Epilepsy, also known as epilepsy among the people, is a chronic disease that occurs when cells in one part of the brain send a sudden and uncontrolled electrical signal and manifests itself with seizures. Epilepsy, which develops in people who have brain damage during or after birth for any reason, is more common in children than adults.
It is estimated that 80.000 children in our country have epilepsy. Since epileptic seizures negatively affect the motor, social and mental development of the child and may cause permanent damage in the future, it is of great importance not to delay the treatment. Although there is a widespread belief in the society that there is no cure for epilepsy, seizures can be controlled and children can continue their daily lives without any problems, thanks to developing treatment methods. As long as it's not too late for treatment! Acıbadem Altunizade Hospital Pediatric Neurosurgery Specialist Prof. Dr. Noting that early diagnosis and correct treatment play a key role in getting effective results from treatment, Memet Özek said, “Children with epilepsy should definitely be checked by a specialist pediatric neurologist. Oral anti-seizure medications should be used as the first option. “Patients who have seizures despite medication should be evaluated by the pediatric epilepsy surgery team to see if they are suitable for surgery.”
Watch out for these symptoms!
Symptoms of epilepsy in children may vary depending on the type and severity of epilepsy. If you have some of the symptoms listed below, it is of great importance to consult a pediatric neurologist without delay, in the early diagnosis and treatment of epilepsy.
- Sudden onset of fear, feeling of non-existent bad odors
- Seeing different colors and lights
- Contractions in the face, arms and legs
- drooling from the mouth
- Sudden contraction and relaxation of muscles
- eyes freezing to one side
- head drop
- Urinary and stool incontinence
- Loss of consciousness
- Fatigue and prolonged sleepiness after the seizure
Diagnosis is made by EEG
The diagnosis of epilepsy is made by monitoring the electrical activity of the brain with electroencephalography, in other words, EEG. This procedure is done with electrodes attached to the scalp of the child. A 30-minute routine EEG may be sufficient in the initial evaluation. However, in cases where the origin of epilepsy cannot be found exactly, it may be necessary to resort to video EEG method for at least 48 hours and sometimes more.
Seizures can be controlled with medication
Oral anti-seizure drugs are the first treatment option in epilepsy. Pediatric Neurosurgery Specialist Prof. Dr. Memet Özek stated that these drugs reduce or stop the seizures in 75 percent of the patients, but they are not useful in the remaining 25 percent of the patients, adding, “We call these children 'patients with drug-resistant seizures'. In such a situation, a special regimen, ketogenic diet, can be applied. However, this is a diet that requires a lot of effort and meticulousness.
If drug therapy fails to help…
prof. Dr. Memet Özek stated that children who cannot be treated with antiepileptic drugs or whose seizures do not stop despite drugs and ketogenic diet should be evaluated in terms of suitability for epilepsy surgery. However, not every child can be a candidate for surgery. Whether the child will benefit from the surgical method is determined by detailed examinations.
The source of the seizures is under the spotlight
During the evaluation of suitability for surgery, it is necessary to benefit from the 3 Tesla thin section epilepsy protocol MR method, which has highly advanced features. "The purpose of applying this method is to find where the seizures originate from," said Pediatric Neurosurgery Specialist Prof. Dr. Memet Özek continues: “In addition, with long-term Video-EEG, it should be determined whether the abnormal brain waves really originate from the problematic area seen in MRI. If the brain region responsible for epilepsy cannot be predicted as a result of MRI and EEG, PET and SPECT methods that determine the epilepsy region according to the metabolism of brain cells can also be used.
Surgical method is critical
Stating that pediatric epilepsy surgery is a team job, Prof. Dr. Memet Özek continues his words as follows: “This team consists of pediatric neurologists, pediatric neurosurgeons, pediatric radiologists, nuclear medicine specialists, EEG technicians, child psychologists, and epilepsy group nurses who provide patient and team coordination.”
Pediatric Neurosurgery Specialist Prof. Dr. Memet Özek, stating that 3 types of surgical methods are applied in epilepsy disease, lists the methods as follows: "These are the removal of the responsible focus in epilepsies caused by the lesion, that is, the lesionectomy surgery, the connection of the affected area with other regions in cases where a large part of the brain is affected that cannot be removed without harming the patient. Disconnection surgery aimed at the cessation of epilepsy and functional surgeries in which epilepsy pacemaker treatment is applied in cases where almost or all of the brain is responsible for epilepsy. The success rate in lesionectomy surgeries is 85 percent, 60 percent in disconnection surgery and 50 percent in neurosurgery.