EPILEPSY: SIGNS, SYMPTOMS, AND TREATMENT

EPILEPSY: SIGNS, SYMPTOMS, AND TREATMENT

For Epilepsy Awareness Month (November), we interviewed SIMED Neurologist Dr. Kraiyuth Vongxaiburana (Vong) to find out what epilepsy is and how it’s treated. But, to understand epilepsy, you must first be able to recognize the signs and symptoms of a seizure.

WHAT IS A SEIZURE?

A seizure is a surge of abnormal electrical discharges in the brain that disrupt normal brainwave patterns. Seizures can manifest in different ways, and Dr. Vong discussed two of them: a generalized seizure and a complex partial seizure.

Generalized Seizures

The most obvious manifestation is a surge of abnormal discharges throughout the brain. The patient loses consciousness and has a convulsion. They may become really stiff at first and draw their arms up. Then, they might begin to shake. The convulsion could end up lasting a minute or two. During that time, the person might lose control of their bladder or bite their tongue. To bystanders, the seizure should be obvious.

Complex Partial Seizure

This type of seizure is less obvious. The abnormal electrical activity is localized to one part of the brain and not generalized. The person might not have convulsions but might instead stare into space and have an oral or manual automatism. They might make repetitive movements with their mouth or hands, like fiddling with their clothes or the buttons on their clothing and smacking their lips.

What they’re doing might look semi-purposeful. Because their eyes are open, you might think they’re awake, but they don’t respond and aren’t actually aware of what’s happening. They might smell a smell that isn’t there or experience a rollercoaster sensation in their stomach. They might also feel a sense of déjà vu. If the seizure starts in one part of the brain and spreads to other parts, it can lead to a convulsion.

WHAT IS EPILEPSY?

About 9 to 10 percent of people have a seizure in their lifetime which is about the same amount of people who are left handed, so it’s pretty common. But having a one-time seizure doesn’t diagnose epilepsy. Epilepsy is usually diagnosed if someone has more than one unprovoked seizure. Someone could also be diagnosed with epilepsy if they have one unprovoked seizure and have high risk for another, a brain tumor, or a brain abnormality.

Unprovoked seizures are not caused by external factors, like low sodium, meningitis, or alcohol withdrawal. If someone had multiple triggered seizures resulting from another factor, they would not be diagnosed with a seizure disorder or epilepsy. Dr. Vong estimates about 3% of people will be diagnosed with epilepsy at one point in their lifetime.

HOW IS EPILEPSY DIAGNOSED OR MONITORED?

When someone has a seizure, doctors look for a provoking factor. Doctors check for abnormalities in the bloodwork like low sodium and evidence of drugs as drug withdrawal could provoke a seizure.

The individual might get imaging done on their brain including an MRI or a CT scan that could indicate previous strokes or a brain tumor. An EEG, which is a test that monitors brainwaves, can indicate abnormal activity and discharges that would provoke a seizure. People might also get additional tests depending on their situation. Testing can indicate if a patient is at higher risk of having another seizure.

WHAT ARE THE CAUSES OF EPILEPSY?

Some forms of epilepsy are genetic and tend to run in families. Other times, people might have abnormalities in their brain or their brain can be formed differently.  Abnormal areas in the brain can initiate seizures, and temporal scarring can also trigger them. If patients had a stroke in the past, they have a greater risk of getting epilepsy.

HOW IS EPILEPSY TREATED?

If a patient is diagnosed with epilepsy, they are put on antiepileptic or antiseizure medications. The medications decrease risk and prevent those individuals from having another seizure. About 60 to 65% of people on the medication can successfully control their seizures with the drugs; however, about 35% of people still have seizures despite taking the antiepileptic drugs.

WHAT IF THE MEDICATION DOES NOT WORK?

Patients who do not respond to the drug have stubborn or intractable epilepsy. If someone has a seizure that isn’t controlled by medicine, they might have other forms of convulsions. For example, if the person has been under a lot of stress they might have a pseudoseizure, a convulsion that looks like a seizure but isn’t. Instead, the action is more of a psychological response to stress.

Determining whether or not the individual has a seizure is important because if they do not have a true seizure, they should not continue to take the seizure medication. Instead, they could see a psychologist who might help tease out the person’s stressors.

Another reason people adverse to the medication should be monitored is to indicate whether the seizures can be prevented with surgery. If you can see on the EEG that the seizure starts at the same place in the brain every time, the person might get seizure surgery which could cure them of their epilepsy. Most patients won’t need surgery and can be controlled with seizure medication, though.

WHAT IS THE DIFFERENCE BETWEEN A STROKE AND A SEIZURE?

A stroke results from damage to the brain that blocks blood flow to the brain. In contrast, a seizure is an abnormal electrical event in the brain. Strokes can increase the risk of seizures and sometimes even cause seizures. Seizures can also mimic strokes. A specific type of seizure makes one side of the body weak.

WHAT AGE IS EPILEPSY MOST COMMONLY DIAGNOSED AT?

Epilepsy is diagnosed in all ages from infancy through adulthood. While the reasons people have seizures might differ, epilepsy can affect anybody.

 

Source: simedhealth.com, Dr. Vong, Kraiyuth Vongxaiburana

Don’t Ignore the Signs of Depression

Don’t Ignore the Signs of Depression

 

Many people with conditions like multiple sclerosis, epilepsy, traumatic brain injury, Alzheimer’s disease, or stroke experience depression. A Danish study in 2016 of stroke survivors found that more than half developed depression within the first three months, and 25 percent were diagnosed with depression two years later. Similar statistics have been reported for other neurologic conditions.

“Cognitive impairment and other neurologic conditions significantly increase the risk for depression, whether you have had depression previously or not,” says Scott Hirsch, MD, a neuropsychiatrist with Contemporary Care of America in Greenwich, CT.

The connection between depression and neurologic disease isn’t entirely clear, and theories vary, depending on the disorder. “Sometimes there can be a purely biological cause, such as biochemical changes in the brain caused by a stroke,” says Dr. Hirsch. After a stroke, the amygdala, the part of the brain involved in regulating emotions, is often damaged, and levels of brain-derived neurotrophic factor (a protein that affects mood) and the stress hormone cortisol are reduced—all of which can trigger depression. And in Parkinson’s, for example, it may be caused by a drop in dopamine.

People who have co-occurring conditions such as cancer and diabetes may also be more prone to depression. “In general, when people are chronically ill with any condition, not just a neurologic disorder, they are more likely to experience depression,” Dr. Hirsch says.

And psychosocial factors, including social isolation, loneliness, and bereavement, can contribute to depression, says Nada El Husseini, MD, FAAN, associate professor of neurology at Duke University Medical Center in Raleigh, NC.

Whatever the cause, it’s important to treat depression. Otherwise, it can lead to isolation, more severe depression, cognitive decline, and even suicide. Here’s what you can do if you think you or a loved one might have depression.

Know the signs. “Some of the most common early signs include sleep disturbances, decreased energy, changes in appetite or activity levels, and decreased concentration,” says Dr. El Husseini. “It’s easy to miss these signs or to assume they are symptoms of the neurologic condition itself rather than of depression.” Another warning sign is loss of interest or pleasure in doing things that you once enjoyed.

Reach out for help. “If a depressed mood or sadness lasts longer than two weeks and you still aren’t enjoying the things you used to, talk to your primary care provider or your neurologist,” Dr. Hirsch says.

Seek treatment. Depression can be addressed through lifestyle approaches, medication, and therapy, says Dr. El Husseini. “To begin, I usually focus on making sure the person is getting enough physical activity and restful sleep. I also make sure they’re eating a healthy diet and avoiding excessive alcohol use. If they smoke, I encourage them to quit.” Talk therapy can help people focus on problem-solving, managing “ruminative thoughts” (excessive focus on problems, negative life events, or symptoms of depression), and coping with grief. Antidepressants also can be helpful. Your doctors can recommend the most appropriate antidepressant medication that will not have negative interactions with other drugs you are taking. “We will usually start with small doses in order to monitor the side effects,” Dr. El Husseini says. “In clinical trials, we have seen a 50 to 65 percent response rate to antidepressants in people with neurologic conditions.”

 

Source: brainandlife.org, Gina Shaw, Art: haleymanchon.com

How to Identify Your Epileptic Seizure Triggers

How to Identify Your Epileptic Seizure Triggers

Epilepsy triggers are what set off seizures. Triggers can be anything, from flashing lights to weather to something you’ve eaten.

Once you know your seizure triggavoid them or be prepared for when you do encounter them. This can make a big difference in how well you control your epilepsy.

This article examines what causes epilepsy, common seizure and epilepsy triggers, and how to avoid them.

Epilepsy Causes

Epilepsy has many causes, including:

  • Genetics
  • Brain trauma or structural abnormalities
  • Autoimmune disease
  • Metabolic problems
  • Infectious illness
  • Lack of oxygen during birth

Regardless of the cause, triggers sometimes interrupt the brain’s orderly electrical rhythms, leading to seizures (sudden, abnormal bursts of electricity).

Common Seizure Triggers

Many things can trigger seizures, including medication, stress, lack of sleep, nutrition, and more.

Medication

Medication can cause seizures in two ways, either from taking specific drugs or missing your epilepsy drugs.

OTC Medications

Some common over-the-counter (OTC) medications can lead to seizures both in people with or without epilepsy. They may even trigger your first seizure before an epilepsy diagnosis.

Other medications may not directly cause a seizure but can lower the threshold for one, making it more likely that you’ll have a seizure.

