Epilepsy | Find info & specialists

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Epilepsy, also known as dropsy, is a functional disorder of the brain. Nerve cells fire their impulses simultaneously and practically "overload" the nervous system. Around 500,000 people in Germany suffer from epilepsy, with older people and children frequently affected. One third of people affected by epilepsy are children, another third are older people aged 60 and over. In principle, however, the disease can occur for the first time at any age.

You can find all the important information and qualified epilepsy doctors here.

ICD codes for this diseases: G40, G41

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Article overview

Causes of dropsy

The causes of epilepsy are not yet understood in detail, but researchers have identified a number of risk factors that promote the occurrence of epileptic seizures. These include, among others:

  • Kinship risk factors, e.g. if a parent already suffers or suffered from epilepsy,
  • Malformations of the brain,
  • Prenatal brain damage,
  • stroke,
  • brain tumors,
  • meningitis,
  • poisoning and,
  • medication, alcohol and drug abuse.

In some cases, no cause can be found at all. These so-called idiopathic epilepsies are a very common form of dropsy. It occurs in up to 40 % of those affected.

Symptoms of epilepsy

Epilepsy is a disease that occurs in the form of seizures. Such a seizure can last from seconds to minutes and usually occurs suddenly. However, epilepsy has a slightly different appearance depending on the area of the brain affected, which is why it is not always easy to recognize a seizure as such. Epilepsy is always an emergency when an acute seizure occurs and requires medical care.

epileptischer Anfall

Some of the following "harbingers" of an epileptic seizure can sometimes be noticed:

  • Upset moods,
  • irritability,
  • headaches and
  • hallucinations (aura vision)

Essentially, two basic forms of epilepsy can be distinguished:

1. focal epilepsy

In this form of seizure, initially only a narrowly defined area of the cerebral cortex is affected. Depending on the function of this area, focal epilepsy causes very different symptoms. The most common symptoms are muscle twitching and perceptual disturbances. The seizures can be experienced both with full consciousness and with a clouding of consciousness.

2 Generalized epilepsy

A grand mal is a generalized epileptic seizure that affects areas of both cerebral hemispheres. The best-known form of grand mal epilepsy is the tonic-clonic seizure, which occurs in two phases.

In the first phase, the convulsions of the muscles predominate. This tonic phase is not experienced consciously. The patient falls to the floor and arms and legs are stretched. The respiratory muscles may fail for a short time. This often results in a bluish coloration of the skin (= cyanosis).

The second phase - the clonic phase - follows the first phase after 10 to 30 seconds. In this part of the epilepsy, the convulsions dominate the clinical picture. This seizure phase is also over after one to two minutes. The patient usually only wakes very briefly and then falls into a deep sleep from which he/she is difficult to awaken. After waking up, those affected can no longer remember the seizure itself. However, urination and defecation or biting the tongue are the first signs of an epileptic seizure.

However, petit mal epilepsy is much more difficult to diagnose. The person affected only shows a lack of concentration or absence for a few seconds, only to continue as normal immediately afterwards. Petit mal or absence epilepsy may show the following signs:

  • Frequent eye blinking,
  • Smacking,
  • head turning backwards or sideways,
  • not infrequently head drooping

Special form: epilepsy in children

A special form of dropsy occurs in children aged between two and eight months, West syndrome. Although rare, West syndrome should be taken seriously and usually has an unfavorable prognosis. It is characterized by lightning seizures with rapid muscle twitching, nodding seizures with neck stiffness and salaam seizures with arms folded in front of the chest. The cause is usually brain damage, so that the affected children generally suffer from a mental developmental disorder.

Treatment of epilepsy

Epilepsy is usually diagnosed and treated by a neurologist. If a patient has already had several seizures, medication should be considered. For most patients, medication helps them to lead a seizure-free life. All available medications act on the nerve cells and prevent them from overreacting.

In individual cases, combinations of at least two different anti-epilepsy medications must be given, as one alone does not suppress the symptoms strongly enough. It is advisable to always take the medication regularly, as this is the only way to guarantee a constant level of the active ingredient in the blood and brain.

Doctors also recommend that epileptics keep a seizure diary. This illustrates the number and severity of epileptic seizures that have occurred and makes it easier to track the course of treatment.

In cases where drug treatment is not possible or does not work, a surgical solution is also available. If the focal seizures always occur in the same area of the brain and this can be safely removed, then surgery is the method of choice. Otherwise, a type of "brain pacemaker" can be implanted to regulate the electrical discharges of the nerve cells. In medical terms, this procedure is known as deep brain stimulation.

Prognosis for epilepsy

If an acute, organic cause for the epilepsy can be identified, it is usually easily treatable or even curable. For many sufferers, however, it is not possible to find a reason for the condition. With the help of medication, however, it is still possible to ensure that those affected remain seizure-free.

To avoid seizures, epileptics should maintain regular sleep hygiene and avoid flickering lights in the home. Driving is possible as soon as no seizure has occurred for a long time. Otherwise, the driver's license must be surrendered. Dangerous work on heavy machinery or in positions of responsibility (e.g. bus driver, cab driver, etc.) should also be avoided.

Which specialists are epilepsy specialists?

As with a large number of diseases, there are also experts available for epilepsy who specialize in the diagnosis, consultation and treatment of this disease. Such experts not only work as doctors in specialist practices or corresponding hospital departments, but also include social workers, psychologists and nurses who are active in the German Society for Epileptology (DGfE). Depending on the location, a distinction can be made between the following facilities (clinic or medical practice):

  • Specialist practices for epileptology
  • Outpatient clinic for epilepsy
  • Center for epilepsy

If children or adolescents suffer from epilepsy and need to be treated, pediatricians with appropriate training in epileptology are the best people to contact.

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