Epilepsy surgery is a brain operation performed to stop or reduce the severity and frequency of seizures. The first treatment for epilepsy is medication therapy. If epilepsy becomes resistant, meaning improvement is not seen despite drug treatment, transition is made to monotherapy and polytherapy. If seizures cannot be controlled despite at least 1 year of multiple drug therapy, surgical treatment may be considered.
✓Epilepsy (Seizure Disorder)
Epilepsy, known as seizure disorder in daily life, is a neurological disorder that occurs when brain cells send abnormal electrical signals. This condition manifests itself as epileptic seizures and is characterized by symptoms such as temporary loss of consciousness, muscle spasms, trembling, and changes in sensory perception. Epilepsy can be seen in all age groups and can affect everyone from children to the elderly.
✓Types of Epilepsy
Simple Partial Seizures: Simple partial seizures are seizures that affect a small area of the brain and do not cause loss of consciousness. These seizures can originate from abnormal electrical activity in different areas of the brain, and symptoms vary depending on which brain area is affected. A person may experience symptoms such as sensory changes, spasms in specific body areas, and sudden psychological changes. Usually short-lived, these seizures can last from a few seconds to several minutes, and the person can remember what happened after the seizure ends.
✓Complex Partial Seizures: Complex partial seizures cause confusion of consciousness and lead to temporary loss of connection with the surroundings. These seizures, which usually occur in the temporal lobe of the brain, may result in the person being unaware of their surroundings and having a blank stare with eyes fixed on one point. During the seizure, the person may display repetitive and meaningless movements (automatisms). When the seizure ends, the person may have difficulty remembering what happened and how long it lasted. Usually lasting a few minutes, these seizures can affect the person's social life and daily activities, so it is important to seek medical help.
✓Generalized Seizures: Generalized seizures occur throughout all areas of the brain and usually lead to loss of consciousness. These seizures have various subtypes. Absence seizures are brief periods of loss of consciousness lasting a few seconds and are usually seen in children. Tonic-clonic seizures are characterized by loss of consciousness and severe convulsions. Myoclonic seizures manifest with rapid muscle jerks and are usually mild. Atonic seizures can cause falling due to sudden loss of muscle tone. With appropriate treatment, the frequency and severity of these seizures can be reduced, thereby improving quality of life.
✓Epilepsy Symptoms
Temporary loss of consciousness or loss of awareness,
✓Uncontrolled muscle jerks or spasms,
✓Sudden falling or collapsing,
✓Eyes fixed on one point,
✓Abnormal smell or taste perception,
✓Clouded consciousness and confusion,
✓Sudden mood changes or intense feeling of fear,
✓Numbness or tingling in the body,
✓Repetitive muscle movements (for example, twitching in hand or facial muscles).
✓Epilepsy Diagnostic Methods
EEG (Electroencephalography): One of the most commonly used methods in diagnosing epilepsy is EEG (Electroencephalography). EEG plays a critical role in epilepsy diagnosis by measuring the brain's electrical activity.
✓MRI (Magnetic Resonance Imaging): Magnetic Resonance (MR) imaging is used to determine whether there is an underlying structural brain problem causing epilepsy. MRI provides detailed images of the brain and can reveal conditions that may cause seizures, such as tumors, cerebrovascular disease, or developmental brain anomalies.
✓CT (Computed Tomography): Computed Tomography (CT) is another important imaging method used to obtain quick and detailed images of the brain. CT is preferred, especially in emergency situations, to detect structural problems in the brain.
✓Epilepsy Specialists and Examination: The first step in diagnosing epilepsy is taking a detailed medical history. Your doctor will ask detailed questions to learn information such as the frequency and duration of seizures and at what age they started. Details about the characteristics of seizures, such as whether there is loss of consciousness and how convulsions occur during the seizure, are important for diagnostic accuracy. The doctor plays a critical role in assessing neurological condition and performs a physical examination to evaluate the patient's overall health and neurological functions.
✓Treatment with Surgical Intervention
Surgical intervention involves removing the epileptic focus through brain surgery or cutting seizure propagation pathways. This method is preferred, especially in cases of focal epilepsy that cannot be controlled with medication. Surgical intervention can reduce the frequency and severity of seizures and improve the quality of life of patients. Successful surgical intervention requires careful evaluation process and is usually performed in collaboration with multiple specialist doctors. The suitability of surgical treatment is evaluated based on the patient's general health status and the effects of epilepsy on the brain.
✓Epilepsy surgery is a surgical procedure performed to remove or inactivate the area where abnormal electrical activity in the brain begins. This operation is applied to epilepsy patients resistant to medication and ensures that seizures are brought under control.
✓After a successful surgery, patients can reduce their medication doses and, in some cases, stop them completely.
✓Who is Epilepsy Surgery Suitable For?
Epilepsy surgery is suitable for patients who continue to have seizures despite medical treatment. The following criteria are considered in determining candidates:
✓Drug resistance: If seizures cannot be controlled despite using two or more epilepsy medications.
✓Seizure source in the brain: If the origin of seizures in a specific area of the brain can be clearly identified.
✓Preservation of cognitive and motor functions: If the surgery will not seriously affect the patient's speech, memory, and movement ability.
✓If epileptic seizures originate from multiple areas of the brain, surgical intervention becomes more difficult.
✓Types of Epilepsy Surgery
Lobectomy (Temporal Lobectomy)
✓The most common epilepsy surgery. The area in the temporal lobe of the brain that is the source of seizures is removed.