OTC medications that may cause seizure activity include:

  • Benadryl (diphenhydramine)
  • Sudafed (pseudoephedrine)
  • Cold, flu, and allergy medications that contain one or both of the above-mentioned drugs
  • Anti-inflammatories, such as Advil (ibuprofen) and Aleve (naproxen)

Be sure to ask your healthcare provider how safe OTC medications are before taking them. If something has triggered a seizure in the past, don’t take it again.

Missed Epilepsy Medication

Missing one or more doses of your epilepsy medication may put you at risk of a seizure. If your epilepsy causes memory problems, you may sometimes forget to take it. However, it’s essential to make sure you take your medication consistently and around the same time(s) every day.

If you miss a dose, the best thing to do is check the packaging information for your specific drug or ask your healthcare provider or pharmacist what to do.

In general, the recommendations are:

  • For a once-a-day dose: Take the missed dose as soon as you realize you’ve forgotten.
  • For a twice-a-day dose: Only take the missed one if you realize you missed it within six hours. If you don’t realize it until later, don’t take it and take your next regular dose at the right time.
  • Do not take a double dose: Doubling up on anti-seizure medications could cause unpleasant side effects.

Remembering to Take Your Medication

If you frequently forget to take your seizure medication, you may want to use alarms or an app to help you remember.

Lack of Sleep

Not getting enough sleep can lead to changes in your brain that trigger seizures. When you have epilepsy, though, it can be hard to get enough sleep.

This is because sleep is linked to chemical and electrical changes in the brain that can cause seizures overnight and disrupt sleep. Poor sleep can lead to a cycle that’s hard to stop.

If you’re often sleep-deprived, talk to your healthcare provider about medications that may help you get adequate rest.

Stress

Experts don’t yet understand why, but high stress levels can be a seizure trigger. Some research has suggested it’s because stress can lead to hyperventilating (rapid breathing), which alters brain activity.

It may also be due to the impact of stress hormones on the nervous system or because some areas of the brain involved in seizures are also part of the body’s response to stress.

While some stress is unavoidable, you may be able to better manage stress and lessen its effect on you. Some ways to manage stress include:

  • Mindfulness practices, such as meditation
  • Deep breathing exercises
  • Learning to say no and setting boundaries
  • Asking for help when you need it
  • Stress therapy

Nutrition

Food can change your brain function, so a healthy diet may help you avoid seizures. However, research in this area is slim and inconsistent.

Very low blood sugar levels (hypoglycemia) can cause seizures. This is most common when people with diabetes take too much insulin. Mild blood sugar dips don’t appear to be seizure triggers.

Low levels of certain vitamins and minerals may also be seizure triggers. These include:

  • Vitamin B6 (pyridoxine), mainly in babies
  • Sodium
  • Calcium
  • Magnesium

If you’re having trouble with seizure control, ask your healthcare provider if it’s beneficial to check for deficiencies. This can be done with a simple blood test.

Alcohol and Drug Use

Alcohol and recreational drugs may be seizure triggers in many people.

An occasional alcoholic beverage is unlikely to be a problem, but the risk may increase after three or more drinks. Binge drinking, and its following withdrawal, are tied to seizures.

It may also lead to the potentially fatal condition of status epilepticus, when seizures are especially long, or you have many close together without time for recovery.

Different recreational drugs have varying effects on epilepsy and seizures.

Any drug that impairs your memory or causes confusion may make you forget to take your epilepsy medication, which can trigger seizures.

Flashing Lights

For people with a condition called photosensitive epilepsy, flashing lights and other visual patterns can be a seizure trigger.

This is most common in children and becomes less of a problem as you get older. About 3% of people with epilepsy have a problem with flashing lights.

Illness

Catching an acute illness (e.g., cold, flu) or coming down with an infection may be a seizure trigger for some people. This can be from:

  • The physical stress of being ill
  • Fever
  • Dehydration
  • Vomiting up seizure medication
  • Not sleeping well

You may want to take steps to prevent illness, such as frequent handwashing, keeping up with vaccines, avoiding sick people, and wearing a mask during cold and flu season.

Menstruation

If you menstruate, you may notice more seizures around your menstrual period. This is called catamenial epilepsy.

These seizures are most common around ovulation, about a week before your period starts. This is believed to be due to hormonal changes.

If this happens to you, talk to your healthcare provider about whether you should increase the dosage of your seizure medications at certain times in your cycle. However, don’t change your dosage without first talking to your healthcare provider.

Hormonal birth control pills can sometimes help control catamenial epilepsy.

Weather

Weather patterns and changes may be a seizure trigger in some people, but research has been inconsistent and inconclusive. Seizures may be more frequent:

  • During unstable weather conditions
  • In the winter, possibly due to lower temperatures
  • During times of low atmospheric pressure and high relative humidity

Studies suggest weather is more likely to impact people with less-severe epilepsy.

Types of Seizures

Seizures are categorized as focal or generalized depending on how much of the brain they involve when they begin. Triggers are generally the same for both types.

Focal Seizures

A focal seizure (also called a partial seizure) starts in a small area of the brain and may spread to other areas and eventually including both sides of the brain.

Symptoms of a focal seizure can include:

  • Twitches or other involuntary movements in one part of the body
  • Jerking or convulsions of the entire body
  • Decreased alertness
  • Complete lack of awareness

When a focal seizure is over, you may have lingering symptoms of weakness.

Generalized Seizures

In a generalized seizure, there’s widespread brain involvement from the beginning. Unlike in a focal seizure, in generalized seizures:

  • Changes in consciousness and whole-body involuntary movements are present from the start.
  • You’re less likely to have lingering symptoms when the seizure is over.

Some people have both focal and generalized seizures, while others may just have one type.

How to Identify Your Triggers

Part of learning to manage your condition is identifying seizure triggers to avoid them. You can start identifying triggers by keeping a seizure diary and making an entry after every seizure. Make a note of:

  • The time of day a seizure occurred
  • What you were doing
  • Where you were
  • How you felt
  • Whether common triggers were present

Once you notice a potential trigger, make a note each time that trigger occurs, whether or not it results in a seizure.

For example, if you had three seizures after especially stressful days at work, make a note about each day. If you have six stressful days in the next month but only have a seizure on one of those days, stress may not be a trigger for you.

Once you’ve identified your triggers, you can work with your healthcare provider on strategies for avoiding them.

Summary

Seizures can have many triggers, including lack of sleep, certain medications, poor nutrition, stress, illness, the menstrual cycle, and changes in the weather. They can be focal or generalized.

A detailed seizure diary can help you identify your seizure triggers. Then you can work on avoiding them whenever possible.

Work with your healthcare provider in making positive changes to control your epilepsy. Don’t change medications or dosages without their input.

FREQUENTLY ASKED QUESTIONS

  • Are there any warning signs before a seizure?

    Sometimes. Common seizure warning signs include:

    • Anxiety or other mood changes
    • Difficulty sleeping
    • Difficulty focusing
    • Dizziness
    • Behavioral changes
    • A feeling of butterflies in the stomach
    • A sense of fear or impending doom
    • Sounds/musical tones, tastes, or smells that are similar every time
    • A sense of déjà vu or familiar surroundings becoming unfamiliar
    • Distorted perceptions, such as feeling too small
  • Can you stop a seizure before it happens?

    If you have warning signs that a seizure is about to happen, you may be able to take steps to stop it. Some people report that smelling a strong odor or squeezing muscles around a twitching area can keep it from developing.

  • What can you do to prevent seizures?

    You can prevent seizures by:

    • Taking your seizure medication as directed
    • Consistently getting enough sleep
    • Eating a healthy diet
    • Avoiding or managing stress
    • Avoiding alcohol and recreational drugs
    • Avoiding illness
    • Staying away from flashing lights

     

 

Source: verywellhealth.com, Adrienne Dellwo, Smita Patel MD

 

Northern Ireland epilepsy numbers “highly concerning”

Northern Ireland epilepsy numbers “highly concerning”

Epilepsy numbers in Northern Ireland have been called “highly concerning” by Epilepsy Action following recently published UK epilepsy prevalence and incidence figures.

A UK research team published findings on the prevalence (number of people) and incidence (number of new cases) of epilepsy in the UK’s different nations in Seizure journal in January this year. The total number of people with epilepsy in the UK has increased to around 633,000 from 600,000 between 2011 when the last review took place and 2018. But the proportion of people who have epilepsy in the whole population of the UK has dropped slightly In that time.

However, the research also looked at England, Scotland, Wales and Northern Ireland separately. The findings showed higher rates of prevalence and incidence of epilepsy in Scotland, Wales and Northern Ireland compared to England and the UK overall. It also showed that the prevalence of epilepsy has increased in Wale and Northern Ireland when compared to the previous 2011 review.

Highest prevalence in the UK

Epilepsy Action has expressed particular concern about the numbers in Northern Ireland, especially considering the political situation at the moment.

In Northern Ireland, one in 83 people has epilepsy. This is the highest prevalence among the UK nations and compares to one in every 107 people in the UK overall. It is also an increase from the prevalence in Northern Ireland in 2011, which was one in 90 people. The number of new cases in Northern Ireland is just over 45 in every 100,000 people a year. This is higher than the UK overall, which is just over 42 new cases in 100,000 people a year.

“These new figures around the prevalence of epilepsy in Northern Ireland are hugely concerning and highlight a significant difference between Northern Ireland and the rest of the UK. This situation is further exacerbated by the fact that waiting times for neurology appointments in Northern Ireland are the highest in the UK.”

