Stating that the rate of patients undergoing surgical procedures is 10%, experts emphasize the importance of rapid and early intervention in children.26 March is commemorated as World Awareness Day. On this day, it is aimed to inform and raise awareness about the disease.
Üsküdar University NPISTANBUL Hospital Neurosurgery Specialist Assoc. Prof. Dr. Akın Akakın said that surgical treatment in epilepsy can be applied in patients who are resistant to medical treatment. Stating that epilepsy is a disease caused by short circuits and discharges that occur over time in the brain working with electrical activity, Assoc. Dr. Akın Akakın stated that the patient experiences fainting and convulsions.
Fast and early intervention is essential in children
Stating that open or closed methods are applied to prevent these discharges in epilepsy surgery, Assoc. Prof. Akın Akakın said, "Epilepsy surgery is a type of surgery based on disconnecting the electrical pathways from each other. Surgery can be performed on any type and any age group, but if we say which patient it is performed on, we need to act more aggressively in children because the discharge activities cause structural and functional disorders of the brain because the brain of children is in the developmental stage. We intervene faster and earlier so that children in the development process are not affected by these discharges, but if epilepsy attacks continue despite 2 years of drug treatment in adults, then we consider epilepsy surgery."
It is applied to patients who do not respond to drug treatment
Stating that it should be observed that the patient's seizures are resistant to medical treatment before deciding on a surgical operation, Assoc. Prof. Dr. Akın Akakın said that surgical procedure is not applied to every patient, and epilepsy surgery can be performed in some patients whose seizures cannot be controlled with antiepileptic drugs.
Surgical procedure is performed in 'one of the patients
Stating that there is a proportion of patients who undergo surgical procedure, Assoc. Prof. Akın Akakın said, "We do not apply the surgical procedure to every patient. These patients need to use medication for at least 2 years. It should be ensured that at least 2-3 appropriate antiepileptic drugs are used individually (monotherapy) and together (polytherapy) in sufficient doses and duration. Surgical methods should be considered if no results are obtained in the treatment despite trying various epilepsy medications and using them for 2 years."
Stating that surgical treatment can be decided earlier in patients whose seizures are due to structural disorders such as brain tumors or vascular abnormalities, Assoc. Prof. Akın Akakın said, "Both drug resistance and surgical success are high in these cases. The longer the seizures cannot be controlled, the lower the success of seizure control after surgery and the higher the likelihood of psychosocial problems."
How is epilepsy surgery performed?
Stating that the most common brain surgery is Resective Neurosurgery, Assoc. Prof. Dr. Akın Akakın said that a part of the brain can be intervened after the patient is put to sleep with anesthesia and a question mark-shaped incision is made. Assoc. Prof. Dr. Akın Akakın said, "Palliative (Functional) epilepsy surgery is performed to cut the seizure spread pathways in patients who cannot undergo resective surgery, thus isolating the epileptic focus from the rest of the brain parts to prevent seizure spread."
Stating that the type of epilepsy, the location of the epilepsy focus and the preoperative researches determine where the surgical procedure will be performed, Assoc. Prof. Akın Akakın said, "The patient uses medication for 1-2 years after the operation. If there are no more seizures, the medications are gradually reduced and discontinued."
Epilepsy surgery has a high success rate
Stating that the success of surgery is quite high when the abnormality that forms the epilepsy focus is a vascular abnormality or a benign mass-like structure, Assoc. Prof. Akın Akakın said, "If surgery will be performed only according to EEG criteria, surgical success is very high in seizures starting from temporal regions. Since it is difficult to determine the seizure onset site in epilepsies that start from the front or back parts of the brain, the success is also low."
There are different types of epilepsy
Stating that different epilepsy conditions are seen depending on where the brain lobes are affected, Assoc. Prof. Akın Akakın explained the types of epilepsy as follows
Benign Rolandic Epilepsy: It is usually seen in primary school periods and the disease is overcome with the overcoming of puberty.
Occipital Lobe Epilepsy: It is a type seen in childhood and has late and early types. The patient has the complaints of focusing on one point for a long time, experiencing visual disturbances, nausea, vomiting and headaches after seizures.
Temporal Lobe Epilepsy: This type, which originates in the temporal region of the brain, is mostly seen in adults. It has effects such as strange behaviors and loss of consciousness in patients.
Childhood Epilepsy: Generally, it starts in the primary school years, with absent-mindedness lasting approximately 5 seconds to 1 minute. The patient loses interest in what he/she is interested in at that moment and there may be a shift in the eyes.
Juvenile Myoclonic Epilepsy: It is seen in adolescence. It manifests itself as sudden startles in the morning hours.
Infantile Spasm: It is a type of epilepsy that occurs in infancy before the age of 1. Seizures occur in the form of forward or backward contractions in the whole body of the patient. The contractions seen in the patient repeat one after the other. These seizures occur as a result of brain damage or metabolic problems.