Epilepsy is a chronic brain disease characterized by recurrent seizures, which are a series of episodes of involuntary movements involving part of the body (partial seizures) or the whole body (generalized seizures) and are sometimes accompanied by loss of consciousness and control of bowel or bladder function. .
Episodes of seizures result from excessive electrical discharges in a group of brain cells, which can occur in any part of the brain. Seizures can vary from loss of consciousness or just brief muscle spasms to severe and prolonged seizures. Seizures can also vary in frequency, from less than 1 per year to several per day.
The occurrence of one seizure does not indicate epilepsy (up to 10% of people worldwide have one seizure in their lifetime). Epilepsy is defined as two or more seizures without an underlying cause.
SIGNS AND SYMPTOMS
The characteristics of seizures vary and depend on which part of the brain is affected first, and how far it spreads to the surrounding brain. When a seizure occurs, symptoms do not persist, such as:
- Loss of consciousness.
- Movement disorders.
- Impaired sensation (including sight, hearing and taste).
- Mood disturbances.
- Other cognitive function disorders.
When the seizure is over, the patient can usually return to normal as before. However, every time there is a seizure there is a possibility that the brain cells will be damaged, especially if the seizure lasts long enough so that oxygen intake to the brain is low, so that it can give permanent symptoms.
People with epilepsy tend to have more physical impairments (such as broken bones and bruises from seizure-related injuries), as well as more psychological disorders, including anxiety and depression. Similarly, the risk of premature death in people with epilepsy is up to three times higher than in the general population. Most of the causes of death are related to epilepsy, such as falls, drowning, burns, and prolonged seizures.
REASON
Epilepsy is not contagious. Although many diseases are known to underlie epilepsy, in general, about 50% of cases have not found a definite cause. The causes of epilepsy are divided into several categories, including: structural, genetic, infectious, metabolic, immune, and unknown (idiopathic). Examples include:
- Brain damage due to prenatal or perinatal causes (eg loss of oxygen or trauma at birth, low birth weight).
- Congenital abnormalities or genetic conditions with associated brain malformations.
- Severe brain injury.
- Strokes.
- Brain infections such as meningitis, encephalitis or tuberculosis.
- Certain genetic syndromes.
- Brain tumor.
TREATMENT
Seizures can be controlled. Up to 70% of people living with epilepsy can become seizure free with the appropriate use of antiseizure medications. Discontinuation of antiseizure drugs may be considered after 2 years without seizures. Unresolved causes of seizures and abnormal electroencephalographic (EEG) patterns are the two most important predictors of seizure recurrence.
Surgery can be beneficial for patients who respond poorly to medications or experience severe side effects. Surgery is also recommended in patients who have a single or non-spreading epileptic focus. Removing the part of the brain that is detected as an epileptic focus can stop seizures without the need for drugs or with minimal doses.
PREVENTION
An estimated 25% of epilepsy cases are preventable, especially in cases where the underlying cause is known, including:
- Preventing brain injury is the most effective way to prevent post-traumatic epilepsy.
- Adequate perinatal care can reduce new cases of epilepsy caused by birth injuries.
- The use of drugs and other methods of lowering body temperature in children with fever can reduce the likelihood of febrile seizures.
- Prevention of epilepsy associated with stroke is focused on reducing cardiovascular risk factors, e.g. steps to prevent or control high blood pressure, diabetes and obesity, and avoid excessive tobacco and alcohol use.
- Central nervous system infections are a common cause of epilepsy in the tropics, control of hosts or parasites in the environment and education about how to avoid infection can be effective.
Article written by dr. I Gde Anom Ananta, Sp.BS (Neurosurgeon Specialist at EMC Hospital Tangerang).