Break the stalemate

Carla Smyth, Northern Ireland services and project manager at Epilepsy Action, said: “These new figures around the prevalence of epilepsy in Northern Ireland are hugely concerning and highlight a significant difference between Northern Ireland and the rest of the UK.

“This situation is further exacerbated by the fact that waiting times for neurology appointments in Northern Ireland are the highest in the UK. We have heard from some people who have been told they face a wait of over four years for an appointment.

“We urgently need all political parties in Northern Ireland to get back round the table, break the current stalemate, restore power-sharing and work together to address the vast problems facing people with neurological conditions like epilepsy.”

The research also found that epilepsy levels were a third higher in poorer areas compared to wealthier areas around the UK. This link has been seen before, with Public Health England figures from 2001-2014 showing a three-times higher risk of epilepsy-related deaths in people living in poorer areas compared to wealthier areas.

The Seizure paper authors said this link between epilepsy numbers and poorer areas needs more research.

 

Source: epilepsy.org.uk,

One Diet Appeared Tops for Short-Term Seizure Control in Pediatric Epilepsy

One Diet Appeared Tops for Short-Term Seizure Control in Pediatric Epilepsy

— With better tolerability, modified Atkins diet the “sounder option,” according to researchers

In children with drug-resistant epilepsy, the modified Atkins and ketogenic diets were more effective than usual care in achieving large short-term reductions in seizures and short-term seizure freedom, a systematic review and network meta-analysis found.

Across 12 randomized trials, all three dietary interventions evaluated — ketogenic, modified Atkins, low glycemic index therapy (LGIT) — showed a short-term benefit (3 months or less) in seizure reductions of at least 50% compared with usual care, reported Dipika Bansal, DM, of the National Institute of Pharmaceutical Education and Research in Punjab, India, and colleagues.

But as described in JAMA Pediatricsopens in a new tab or windowonly the modified Atkins and ketogenic diets were effective for short-term seizure reductions of 90% or more compared with usual care and for achieving short-term freedom from seizures.

These may be more meaningful outcomes for children with a very high burden of daily seizures, such as those with drug-resistant epilepsy, according to the researchers.

While direct comparisons showed no significant differences, they concluded that with its better tolerability, the modified Atkins diet “may be a sounder option than ketogenic diet.”

Across dietary interventions, pooled results showed that 36% of children achieved short-term seizure reductions of 50% or more, 17% had reductions of 90% or more, and 10% achieved short-term seizure freedom. Data on intermediate outcomes were more mixed and only one study examined long-term outcomes.

Modified Atkins and ketogenic diets were both associated with more adverse event-related discontinuations versus usual care. Adverse events included constipation, lack of energy, and vomiting.

Participants also withdrew from the diets for reasons including “inefficacy, parental unhappiness, behavioral food refusal, dissatisfaction with randomization results, and food texture,” Bansal and co-authors noted. “This echoes with the fact that parental food habits opens in a new tab or window and feeding strategies determine their child’s eating behavior.”

Dietary therapies have long been used to treat the nearly 30% of pediatric epilepsy patients who are resistant to antiseizure medication, but investigations into the comparative efficacy of various interventions, along with their safety, have been lacking.

“Although epilepsy surgery is a curative treatment option for surgically amenable DRE [drug-resistant epilepsy], alternative modalities such as dietary therapies are often used on the failure of two or more appropriately chosen antiseizure medications while awaiting epilepsy surgery, in nonsurgical DRE, and specific neurometabolic disorders,” wrote Bansal and colleagues.

In addition to patient-specific factors such as primary diagnosis and child/family dietary preferences, selection of a drug-resistant epilepsy diet should take into account the interactions of different dietary therapies, including the possible adverse effects of carbonic anhydrase inhibitors and valproic acid in patients on a ketogenic diet, the group advised.

For their systematic review and network meta-analysis, the researchers identified 12 eligible randomized trials (11 open-label, one single-blinded) involving patients ages 18 years and younger with drug-resistant epilepsy, according to criteria opens in a new tab or window of the International League Against Epilepsy (failure of two or more appropriately chosen antiseizure medications).

Trials were conducted in multiple countries — India, Iran, Korea, The Netherlands, and the U.K. — and compared the three dietary interventions with each other or with usual care, which included ongoing use of antiseizure medications. Dietary interventions included the ketogenic diet (classic ketogenic diet or the medium-chain triglyceride ketogenic diet [MCT-KD]), modified Atkins, and LGIT.

Ketogenic diets “have been used for over a century with promising results,” according to the researchers, but adherence difficulties have limited their use.

“The classic KD [ketogenic diet], with a ketogenic ratio of 4:1, derives 80% of total energy intake from fat (mostly long-chain triglycerides; medium-chain triglycerides in MCT-KD) and the rest from carbohydrate and protein combined,” the authors explained. Less restrictive diets assessed included modified Atkins and LGIT, which use low-glycemic index foods to limit daily carbohydrate intake to 10-20 g and 40-60 g, respectively, without any fixed ketogenic ratios.

Overall, 907 patients in the studies were randomized (676 to dietary interventions, 257 to care as usual). Two-thirds of the children were boys, and the average age at enrollment was 4.6 years (SD 2.4). Initiation of dietary therapies was delayed to an average age of over 4 years in seven studies.

Mean age at seizure onset was 1.4 years (SD 1.6) and the mean seizure frequency was 27.1 per day (SD 31.8), ranging from 4 to 59.5 per day due to different seizure types in all likelihood, according to the researchers.

As noted, short-term seizure reductions of 50% or more was achieved with all three interventions when compared with usual care:

  • LGIT: OR 24.7 (95% CI 5.3-115.4)
  • Modified Atkins: OR 11.3 (95% CI 5.1-25.1)
  • Ketogenic: OR 8.6 (95% CI 3.7-20.0)

Limitations, the team noted, included within-study bias due to the open-label nature of most of the trials, the “clinical heterogeneity” of patients involved, and the “imprecision and unavailability of robust evidence for indirect comparison between different dietary interventions and for intermediate- and long-term outcomes.”

They added that “direct head-to-head comparison studies in the future are needed to confirm these findings further.”

 

Source: medpagetoday.com, Kate Kneisel

Flying high: Riverchase teen soars with epilepsy awareness efforts

Flying high: Riverchase teen soars with epilepsy awareness efforts

For six years, Elaina Burt has watched her cousin, Charlie Wilson, battle epilepsy caused by a gene mutation called SMC1A.

Charlie is nonverbal, stays in a chair all day long and is fed through a tube. She’s on medication for epilepsy, but if she didn’t have the medication, she would continuously have seizures all day, said Burt, a 17-year-old who lives in Riverchase.

“We’ve really had to grapple with the unfairness of that,” Burt said.

Burt, a junior at Briarwood Christian School who was named Miss Jefferson County’s Outstanding Teen last July, decided to take action. She started a nonprofit called Charlie’s Chance and now works to raise awareness about epilepsy, advocate for people suffering from it and raise money to enrich their lives.

She took it upon herself to organize a fundraising gala for Epilepsy Foundation Alabama this past November. The gala, Wings of Hope, drew about 200 people and raised more than $32,000.

Sara Franklin, a regional director for the Epilepsy Foundation who lives and works in Hoover, said she has been blown away by Burt and her contributions to the cause over the past two years.

Burt served as an ambassador for the Epilepsy Foundation, helping with events and encouraging family and friends to support seizure training so more people will know how to respond and help people when seizures occur.

She also helped call and email state legislators to gain support for the Seizure Safe Schools Act, which was passed by the Alabama Legislature and signed by Gov. Kay Ivey in the spring of 2021 and went into effect this school year. The act allows non-medical school personnel who are trained to administer nasal anti-seizure medication to do so in emergency situations when a school nurse is not on campus.

Burt has been a tremendous help, Franklin said. “She’s just had so many good ideas about how to raise epilepsy awareness and train people in seizure first aid,” Franklin said.

Also, Franklin was impressed that Burt took her support to the next level by coming up with the idea for a fundraising gala and organizing it herself, with some assistance from her mom. The event sold out and was a great success, Franklin said.

With limited staff, the Epilepsy Foundation Alabama organization didn’t have the bandwidth to do that themselves, Franklin said.

The Wings of Hope Gala was held at the Southern Museum of Flight, enabling Burt to combine her passion for epilepsy awareness with her passion for flying.

From a young age, she always thought flying was something she would like to try, she said. Her grandfather, Bob Wall, is a pilot and paid for Burt’s first flying lesson as a 16th birthday present.

“I just fell in love from there,” she said. “It’s really just snowballed into one of my favorite passions.”

Her friends thought she was crazy for wanting to fly a plane, but she liked the challenge of doing something in a male-dominated field, she said. She hopes to study aviation at Auburn University and become a commercial airline pilot for Delta, she said.

Burt flies with Over the Mountain Aviation at the Shelby County Airport. She already has completed her first solo flight, first cross-country solo flight and first night flight and is scheduled for her Federal Aviation Administration check ride on Feb. 4 to get her private pilot license, she said.

While Burt is Miss Jefferson County’s Outstanding Teen for 2023, she hasn’t been in a lot of those types of competitions. So far, she has been in only three. She won her very first preliminary and became Miss Leeds Area’s Outstanding Teen in June 2021 and went on to be named second runner-up in the Miss Alabama’s Outstanding Teen competition in March 2022. The Miss Jefferson County’s Outstanding Teen competition last year was her third competition, and her fourth will be the Miss Alabama’s Outstanding Teen competition this coming March.

