EPILEPSY: CLINICAL MANIFESTATIONS, DIAGNOSTIC APPROACHES, AND MODERN TREATMENT MEASURES

Аннотация

This article analyzes the main clinical presentations of epilepsy, the methods used for its diagnosis, and modern treatment strategies. Epilepsy is a chronic disease of the central nervous system characterized by recurrent seizures. Through early detection and modern therapeutic approaches, patients’ quality oflifecan besignificantly improved. Keywords: Epilepsy, clinical manifestations, diagnosis, modern treatment, antiepileptic drugs, neurostimulation Introduction to Epilepsy. Epilepsy is a neurological disorder caused by excessive and sudden electrical activity of brain neurons. Worldwide, the disease affects about 1–2 out of every 100 individuals. Epilepsy not only produces physical symptoms but also psychological and social problems. Therefore, understanding, diagnosing, and treating this illness correctly is an importanttask in modern medicine. Generalized seizures. Generalized seizures are those in which epileptic activity spreads simultaneously across both cerebral hemispheres. The patient usually loses consciousness completely and does not respond to external stimuli. These seizures are further classified into several clinical types: 1.Tonic-ClonicSeizure(Classic GrandMal) Thisis themost common and typically themostsevere form.  Tonic phase (10–30 seconds): The patient loses consciousness; all muscles stiffen suddenly and intensely, often causing a fall. Occasionally the patient may bite their tongue or makesounds.  Clonic phase (30–60 seconds): Muscles begin to contract rhythmically—these jerking movements gradually decrease in frequency andintensity. Postictal phase: After the seizure, the patient slowly regains consciousness. They may be lethargic, fatigued, or confused. This state can last from several minutes to several hours. Signs can include frothing at the mouth, urinary or fecal incontinence, labored breathing, cyanosis (due to hypoxia), and temporary disturbances of hearing or vision. If you would like me to continue translating the remaining sections following exactly the same structure—such as absences, myoclonic and atonic seizures, focal seizures, diagnosis methods (EEG, MRI, CT), and modern treatment modalities—please let meknow. https://ijmri.de/index.php/jmsi volume 4,issue6,2025 380 2.AbsenceSeizures (PetitMal) Theseare mostcommon in children. There is abrief (5–15seconds) loss ofconsciousness during which thechild stares blankly; if speaking, thechild stops mid-sentence. There is nopain or falling involved, and thechild often doesn’t remember theepisode. Theseseizures canoccur multipletimesa day. 3.MyoclonicSeizures Theseinvolvebrief, sudden musclejerks—especially in thearms and shoulders. They typically occurinthemorning orunderstress. 4.AtonicSeizures Muscletone suddenly drops, causing thepatient to collapse. The head, legs, orarms may golimp. Although these seizures are very brief, they carry ahigh risk ofinjury. 5.IsolatedTonicorClonicSeizures  Tonic:Only muscle stiffening occurs (often at night).  Clonic:Only rhythmic jerking movements are observed. Generalized seizures generally posegreater risksdue tothe potential forfalls and injuries. They can temporarily affect lung andheart function. If prolonged, theymay lead tostatus epilepticus—alife-threatening condition ofcontinuous seizureactivity. Focal Seizures Focal seizures involveepilepticactivity in onlya specific part of thecerebral cortex,and donot immediatelyspread tothewhole brain. Clinical signs vary depending ontheregion of thebrain where theseizurebegins. Focal seizures are divided intotwo main types: 1.Simple(Focal) Seizures –Awareness Preserved Thepatient remains conscious. Symptoms depend onthebrain region involved:  Motorarea: Jerking ortwitching in thearm, leg, orface  Sensoryarea: Tingling, numbness, orelectric-shock sensations  Visualfield:Flashes oflight orcolors in vision  Auditory area: Hearing unusualnoises or sounds  Olfactory: Smellingstrangeor oddodors  Psychic changes: Fear, a sudden sense of familiarity (déjà-vu) These seizures typically last 30 seconds to 2 minutes and may go unnoticed by others. https://ijmri.de/index.php/jmsi volume 4,issue6,2025 381 2.Complex Focal Seizures –Impaired Awareness Consciousnessis lost orclouded. The patient mayperform automatic movements such as:  Chewing  Lip-smacking  Fiddlingwith clothing  Staring into space Communication breaks down, though the patient’s eyes may remain open. Seizures usually last 1–2minutes,followed byaperiod of confusion and fatigue. Secondary Generalization ofFocal Seizures At times,a focal seizurecan start in a limited areabut then spread to both hemispheres— evolvinginto ageneralized tonic-clonic seizure. This process is called secondary generalization. Focal seizures can bedifficult to recognize because theysometimes begin with mildorpeculiar movements. They can interfere with daily activities such as working, driving, swimming, or being at heights. Correct diagnosis requires tools such as EEG andMRI. Methods forDiagnosing Epi