Epilepsy is one of the most common chronic diseases of the central nervous system. Permanently affected by epilepsy, ie recurrent epileptic seizures, are in Germany 500, 000 people. The term comes from the Greek and means "to be touched by something violently". Already back then, the disease, which was already known in antiquity, was regarded as mysterious: those affected fall down - often screaming - to the ground, lose consciousness and move their entire body unchecked. In some cases, foam may also form in front of the mouth.
Definition: Epilepsy or epileptic seizure?
Even today, the disease is still filled with many prejudices. Contrary to popular belief, epilepsy is not hereditary; at most, the tendency to epilepsy can be inherited. In addition, a distinction must be made between individual "epileptic seizures" and the disease "epilepsy". This is not diagnosed until the patient has had more than two seizures for no apparent reason. People who suffer from epilepsy, depending on the nature of their disease in many areas of life severely limited.
To shed light on the seizure disorder and to reduce prejudice against epileptics, Epilepsy Day is celebrated every October.
Epilepsy: seizure as a thunderstorm in the head
To explain what epilepsy actually is, physicians and affected people like to use the image of the "storm in the head". However, they do not think about headaches. Rather, the uncontrolled impulse discharges of nerve cells in the foreground, which make the normal, orderly functioning of the brain impossible.
In an epileptic, the signals that transmit the nerve cells are either too long or too short: The result of the "false reports" are then uncontrolled muscle movements, which are experienced as cramps. But also nerve cells, which are responsible for the thinking and the consciousness, can be affected. Then an epileptic loses consciousness in a seizure.
Epileptic seizures can look very different. Some patients have severe cramps, while others have symptoms of epilepsy so minimal that they are barely noticeable.
Caution, danger of confusion
However, not all seizures are epileptic seizures. Many infants and young children suffer from febrile illnesses so-called "febrile convulsions", which also disappear after the underlying disease subsides.
Nevertheless, an epileptic illness must always be ruled out after a febrile convulsion by measuring the brain waves.
Forms of epilepsy
The International League Against Epilepsy has described a total of ten different seizure types and even more types of epilepsy. An epilepsy form can have different seizure forms. An epileptic usually suffers only from an epileptic form, but he can go through several different seizure forms.
As different as the individual epilepsy forms and seizure forms are, so are the distances between the individual seizures. Some patients have years or decades between seizures. For others, only seconds pass before the next attack.
A distinction is made above all between the "focal" and the "generalized" seizure. In focal seizures, only a delineated area in the brain is affected, while in a generalized seizure both halves of the brain or the entire brain is affected from the beginning.
Causes and diagnosis of epilepsy
Around 50 percent of the illnesses occur in childhood, with the possibility of a "spontaneous" healing. Epilepsy can also be the result of a brain injury, for example, after an accident, when the cells of individual brain regions can no longer work coordinated. Other causes of epilepsy include:
- brain inflammation
- cerebral hemorrhage
- Oxygen deficiency at birth
- Metabolic disorder of the brain
- Malformation in brain development
If a patient experiences a seizure for no apparent reason, the diagnosis is confirmed by an electroencephalogram (EEG).
Therapy of epilepsy
For the treatment of epilepsy there are various possibilities:
- line break
- Detection and prevention of seizure triggers
- Vagus nerve stimulation
1. Treatment with drugs
In the treatment of epilepsy the overexcitability of nerve cells is reduced or inhibition mechanisms are increased. This requires regular medication, such as gabapentin and medical control.
Although many remedies for epilepsy are easy to take, the side effects are massive in many cases. These include allergic skin reactions, nausea and vomiting as well as dizziness, tiredness and blurred vision. Liver, lymph glands and bones can also suffer from medication.
As a rule, a drug is given that is controlled by EEG and drug levels. Only when all possible single preparations have failed, combination treatments with two or more drugs are used. If patients are seizure-free for a period of three years, it is often attempted to gradually stop the medication.
2. Operative therapy of epilepsy
The seizure center in the brain is surgically removed. However, this is only possible if the seizures always occur in the same place and this area safely and without other unacceptable disadvantages for the patient can be removed from the brain.
3. Line interruption
In case of a line interruption, those nerve tracts are separated, over which a seizure spreads. Pulse propagation is then no longer possible.
4. Detection and prevention of seizure triggers
This form of treatment requires a lot of self-discipline from those affected. As an adjunctive treatment to other forms of treatment, however, self-control has a not inconsiderable role in epilepsy treatment.
5. vagus nerve stimulation
In this treatment, a pacemaker is used, which affects the vagus nerve and thus makes the discharges of the nerve cells controllable.
Living with epilepsy
Epileptics today have good ways to control their illness. However, they are particularly prone to falls due to falls during seizures. Among other things, they are restricted in their work and spare time, for example because they are not allowed to operate machines: Driving a car or even a job as a pilot is a thing of the past, even dealing with sensitive or dangerous substances is not possible.
Many young people with epilepsy therefore have considerable difficulty finding an apprenticeship at all. While families with epileptics over the years can adjust to the disease, employers and colleagues are often overwhelmed with the disease.
It is also important to be able to act immediately in the event of a seizure: even if the patients carry an emergency card and appropriate medication, the environment must be able to deal with the patient. People with epilepsy therefore need understanding and support - but no pity.
The Vocational Training Center Bethel has made every effort to train adolescents with epilepsy. In their own hotel "Lindenhof", adolescents with epilepsy are trained in all areas of the hotel and restaurant industry. The training model is unique nationwide.