Epilepsy

Epilepsy is a group of brain disorders manifested by recurrent seizures - paroxysms of different character. Seizures are caused by a focus of abnormal irritation of brain cells - neurons. The clinical manifestations of these paroxysms are varied: disturbances of consciousness and perception, convulsions of the limbs, vegetative manifestations, psychological symptoms. The classic seizure is the so-called grandmal - a seizure with sudden unconsciousness, convulsions, urination, biting. Other seizures include absence seizures - twitches (sometimes barely perceptible by the surroundings), then bearing seizures - twitches in certain muscle groups without loss of consciousness, olfactory seizures, etc. The nature of the seizure depends on the site in the brain that is affected. The cause is sometimes unknown, sometimes it is the result of another brain involvement - e.g. tumour, injury, vascular changes, congenital developmental defects. Epilepsy is the most common of all serious neurological diseases affecting both adult and pediatric patients, affecting approximately 0.5-1% of the total population. The disease is very disturbing, restrictive and limiting, and significantly changes the patient's life in many activities. About 60% of those affected experience only a few seizures, or seizures are well compensated by antiepileptic treatment with some possibility of discontinuation, 20% of those affected can be suppressed by permanent lifestyle measures and permanent medication, and about 20% of epileptics fail to compensate even with these lifelong measures and treatment - these are termed pharmacoresistant. For the diagnosis of epilepsy, it is of great importance to obtain anamnestic data from the patient, but also the so-called anamnesis objective from the witnesses of the paroxysm, the basic clinical neurological examination, lab tests, home video, electroencephalogram - EEG, neuroimaging CT and MR and a number of other examinations, e.g. neuropsychological, cardiological and in some cases also genetic examinations. For maximum effect of the treatment to achieve good results, above average cooperation of the patient and erudition (thorough education and knowledge) of the physician is necessary. The neurological clinic also includes a specialised clinic for the diagnosis and treatment of epilepsy, run by a licensed epileptologist. The epileptologist can consult uncompensated (resistant) patients with epilepsy from fellow specialists, and also decides on the consultation of such patients at a higher department. These higher workplaces (mostly established at teaching hospitals - Prague, Brno) then have additional advanced diagnostic methods, including the possibility of surgical treatment.