Epilepsy, commonly known as “crohn’s disease” or “sheep epilepsy”, is a chronic disease in which sudden abnormal discharges of neurons in the brain cause transient brain dysfunction. What are the common types of epilepsy that can be operated on? The following are the common types of epilepsy that can be operated on.
I. Temporal lobe epilepsy
Clinical manifestations are: the most initial aura (panic, fear, nausea, sense of déjà vu, low self-esteem, sense of abandonment, depression, feeling of gas upsurge, sense of unreality, spatial abnormality, smell and taste hallucinations, etc.), followed by some aimless movements such as chewing, swallowing, adding mouth, smacking mouth, hands constantly groping, looking for something, leaving, walking, etc. In severe cases, tonic twitching of limbs and foaming at the mouth may occur.
Imaging:It is common to have hippocampal sclerosis on one side.
EEG:The seizure phase originates from one temporal region.
II. Frontal lobe epilepsy
Its manifestations are diverse, and the classification according to the anatomical site is as follows
1. para-motor area seizures: seizures in the form of postural focal tonicity with speech pause as well as fencing posture.
2. Prefrontal polar area seizures: Prefrontal polar area seizures take the form of compulsive thinking and rotational movements of the head and eyes, which may progress to the person turning to the opposite side and falling.
3, motor cortical seizures: The main feature of motor cortical seizures is simple partial motor seizures. When the paracentral lobule is involved, the seizures show tonic movements of the ipsilateral foot, as well as movements of the contralateral leg, and Todd paresis is often seen after the seizure.
4. Orbitofrontal seizures: Orbitofrontal seizures are also complex partial seizures, initially characterized by motor and postural automatisms, accompanied by olfactory hallucinations and delusions and vegetative neurological signs.
5. Cingulate seizures: Complex partial seizures with complex motor and postural automatism, common vegetative neurological signs and changes in mood and emotion.
6. Insular seizures: Features of insular seizures include chewing, salivation, swallowing, symptoms of larynx, speech arrest epigastric aura fear, and autonomic sign phenomena.
7. Dorsolateral frontal seizures: Seizures may take the form of tonic or, less commonly, clonic episodes with eye and head rotation and speech arrest.
Imaging is common: cortical dysplasia, glioma, cavernous hemangioma, meningeal brain scarring brain atrophy, cystic brain changes, etc.
EEG: Intermittent discharges are mainly in the frontal area, but may not occur easily. The onset of seizures is often not easily determined, and the ground-wave amplitude fast waves starting in the frontal and central regions are often masked by a large number of EMG or motor artifacts.
III. Parietal lobe epilepsy
Clinical manifestations include numbness, sensation of absence of a part of the body, tingling, sensation of rising or weightlessness, obstruction, pain, and deformation and distortion.
EEG: abnormal discharges may appear in the central and parietal regions during the interphase, and abnormal discharges starting in the central and parietal regions during the seizure phase. Since the anatomical site is very close to the frontal and central regions, the definite site should be under the best surgical guidance.
IV. Occipital lobe epilepsy
The clinical manifestations are: aura of visual symptoms, blind spot, hemianopsia, black haze, and most commonly, flash and light hallucinations and visual object distortion. The seizures start with tonic and/or clonic deflection of the head and eyes to the opposite side, eyelid twitching and closure, and later may cause tonic jerking of the limbs. Due to its special anatomical location, occipital seizures can spread to other brain lobes such as (frontal, temporal and parietal regions) and cause different seizure manifestations.
EEG: abnormal discharges predominantly in the occipital region during the interphase, and abnormal discharges starting in the occipital region during the seizure phase.
Extensive lesions in one hemisphere, diffuse discharges in the hemisphere during the interictal phase of EEG, EEG; low voltage origin in one side of the lesion during the seizure phase, anatomical hemisphere or functional hemisphere resection can be considered for each case.