✓Who it is suitable for: Patients with temporal lobe epilepsy
✓Success rate: Seizures stop completely in approximately 60-80% of patients.
✓Lesionectomy
✓Structures causing epilepsy such as tumors, cysts, or brain damage are surgically removed.
✓Suitable for patients with structural abnormalities causing epilepsy
✓Corpus Callosotomy
✓The corpus callosum, which provides connection between the two hemispheres of the brain, is cut to prevent the spread of seizures.
✓Who it is suitable for: Patients who experience widespread and severe seizures
✓This surgery does not completely stop seizures but can reduce their severity and frequency.
✓Deep Brain Stimulation (DBS)
✓Electrodes implanted in the brain send low-voltage electrical signals to suppress abnormal electrical activity.
✓Who it is suitable for: Patients in whom the seizure source cannot be removed by surgery
✓Duration of Epilepsy Surgery
The duration of surgery depends on the surgical technique used:
✓Lobectomy: 3-6 hours
✓Lesionectomy: 2-5 hours
✓Corpus Callosotomy: 3-5 hours
✓Deep Brain Stimulation: 4-7 hours
✓How Long Does Epilepsy Surgery Take?
Lobectomy: 3-6 hours
✓Lesionectomy: 2-5 hours
✓Corpus Callosotomy: 3-5 hours
✓Deep Brain Stimulation: 4-7 hours
✓Do Seizures Continue After Epilepsy Surgery?
While seizures may completely stop in some patients after surgery, in others they may decrease but not completely resolve.
✓Success rates:
✓Temporal lobectomy: 60-80% seizure-free life
✓Lesionectomy: 50-70% seizure-free life
✓Corpus callosotomy: Reduces the severity of seizures, does not stop them completely
✓DBS: Can reduce seizures by up to 50%
Can Epilepsy Be Treated?
Epilepsy can be treated but may not completely disappear. Most patients can control seizures with regular antiepileptic medication use. Surgical intervention and other treatment methods may also be effective for some patients.
How Are Epilepsy Seizures Prevented?
The best way to prevent epilepsy seizures is to follow the treatment plan recommended by your doctor. Taking medications regularly, getting enough sleep, managing stress, and avoiding triggers can reduce seizure risk.
Is Epilepsy Genetic?
Epilepsy can be related to genetic factors in some cases. Individuals with a family history of epilepsy may have a higher risk of developing epilepsy. However, environmental factors in addition to genetic predisposition can also lead to epilepsy.
Do Epilepsy Seizures Occur During Sleep?
Yes, epilepsy seizures can occur during sleep. Such seizures are called "sleep-related epilepsy" and typically show symptoms that disrupt nighttime sleep (nocturnal seizures) or make waking up in the morning difficult.
What Is Epilepsy (Sara Disease)?
Epilepsy is the common name for epilepsy among the public. It is a neurological disorder characterized by seizures resulting from abnormal electrical activity in the brain.
Does Epilepsy Cause Death?
Epilepsy is generally not fatal; however, uncontrolled seizures can lead to serious injuries or life-threatening situations. With regular treatment and precautions, these risks can be reduced.
How Is Epilepsy Diagnosed?
Epilepsy is diagnosed through recurring seizures. Neurological tests such as EEG (Electroencephalography) and MRI (Magnetic Resonance Imaging) can be performed to make a diagnosis. Symptoms, neurological examination, and patient history are evaluated.
Does Epilepsy Go Away?
Some children may overcome epilepsy as they enter adolescence. However, many adult epilepsy patients require lifelong treatment. Treatment focuses on controlling seizures and improving quality of life.
Does Stress Affect Epilepsy?
Yes, stress can affect epilepsy and trigger seizures. Stress management techniques and relaxation methods can help reduce seizure frequency.
What Does a Person Feel After an Epilepsy Seizure?
After an epilepsy seizure, a person typically feels tired, confused, or has a headache. Memory loss, muscle aches, and sleepiness are also common symptoms. The person may need rest until fully recovered.
What Are the Symptoms of Sleep-Related Epilepsy?
Symptoms of sleep-related epilepsy include involuntary muscle movements during sleep, falling out of bed, inability to wake up, frequent waking, and waking up tired in the morning. These symptoms can seriously affect sleep quality.
What Are the Symptoms of Epilepsy in Babies?
Symptoms of epilepsy in babies include brief loss of consciousness, abnormal eye movements, sudden muscle contractions or tremors in the body, and changes in sleep patterns. These symptoms should be carefully observed and shared with a specialist.
What Are the Psychological Symptoms of Epilepsy?
Psychological epilepsy may include psychosomatic or stress-related epilepsy symptoms. These symptoms may include sudden fear, anxiety, déjà vu sensation, and emotional fluctuations. Such symptoms are typically managed with psychotherapy and medical treatment.
What Is an Epileptic Fit?
An epileptic fit is the common name for an epilepsy seizure. These are seizures characterized by sudden electrical changes in the brain resulting in loss of consciousness, convulsions, and tremors. Certain precautions should be taken to ensure the person's safety during a fit.
Is Epilepsy Surgery Dangerous?
Brain surgery carries risks, but with proper patient selection and experienced surgeons, the success rate is high.
How Many Days of Hospitalization Does Epilepsy Surgery Require?
It typically ranges between 3-7 days.
How Long Is the Recovery Time After Surgery?
Full recovery time can vary between 3-6 months.
Can Epilepsy Surgery Be Performed on Children?
Yes, it can be applied to children in some cases of resistant epilepsy.
When Can Physical Activities Be Started After Surgery?
Light activities can generally be started within 1-2 months.