity are detected. Whether there is any structural problem that causes seizures is understood by MRI and tomography. If required by specialist physicians, blood and urine tests are also performed.
For the diagnosis of epilepsy, the patient’s medical history, frequency and severity of seizures, and symptoms are among the points that physicians pay attention to. Sometimes, extreme stress, fatigue, emotional and hormonal changes can also cause seizures. In this sense, not every seizure indicates epilepsy. Physicians can make a diagnosis after listening to the patient’s story.
What are the Treatment Methods?
Medical and surgical methods are used in the treatment of epilepsy. In drug therapy, it is aimed only at the elimination of seizures and symptoms, not the source of epilepsy. An average of 60%-65% of patients can continue their daily lives using only one type of drug.
In addition to the patient group in which the symptoms can be suppressed, the symptoms and seizures are much more severe in a group of 20% on average. These patients, for whom medical treatment is not sufficient, benefit from surgical methods. Epilepsy surgery provides complete or partial elimination of seizures.
What is Epilepsy Surgery?
Epilepsy surgery, which is among the treatment methods of epilepsy, aims to detect the regions in the brain that cause epileptic seizures and to remove the damages in this region with surgical procedures. Although the aim of epilepsy surgery is to minimize seizures, basically eliminating seizures is the reason for resorting to these surgical methods. At the same time, it is also aimed to eliminate the side effects of drugs used for epilepsy. One of the reasons for applying epilepsy surgery is to enable people to continue their social life.
What are Surgical Operations Techniques?
Surgical operations are divided into two as functional and resective according to the type of epilepsy and purpose:
Functional Surgery
Functional surgery, also known as palliative surgery, is generally applied to minimize the severity and frequency of seizures. It is aimed to prevent certain parts of the brain that cause seizures from affecting other regions. Any age group patient who is resistant to drug treatment can be taken into this operation. The average success rate of functional surgery is around 80%.
Resective Surgery
Resective surgery, on the other hand, is one of the most preferred methods because it is suitable for all epilepsy types. The aim of this procedure is to completely remove the part of the brain that causes the seizure. Patients who do not respond to drug treatment before the operation should use drugs for 1-2 more years after the operation. Medical treatment continues in this process, depending on whether seizures are seen or not.
Frequently asked Questions
Who can have epilepsy surgery?
In order for epilepsy surgery to be performed, patients should not be responding to drug therapy (especially having epileptic seizures despite 3 antiepileptic drugs). At the same time, it is one of the conditions sought for epilepsy syndromes to be suitable and treatable for surgical procedures.
Does epilepsy go away completely?
Epilepsy is a disease that can be treated after a long process. However, the treatment method applied is determined according to the type of epilepsy, the severity and frequency of the seizures, and the syndromes shown by the patients. While medical treatment only prevents seizures, surgical operations can also provide complete disappearance of epilepsy. Complete remission of epilepsy varies according to the condition of the patients.
What should be considered after the operation?
Since epilepsy surgery does not eliminate the disease in an instant, patients should continue medical treatment for another 1-2 years. The absence of seizures during this period does not mean that they will never occur. For this reason, it is imperative that the medications continue to be taken during the period deemed appropriate by the specialist physicians after the surgery. If the seizure does not occur, the drugs are gradually discontinued.
How should patients be helped during epileptic seizures?
Epileptic seizures last 1-2 minutes on average. During this period, it is absolutely necessary not to interfere with the patients. be particularly common