What is Epilepsy ?
Epilepsy is a chronic state of the brain, characterized by seizure occurrence. Epileptic seizures are usually abrupt, without being evoked by specific stimuli. Epilepsy can begin at any age, even from the first days of life. The usual etiologies for epilepsy are disturbances in the developmental procedures in the brain during the fetal life or early childhood, therefore the majority of patients suffering epileptic seizures are children. Other etiologies include brain trauma, tumors and strokes in the elder.
There is a variety of epileptic seizures that patients can exhibit:
– They may occur as muscle spasms of the body or parts of the body, whose power can range from mild to intense
– Patients may suddenly lose control of their body and fall, and they are liable to injury
– They may partially or totally lose contact with their environment, which is often accompanied by automatic movements of the mouth and the hands.
Patients suffering from epilepsy are often confused or exhausted after a seizure, and sometimes tend to sleep. In other cases, they swiftly regain total control after the seizure has ceased.
Epileptic seizures are generated by the sudden and hyper-synchronized electric discharge of abnormal neuronal cells situated in the cortex of the brain’s hemispheres. This discharge, which is often strong, interrupts the normal function of the brain and temporarily functionally disconnects communicating areas of the brain. The epileptic electric discharge may restrict itself locally in the brain, in which case the seizures are focal, but may also spread to the total volume of the brain, in which case the seizures are generalized.
Treatment of Epilepsy
Epilepsy has the higher percentage of successful treatment among the neurological disorders. In more than 90% of patients, seizures can be well controlled. The basic tools of model medicine against epilepsy are the anti-epileptic drugs (more than 20 anti-epileptic drugs are available) and neurosurgery.
Regarding the evolvement of seizures, there are three main categories:
– Seizures that spontaneously withdraw during or after puberty
These seizures are characterized as benign forms of epilepsy, owing to temporary disruptions of the brain’s development. They are treated with anti-epileptic drugs, until their spontaneous withdrawal a few years after onset.
– Seizures with satisfactory response to life-long drug treatment
These seizures mainly owe to permanent abnormalities of the structure or function of the brain. Given that they have been diagnosed sufficiently, the right anti-epileptic treatment can significantly reduce seizures and allow the patient to lead a normal life.
– Seizures that cannot be controlled by any anti-epileptic drug (drug-resistant epilepsy)
In these cases, anti-epileptic treatment fails to control the epileptic seizures. Patients of this category are candidates for pre-surgical evaluation, in order to determine whether undergoing a surgical procedure can be beneficial.
The epilepsy center of Thessaloniki
is a specialized center of the health system. The center is supported by the Neurological, Neurosurgical and Radiology departments of St.Luke’s Hospital in Panorama of Thessaloniki. Cutting-edge technology for diagnosis, drug-treatment and neurosurgical approaches, are used in order to achieve the optimal seizure control for patients and improve the quality of life of adults and children suffering from epilepsy.
The objectives of a specialized epilepsy center are:
– To provide a data-based evaluation towards a reliable diagnosis
– To determine individualized drug-management schemes for each patient
– To inform parents and relatives of patients regarding the particularities of each condition
– To indicate the potential candidates for epilepsy surgery
– To perform the pre-surgical evaluation in candidate patients
– To perform epilepsy surgery in successful candidates
– To monitor and manage the patients post-surgically
More specifically, the epilepsy treatment program includes:
– 24-hour video-electroencephalography monitoring (video-EEG)
– Specialized neuroimaging techniques, including high resolution structural imaging (MRI), functional imaging (fMRI), tractography (DTI) and combined electroencephalography with functional imaging (EEG-fMRI)
– Neuropsychological evaluation of the patient’s cognitive abilities in view of epilepsy surgery
– Experienced neurosurgical team specialized in epilepsy surgery
– The potential to perform chronic and acute electrocorticography (ECoG), as well as electrical cortical stimulation (CES), for detailed identification of the epileptogenic zone as well as its surrounding eloquent areas
– Surgical planning by navigation (Neuronavigation) based on typical MRI as well as functional neuroimaging data
The scientific and clinically multidisciplinary approach of the epilepsy program aims in providing the patient with the outmost of modern medical knowledge following internationally approved procedures in the epilepsy treatment field.