Epilepsy: Causes, Symptoms and Treatment

Epilepsy is a chronic neurological disorder characterized by recurrent epileptic seizures, caused by abnormal electrical activity in the brain. Seizures may vary in clinical presentation, duration, and severity, and can affect consciousness, motor control, sensation, or behavior.

Epilepsy is not a single disease, but rather an umbrella term that includes a wide range of epileptic disorders and syndromes.

What is an epileptic seizure?

An epileptic seizure occurs when a group of neurons in the brain generates excessive and disorganized electrical signals. Clinical manifestations may include:

• involuntary movements or convulsions;
• loss or alteration of consciousness;
• unusual sensory experiences (visual, olfactory, gustatory);
• emotional or behavioral changes;
• brief episodes of unresponsiveness or disconnection from the environment.

Not every seizure indicates epilepsy. The diagnosis of epilepsy is established when two or more unprovoked seizures occur at different points in time.

Types of epileptic seizures

Epileptic seizures are classified based on their site of onset in the brain and clinical features.

Focal seizures

Focal seizures originate in a specific area of the brain and may occur:

• with preserved awareness;
• with impaired awareness.

Clinical manifestations may include localized motor symptoms, sensory disturbances, or emotional changes.

Generalized seizures

Generalized seizures involve both cerebral hemispheres from onset and include:

• tonic-clonic seizures;
• absence seizures;
• myoclonic seizures;
• atonic seizures.

Causes of epilepsy

In many cases, the exact cause of epilepsy cannot be identified. However, epilepsy may be associated with:

• traumatic brain injury;
• stroke;
• brain tumors;
• infections of the central nervous system;
• congenital brain malformations;
• genetic factors;
• perinatal complications.

How is epilepsy diagnosed?

The diagnosis of epilepsy is based on a comprehensive clinical and paraclinical assessment and includes:

• detailed medical history and accurate description of seizure events;
• electroencephalography (EEG);
• neuroimaging studies, particularly brain MRI;
• additional laboratory investigations, when clinically indicated.

Accurate classification of seizure type and epileptic syndrome is essential for selecting the appropriate treatment strategy.

Epilepsy evaluation at CardioPrima

At CardioPrima, patients with suspected or confirmed epilepsy benefit from epileptology consultations performed by a neurologist, as well as advanced neurophysiological investigations.

A key diagnostic tool is Video-EEG monitoring, which allows simultaneous recording of brain electrical activity and clinical manifestations. Video-EEG is essential for precise seizure classification, differentiation between epileptic and non-epileptic events, and optimization of treatment strategies, particularly in complex diagnostic cases or pharmacoresistant epilepsy.

Treatment of epilepsy

The primary goal of treatment is seizure control while maintaining a good quality of life. Therapeutic options include:

• antiepileptic medications as first-line treatment;
• treatment adjustment in cases of inadequate seizure control;
• surgical treatment in selected cases of pharmacoresistant epilepsy;
• adjunctive therapies (dietary therapy, neuromodulation), when indicated.

Approximately two-thirds of patients achieve satisfactory seizure control with appropriately individualized treatment.

Living with epilepsy

With accurate diagnosis and proper management, most individuals with epilepsy can lead an active and socially functional life. Patient education, adherence to prescribed treatment, and avoidance of known seizure triggers play a crucial role in reducing seizure recurrence.

International Epilepsy Day

International Epilepsy Day highlights the importance of early diagnosis, personalized treatment, and reducing stigma associated with this common neurological disorder.