Although epilepsy is one of the most common neurological disorders, it remains widely unknown and is surrounded by a stigma that deeply impacts the lives of patients and their immediate environment. Few people would be able to offer a clear definition of the disease or identify its symptoms. Therefore, the first thing to do is eliminate prejudices. In this sense, Dr. Mar Carreño, neurologist at the Hospital Clinic Barcelonaemphasizes that “it must be clarified that epilepsy is a neurological or brain disease, and not a psychiatric or mental one.”
Epilepsy is a group of disorders of the nervous system caused by alterations in the electrical activity of the brain, which gives rise to sudden symptoms. In fact, the term “epilepsy” comes from the Greek “epilambaneim,” which means “to take by surprise.” The symptoms, known as epileptic seizures, are usually accompanied by loss of consciousness. These crises occur when there is excessive neuronal activity, which causes sudden and transient alterations in perception, behavior and mobility. Dr. Carreño explains that seizure symptoms occur when “neurons discharge too much and do so at the same time.”
It must be clarified that epilepsy is a neurological or brain disease, and not a psychiatric or mental one.
There are different guys of epileptic seizures. Acute symptomatic seizures are those that occur as a result of a brain problem, such as a stroke. On the other hand, unprovoked crises occur without an obvious external factor. They can also be classified according to the area of the brain in which they originate. Generalized seizures affect networks of neurons distributed throughout the brain, while focal seizures only affect one cerebral hemisphere. Symptoms vary depending on the type of crisis.
Symptoms appear when the neuronal groups responsible for seizures are activated. Before losing consciousness, some patients experience a sensation known as an aura. The type of aura depends on the neuronal groups affected, but is usually the same in each patient. Some of the most common sensations are sudden fear, a feeling of déjà vu, nausea, tingling, or the perception of lights, colors or figures. Unpleasant odors, abnormal noises and sound distortion may also appear.
During the physical examination, it is possible to detect various signs that indicate the presence of epilepsy. These include alterations in the level of consciousness, automatisms, rigidity, muscle jerks, seizures, confusion and difficulty speaking. Recognizing these signs is essential, since the diagnosis of epilepsy is clinical and based on the patient’s experience. “The most important thing is to explain in detail what the symptoms you have consist of, no matter how strange they may be when you relate them,” says Dr. Fran Gil, a neurologist at the Hospital Clínic Barcelona.
The causes of epilepsy are varied. They can be structural, such as those caused by a stroke, a head injury or a brain tumor. They can also be infectious, which are the most common, genetic or metabolic. Another possible cause is autoimmune disorders that affect the central nervous system. In some cases, the cause is unknown. In addition, there are risk factors that influence its development, such as having family members with a history of seizures, problems during childbirth, febrile seizures in childhood, brain infections or severe head trauma with loss of consciousness.
The most important thing is to explain in detail what the symptoms you have consist of, no matter how strange they may be when recounting them.
Although 70% of epilepsy cases can be controlled with drugs, they can also occur complications. The most serious is status epilepticus, which can put the patient’s life at risk. These are seizures that last more than 30 minutes or repeated seizures without recovery between them, generally caused by non-compliance with pharmacological treatment, cerebrovascular accidents, anoxia, metabolic alterations, tumors or fever. Furthermore, in some cases there may be consequences. The prognosis will depend on the cause of the crisis, its duration and the patient’s age.
Epilepsy is associated with a slightly higher risk of mortality compared to the general population. The main causes of death directly related to epilepsy are sudden death, which occurs most frequently during nocturnal seizures or when the person is unsupervised, accidents during a seizure, and status epilepticus. Despite this, if the treatment is followed properly and the recommendations According to experts, it is possible to lead a normal and active life.
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