Volksstimme telephone forum
On October 8, 2024, the Volksstimme cordially invites you to a telephone forum where you can ask your questions on the topic of “Epilepsy, often unrecognized and undertreated - known and new treatment options”. Privatdozent Dr. med. Friedhelm C. Schmitt and his colleague Senior Physician Olga Kukhlenko from the University Clinic for Neurology Magdeburg will be available to answer your questions. The experts can be reached from 10:00 to 12:00 on (0391) 532970 in the Volksstimme.
Photo: Senior physician Olga Kukhlenko & private lecturer Dr. med. Friedhelm C. Schmitt
Epilepsy is one of the most common neurological disorders worldwide, yet it often remains undiagnosed and undertreated. This is partly due to the fact that seizures are not always classically accompanied by convulsions and loss of consciousness, but can also occur in more inconspicuous forms, such as brief moments of absence or unusual behavior. It is only when the brain tends to spontaneously and repeatedly generate epileptic seizures that we speak of epilepsy. Due to the wide range of symptoms, the disease is often misinterpreted or overlooked, which can lead to inadequate care for those affected. An early and correct diagnosis is crucial in order to improve the patient's quality of life.
Epilepsy is the most common chronic disease in neurology after migraine: the incidence of this disease is around 0.7 percent of the population. This means that around 17,000 people are affected in Saxony-Anhalt alone, and around 500,000 people are affected in Germany as a whole.
Known treatment options
Drug therapy is still the most commonly used method of treating epilepsy. Seizure-suppressing medication (ASM) helps to control seizures or reduce their frequency and severity. It is important to tailor the medication to the individual patient, as not everyone responds equally to all active substances. The aim of drug therapy should always be to achieve freedom from seizures while at the same time ensuring that the ASM is well tolerated. In patients who do not become seizure-free after two ASMs (so-called pharmacorefractory cases), the possibility of another diagnosis or neurosurgical intervention should also be considered. First of all, the affected area of the brain must be specifically searched for by means of an inpatient stay with simultaneous video and brain recording, known as “EEG recording”. An operation recommendation can then be made if necessary. In Saxony-Anhalt, only the University Clinic for Neurology in Magdeburg has this personnel-intensive and technically complex technology.
New approaches and innovative treatment options
In den letzten Jahren haben sich die Behandlungsmöglichkeiten für Epilepsie erweitert. Neuere Entwicklungen umfassen die Tiefenhirnstimulation, bei der elektrische Impulse gezielt an betroffene Gehirnregionen gesendet werden, um die Anfallshäufigkeit zu senken. Auch die vagusnervstimulierende Therapie, bei der eine Elektrode implantiert wird, die den Vagusnerv stimuliert und so die Anfallskontrolle unterstützt, zeigt gute Ergebnisse. In Magdeburg wurde 2019 erstmals die sogenannte stereotaktische Laser-Thermoablation in Deutschland durchgeführt. Schon seit 15 Jahren erfreut sich dieses minimal-invasive Verfahren sowohl bei Patient:innen wie auch Ärzt:innen in Nordamerika großer Beliebtheit, da hier nur eine kleines 0,5 mm großes Bohrloch am Schädel durchgeführt werden muss, um dann das betroffene Hirnareal mittels des Lasers zu zerstören, ohne dabei benachbarte Strukturen zu gefährden. Zudem wird intensiv an medikamentösen Neuerungen sowie genetischen und molekularen Ansätzen geforscht, um die Behandlung weiter zu individualisieren und effektiver zu gestalten. Diese neuen Ansätze geben Hoffnung für viele Betroffene, die bisher nur unzureichend auf die derzeitigen Standardtherapien ansprechen.
Treatment options for epilepsy have expanded in recent years. Recent developments include deep brain stimulation, in which electrical impulses are sent specifically to affected regions of the brain in order to reduce the frequency of seizures. Vagus nerve stimulation therapy, in which an electrode is implanted to stimulate the vagus nerve and thus support seizure control, is also showing good results. In Magdeburg, stereotactic laser thermal ablation was performed for the first time in Germany in 2019. This minimally invasive procedure has been very popular with both patients and doctors in North America for 15 years, as it only requires a small 0.5 mm drill hole to be made in the skull in order to destroy the affected area of the brain using the laser without endangering neighboring structures. In addition, intensive research is being carried out into new drugs and genetic and molecular approaches to further individualize treatment and make it more effective. These new approaches give hope to many patients who have so far responded inadequately to current standard therapies.