What Is Epilepsy?
Epilepsy is a neurological disorder that occurs as a result of an unusual electro-chemical discharge of nerve cells in the brain.
Epilepsy, also known as ‘epilepsy ’among the public, is due to short-term brain dysfunction and occurs as a result of temporary abnormal electrical propagation in brain cells.
It causes temporary loss of consciousness caused by excessive and uncontrolled spread of electricity related to the normal functioning of the brain. If the seizure lasts too long, it will be dangerous (30 minutes).
Epilepsy is a disease that affects about 1% of the world's population. The disease is seen equally in men and women, regardless of race. Epileptic seizures can occur at any age, but are often affected by the youngest and oldest.
Epilepsy is not mental retardation.
Epilepsy is a disease seen at any age.
Seizures are incomprehensible.
Epilepsy is taken under control as soon as it is treated.
Epilepsy can have behavioral and learning disorders.
Every year, 120 out of every 100,000 people are diagnosed with epilepsy.
Epilepsy is not a contagious disease.
If epileptic seizures are not controlled, they can cause problems with intelligence.
Epilepsy can begin immediately after birth or years later.
What Are The Causes of Epilepsy?
Vascular (infarction, bleeding, bleeding from anivrauma)
Blows to the head, traffic accidents
Problems in the womb
Damage left over from birth (congenital)
Genetic and metabolic diseases
Brain infections such as meningitis can lead to epilepsy.
What Are The Symptoms of Epilepsy?
Symptoms of epilepsy vary from person to person and not all symptoms may be seen in patients. Since epilepsy is caused by a disruption of a function in the human brain, its symptoms may vary according to the region where the brain is affected and the symptoms may differ according to the function. In general, the symptoms of epilepsy are as follows;
Sudden contractions in the body
Uncontrollable swings in arms and legs
Continuous nodding motion
Focusing on a fixed point
Blinking continuously and quickly
Psychological symptoms such as fear, anxiety, or dejavu (feeling like you've experienced that moment before)
Epilepsy is defined as subjective sensations felt by the patient before the seizure.
Changes in vision and hearing
Nausea or feeling of pressure in the stomach
Sudden feeling of fear
What Are The Treatment Methods?
The fact that epilepsy patients believe that they have lost their health and freedom irreversibly, that they have a fear of death and that the disease is chronic can cause acute or chronic stress. The often uncertain nature of epilepsy causes patients to experience many psychosocial problems.
Psychosocial problems associated with epilepsy may be related to the age of the patient, the underlying etiology and neuropathy of the disease, the duration of epilepsy, the frequency, severity and type of seizures, EEG discharge, antiepileptic drugs and various psychological factors.
Fall in the academic success of the patient, inadequacy in family and environmental support, chronic disease status, negative behaviors of the society towards epilepsy are other factors that cause psychosocial problems.
In order to maintain or regulate the daily functions and positions of epilepsy patients in society, it is necessary to struggle to change society's views on epilepsy and to provide patients with treatment.
It is stated that epilepsy is effective in the treatment of patients in applications such as antiepileptic drugs, neurosurgery, as well as in applications including education and psychological interventions.
In some studies, it is seen that psychological interventions reduce the frequency of seizures and stress in patients with epilepsy. Communication between healthcare professionals, the patient and their family is very important in the method of epilepsy.
It is stated that the diagnosis of epilepsy is higher in individuals diagnosed as children than in adults. Since the first diagnosis of epilepsy patients; diagnosis and treatment, situations to pay attention to in life, not being informed about social aspects such as stigma related to the disease negatively affects the patient and his family to cope with the disease. Therefore, the patient and his/her family should be supported and informed in the method of epilepsy. Nurses play a key role in improving the quality of care of the patient with epilepsy and regulating their communication with other healthcare professionals.
Starting Drug Therapy
The most important point in the treatment of epilepsy is the regular and planned use of drugs selected to stop seizures. Seizures stop if appropriate medications are selected in four out of five patients and taken at adequate doses. Physicians often prefer to start treatment with a single epilepsy medication. If this medication is not able to take the seizures under control adequately, then medication may be changed or a second medication may be added.
Before deciding on surgical treatment, it is necessary to show that the patient's seizures are resistant to medical treatment. Therefore, patients should take medication for at least 2 years. It should be ensured that at least 2-3 appropriate antiepileptic drugs are used individually (monotherapy) and together (polytherapy) in sufficient doses and time. These medications should be gradually increased until seizures are controlled or unacceptable dose-related side effects develop.
Surgical treatment can be decided earlier in patients whose seizures are due to structural disorders such as tumors and vascular abnormalities in the brain. Both drug resistance and surgical success are high in these cases. The longer the seizures can not be controlled, the lower the success of seizure control after surgery and the higher the likelihood of psychosocial problems.
There are two main types of epilepsy surgery.
Resective Surgery: It is more preferred to remove the epileptic focus itself.
Functional surgery and palliative surgery: It is a surgical method to reduce the spread, frequency and severity of seizures by cutting the seizure spread pathways.
Resective surgery methods for the complete elimination of seizures are applied to patients with partial onset seizures, that is, patients whose seizures start from a certain focus. These patients are low quality of life patients who have been proven to be resistant after using drugs in sufficient number, dose and time.
If the epileptic focus is on one side of the brain and relatively harmless, that is, if important cognitive functions such as mobility, memory speech, and vision will not be impaired after surgery, the surgical method should be determined without delay. This decision can only be made after preoperative examinations.
As a result of the tests performed by a team of neurologist, neurosurgeon, radiology and neuropsychology, psychiatric specialists before surgery, it is decided whether the patient is suitable for this type of surgery.