Burt said she feels honored to represent Jefferson County in this year’s state competition and has been thrilled to have already received $25,000 in scholarships through these competitions.

She won the Jessica Baeder Community Service Award at the state competition last year for her work involving epilepsy awareness.

In addition to flying planes and working to battle epilepsy, Burt has several other hobbies. She has been a member of the track team and cheerleading squad at Briarwood since her freshman year and currently participates on both the varsity sideline football and basketball cheerleading squads and varsity competitive cheer squad.

She also has been dancing since age 2 and currently dances with the Birmingham Dance Theatre in Hoover. When she was younger, she did many types of dancing, including ballet, hip hop, jazz, tap and clogging, but she now focuses on ballet en pointe, which is the talent she performs in the scholarship competitions.

Burt is the daughter of Zane Burt and Eric and Kalika Gibbons.

 

Source: hooversun.com, Jon Anderson

Korea has no policy to improve epilepsy patients’ life: IBE chief

Korea has no policy to improve epilepsy patients’ life: IBE chief

The International Bureau for Epilepsy (IBE) has called for Korea to enact the bill to “manage epilepsy and support epilepsy patients” pending at the National Assembly Committee for Health and Welfare.

“The government of the Republic of Korea took part in the unanimous approval of the Global Action Plan on Epilepsy and other neurological disorders in the general assembly of the World Health Organization in May last year,” said Francesca Sophia, chairperson of IBE in a statement on Tuesday.

Stressing that epilepsy is one of the top five causes of neurological disorders and that the government should make it a public health policy priority, the IBE head pointed out that there is no policy to improve the lives of epilepsy patients in Korea.

“Twenty-five percent of epilepsy is preventable, and good planning can improve disease outcomes and patient quality of life,” Sophia said. “However, Korea lacks epidemiological data on epilepsy and indicators on the quality of life and experience of epilepsy patients.”

She went on to say, “In particular, in Korea, patients are discriminated against at school and work due to serious prejudice against epilepsy, she noted. As a result, the quality of life of patients and their families is decreasing due to social stigma, and superstitions and misinformation related to epilepsy are also prevalent.”

The IBE head then called for Korea to enact epilepsy patient-supporting law to prevent discrimination against people with the disease.

“The member countries of WHO are urging their governments to rectify discriminatory laws against epilepsy patients and are striving to protect their human rights,” Sophia said. “Korea, too, should enact the Epilepsy Support Law pending at the National Assembly, setting an example for other WHO members.”

Kim Heung-dong, who heads the Korean Bureau for Epilepsy, also said, “There is a serious lack of social safety nets to protect people with epilepsy. The government should take action as it has adopted the action plan. We will strengthen communication and cooperation across the country to enhance the rights and interests of epilepsy patients and improve their quality of life.

Currently, there are two law bills on supporting epilepsy patients pending at the National Assembly Health-Welfare Committee’s subcommittee for examining law bills, each proposed by Rep. Nam In-soon of the opposition Democratic Party of Korea and Rep. Kang Ki-yoon of the ruling People Power Party. The bills contain ways to prevent and treat epilepsy, protect and support epilepsy patients and research, improve awareness, and prohibit discrimination.

Source: koreabiomed.com, Kim-Ju-yeon

Sleep WELL

Sleep WELL

If you are experiencing stress and have tried the best possible ways to come out of it, then here’s something to your rescue: Weighted blanket

 

There are several simple ways to improve your sleep quality, from cutting out cups of coffee to avoiding any daytime naps – but there are also bedroom additions to consider; specifically weighted blankets. While a weighted blanket will certainly make you feel cosier in your bedroom, it also has plenty of benefits that will not only contribute to a better night’s sleep but can also help with several health problems. Experts have outlined eight benefits of a weighted blanket, including chronic pain relief and decreasing the frequency of seizures.

Relieves anxiety symptoms
Anxiety is a mental health disorder experienced by many with approximately 275 million people around the world suffering from this. Some of the common symptoms include fast heart rate and quick breathing which can be relieved with a weighted blanket. It puts the autonomic nervous system into rest mode and promotes feelings of relaxation.

Promotes deep sleep
Over 35 per cent of Americans get under seven hours of shut-eye at night, with nearly half of the nation claiming that they feel tired in the daytime between three to seven days each week. Weighted blankets can combat the struggles of insufficient sleep similarly to the way they help anxiety, by calming the heart rate to ensure you fall into a deep sleep. Plus, they use deep pressure stimulation which increases levels of melatonin, known as the sleep hormone.

Lowers your stress response
There are many health problems that can occur from an overactive sympathetic nervous system, which triggers our fight or flight response, such as obesity and kidney disease. The deep pressure stimulation in a weighted blanket works to calm nerves and lowers physiological stress levels, preventing these harmful health issues.

Eases pain
Chronic pain including headaches, arthritis, and back pain affects 1 in 5 Americans. Research has shown that sleeping with a weighted blanket can reduce pain; a recent study of 94 chronic pain patients discovered that the gentle pressure from a 15lb weighted blanket eased their symptoms.

Helps with Alzheimer’s and dementia
Some of the symptoms that people with Alzheimer’s and dementia may face are difficulty sleeping due to agitation. Given that weighted blankets promote relaxation by calming nerves and reducing anxiety, they can be used as a non-drug option for dementia and Alzheimer’s sufferers. As well as this, a previous case study reflected a decrease in night-time wandering, hallucinations, and emotional disturbances for a patient with Alzheimer’s by using a weighted blanket.

Reduce the incidence of seizures
Epilepsy is one of the most common conditions affecting the brain, with 5.1 million people in the U.S having a history of the condition. Relaxation techniques can work effectively alongside epilepsy medication to reduce the frequency of seizures. One of these techniques is using a weighted blanket as it has deep touch pressure, lowering stress. Although, it’s important to note that some forms of epilepsy make you more prone to seizures when you feel deeply relaxed therefore, please consult with a doctor.

Decreases cortisol levels
Cortisol, the stress hormone, has been linked to many health issues, including heart disease, weight gain, and high blood sugar – so it’s important to keep the levels low when you can, which is possible with a weighted blanket. Studies have found that deep pressure can lower our cortisol levels and increase serotonin production.

Boosts your mood
In addition to the benefits of improving mental disorders and easing pain, weighted blankets can act as a mood booster. Due to the pressure of a weighted blanket, the production of oxytocin increases, which is a feelgood hormone – and combined with the decrease in cortisol, this works to improve your overall mood.

 

Source: punemirror.com, IANS

Exercise is beneficial for people with epilepsy. Many physicians still don’t encourage it.

Exercise is beneficial for people with epilepsy. Many physicians still don’t encourage it.

Newswise — Exercise helped Delhi college student Vinay Jani gain strength and lose weight. But in 2005, he began having seizures. Seizure control was elusive, and Jani went into a depression. He stopped exercising and gained back more than half the weight he had lost.

After a hospital stay due to a seizure, Jani went back to the gym. Because he was still having seizures, he asked friends to watch out for him during his workouts.

His seizures were controlled for a time, but then returned. He changed neurologists, tried new medications, and eventually underwent surgery. Through it all, he exercised. His gym visits led to indoor cycling, which led to outdoor endurance cycling. A few years ago, he added running to the mix.

Today, Jani is an endurance cyclist, marathoner, and epilepsy advocate who encourages everyone with epilepsy to be physically active—for fitness reasons, but also for social and emotional ones.

“Many times, people isolate themselves when they are diagnosed with epilepsy,” said Jani. “They don’t share their hearts. They start living alone. If they’re going out for a workout, any kind of workout, they will meet people and they can get relief from stress.”

ILAE recommendations on exercise

Studies suggest that exercise improves physical fitness, mood, thinking and memory, and overall quality of life in people with epilepsy—all benefits that apply to people without epilepsy as well. Other than in rare cases (exercise-induced reflex epilepsy), physical activity does not increase the risk for seizures. But surveys have shown that people with epilepsy are less active than the general population, tend to perceive their health as poor, and have poorer objective physical fitness on muscle tests, compared to people without epilepsy.

People with epilepsy often have been excluded from sports and exercise, usually due to fear, overprotection, and ignorance about the specific benefits and risks associated with such activities. Many may also avoid physical activity due to these same fears and misperceptions.

In 2015, the  International League Against Epilepsy (ILAE) Task Force on Sports and Epilepsy published a report that provided guidance on which sports and types of exercise are considered safe, depending upon seizure frequency and type.

Jaime Carrizosa and Ricardo Arida spearheaded a recent survey of Latin American neurologists to assess their knowledge of the importance of physical activity in people with epilepsy, as well as their awareness of the ILAE report.

“What surprised us, in a positive way, is that most neurologists know the benefits of exercise in epilepsy,” said Arida, of the Federal University of São Paulo, Brazil.

More than 90% of surveyed neurologists supported physical activity for people with epilepsy and agreed that exercise can reduce comorbidities. But only 40% were aware of the ILAE recommendations, and 35% said they had no information about physical activities for people with epilepsy.

“It’s one thing to be aware of the benefits of exercise, and another to discuss exercise with a patient and prescribe or recommend it,” said Carrizosa, professor of child neurology at the University of Antioquia, Medellín, Colombia. “How many of them tell patients about how it’s important to do some physical activity 3 to 5 times a week for a certain amount of time? Or do they only talk about it if the patient asks about it?”

The researchers completed a literature review on physical activity and epilepsy, said Carrizosa. “We found fewer than 42 people who experienced an association between exercise and seizures, over more than 30 years of research literature,” he said. “I would say in more than 99.5% of people, there is no association.”

