Epilepsy: What It Is, Causes, Symptoms, and Treatment

Epilepsy, commonly known as "sara" in everyday language, is a neurological disorder characterized by seizures. Caused by abnormal electrical activity in the brain cells, epilepsy leads to temporary disruptions in brain activity. Epilepsy is characterized by short seizure durations, and its global prevalence is around 1%. As the fourth most common neurological disorder, epilepsy can occur at almost any age.

What is Epilepsy?

Epilepsy, which often manifests as spontaneous seizures, develops for various reasons and is characterized by recurring episodes. A neurological disorder, epilepsy occurs due to abnormal electrical activity in a group of neurons in the brain. This disruption in electrical activity leads to temporary impairments in brain functions during a seizure. There are many different types of epilepsy seizures, but they are typically categorized into two main types: partial seizures (which are limited to a part of the brain) and generalized seizures (which begin throughout the brain). Although the symptoms during an epilepsy seizure may sometimes be vague, they generally result in uncontrollable body movements due to the disruption of brain functions. Epileptic seizures typically last between 30 seconds and 2 minutes, but seizures lasting longer than 5 minutes can occur. In such cases, the individual requires emergency medical assistance. Epilepsy symptoms can vary from person to person but typically include uncontrollable body movements, fainting, tremors, loss of consciousness and memory, urinary incontinence, sensitivity to smells, fatigue, and confusion after the seizure. Before delving into epilepsy symptoms, it's important to answer the question: What are the types of epilepsy?

What Are the Types of Epilepsy?

Epilepsy can be classified based on the region of the brain affected. Some individuals may experience multiple types of epilepsy. Common types of epilepsy include:

• Absence Seizures: More common in childhood, absence seizures cause the individual to appear as if they are "staring off." These seizures are characterized by a child suddenly becoming silent during conversation and remaining motionless for about 10 seconds. The child does not respond to questions. In adults, absence seizures may involve meaningless words, walking, or repetitive movements of the hands and/or lips. The duration of absence seizures is short, and the individual does not remember what happened during the seizure.
• Simple Partial Seizures: During simple partial seizures, which develop in three different ways, the person remains conscious. This type of seizure usually originates from one of the brain's frontal, temporal, or parietal lobes. Seizures originating in the temporal lobe are described as motor seizures. During a motor seizure, the person may experience a strange smell or taste, sudden fear, and dizziness. Symptoms such as déjà vu, perception and memory issues, numbness, sweating, and nausea may also appear. The person may move their head or raise their arm. The side of the head or arm movement indicates which frontal lobe is affected. For example, if the person turns their head to the left, the seizure originates from the left frontal lobe. Since the speech center is located in the frontal lobe, temporary speech impairments may occur. After the seizure, the person may experience temporary weakness or paralysis. The parietal lobe is responsible for body sensations, and seizures originating here can lead to unusual feelings such as temporary pain and numbness.
• Complex Partial Seizures: During complex partial seizures, which the person does not remember, the individual does not fall to the ground. Actions such as lip-smacking, swallowing, and chewing may occur. The person may also wander around or tug at their clothing.
• Generalized Seizures: The most common type of seizure associated with epilepsy, generalized seizures cause the person to become stiff and fall to the ground. All the muscles in the body involuntarily contract and relax. The person's consciousness is lost during the seizure, and they do not remember anything afterward. Following the end of the generalized seizure, the person gradually regains consciousness and is usually left feeling fatigued and confused.

What Are the Symptoms of Epilepsy?

Although the symptoms of epilepsy can vary depending on the type of the disease, the general signs of epilepsy can be listed as follows:

• Loss of Consciousness: During a seizure, the individual cannot control or remember what happened.
• Muscle Contractions: During a seizure, all of the person's muscles involuntarily contract and relax, leading to trembling and thrashing.
• Turning of the Head and Eyes: The person may move their head and eyes to the right or left during the seizure.
• Urinary Incontinence: Due to the inability to control muscles during the seizure, the person may lose control of their bladder.
• Confusion After the Seizure: Once the seizure ends, the person may feel fatigued and confused.

What Are the Symptoms That May Occur Along with Epilepsy?

In addition to the common symptoms of epilepsy, other symptoms may appear depending on the type of seizure. Some of these symptoms include:

• Involuntary muscle movements
• Repetitive movements
• Sudden falling
• Strange behaviors and speech
• Distortions in taste, smell, touch, and vision
• Brief episodes of staring or zoning out
• Dropping objects being held
• Lack of responsiveness
• Speaking incomprehensible words
• Failing to answer questions

What Causes Epilepsy?

Epilepsy can be caused by genetic factors, congenital anomalies, and birth trauma. Additionally, various factors such as brain vascular diseases, brain inflammation, head trauma, brain hemorrhages, the presence of tumors, high fever during childhood, and alcohol use may play a role in the development of epilepsy. However, in many cases of epilepsy, no specific trigger for the seizures can be identified.

What Are the Stages of Epilepsy?

Some individuals may experience certain symptoms before an epilepsy seizure occurs. If the seizure originates from a small area of the brain, the symptoms that can sometimes be felt before the seizure are referred to as an "aura." These symptoms can vary depending on the region of the brain where abnormal electrical activity is taking place. The symptoms that may occur before an epileptic seizure are as follows:

• Numbness: The person may feel numbness in a specific part of their body.
• Loss of Vision and Hearing: The person may experience changes in their vision or hearing.
• Smell: The person may detect a bad odor before the seizure.
• Nausea: A feeling of pressure or nausea in the stomach may occur.
• Mood Changes: The person may suddenly experience feelings of fear.

How is Epilepsy Diagnosed?

A person experiencing an epileptic seizure will not remember what happened. Therefore, it is recommended that the person’s close family member, who is present during the seizure, also visit the doctor to provide detailed information. The doctor will ask questions regarding the duration and type of the seizure. To clarify the diagnosis of epilepsy, radiological imaging tests such as MRI, CT scan, PET, and EEG may be conducted. Based on the results of the examination and radiological imaging, a diagnosis of epilepsy can be made.

How is Epilepsy Treated?

The goal of epilepsy treatment is to reduce the frequency of seizures and prevent them completely.

Epilepsy treatment is primarily medication-based. The doctor prescribes the appropriate medications for the person diagnosed with epilepsy. It is crucial to take these medications regularly at the dosage prescribed by the doctor.

In cases where the medication does not provide adequate results, such as in drug-resistant epilepsy, surgical treatment may be considered. The type, form, and frequency of seizures, as well as the use of multiple medications, will be evaluated, and if appropriate indications are found through additional tests, surgery may be applied.