Epilepsy: Types of Seizures, Symptoms, and Treatment Methods

Epilepsy is a neurological disorder originating from the central nervous system. It is a medical condition that can cause abnormal behaviors, sometimes loss of consciousness, and especially seizures. It affects approximately 1% of the world’s population. Experts state that, for an epilepsy diagnosis, seizures must occur at least twice, with a minimum of 24 hours between each occurrence, and there should be no identifiable trigger for their onset.

What is Epilepsy?

To understand epilepsy, the concept of seizures must first be understood correctly. A seizure is a medical condition resulting from a disturbance in the brain’s electrical activity, causing sudden and unexpected changes in movement, behavior, sensation, or consciousness. There are many potential causes for seizures. Because seizures occur due to uncontrolled electrical waves, they can lead to muscle spasms, mental confusion, loss of consciousness, and uncontrolled body movements. While the exact duration of a seizure’s impact on an individual cannot be predicted, it usually resolves by itself within seconds or minutes.

Epilepsy, however, is characterized by the repeated occurrence of these seizures. It is not accurate to define every seizure as epilepsy. Seizures can also occur due to various factors such as diseases that cause high fever, severe head trauma, or oxygen deprivation. Additionally, epilepsy is a condition that affects the brain’s electrical connections and tends to persist throughout life. Although there is no definitive cure, it can be controlled with medical treatments and medications.

Types of Epileptic Seizures

• Simple Partial Seizure: In simple partial seizures, consciousness remains fully intact, but the individual cannot control the seizure. The seizure occurs due to activity in a small part of the brain. How the person is affected depends on which part of the brain the seizure occurs in. For example, if the seizure happens in the occipital lobe, which is related to vision, symptoms affecting the visual field may appear in the individual.
• Complex Partial Seizures: In this type of seizure, consciousness is affected. The person may not remember the seizure, or temporary memory loss may occur. During the seizure, actions such as chewing, licking, swallowing, or a confused gaze may be observed.
• Generalized Seizures: These seizures affect the entire brain, leading to violent movements outside of the person's control. The person first experiences muscle contractions and may fall to the ground, followed by contractions and relaxations of all body muscles in succession.
• Absence Seizures: These seizures, which affect the entire brain, are mild but can be frequent enough to impact daily life. During a seizure, the person's appearance resembles that of someone daydreaming. The person may experience brief loss of consciousness and be unable to perceive external stimuli. These seizures are more common between the ages of 6 and 12 and are more frequent in girls. If unnoticed, these seizures can lead to learning difficulties in school, missing the end of a sentence after hearing the beginning, or unwillingness to participate in activities.

What Are the Symptoms of Epilepsy?

The symptoms of epilepsy depend on which area of the brain the seizures originate from.

Symptoms of Seizures from the Temporal Lobe:

• Sudden fear, panic
• Inability to make connections between events, memory loss of events, feeling that events that didn’t happen have occurred
• Thinking unfamiliar people are familiar, being unable to recognize familiar people
• Unpleasant smells and tastes

Symptoms of Seizures from the Frontal Lobe:

• Problems with movement, weakness
• Sudden turning of the head
• Involuntary raising of the arm
• Jerking, rhythmic muscle contractions and relaxations in the limbs
• Interruptions in speech
• Speech becoming incomprehensible
• Temporary paralysis
• If the left side of the person is affected during the seizure, it indicates the seizure is originating from the right frontal lobe.

Symptoms of Seizures from the Parietal Lobe:

• Strange sensory sensations
• Temporary numbness or loss of sensation

Symptoms of Seizures from the Occipital Lobe:

• Flashing lights affecting vision
• Seeing colors in the visual field that are different from what should be seen

Understanding the area of the brain where seizures occur is extremely important in the diagnosis and treatment of epilepsy. Therefore, seizures should be carefully observed by the patient’s family members and reported in detail to healthcare professionals.

How is Epilepsy Diagnosed?

Epilepsy is diagnosed by neurologists. A detailed medical history of the individual must be taken, and a thorough neurological examination should be performed by the doctor. To diagnose epilepsy, the individual must also undergo certain tests. Some of the test methods used include:

Electroencephalography (EEG): EEG is a method used to detect abnormal electrical activities in the brain. It was developed by Dr. Hans Berger in 1929. Electrical methods are used, but since no electric current is applied to the individual, there is no possibility of pain or discomfort. Electrodes placed on the scalp detect and record the electrical activity patterns. The test is performed in a specially equipped room in the hospital by an EEG technician. During the test, the individual lies flat on their back, and discs are placed on the scalp with the help of a paste, which are connected to a recording machine by wires. The machine records brain signals, and these signals form a wavy line pattern. During the review of the recording, abnormalities compared to normal can reveal brain dysfunctions. Since movement may alter the test results, the individual is asked to remain still. To examine brain wave activity during sleep, the individual may be asked to stay awake the night before the test. For children, the doctor may ask for the child to be kept awake the night before, or medication may be given prior to the test.

Magnetic Resonance Imaging (MRI): MRI is a medical imaging technique that uses magnetic fields and radio waves to produce detailed images of tissues and organs in the body. For epilepsy diagnosis, an image of the brain is taken. Unlike radiography, which uses X-rays, MRI imaging utilizes the magnetic properties of atoms. The MRI machine is essentially a large tube-shaped magnet. The powerful magnet in the machine generates a strong magnetic field around the body, and some hydrogen atoms in human tissues align with this field. In brief, MRI re-aligns the water molecules in the body in real-time. This generates signals that are used to create images of the body part. It is also possible to capture three-dimensional images with MRI.

Positron Emission Tomography (PET): PET is a medical imaging technique used to evaluate the brain's energy activity. For the scan, radioactive tracers containing chemicals that are absorbed by organs and tissues are injected into the patient's body. When used for brain diseases, the tracers in the prepared medicine bind to compounds like glucose. The scanner detects the radioactive glucose and identifies which areas of the brain use the most glucose. PET images are programmed to show different colors or brightness levels based on the amount of glucose used. This way, the area of the brain where the seizure occurs for epilepsy can be detected, as it will appear different from other areas.

Epilepsy Treatment Methods

Epilepsy treatment should be tailored to the individual. It is important to create a treatment plan based on the underlying cause. The primary treatment for epilepsy has been antiepileptic drugs that prevent seizure development for many years. Medication therapy is effective for the majority of patients. For patients who do not respond to medication, stimulant therapies and epilepsy surgery may be applied.

For drug-resistant epilepsy, medical nutrition therapy such as ketogenic diets may be used. A ketogenic diet is a high-fat, low-carbohydrate diet. This treatment utilizes the anticonvulsant effects of high ketone bodies, high fatty acids, and low glucose levels. The ketogenic diet has various applications and must be planned individually for each person. It is crucial that this treatment be carried out by a specialized dietitian, and the patient should be monitored closely during the process.