Widespread misconceptions about exercise

“I think there’s a lot of widespread misconceptions about exercise in people with epilepsy, which is problematic,” said Hailey Briglia Alexander, a neurologist at Wake Forest Baptist Health in Winston-Salem, North Carolina, USA. “I think it’s a definite gap that people who care for people with epilepsy are not up to date on the current knowledge.”

People with epilepsy may still be afraid to exercise, or their family members may be afraid to let them. Alexander said more information and better clinician-patient communication are needed.

“We don’t really know what kind of fear it is,” she said. “Fear of injury from a seizure? Fear of embarrassment? Fear that other people won’t know what to do if they have a seizure? Medical providers can help to dispel all of these fears, but we have to talk about it.”

For physicians with time constraints, Alexander suggests offering a handout on exercise and epilepsy, or referring patients to the Epilepsy Foundation website, which has a section on exercise.

Alexander noted that some people with epilepsy have risk factors for cardiovascular disease that may place them at greater risk than the general population. And while some of these risk factors can’t be controlled, physical activity can improve cardiovascular health in people with epilepsy, just as it does in others.

If providers wait for patients to ask about exercise, it may never happen, she said. “At least in my experience, patients almost never bring up the topic. That may be different in pediatrics where parents may ask about it, but in the adult realm I don’t get the question a lot.”

“Exercise may be something we should be pushing for,” she said. “Not just answering questions about it if it comes up in clinic but initiating the conversation and encouraging exercise, just like we counsel people on the importance of adequate sleep and not missing doses of medication.”

ILAE Task Force recommendations on exercise: A summary

  • People who are seizure free for at least 12 months, and those with resolved epilepsy*, may participate in any type of exercise or physical activity.
  • Except those with exercise-induced reflex epilepsies, anyone with epilepsy may participate in Group 1** activities.
  • Most people with epilepsy may participate in Group 2** activities; some should consult a neurologist before starting.
  • Group 3** activities are generally barred for people with continuing seizures, but some activities may be considered, with restrictions, at a neurologist’s discretion.

*Resolved epilepsy is defined as no seizures for at least 10 years and no anti-seizure medication use for at least 5 years.

**See tables for lists of activities by group, and for specific recommendations.

Facing fears

The clinician can make a difference by addressing people’s fears through conversations.

Sports and exercises categorized by group – click to expand

“Physicians can impact a patient’s decision to be more physically active or to initiate an exercise program,” said Arida. “They can help patients be more confident in doing exercise and talk about which activities they might be more comfortable doing.”

Addressing the fear of having a seizure during exercise also is important.

“For people who are well controlled, this is not a realistic fear,” said Jane Allendorfer, associate professor of neurology at the Heersink School of Medicine, University of Alabama, Birmingham. USA. “Hearing that from a physician, someone they look up to for medical advice, would be really helpful. To be told, ‘You are seizure free; there is nothing preventing you from doing physical activity.’”

There are other barriers to physical activity in people with epilepsy:

  • Access to a safe and appropriate place to exercise, such as a gym or walking trail
  • Access and availability of group activities
  • Costs, for membership, lessons, transportation, or equipment
  • Depression and anxiety, which can make it difficult to initiate and continue exercise
  • Fear of being stigmatized by having a seizure in public

“Some people may want to do sports with others, but can’t find a way to do that,” said Carrizosa. “Or they may have an opportunity to do it but feel afraid or ashamed due to their epilepsy. They don’t want to disclose that they have epilepsy, and that prevents them from engaging.”

While stigma can deter people from exercise, exercise can help to reduce stigma and bolster self-advocacy. Jani said he was open with his gym-going friends about his condition so they could help him be safe while working out. When he began outdoor cycling, his trainer and co-riders were aware of his condition and learned what to do if he had a seizure. When he joined a running club in Delhi, he told the group that he was a person with epilepsy and would need someone to accompany him.

Before his surgery, Jani had auras, so he could stop his activity and alert someone. He remembers only one seizure during physical activity in 15 years; it occurred while cycling outdoors. “When I had the aura, I stopped my bicycle and informed my co-rider,” he said. “My co-riders keep my medicines with them.”

What types of activity are safe?

“If you’re seizure free, there shouldn’t be anything stopping you,” said Allendorfer. “Your risk of injury is the same as anyone else. If you have seizures, there’s some caution depending upon the type of sports or exercise you engage in.”

The tables in this article are reproduced with minor alterations from the ILAE consensus report.

What the research shows

Recent research on physical activity in people with epilepsy has found improvements in quality of life and cardiovascular health. Some studies that used EEG monitoring found that interictal epileptiform discharges decreased during the post-exercise period.

Controlled physical activity trials in people with epilepsy are complex. Allendorfer ran a recent pilot study on the effects of exercise on cognition. Study participants completed weight training sessions, as well as exercise on an indoor recumbent bicycle. During the six-week program, participants visited the study site three times per week for supervised training.

“Memory is the number-one cognitive complaint in people with epilepsy, and there’s no pill you can take to improve memory function,” she said. “In our study, there were improvements in verbal learning and in verbal recognition memory in the group that exercised, and a slight decline in the group that didn’t.”

Allendorfer saw changes in hippocampal functional connectivity on MRI that correlated with the changes in verbal learning and memory. She’s now running a randomized controlled trial to further explore the effects of exercise on cognition.

“The people who did the pilot study were really thankful and encouraged that they could exercise to the level that they did,” she said. “They worked hard! And afterward, we were able to give them the specifications of their workout: What they did during the study, the settings for all of the gym machines and the intervals, and so now they can walk into any gym and know what they’re doing.”

Multiple benefits

Gym training isn’t accessible to everyone, but everyone can start somewhere, said Jani. “People can involve themselves in any kind of physical activity that works for them. They can go for a walk or a run, they can do yoga. And exercise gives you options for socializing, getting out and meeting people to work out together.”

The impact of a healthy lifestyle is important to remember, said Carrizosa. “There’s a lot of talk about new technology, new medications, surgeries and so on, but there is not enough about what people can do in everyday life—like getting exercise,” he said. “It’s something you can do worldwide, wherever you are, and it has a great impact. So I think it is important to increase awareness.”

 

Souese: newswise.com, International League Against Epilepsy

First as epilepsy and mental health survey launched

First as epilepsy and mental health survey launched

A CHARITY has today launched Scotland’s first-ever national survey seeking to understand the effect epilepsy can have on the mental health of someone who has the neurological condition.

People living with epilepsy, particularly those with uncontrolled and frequent seizures, are more likely to experience mental health issues such as anxiety or depression, as well as to become socially isolated.

Through the survey, entitled It’s Time to Talk about Epilepsy, Epilepsy Scotland wants to hear from as many people as possible who are living with epilepsy, including those whose seizures are controlled through medication.

The survey was launched by SNP MSP Alasdair Allan and mental health campaigner and former Labour MP Danielle Rowley. They are two of the estimated 58,000 people living with epilepsy in Scotland.

Allan said: “While public understanding of epilepsy is much greater than it used to be, it is important to continue to raise awareness and to highlight that the condition is more than seizures.

“For example, there are a range of challenges in the lives of many people with epilepsy which makes it more common to experience issues related to mental health. This national survey from Epilepsy Scotland is an important tool in aiding our understanding of the effect epilepsy can have on mental health and what specific support is required.

“Talking about mental health is rarely easy but I would encourage as many people as possible to take part.”

Rowley said: “As someone living with epilepsy, I am delighted to support the launch of an important national survey.

“There are estimated to be around 5600 people here in Edinburgh and 58,000 across Scotland living with epilepsy, including many with uncontrolled seizures which can have a significant impact on their day-to-day life and their mental wellbeing.”

Mental health conditions including anxiety and depression are common for people living with epilepsy.

Epilepsy Scotland policy and communications manager Ross Cunningham said: “Epilepsy can also have a very significant impact on someone’s relationships and family life, education and employment opportunities, the ability to drive and on mental health and wellbeing.

“We want to hear about the experiences of people living with epilepsy in every corner of Scotland to better inform ourselves and policy makers about the extent to which epilepsy can affect someone’s mental health so we can highlight the specific support that is required.”

The survey will run until Monday, March 13.

Source: thenational.scot, Jane Cassidy

Family Planning With Epilepsy

Family Planning With Epilepsy

 Epilepsy impacts 1.3 million women of childbearing age across the United States. Couples with epilepsy often have concerns about passing the condition to their children, fertility, and pregnancy safety.

Though epilepsy can present challenges, positive pregnancy outcomes are possible. This is especially true with planning and guidance from your healthcare team.

This article reviews how antiepileptic drugs (AEDs) may affect fertility, risk factors affecting a couple’s ability to get pregnant, pregnancy safety, and family planning with your healthcare provider.

Medication for Epilepsy and Fertility

When it comes to family planning, managing epilepsy and keeping seizures under control is key. But antiepileptic drugs (AEDs) can have unwelcome side effects regarding fertility (the ability to get pregnant) for both sexes.

Not all antiepileptic drugs carry the same potential side effects. Some AEDs affect sex hormones, while others affect the areas of the brain responsible for sexual desire and function.

 

Old and New Generation AEDs

Older-generation AEDs are more likely to cause fertility problems and sexual dysfunction than newer-generation AEDs.

