Epilepsy, a common disease in the society, is also known as "epilepsy". Although the most well-known type is the seizure type, which is characterized by severe contractions and relaxations, loss of consciousness and some involuntary movements and usually lasts for a few minutes, there are many types of epilepsy. Stating that epilepsy can occur at any age, in different forms and at different degrees, Prof. Dr. Mustafa Bozbuğa warned, "Epileptic seizures in which the first attack occurs at an advanced age should always suggest an underlying primary brain disease."
Every year, the second Monday of February is recognized as World Epilepsy Day. Üsküdar University NPISTANBUL Hospital Neurosurgery Specialist Prof. Dr. Mustafa Bozbuğa gave important information about the relationship between epilepsy and brain diseases.
The most recognized type in the society: Grand mal epilepsy
"Epileptic seizures (epilepsy) are common in the general population and have been recognized since antiquity. Epilepsy is a clinical picture caused by abnormal and strong electrical discharges of brain tissue or a group of brain cells (neurons) that occur from time to time and at irregular intervals." Says Prof. Dr. Mustafa Bozbuğa,
"Although 'grand mal epilepsy' (a type of seizure involving the whole body, with severe contractions and relaxations, loss of consciousness and some involuntary - autonomic movements, usually lasting for a few minutes) is the most widely recognized, there are many types of epilepsy and in some rare forms (e.g. some patients with purely psychocognitive - psychomotor symptoms, some patients with autonomic nervous system symptoms and signs, some patients with very short-term immersions, etc.) it can be difficult to diagnose even experienced specialists. In some patients, the diagnosis can be difficult even for experienced specialists. In addition, some conditions may mimic/similar to epilepsy attacks, most commonly syncope (fainting) and psychic states - somatization attacks can be confused with epilepsy."
Beware of epilepsy attacks in advanced age!
Stating that epilepsy can occur at any age, in different forms and at different degrees, Prof. Dr. Bozbuğa said, "In most patients, it is a disease on its own and the treatment is aimed directly at epileptic seizures. These treatments are usually done in the form of medication and rarely require surgical interventions, especially today."
"However, in some cases, epileptic seizures are not a disease in themselves, but can be seen as a symptom of some brain diseases. One of the most striking features of these patients is that unlike primary idiopathic epilepsy (epilepsy attacks that are diseases on their own), which usually occur in childhood, epilepsy attacks occur at a late age (in adulthood). Therefore, epileptic seizures in which the first attack occurs at an advanced age should always suggest an underlying primary brain disease and require specialist evaluation and investigations.
Epilepsy in adulthood may indicate a brain tumor
In epilepsy that starts in adulthood, brain tumors are often seen as a primary brain disease. These seizures, which can be a symptom of brain tumors, may involve the whole body, or they may occur only in a certain part of the body (focal motor epilepsy attack), they may start in a certain area and spread to other parts of the body (motor Jacksonian epilepsy attack), or they may manifest themselves in sensory perception disorders and behavioral changes or in other different ways. The incidence of epilepsy in brain tumors, whether diffuse or localized, is 25-50% and usually occurs as a symptom in slow-growing tumors and in tumors that involve/affect areas of the brain where the cortex (cerebral cortex) is highly stimulated. In addition to insidious and often insufficiently warning brain tumor symptoms such as headache, personality and behavioral changes reflected in the clinical picture in the slow progressive type, epileptic seizures can be a warning for the examination and recognition of the disease.
Insomnia and stress facilitate epilepsy
Prof. Dr. Mustafa Bozbuğa stated that apart from brain tumors, epilepsy attacks can also occur in the tangles of the brain vessels, which is one of the most important diseases of Neurosurgery,
"Epilepsies that occur in arteriovenous malformations of the cerebral vessels are usually prominent in the young and middle age group and may be accompanied by headache, loss of strength in the arms and legs, sensory disorders, speech disorders, etc. and constitute an important symptom - finding for diagnosis. The causes of epilepsy attacks include many diseases. In addition to brain tumors and cerebrovascular tangles, which are very important for us neurosurgeons, diseases such as brain abscesses, metabolic diseases, brain inflammations, head traumas, certain medications used or suddenly discontinued, degenerative diseases of the brain (MS, etc.) should be specifically mentioned among the diseases that cause epilepsy. In addition, insomnia, emotional stress, hormonal changes / disorders, fluid - electrolyte balance disorders, etc. many conditions can also facilitate the formation of epilepsy."
Contact a specialist before too long!
"Every situation in which an epilepsy attack is observed is actually a medical phenomenon that also shows some degree of urgency," said Üsküdar University NPISTANBUL Hospital Neurosurgery Specialist Prof. Dr. Mustafa Bozbuğa and underlined that when an epilepsy attack occurs, it is necessary to consult a physician and a specialist without delay.
Does epilepsy go away after tumor treatment?
"An epilepsy attack should essentially be considered as a symptom and the underlying problem should be tried to be understood. These causes - diseases cover a very wide range," said Prof. Dr. Bozbuğa,
"Epilepsy can be seen from the newborn period to very old ages, that is, at any age, and the diagnosis of the primary disease is provided by looking at at what age epilepsy occurs, what kind of epilepsy and how often it occurs, and what symptoms and signs accompany it. In this process, many examinations must be carried out meticulously. Brain imaging, electroencephalography (EEG), various blood tests are the first step. If a brain tumor is diagnosed after all examinations and tests (and epilepsy is thought to be caused by this tumor), epilepsy is expected to disappear after surgical resection/removal of the brain tumor and other adjuvant treatments if necessary; however, we still see that epilepsy persists in some of our patients, albeit in a small percentage of our patients. At this stage, epilepsy can be controlled with appropriate medications."
What are the treatment methods?
Üsküdar University NPISTANBUL Hospital Neurosurgery Specialist Prof. Dr. Mustafa Bozbuğa said, "Epilepsy is examined and evaluated in detail; underlying causes, facilitating factors are determined and treatment is organized for the main cause." and concluded his words as follows:
"This is either to diagnose and evaluate epilepsy as a disease on its own, to start appropriate drug treatment, to regulate lifestyle, or if a primary brain disease (brain tumor, tangles of brain vessels, brain abscesses or inflammation, brain trauma, degenerative diseases of the brain... and facilitating factors) causing epilepsy is revealed, to treat the cause and to follow the course of epilepsy and to apply additional treatments if necessary."
