International Epilepsy Day
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Iván Gelibter
Malaga
Monday, 12 February 2024
Around 25,000 people in Malaga province have had an epileptic seizure at some point in their lives, with about half of those considered active cases, referring to episodes that have happened in the past five years. This sums up the current situation regarding an illness which, in many cases, remains a taboo among its own patients, who prefer to keep quiet about their condition, according to Pedro Serrano, Director of Neurology at Malaga's Hospital Regional and one of the leading experts on epilepsy in Spain.
Serrano himself directed a large-scale study which concluded that 1.4 per cent of the general population have suffered an epileptic seizure at least once in their lives. Active cases, however, only account for around 0.6 per cent of the population. Although the latter figure is in line with the European average, the former is higher, the reason for which is directly linked to Spain's development as a country. Serrano explained that "lesser developed countries have higher rates of epilepsy", which translates to cases being more prevalent among Spain's older population, who lived through a period when the country was less developed. Now, as a result of Spain's progress, the figure is more level with its European neighbours.
According to Serrano, epilepsy is a neurological illness. "Although it may seem obvious, it is important to make this clarification because it is widely unknown, and there are many who think that it is a psychiatric illness, or that it is not an illness at all, and involves some sort of sign or even supernatural phenomena," he described. He added that, during epilepsy, a group of neurons become hyperexcitable and begin to malfunction, causing certain changes in the brain.
Serrano stated that "a lot" of progress has been made in the understanding of this illness, although not so much from a sociological point of view. "It continues to be a taboo, so patients don't want people to know that they have the condition, which is understandable in many cases. Sometimes they have a hard time getting work because people don't want to hire them, in order to avoid a seizure happening in the workplace. It's one of those illnesses that remains hidden, precisely because the seizures are unpredictable," he explained.
As for those with epilepsy, there are two age groups where cases are most prevalent, the first one being during childhood, where genetic epilepsies start to appear. These do not arise from injury and are caused by genetic factors. The second usually occurs on the opposite end of the spectrum, involving focal epilepsies caused by trauma from head injuries, strokes or tumours, among others. The former group of epilepsies, as a result of genetic factors, cannot be prevented, unlike the latter, given that they stem from lifestyle factors.
"The same methods used to prevent strokes can also be used for epilepsy. Or, for example, if we reduce the number of traffic accidents, there'll also be fewer cases of epilepsy," Serrano pointed out.
Typical treatment for people with epilepsy is medication available at pharmacies, which has significantly improved over the years in terms of assuring the patients' quality of life.
Serrano explained that a diagnosis can be made from a patient's clinical history and further examination, but there are also tools, particularly the electroencephalogram (EEG), which measure electrical activity in the brain and detect the increased activity of a given group of neurons. Moreover, techniques such as magnetic resolution (MRI), nuclear medicine, or neuropsychology can be used, the combination of which allows for an accurate diagnosis of a specific type of epilepsy.
However, in the case of epilepsy found in childhood, which is caused by genetic factors and cannot be prevented or cured, the focus of future research should not be to eliminate the illness, but on specialised medicine. "Treatment should develop to accommodate genetic conditions," Serrano concluded.
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