Though this is not an exhaustive list, examples of older-generation AEDs include:

  • Dilantin (phenytoin)
  • Tegretol, Curatil (carbamazepine)
  • Belvo, Depakote, Dyzantil, Convulex, Syonell (valproic acid)
  • Solfoton (phenobarbital)

Newer-generation AEDs include:

  • Lamictal (lamotrigine)
  • Trileptal (oxcarbazepine)
  • Keppra (levetiracetam)

AED fertility effects are often dose-dependent. For example, gabapentin-induced sexual dysfunction occurs more often with daily doses larger than 900 milligrams (mg).

Women

Seizures can harm female fertility. For example, hormone fluctuations trigger certain seizures, especially for those with catamenial epilepsy. This often occurs during ovulation (egg production), when a woman is most likely to conceive.

Some hormonal medications that treat catamenial epilepsy will alter or stop a woman’s menstrual cycle. Antiepileptic drugs (AEDs) can make it more challenging for women to become pregnant by causing:

  • Disruption of hormone levels
  • Menstrual cycle irregularities
  • Decreased libido (sex drive)
  • Weight gain (which can lead to metabolic problems)

In addition, higher AED doses tend to increase the risk of ovulation problems.

Men

For some, epilepsy may cause male infertility related to sperm quality, count, and mobility. Certain AEDs can also contribute by causing:

  • Decreased sex hormones (especially enzyme-inducing AEDS)
  • Decreased libido
  • Problems with sperm count and quality
  • Sexual or erectile dysfunction

Not all AEDs cause the same types and levels of male fertility problems. For example:

  • Trileptal (oxcarbazepine), Keppra (levetiracetam), and Lamictal (lamotrigine) don’t significantly affect sexual function or hormones.
  • Trileptal (oxcarbazepine) may improve sperm quality but occasionally causes orgasm and ejaculation problems.
  • Lamictal (lamotrigine) is less likely to cause erectile dysfunction than Depakote (valproic acid) and Tegretol (carbamazepine).

Other Factors Affecting the Ability to Get Pregnant

Those with epilepsy have lower pregnancy rates than those without it. However, fertility rates (ability to get pregnant) are similar. Experts agree that multiple factors contribute to these statistics, not just the disease alone.

Hormones

The endocrine system is a web of organs and glands working with hormones to assist the body in many functions, including reproduction.

Epilepsy and AEDs can interfere with this balancing act by disrupting the hypothalamicpituitary axis and gonadotropin-releasing hormones (GnRH). This causes problems with reproductive hormone development and regulation.

Disruptions in female hormones such as estrogen and progesterone can lead to menstrual cycle disruption and a decrease in sexual interest or enjoyment.

An imbalance of male sex hormones, such as testosterone, can cause decreased sex drive and sexual dysfunction (problems with erection, orgasm, or ejaculation).

Menstrual Cycles

Epilepsy and AEDs can cause an imbalance of the following hormones:

  • Estrogen
  • Progesterone
  • Luteinizing hormone (LH)
  • Follicle-stimulating hormone (FSH)
  • Gonadotropin-releasing hormone (GnRH)

These imbalances can cause fertility problems by slowing or stopping ovulation and menstrual cycles (periods).

Hypothalamic Amenorrhea

A lack of gonadotropin-releasing hormone (GnRH) causes hypothalamic amenorrhea (no menstruation). This means the hypothalamus (an endocrine gland in the brain) stops producing GnRH, which triggers a woman’s menstrual cycle.

Catamenial epilepsy affects about 40% of women with epilepsy. Their seizures frequently worsen with hormone fluctuations. Treatment often involves hormones that stop menstrual cycles, impacting fertility.

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a condition that affects many women with epilepsy, especially those who take valproic acid. Symptoms include excessive hair growth, weight gain, and difficulty sleeping.

PCOS stems from an imbalance of hormones and can impact fertility by causing irregular periods and stopping ovulation. It also increases the risk of miscarriage.

Mental Health

Various mental health disorders, including depression, anxiety, and obsessive-compulsive disorder (OCD), are more common in individuals with epilepsy.

Mental health disorders and treatment can cause fertility issues or sexual problems due to the following:

  • Decreased self-esteem
  • Social isolation
  • Sexual dysfunction
  • Decreased sexual desire
  • Inadequate vaginal lubrication
  • Problems with interpersonal interactions

For some, a fear that sexual activity can induce seizures can negatively impact fertility.

Risks During Pregnancy Related to Epilepsy

Over 90% of pregnancies involving women with epilepsy proceed without any significant issues. However, seizure control and epilepsy care can change during pregnancy, making it high-risk.

Medication

The body’s physiological and hormonal changes during pregnancy can affect how AEDs work. Your healthcare provider might adjust your dosage or monitor AED blood levels throughout pregnancy. They may also change your AED to minimize the risk to your unborn baby.

Can Paternal Exposure to AEDs Harm the Baby?

For males planning a family using their own sperm, consider speaking to your healthcare provider before trying to conceive. They can check the latest research to ensure the AED you take will not cause potential harm to the baby you conceive.

Seizures

Tight seizure control is essential during pregnancy because prolonged seizure activity can decrease the oxygen supply to your unborn infant. It’s important to avoid triggers, get plenty of rest, and take AEDs as prescribed.

If your seizure activity changes with pregnancy, notify your healthcare provider immediately. They can monitor you and your medication to help minimize seizure risk.

Potential Changes to Epilepsy During Pregnancy

Your type of epilepsy and treatment can affect your body’s reaction to pregnancy. For some, hormone changes and stress might increase or decrease seizure activity. However, many people have the same amount of seizures.

Those with catamenial epilepsy may have more seizures if they have to stop hormone treatments while trying to conceive. The hormone fluctuations that occur during or after pregnancy can also be a trigger.

Miscarriage

Miscarriage rates for women with epilepsy double when the pregnancy is unplanned. This is compared to those with epilepsy who plan their pregnancy and the general population.

When planning a family, it’s important to note that some AEDs reduce how well hormonal birth control works. This is especially true with enzyme-inducing AEDs.

Birth Defects

In the general population, the rate of birth defects is 2.3%. This increases to 7% for mothers with epilepsy. Though the exact cause of this is unknown, it’s most likely due to poor seizure control (depriving the baby of oxygen) and taking certain AEDs during pregnancy.

AEDs can increase the risks of congenital (present at birth) disabilities such as:

  • Cleft lip and palate
  • Spina bifida (cleft spine)
  • Developmental problems
  • Cognitive impairment (lower IQ)

The risk appears greater with older-generation AEDs, higher doses, and polypharmacy (taking multiple AEDs together). Healthcare providers typically avoid Depakote (valproic acid) during pregnancy. They may also avoid Topamax (topiramate), especially during the first trimester and in higher doses.

Though newer-generation medications carry a lower risk of birth defects, they are not risk-free, especially in higher doses.

Folic Acid

Your provider will likely recommend taking folic acid supplements during pregnancy. It reduces the risk that your baby will be born with neural tube defects such as spina bifida. Studies also link folic acid with a lower risk of the baby developing epilepsy.

Preparing for Pregnancy

You can begin pregnancy planning by making healthy lifestyle choices. This includes:

  • Getting enough sleep
  • Maintaining a healthy weight
  • Eating a healthy diet
  • Avoiding cigarettes, alcohol, caffeine, and illegal drugs

Though it’s not always possible, discussing your pregnancy plans with your healthcare provider before getting pregnant is important. It’s safer for you and your unborn baby. It is also essential to:

  • Notify your healthcare provider(s) if you have changes in seizure activity
  • Go to all prenatal appointments (when pregnant)
  • Take prenatal vitamins and folic acid (if prescribed)

Talk to Your Healthcare Provider About Family Planning

If you’re considering starting a family, have an open conversation with your healthcare team. It’s best to reach out sooner rather than later. You can discuss the best way to prevent breakthrough seizures, possible congenital disabilities, and potential fertility problems.

Your team may suggest expert consultations, changes in medication or lifestyle, frequent monitoring, and genetic testing (to evaluate the risk of your baby having epilepsy).

Summary

Prospective parents with epilepsy often have concerns about fertility and safety during pregnancy. Positive pregnancy outcomes are possible with proper planning and guidance from your healthcare team.

When it comes to family planning, managing epilepsy and keeping seizures under control is critical. Ask your healthcare provider if your antiepileptic drugs (AEDs) can cause issues with your hormones, fertility, menstruation (period), and sexual function and cause potential birth defects.

 

FREQUENTLY ASKED QUESTIONS

  • Is epilepsy genetic?

    Studies show that more than half of epilepsies have a genetic component. Research also links specific genetic mutations to certain epilepsy types, such as genetic epilepsy with febrile seizures plus (GEFS+) and Dravet syndrome. There is also a familial or hereditary connection. Children of mothers with epilepsy are at greater risk than the general population and children of fathers with epilepsy.

  • Do people with epilepsy have high-risk pregnancies?

    Over 90% of pregnancies for women with epilepsy proceed with no complications. Pregnancy for those with epilepsy is high-risk because seizure control can change, miscarriage risk is higher with an unplanned pregnancy, and your healthcare provider may need to adjust treatment during pregnancy

    Why should epileptic women take folic acid before and during pregnancy?

    Healthcare providers recommend folic acid to most pregnant people. It plays a crucial role in developing the nervous system (spinal cord and brain). Folic acid reduces the risk of babies being born with neural tube defects such as spina bifida. Studies also link folic acid with a lower risk that the baby will develop epilepsy.

