“Code Crisis” to act quickly in epilepsy seizures

2023-05-24 09:16:38

Acting quickly and precisely in the event of an epileptic seizure is key to a better prognosis for patients, which is why experts propose the implementation of a “Seizure Code”, similar to the “Stroke Code”. In addition, the sensitivity of diagnostic tests is greater in the first hours after an episode occurs.

Exhibition “Brain(s)” at the Center for Contemporary Culture of Barcelona (CCCB). EFE/ Enric Fontcuberta

An epileptic seizure is a neurological episode generated by excessive electrical activity of brain neurons. He explains it coordinator of the epilepsy study group of the Spanish Society of Neurology (SEN), Juan José Pozaon the occasion of National day of this diseasetoday May 24.

Types of epilepsy seizures

Depending on the part of the brain affected by this excessive electrical activity, the seizures can present themselves in different ways. In fact, according to Dr. Poza, more than 30 types have been classified that can range from brief alterations in movement, memory, senses, to the level of consciousness with “disconnection from the environment, muscle contractions or prolonged and severe convulsions ”.

However, the expert continues, there are basically two types: generalized, which are those that affect the entire cerebral cortex, and partial or focal, which involve a specific group of brain neurons.

According to the SEN, more than 400,000 people in Spain suffer from epilepsyof which some 100,000 are children. In fact, it is the most common neurological disorder in children and the third most prevalent neurological disease.

Delay in diagnosis

Experts lament the inequality in access to diagnostic techniques depending on the territory. This, together with the fact that epileptic seizures can go unnoticed in up to 25% of cases, both by patients and family members and even by health personnel, “makes diagnosis times difficult.”

In this sense, the SEN indicates that the delay in diagnosis can take up to ten years.

“You have to keep in mind that having a seizure does not mean that you have epilepsy. Up to 10% of the population will have a seizure throughout their lives, but only 3% will suffer from epilepsy”, adds Juan José Poza.

EFE/Enric Fontcuberta

For all these reasons, experts insist on the need for diagnostic tests to be carried out on all patients suspected of having this disorder. And that it is, mainly, with a prolonged video-EEG (electroencephalogram) monitoring, as the first step for a correct treatment.

therapeutic weapons

And it is that in the last decades the therapeutic weapons against the disease have increased considerably. But not only the number of available antiepileptic drugs, which have enabled nearly 70% of patients with epilepsy to control their seizures. Additionally, 5% may benefit from surgical treatment.

However, 30% of patients are drug resistant. This means that “their quality of life will be seriously compromised.”

50% of those affected live “stigmatized”, according to the SEN. With a life expectancy compared to the rest of the population that is reduced between two and ten years. And with a mortality rate that can even triple.

Epileptic seizures are a frequent cause in the ER and account for between 1% and 3% of total annual hospital admissions. We must not forget that it is the second cause of neurological attention in the ER after stroke.

speed is key

“For this reason, from the SEN, we have been working for years with the objective of implanting throughout the national territory a ‘Crisis Code’similar to the ‘Stroke Code’”, says Dr. Poza.

He “Stroke Code” It was designed with the aim of identifying, notifying and transferring stroke patients to the emergency services as soon as possible. If a patient who suffers a stroke is seen by a neurologist in the first few hours, the probability of dying or being severely disabled is reduced by half.

In the case of urgent epileptic seizures, they require “early and precise” diagnostic-therapeutic action by health personnel who are used to managing the disease.

Video provided by the SEN

And it is that epilepsy is a “time-dependent disease”. This means that patients will have a better prognosis the sooner their crisis is treated and “because the sensitivity of diagnostic tests, such as the EEG, is greater in the first hours after the crisis occurs,” emphasizes the neurologist.

The SEN does not overlook the fact that admissions due to crises have a “relevant morbidity and mortality”. This is because it can be a direct consequence of some potentially serious cause (such as trauma, stroke, among others) or complications such as status epilepticus.

Hence the sen maintain that “status epilepticus is a neurological emergency.” It represents approximately 10% of urgent epileptic seizures and is associated with a short-term mortality of 20%.