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EPILEPSY (SARA DISEASE)

Updated: Jun 2, 2022


Epilepsy is a clinical picture that includes recurrent seizures due to an underlying process. Epileptic seizures occur as a result of sudden abnormal and intense discharges of nerve cells in the brain. The clinical picture can be very diverse. It varies according to which region of the brain the nerves are discharged and whether they spread to the whole brain. In the classical type (generalized tonic-clonic type seizure), which is called epileptic seizure among the people, epileptic seizures can be seen in the form of contractions in the hands and in the form of foaming at the mouth, as well as in the form of fainting attacks in the eyes that last only a few seconds (absence type epilepsy). Seizures can be seen with or without a change in consciousness. Its incidence in the community is between 5 and 10 people per thousand.



What are the types of epilepsy?

There are two types of epileptic seizures: partial (partial) or generalized (common). In partial (partial) seizures, seizure activity is limited to a certain part of the brain and does not spread to other parts of the brain. In generalized epilepsy, other parts of the brain are commonly affected simultaneously. In partial seizures, there is usually a structural disorder of the underlying brain.



1-Partial (partial) seizures

Partial (partial) seizures are divided into two groups as simple partial epilepsy and complex partial epilepsy. While there is no unconsciousness in simple partial seizures, there is impairment in consciousness in complex partial seizures. The symptoms seen in partial (partial) seizures are the findings of whichever part of the brain is affected and which task this part of the brain assumes. In simple partial seizures, motor, sensory, autonomic or psychic complaints occur without any unconsciousness. While consciousness is completely normal in focal motor seizures, seizures may occur in the form of contraction-trembling in an arm or leg, or involuntary turning of the head and neck to one side, or seizures in the form of contraction-rotation and speech disorder in the whole body. In sensory seizures, seizures such as numbness, tingling, pain or burning in one arm, leg or half of the face can be seen in a part of the body. In seizures with autonomic symptoms, it can be in the form of flushing, decrease or increase in blood pressure, sweating, fading, pupillary enlargement or shrinkage. In seizures with psychogenic symptoms, it can be seen as déjà vu (feeling as if you have experienced that moment before), jamais vu (feeling as if you are in a very foreign place at the moment), fear and nervousness attacks.



Complex partial epilepsy (psychomotor epilepsy)

It usually starts as a strange feeling in the stomach and then stays still, looking at a fixed point, smacking, licking, meaningless movements as if playing with something with hands and fingers. The patient cannot answer when the people around him at that moment ask questions, assuming that the patient is awake. These seizures usually do not exceed 1-2 minutes.



2-generalized (common) seizures:

Generalized seizures can be of absence, generalized myoclonic, generalized tonic, and generalized tonic-clonic types. Absence seizures are usually seen in children, and they are in the form of sluggish attacks lasting 5-10 seconds. The child stays in this way for 5-10 seconds, staring at something. In generalized myoclonic seizures, there may be sudden jumping movements in one or both arms. In the meantime, the patient can drop or throw the items in his hand.

Generalized toic-clonic seizures are the most common of the generalized seizures. It is the type known as epilepsy among the people. The patient also has fainting in the hands, arms and whole body in the form of contractions and trembling. Foaming at the mouth, biting the tongue, urinary incontinence can be seen.

Sometimes seizures may start as partial (partial) and become generalized.



How is the diagnosis made in epilepsy?

The presence of a seizure is of great importance in the diagnosis of epilepsy. Therefore, recording the seizures of epilepsy patients is very helpful in diagnosis. Brain MRI is performed to see if there is a structural lesion of the brain that causes epilepsy. EEG examination is important in order to diagnose or support the diagnosis of epilepsy and to determine the type of epilepsy. Epileptiform activity is observed at a rate of 50% in the awake EEG of adult patients with epilepsy. In EEG taken during sleep, this rate rises to 80%. Epileptiform activity can be seen on EEG in 2-3% of patients without epilepsy. For this reason, it is very important to see epileptic seizures. PET (positron emission tomography) can be used in some centers in cases where cranial MR and EEG do not provide information because it gives information about regional blood flow in some patients.



What is the treatment for epilepsy?

It can be difficult to determine whether the attack is an epileptic seizure in patients who have had a seizure for the first time. Cardiac or hypoglycemia such as syncope, arrhythmia, hypotension, hepatic failure

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