Epilepsy: Symptoms, diagnosis & treatment options in Turkey

Understanding epilepsy

Epilepsy is a chronic neurological disorder characterized by the repeated occurrence of epileptic seizures. These result from abnormal and excessive electrical activity in certain neurons, particularly in the cerebral cortex. During these seizures, the brain temporarily “short-circuits.”

Each person experiences their seizures differently. Some are subtle and go unnoticed, while others can be more dramatic, especially in the case of generalized convulsions.

Causes of epileptic seizures

Several causes can be at the origin of epilepsy, including:

• The genetic factor: Epilepsy is strongly influenced by genetics. In fact, researchers have linked certain types of epilepsy to specific genes.
• Head trauma resulting from a car accident or another traumatic injury can cause epilepsy.
• Brain tumors: Epilepsy can also be caused by how blood vessels form in the brain. People with vascular conditions such as arteriovenous malformations and cavernous malformations may experience seizures.
• Infections that primarily affect the brain, such as neurocysticercosis (a parasitic infection),meningitis, HIV, viral encephalitis, and other parasitic infections.
• Developmental disorders: Epilepsy can sometimes occur alongside developmental disorders. Autistic individuals are more likely to experience epilepsy than non-autistic individuals.

Symptoms of epileptic seizures

Epileptic seizures can be focal (limited to one part of the brain) or generalized (affecting both hemispheres of the brain). Their symptoms vary, but the most common include:

• Temporary confusion or disturbances of consciousness.
• Intense muscle contractions.
• Involuntary tremors of the arms and legs.
• Sudden stiffness or relaxation of the respiratory muscles.
• Psychic alterations (hallucinations, sudden fear, disorientation, déjà-vu sensations…)
• Absences or loss of consciousness.

Often, a person with epilepsy consistently experiences the same type of seizure, which makes them easier to identify and monitor.

Diagnosis of epilepsy in Turkey

In Turkey, the diagnosis of epilepsy is based on a comprehensive evaluation by neurology specialists and epileptologists. Several tests are used to analyze brain activity and identify the origin of the seizures:

• The electroencephalogram (EEG) is the basic test. It records the brain's electrical signals using electrodes placed on the scalp. Even outside of seizures, abnormalities can be detected in nearly 50% of patients.
• Brain MRI or CT scan (computed tomography) helps visualize possible brain lesions (malformations, tumors, trauma sequelae...) that may cause epilepsy.
• In some cases, more in-depth tests are recommended: prolonged EEG or video-EEG, functional MRI, PET scan, or neuropsychological tests.

The goal is to establish an accurate diagnosis, determine the type of epilepsy, and assess whether medical or surgical treatment is possible.

Different types of epilepsy

Epilepsy does not always manifest in the same way. There are several forms, depending on the area of the brain involved and the mode of expression of the seizures. Here are the main ones:

Focal seizures

Also known as partial seizures, they start in a single region of the brain, usually within one hemisphere. Two forms can be distinguished:

• Focal aware seizures: These involve localized symptoms (involuntary movements, sensory or emotional disturbances) without loss of consciousness. The patient remains aware but may experience strange sensations or abnormal movements on one side of the body.
• Focal impaired awareness seizures: These lead to impaired consciousness. The person may have a fixed stare, automatic movements (chewing, handling objects…),and usually does not remember the episode.
• In Turkey, specialized centers manage both forms with high diagnostic precision to tailor the treatment accordingly.

Generalized seizures

In this type of epilepsy, both cerebral hemispheres are simultaneously affected from the beginning of the seizure. They systematically involve a sudden loss of consciousness. The most common forms include:

• Tonic-clonic seizures: sudden muscle stiffness (tonic phase) followed by rhythmic jerking (clonic phase).
• Absence seizures: brief episodes of unresponsiveness, often seen in children.
• Atonic or myoclonic seizures: sudden loss of muscle tone or brief, isolated jerks.

