Surgery and Medication are Both Effective Treatments for Epilepsy

Medications, surgery, and nerve stimulation techniques can be used to treat epilepsy, which can occur due to consanguineous marriages and inherited conditions. This is how a person's health and quality of life can be managed.

Human history predates the onset of epilepsy! It is even referenced in the Code of Hammurabi. Many historical figures are known to have epilepsy, including the Roman emperor Julius Caesar, Alexander the Great, Dostoevsky, and Vincent van Gogh. Each year, 50 out of every 100,000 people are affected by this condition, which is characterized by certain seizure events caused by the disruption of electrical activity in the brain. In less developed countries, this rate may rise to 80-100 due to birth difficulties or delay in diagnosing disorders that need to be treated.

Epilepsy can occur at any age. Stating that epilepsy is more common in the first five years of age, Yeditepe University Rector and Yeditepe University Hospitals Neurology Specialist Prof. Dr. Canan Aykut Bingöl and Neurology Specialist Prof. Dr. Berrin Aktekin shared that "While the disease is observed at a certain rate until the age of 10, it is less common between the ages of 10-40. After the age of 40, the incidence of epilepsy increases in parallel with the incidence of vascular and brain diseases."

The Importance of Genetic Impact

Consanguineous marriage is an important risk factor for epilepsy. For this reason, Prof. Stating that the risk of the disease increased 40 times. Prof. Dr. Canan Aykut Bingöl gave information about a research they did.

"There may be a genetic predisposition to epilepsy. However, as of today, there are very few genetically diagnosed epilepsy diseases. We know that consanguineous marriages increase the incidence of the disease. In a study we conducted in Turkey in the past years, we examined a group of approximately 2000 people from seven families with consanguineous marriages. As a result of the research; It was determined that epilepsy disease was 40 times more common in those who had consanguineous marriages compared to those who did not. The disease may not occur in people with a genetic predisposition, but epilepsy can be encountered in consanguineous couples with the combination of genes. On the other hand, due to the decrease in consanguineous marriages in our country in recent years, there may be a decrease in the rate of related diseases"

It Might Result in Learning Difficulties

Depending on the age at which the disease manifests itself, the symptoms can change. Besides that, some environmental elements have been found to cause seizures. As an illustration, consider drug usage, chronic sleeplessness, stress, alcoholism, and the use of some drugs. Seizures can be brought on by a variety of causes that can alter the body's chemistry. On the other hand, epilepsy should also be considered when evaluating kids with learning challenges. Prof. Dr. Canan Aykut Bingöl underlined that unrecognized epileptic seizures can result in learning and memory issues and added, "In this case, the child's school performance drops and she/he has difficulty in establishing relationships. It is important for a psychologist and neurologist to evaluate children with learning difficulties together and to distinguish between epilepsy. When these children are treated, both their school success and their relationships with friends improve; comes to the same point as his peers"

15% of Patients Receive Surgical Treatment

Medication is an effective treatment for 70% of epilepsy sufferers. Seizures in the 15% of patients can be controlled with surgery or techniques for nerve stimulation. Prof. Dr. Canan Aykut Bingöl says, "Surgical treatment is utilized in the 15% of patients who do not respond to medicine, therefore those who had surgery are a little luckier because the chance of seizures later on diminishes. The likelihood that the seizures won't return increases the earlier the treatment is assessed following the commencement of the seizures and, if necessary, surgical referral. Hence, it is crucial that patients are properly assessed and guided to the appropriate facilities.

Yeditepe University Faculty of Medicine Head of Neurosurgery Department and Yeditepe University Hospitals Neurosurgery Specialist Prof.Dr. Uğur Türe emphasizes that this treatment is still the most popular one and claims that in some circumstances, it is sufficient to remove only the damaged hippocampus region of the brain: "However, removing that region required a difficult procedure. This was also impacted by the outdated surgical and imaging procedures used at the time. With the microsurgery technique he invented, Prof. Dr. Gazi Yaşargil merely excised the damaged portion of the hippocampus in the 1970s. Epilepsy surgery was hailed as having undergone a revolution thanks to Prof.Dr. Yasargil's procedure"

The Technique is Now Accessible Across the Entire World

Traditional temporal neurosurgery is carried out from the forehead. Risks associated with the surgery include damage to the brain and difficulties in accessing the back of the brain. Prof. Dr. Uğur Türe stated that they considered executing the procedure from the nape area for these reasons and added, "We introduced this method, which we developed over time, to the world as a new surgical development. The technique could become impossible while attempting to extract the posterior portion of the hippocampus from the front of the head. Yet using our technique, the patient's hippocampus can be removed without harming any brain tissue that is healthy and working correctly.

Prof. Dr. Uğur Türe and his team's procedure was shared with the scientific community after it was published in the prestigious journal Journal of Neurosurgery in April 2012. Prof. Dr. Uğur Türe says that neurosurgery is a team effort and that this technique was taught in training courses to many surgeons around the world.


10 March 2023