     

     

Source: verywellhealth.com, Brandi Jones MSN-ED RN-BC, Huma Sherikh

Personalized Brain Modeling for Clinical Epilepsy Trial Breakthroughs

Personalized Brain Modeling for Clinical Epilepsy Trial Breakthroughs

Researchers of the Human Brain Project (HBP) have published a new study in Science Translational Medicine presenting advanced brain modelling methods for epilepsy clinical care. The article, which is featured on this week’s cover of the journal, describes the methodology used in the EPINOV clinical trial (Improving Epilepsy surgery management and progNOsis using Virtual brain technology). The personalized brain modelling approach has been developed over several years in the HBP, and is supported by the digital research infrastructure EBRAINS.

To create personalized brain models, the researchers use a simulation technology called The Virtual Brain (TVB), which HBP scientist Viktor Jirsa has developed together with collaborators. For each patient, the computational models are created from individually measured anatomy, structural connectivity and brain dynamics data.

For epilepsy, the approach is currently being tested in a large-scale clinical trial to provide a computational, predictive tool in surgery preparation

Even though for many patients, epileptic seizures can be controlled by drugs, almost one-third of patients do not respond to medication. For this group, surgical removal of the epileptogenic zone, the brain area from which the seizure originates and propagates, presents the only treatment option. Currently, the procedure has a 60% success rate.

The TVB technology enables clinicians to simulate the spread of abnormal activity during epileptic seizures in a patient’s brain, helping them to identify the target areas better. The simulations are personalised for each patient, effectively providing a virtual epileptic patient (VEP) tailored to each individual real one. The approach has been tested in several retrospective studies, the latest one published this year in Epilepsia. The clinical trial is expected to run until 2025.

Ongoing work in the HBP uses the EBRAINS research infrastructure to further improve the method’s predictive power with new high-resolution data from the HBP’s multilevel human brain atlas. “Computational neuromedicine needs to integrate high-resolution brain data and patient specificity,” explains Jirsa. “Our approach heavily relies on the research technologies in EBRAINS and could only have been possible in a large-scale, collaborative project such as the HBP.”

 

Source: miragenews.com,

Life in my body with epilepsy: “I can’t change my condition, but I can change my mindset towards it”

Life in my body with epilepsy: “I can’t change my condition, but I can change my mindset towards it”

Olivia Salvati, a 25-year-old paralegal and law student shares her story of being diagnosed at 11

When I was 11 years old, I was trying on a new pair of shoes at the shopping centre with my mum. The next moment, we were outside the bookshop – I didn’t know how we’d got there. It felt like time had somehow skipped forward, as if someone had accidentally sat on the remote control to my life.

This happened again. And again. Soon enough, I was at the doctor’s office and my mum explained what had been going on, listing my symptoms, which included: vacant stares, long pauses and memory loss. I was referred to a specialist, and tests confirmed there was seizure activity in my brain. What I’d been experiencing were absence seizures: brief but sudden lapses of consciousness. Everything happened pretty quickly after that. I had tests, and more tests and was told “try this medication”, or “try that one”. I felt like a guinea pig.

After my diagnosis, I noticed a change in my family dynamic right away. Everyone around me was suddenly on edge. To me it felt very weird, they constantly had eyes on me, nervously checking in. Having epilepsy meant my childhood ended quite abruptly, because I had to think like an adult – as much as they loved me, my mum and dad couldn’t fix this for me.

A few years later, at the age of 14, I had my first tonic-clonic seizure – a fit involving stiffening and jerking of the body – this is what most people think of when I tell them I’ve got epilepsy. It was a struggle getting to grips with a new element of my epilepsy, with my tonic-clonic seizures becoming a weekly occurrence. This totally depleted my confidence. Having your teachers, school friends and even your crushes see you in such a vulnerable state felt so embarrassing – even though it shouldn’t have.

I was put on to a special medication to manage my tonic-clonic seizures, but the side effects were severe and I was overcome with near-constant anger and anxiety. Balancing seizures, puberty and the side effects of the medication was tough, so I was grateful when my medication was changed. Although, it took about six months until I felt like myself again.

Annoyingly, though, as soon as one area of my life evened out, something else fell apart. At 18, I headed off to university, full of excitement for the future. But I was forced to drop out as my seizures worsened. Believing that epilepsy had put an end to my dreams, I fell into a deep depression.

Through the help of therapy, however, I learned to accept that, although I can’t change my condition, I can change my mindset towards it. Therapy – and the right medication, which has taken ten years to find – has also made my seizures more manageable, which I think shows how much your physical and mental health are connected.

Shortly after dropping out of uni, I found the strength to return and soon I’ll be a human rights solicitor. Looking back, I see that, although epilepsy is a challenge, it hasn’t stopped me from achieving my goals. I’ve arrived at every destination, just with a detour along the way.

What helps Olivia

Setting boundaries

People think that epilepsy is being triggered by flashing lights and involves foaming at the mouth – but the condition is so much more complex than these stereotypes would have you believe. My triggers are actually stress, anxiety and tiredness, so I’m more wary of my mental health and lifestyle choices than I am of flashing lights. If a friend asks to hang out on Saturday but I had a busy Friday, for example, I’ve learnt to say no and respect what my body can handle. It’s been a hard lesson to learn – FOMO is real! – but boundaries protect my health.

Self-care at work

It can be daunting to tell an employer about a health condition, but being honest with mine led us to create a care plan. Now my team is aware of how to help me if I have a seizure at work, and there’s flexibility for me to take time off when I need to recover, as seizures can sometimes wipe me out for days.

Rest, rest and more rest

There are a lot of misconceptions about invisible illnesses in general, but one that affects epilepsy sufferers in particular is how up and down our health can be. I might need to take time off work one day, but the following day I’m totally fine – other times, I might need longer to recover. After a tonic-clonic seizure, for example, I might be unable to get out of bed for a few weeks. I recently ran a marathon to support Young Epilepsy, and that was nowhere near as physically exhausting as having a tonic-clonic seizure. Absence seizures are much easier to recover from though. The rest and recovery time that comes with epilepsy is something people can struggle to wrap their heads around.

No more comparison

Social media has made us experts at comparing ourselves to others, so it can be tough seeing people my age achieving goals that I haven’t. When I feel this way, I remind myself that I’ve been through a lot and I’ll get there in my own time.

 

Source: cosmopolitan.com, Jade Biggs

Fear of Public Places Is Common in Adults With Epilepsy

Fear of Public Places Is Common in Adults With Epilepsy

Summary: Phobic and agoraphobic symptoms are common in those with epilepsy and result in a poorer quality of life.

Source: Wake Forest University

About 5.1 million people in the U.S. have a history of epilepsy, which causes repeated seizures. According to the Epilepsy Foundation, epilepsy is the fourth most common neurological disorder.

While current research has shown an increase in anxiety and depression among people with epilepsy, little is known about this population and agoraphobia, an anxiety disorder that involves the fear of being in a public place or in a situation that might cause panic or embarrassment.

However, a recent study from Heidi Munger Clary, M.D., M.P.H., associate professor of neurology at Wake Forest University School of Medicine, shows that phobic and agoraphobic symptoms are common and associated with poor quality of life in people with epilepsy.

The study appears online in Epilepsy Research.

“We know that agoraphobia can lead to delays in patient care because of a reluctance to go out in public, which includes appointments with health care providers,” said Munger Clary, the study’s principal investigator. “So, this is an area that needs more attention in clinical practice.”

In the study, researchers conducted a cross-sectional analysis of baseline clinical data from a neuropsychology registry cohort study. Researchers analyzed a diverse sample of 420 adults, ages 18 to 75, with epilepsy who underwent neuropsychological evaluation over a 14-year period at Columbia University Medical Center in New York.

“More than one-third of the participants reported significant phobic/agoraphobic symptoms,” Munger Clary said. “We also found that phobic/agoraphobic symptoms, along with depression symptoms, were independently associated with poor quality of life, but generalized anxiety symptoms were not.”

According to Munger Clary, because phobic/agoraphobic symptoms are not routinely assessed by clinicians, the findings may suggest a need for future studies to develop more comprehensive screeners for psychiatric comorbidity in epilepsy.

“Symptoms of agoraphobia do not fully overlap with generalized anxiety or depression symptoms that are often screened in routine practice,” Munger Clary said.

“Providers might want to consider more robust symptom screening methods to identify and better assist these patients. This may be important to improve health equity, given other key study findings that show those with lower education and non-white race/ethnicity had increased odds of significant phobic/agoraphobic symptoms.”

 

Source: neurosciencenews.com, Myra Wright, Wake Forest University

What to Know About Epilepsy and Pregnancy

What to Know About Epilepsy and Pregnancy

Epilepsy is a chronic seizure condition that can affect a person’s pregnancy and postpartum recovery. It does not appear to affect fertility or the ability to become pregnant.

Epilepsy is one of the most common medical conditions among people of reproductive age. It’s estimated that more than 1.1 million women with epilepsy in the United States are of childbearing age. Each year about 24,000 babies are born to people with epilepsy.

This article discusses how epilepsy affects fertility, gestation, and postpartum recovery.

Epilepsy and Fertility

Epilepsy does not impact your ability to become pregnant, but it is best to talk with your healthcare team before pregnancy begins. This is because epilepsy can significantly affect your pregnancy and the baby’s health. Work with your healthcare team to get your seizures well under control before conceiving. People who have been seizure free for nine months before pregnancy are likely to remain seizure-free during pregnancy.

Some epilepsy treatments are not safe during pregnancy. Certain epilepsy medications, known as antiepileptics, have been linked to congenital disabilities when taken during pregnancy. Your healthcare providers may recommend switching medications when you are trying to conceive.

