Second Opinion on Adult Epilepsy

Epilepsy is one of the most common neurological disorders. Epileptic seizures present a health risk and have a major impact on a person's life.

What is the disease about?

Five percent of all people have an epileptic seizure once in their life. The disorder can occur at any age. Most often it concerns children and adolescents, but adults are also susceptible to the disease.

Epileptic seizures are triggered by a disturbance in the electrochemical signal transmission of the brain nerve cells. It may remain limited to one region of the brain ("focal seizure") or spread throughout the brain ("generalized seizure"). Correspondingly, epileptic seizures can have different manifestations.

How does it develop?

Single or serial convulsive seizures in adults can be provoked by congenital and acquired damage to the brain structure, acute irritations such as those caused by high fever, alcohol poisoning or brain inflammation or meningitis. However, the true causes of adult epilepsy often remain unexplained.

An epileptic seizure can be figuratively called “a thunderstorm in the brain".  The complex electrochemical stability of the brain's electrical activity is thrown out of balance. The visible consequence is a temporary, seizure-like disturbance of wakefulness, consciousness, bodily functions, and voluntary movements of various types and duration.

Epilepsy manifestations

There are many different symptoms of the disease. They may change during the course of the disease.

The most common signs of the disorder in adults are:

• brief loss of consciousness;
• loss of consciousness, stiffness, twitching of arms and legs;
• febrile convulsions;
• partial disability;
• severe impairment of behavior or intelligence;
• loss of speech.

How is it diagnosed?

In order to make an accurate diagnosis and choose the right treatment, it is important to know and understand the type of seizures and their features. For this purpose, doctors conduct detailed interviews with the patient or the family, and review video recordings of seizures. Of key importance are routine electroencephalography, as well as video EEG test results. The latter is a recording of bioelectrical brain activity, combined with video recording of what the patient is doing or experiencing. The diagnosis is backed up by laboratory tests and high-resolution magnetic resonance imaging (MRI) of the head.

Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) scans provide additional data on the brain and its metabolism. The examination routine also includes laboratory tests of blood, serum, and cerebrospinal fluid to rule out or detect immunologic or infectious diseases.

Treatment of epilepsy in adults

The modern approach to the treatment of this disease is holistic, that is, comprehensive. Therapy is based on the individual clinical situation, the patient's life circumstances and needs. The main focus is on the careful selection of the type and dosage of antiepileptic drugs aimed at getting rid of seizures, or at least controlling their frequency and preventing their consequences.

In certain cases, doctors resort to surgical removal of epileptogenic foci or stimulation procedures (vagus nerve stimulation, VNS).