Status epilepticus: a life-threatening emergency

Status epilepticus refers to a succession of closely spaced or prolonged seizures without full recovery of consciousness between episodes. This state constitutes an absolute neurological emergency, potentially leading to:

• Respiratory distress.
• Risk of brain damage.
• A life-threatening situation.

Immediate management in a hospital setting is essential. In Turkey, neurology departments are trained to intervene rapidly with intensive treatments, particularly in intensive care or specialized units.

Pharmacological treatment of epilepsy

In about 70% of cases, patients with epilepsy manage to stabilize or significantly reduce their seizures through appropriate medication.

In Turkey, the therapeutic approach generally begins with the gradual introduction of a single antiepileptic medication. The neurologist or epileptologist then adjusts the dosage based on the drug's effectiveness and the patient's tolerance. If a single treatment proves insufficient, a combination of several medications may be considered.

Today, there are more than 20 types of antiepileptic drugs, chosen based on the type of seizure, the patient's age, medical history, and profile. Possible side effects include:

• Fatigue, dizziness, weight gain.
• Memory or coordination problems.
• Skin rashes, speech disturbances.

In rare cases, more severe side effects can occur, such as severe allergic reactions, depression, or suicidal thoughts. Regular monitoring is therefore essential to adjust the treatment and monitor tolerance.

Surgery and alternative approaches to drug resistance

When seizures persist despite well-conducted treatment, it is known as drug-resistant epilepsy. In such cases, other solutions may be offered in Turkey, including surgery or neurostimulation.

Epilepsy surgery

If the epileptic focus can be precisely located and is situated in a non-essential area of the brain (such as language, motor control, hearing…),a surgical procedure can be considered to remove or destroy the responsible area.

Available techniques include:

• Conventional surgical resection: removal of the epileptic focus.
• MRI-guided stereotactic laser ablation: a minimally invasive technique that uses heat to destroy the responsible tissue, with faster recovery.

Even after successful surgery, some patients continue to take medication, though often at reduced doses. As with any brain surgery, risks exist, including possible cognitive impairment (in rare cases).

Deep brain stimulation

This technique involves implanting electrodes in a targeted area of the brain, often the thalamus. These electrodes are connected to a pulse generator placed under the skin in the chest area.

The device delivers regular stimulations to the brain, significantly reducing the number of seizures. This treatment is indicated for certain patients whose seizures are resistant and poorly localized.

Vagus Nerve Stimulation (VNS)

Vagus Nerve Stimulation (VNS) involves implanting a device that sends regular, mild electrical pulses to the vagus nerve in the neck. This nerve stimulation can help reduce the frequency and severity of seizures in patients with drug-resistant epilepsy who are not candidates for resective surgery.

Responsive neurostimulation (RNS)

This is an intelligent device, comparable to a pacemaker, that analyzes brain activity in real time. When abnormal activity is detected, it delivers an electrical impulse or localized medication to stop the seizure before it manifests.

This personalized approach offers:

• A significant long-term reduction in seizures.
• Few side effects.
• Improved quality of life.

How can I access epilepsy treatment with Turquie Santé?

Turquie Santé makes it easier for you to access the best neurology and epilepsy surgery specialists in the top clinics and hospitals in Turkey. Whether you're seeking a second opinion, a treatment plan, or advanced surgery, our team supports you every step of the way.

Your contact and appointment journey is as follows:

1. Fill out our secure online form to provide us with your needs and medical history.

2. A dedicated medical coordinator will contact you within 24 hours to review your medical file, arrange for a remote or in-person consultation, and plan the necessary exams or interventions.

3. You will receive free personalized quotes from our partner facilities that are best suited to your profile.

The support is 100% free, with no commitment, and can include logistical assistance (hotel, airport transfers, interpreter).

Your data privacy and security

At Turquie Santé, all medical information is handled with strict confidentiality, in accordance with international standards for the protection of health data (GDPR). No documents are shared without your written consent.

Your exchanges with doctors and coordinators are secure, discreet, and respect your anonymity.

We understand that discussing health matters — especially neurology — can be sensitive. That's why we're committed to providing a trustworthy, attentive, and respectful environment from your very first contact.