Gerónimo Aguayo Leytte
A few weeks ago we said that epilepsy is a common disease that manifests itself in different ways and also occurs for different reasons. We also said that there is a lack of knowledge about the disease, which sometimes makes us afraid of the sick because of the fact that it sometimes manifests itself abruptly or, even worse, because of discrimination in the family, at school, university or in the workplace.
Currently, about 15 antiepileptic drugs are available in our country for the treatment of this disease, and most patients respond well to the medicine correctly selected and dosed by the doctor. In some cases, it is necessary to resort to a second drug, which, in combination with the first, allows you to control seizures. This group of patients who manage to remain disease-free can qualify for drug withdrawal for a period of time that can range from two to five years and can be considered cured. These are usually patients who do not have brain lesions and are normal on neurological examination. It is estimated that they correspond to 70% of cases.
The remaining 30% of patients with epilepsy are considered difficult to control because seizures cannot be completely controlled and they tend to take multiple medications for a long time or for the rest of their lives. For these cases, which are often brain lesions and therefore present on neurological examination, there are now more options. On the one hand, the growing number of new drugs that work better and with fewer side effects, and on the other, epilepsy surgery, which is already being performed in some public and private medical centers in the country, although not as often as we would like. . It is about removing the brain tissue that contains the epileptogenic focus without causing more damage than what is already there.
In these centers of concentration, they also began to place small electrodes in the deep regions of the brain, especially in the thalamus, which are the nuclei of the brain, which are relays of great importance for the transmission of electrical impulses generated in the brain regions. cortex to spread it to other areas of the brain. Stimulation of these nuclei inhibits the spread of the abnormal electrical discharge and therefore reduces epileptic seizures.
Unfortunately, new antiepileptic drugs, epilepsy surgery, and electrodes that can be implanted in the brain are still very expensive, and there are still very few beneficiaries in public hospitals. As in many other areas of public and private medicine, we need to make progress to ensure that these resources reach those who need them most, and in particular in the case of epilepsy, given its high frequency and social consequences. Comprehensive treatment, including not only neurologists, but also doctors in general, therapists, pediatricians, psychologists, psychiatrists, social workers, rehabilitators, psychological and educational consultants, etc., is highly valued in this condition.
And, as with many chronic diseases, patients have a say because they are the ones who suffer from the disease, and through their stories and the experiences they share with us, we learn more every day.