Sun. Apr 21st, 2024

The second Monday of February commemorates the International Epilepsy Day with the aim of raising awareness about the challenges faced by people living with this disease. And, this year, on February 13, It is the date on which organizations from more than 120 countries unite under the slogan ‘Take a step forward against the stigma of epilepsy’ to try to eliminate the false myths that still exist about it.

Epilepsy is a disease characterized by a abnormal electrical activity in the brain that causes seizures, unusual behaviors and sensations, or episodes of altered consciousness. It is the fourth most common neurological disease and it is estimated that more than 50 million people suffer from epilepsy worldwide. In Spain, according to data from the Spanish Society of Neurology (SEN), epilepsy affects some 400,000 people, It is the third most common neurological disease in the elderly, and the most common neurological disorder in children..

“Approximately two thirds of the cases the disease is adequately controlled with medication. We currently have drugs with very good tolerability and comfortable for the patient to use, which improves adherence to treatment and their response to it. Unfortunately, one third of patients with difficult-to-control epilepsy remain. However, the development of surgical and neurostimulation techniques, as well as new drugs specifically targeted at this population, opens a door to hope for these patients with drug-resistant epilepsy”, explains Dr. Juan José Poza, Coordinator of the Epilepsy Study Group of the Spanish Society of Neurology (SEN).

An accurate diagnosis of epilepsy is essential.

And a fundamental aspect for the treatment of epilepsy is the precise diagnosis of the disease and that it be carried out as soon as possible. From the SEN it is considered essential thatThe diagnosis of the disease is based on a positive diagnostic test, mainly after carrying out prolonged video-EEG monitoring, of one or several days. “Unfortunately, access to this diagnostic technique is limited in many regions. Even today, in too many cases, the diagnosis is based on the witness accounts of the seizures and when, after the failure of various therapeutic trials, adequate monitoring is carried out in an epilepsy unit, andAround 20% of patients referred for evaluation of surgery due to drug-resistant epilepsy do not really have epilepsy or suffer from a different epileptic syndrome than the one suspected and are inadequately treated”, says Dr. Juan José Poza.

Besides, epilepsy is the second leading cause of neurological care in the ER. ”The maxim ‘time is brain’, which has traditionally been applied to stroke, should also be applied to epilepsy. For this, we consider essential the implementation of a crisis code that, in a similar way to the stroke code, allows coordination of extra and intra-hospital emergency services. So we will get a adequate and early care of epileptic seizuresespecially the potentially serious ones, which can lead to status epilepticus”.

On the other hand, often epilepsy is associated with other diseasesboth physical and psychiatric. Depression (23%) or anxiety (20%) stand out among the most frequent psychiatric conditions, while headaches, heart and digestive problems, arthritis, dementia… also affect people with epilepsy to a greater extent. In children, intellectual disability is the most frequent comorbid condition (30-40%). In any case, it must be taken into account that it is a very heterogeneous disease, so that comorbidities will vary depending on the type of epilepsy.

“In addition, another of the main problems that patients with epilepsy must face is the social rejection that the disease entails. At least 25% of the adult population suffering from epilepsy suffers from discrimination. Erroneous beliefs that epilepsy can be a contagious disease or fear due to the social ignorance that still exists about this disease are usually the causes of the stigmatization suffered by many patients”, comments Dr. Juan José Poza.

Risk factors that could help prevent cases of epilepsy

“From the SEN we trust that days like today will serve to promote social knowledge of this disease and encourage the scientific community to continue research to improve the quality of life of our patients.”

The SEN estimates that the 3% of the Spanish population will suffer from epilepsy at some point in their lives. It is a disease that can start at any age and although various genetic and metabolic factors appear to be involved in its development, many other factors that may also influence its origin still remain to be determined.

In any case, certain risk factors have been identified that, if prevented or addressed correctly, could help prevent at least 25% of epilepsy cases. “A increased control over maternal and newborn healthon certain communicable diseases (such as bacterial meningitis or viral encephalitis), as well as prevent head injuries or vascular problems, are measures that could help to significantly reduce the number of cases. But the best prevention, in reality, is based on carrying a vhealthy eating, with an adequate diet, avoiding a sedentary lifestyle, promoting intellectual and social activity and respecting biological rhythms that help to maintain a good quality of sleep”, highlights Dr. Juan José Poza. ”We believe, therefore, that it is important to try to promote prevention strategies to try to reduce the number of cases that are diagnosed each year. In Spain, currently, about 20,000 new cases are diagnosed each year and, if preventive measures are not established, in the coming years we will witness a large increase in the number of patients, due to the progressive aging of the population”.

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