Before getting pregnant, talk with your obstetrician-gynecologist (ob-gyn) and neurologist. Your neurologist will likely recommend a blood test to determine how much epilepsy medication is in your blood. This lab value will act as your baseline throughout pregnancy. Your healthcare providers will monitor your blood to ensure your medication dosage is safe for you and your baby.

Is Epilepsy Genetic?

Epilepsy sometimes runs in families, but most children do not inherit it from their parents. A child has about a 5% increased risk of developing epilepsy if their parent has it.

Epilepsy and Gestation

It is possible to have a healthy pregnancy and baby when you have epilepsy. For the majority of people with epilepsy, their seizure frequency remains the same or even decreases during pregnancy. However, people with epilepsy require special care during pregnancy to ensure their health and safety.

Risks

People with epilepsy are at risk of certain complications during pregnancy. It is possible to experience more seizures when you are pregnant. About 15% to 30% of people with epilepsy experience increased seizure activity during their pregnancies. This increase usually occurs in the first or third trimester.

Possible triggers of increased seizure activity during pregnancy include:

  • Hormonal changes
  • Water and sodium retention
  • Decreased blood levels of antiepileptic medication
  • Stress
  • Lack of sleep

It is possible to experience more seizures during pregnancy because of how the body metabolizes epilepsy medication. The physical changes during pregnancy, such as weight gain and fluid retention, may cause your blood level of medication to go down.

This means that your body will require an increased dose to prevent seizures. It’s important to see your neurologist regularly and have your blood tested for medication levels. Your neurologist will also test your kidney and liver function regularly.

Pregnant people have an increased level of estrogen. Estrogen is considered pro-convulsive and can increase the risk of seizures.

Treatment

People with epilepsy must follow their treatment plan during pregnancy. Having a seizure while pregnant puts you and your baby at risk of injury and preterm birth. Work with your healthcare team to develop a medication plan to control seizure activity.

Certain antiepileptic medications are unsafe during pregnancy because they raise the risk of congenital disabilities. The risk of congenital disabilities in the general public is 2% to 3%, and the risk in people with epilepsy is 4% to 6%.

The most common congenital disabilities are cleft lip or cleft palate. Both of these conditions can be corrected surgically. Other possible congenital disabilities include cardiac and urogenital defects.

Antiepileptics that have been linked to congenital disabilities include:

  • Valproate or Depakote (valproic acid): Increases the risk of neural tube defects by 1% to 2% and increases the risk of major congenital malformations by 10%
  • Topamax (topiramate): Increases cleft lip or palate risk
  • Phenobarbital: Increases the risk of a fetal bleeding disorder
  • Dilantin (phenytoin): Increases the risk of a fetal bleeding disorder

If you are experiencing severe nausea and vomiting during pregnancy, your body may not absorb your medication. Talk with your healthcare provider about possible treatment options for morning sickness.

Concerning Symptoms

Concerning symptoms during pregnancy include increased seizure activity and any complications a seizure can cause. Possible risks of experiencing a seizure during pregnancy include:

  • Physical injury (from falling)
  • Fluctuating fetal heart rate
  • Decreased oxygen to the fetus
  • Preterm birth
  • Low birth weight

Epilepsy and Postpartum

For most new parents with epilepsy, their condition does not affect their ability to heal in the postpartum period (after the baby is born). It is important to take extra safety precautions when with your baby in case you have a seizure. Perform diaper changes on the floor, and be sure to have another adult present when bathing your child.

Impact on Recovery

Research shows that people with epilepsy may be at increased risk of experiencing anxiety and depression during and after pregnancy. This could have a significant impact on your recovery and quality of life. If you have any concerns about your mood, talk with your healthcare provider immediately. There are treatments available to help you feel more like yourself.

Breastfeeding

Most people with epilepsy can safely breastfeed. If you are concerned about having a seizure while feeding your baby, make a plan with your partner or other supportive people. Consider having another adult present when you breastfeed if your seizures are not controlled.

Many antiepileptic medications can be passed to your baby through your breast milk. Talk with your child’s healthcare provider about which drugs are safe. Medications that may not be safe to take while breastfeeding include:

  • Luminal (phenobarbital)
  • Mysoline (primidone)
  • Ativan (lorazepam)
  • Zarontin (ethosuximide)

Summary 

Epilepsy is a chronic seizure condition that may affect pregnancy and postpartum. Having epilepsy does not affect your ability to become pregnant, but uncontrolled seizures during pregnancy can cause serious complications to you and your baby.

Talk with your healthcare provider about a treatment plan before, during, and after pregnancy. Certain antiepileptic medications raise the risk of congenital disabilities, so it is important to work with your healthcare team before you become pregnant.

FREQUENTLY ASKED QUESTIONS

  • Will pregnancy make my epilepsy worse?

    Most people with epilepsy experience the same or slightly improved seizure frequency during pregnancy.2 However, it is possible to have more seizures when you are pregnant. Stay in close contact with your neurologist when you are pregnant and alert them if your seizures worsen.

  • Is it safe to breastfeed with epilepsy?

    For many people with epilepsy, breastfeeding is safe. Talk with your healthcare provider about your current medication plan to determine if any changes are needed. Consider having another adult present if you are concerned about having a seizure while feeding your baby.

     

 

Source: verywellhealth.com, Carrie Madormo RN MPH, Brigid Dwyer

Epileptic Seizures in Cats: Symptoms, Causes, & Treatments

Epileptic Seizures in Cats: Symptoms, Causes, & Treatments

Epileptic seizures in cats usually happen due to a brain dysfunction. The cause can be a number of things, including trauma, toxic chemicals, and infection.

If you see the signs of the condition in your cat, then get to a veterinarian for a proper diagnosis and treatment.

Here’s what you should know about the symptoms, causes, and treatments for the condition.

Symptoms of Epileptic Seizures in Cats

The condition produces a number of symptoms. For example, some of the most common symptoms include:

  • Losing consciousness
  • Drooling
  • Peeing involuntarily
  • Pooping involuntarily
  • Convulsions
  • Pacing
  • Muscles contracting
  • Hallucinations
  • Running around in circles

Additionally, the condition usually takes place in three stages. Firstly, a cat can seem restless and salivate. Secondly, a cat may vomit, run in circles, and experience convulsions. Thirdly, a cat will seem uncoordinated and confused.

Causes of Epileptic Seizures in Cats

The cause of the condition can be a number of things. For example, some of the potential causes include:

  • Infection
  • Chemicals
  • Trauma
  • Tumors
  • Genetic factors

Treatments for Epileptic Seizures in Cats

Firstly, your vet will ask about your cat’s symptoms. Secondly, your vet will ask about any circumstances where your cat could have suffered a head trauma or ingested toxic chemicals.

Thirdly, a full physical examination will be carried out. Blood and urine tests will be taken. Also, an electrocardiogram (EKG) will be used to rule out other conditions.

Generally, treatment will involve your vet prescribing anticonvulsant medication. This is so that you can control any further epileptic seizures that your cat might experience.

As always, if your vet prescribes your cat any medicine, make sure to stick to the correct dose and frequency instructions. Also, complete the full course of medicine.

 

Source: .yahoo.com, Phillip Mlynar

METHOD HELPS FINDS SOURCE OF EPILEPSY SEIZURES BEFORE THEY BEGIN

METHOD HELPS FINDS SOURCE OF EPILEPSY SEIZURES BEFORE THEY BEGIN

Using low frequencies to determine causal flow could help locate an epilepsy seizure long before it occurs. “The method can potentially open up a whole new possibility of localizing seizures with a… non-invasive approach,” says Mukesh Dhamala. “That’s the idea.”

A measure of brain activity known as causal flow can help locate the source of epilepsy seizures before they occur, according to a new study.

The finding could reduce the need for invasive procedures in treating drug-resistant forms of the disorder.

According to the World Health Organization, about 50 million people worldwide live with epilepsy. The neurological disorder is marked by recurrent seizures—sudden bouts of abnormal electrical activity in the brain.

“Seizures are often described as electrical storms in the brain,” says coauthor Mukesh Dhamala, an associate professor in Georgia State University’s Neuroscience Institute and physics and astronomy department. “And that can take over normal functioning. Patients can lose consciousness and control of their behaviors for seconds to minutes.”

While some cases of epilepsy can be treated with medication, about 30% are considered drug-resistant. These cases require surgical intervention on the brain area where the seizure starts, known as the seizure focus.

Neurosurgeons look for areas of abnormal activity using intracranial electroencephalogram (iEEG), a procedure in which electrodes are surgically implanted into the brain for the duration of the test. To work, the patient must have a seizure while the iEEG is recording.

This approach to locating the seizure focus is successful only 40 to 60% of the time for multiple reasons. First, the patient must have a seizure while the iEEG is recording. When seizures occur sporadically and without warning, this can be a problem. Second, the iEEG can miss a focus region or detect multiple regions of abnormal activity. In these cases, it can be difficult—if not impossible—to visually interpret the iEEG recordings.

“That’s where we come in—to help neurosurgeons by analyzing recorded data,” Dhamala says.

Rather than looking at the output from each individual electrode, Dhamala and his team have started to combine data from each point to get a broader picture of the brain’s activity. Like using seismographs to determine the location and strength of an earthquake, these data points can be used to determine causal flow, a measurement that quantifies the activity of this broader network.

Previously, Dhamala and his colleagues used high-frequency activity known to be present during seizures to show that causal flow can locate foci. In its recent study, the team was able to do the same using low-frequency activity, which occurs before a seizure starts. Their findings suggest that using low frequencies to determine causal flow could help locate a seizure long before one occurs.

“The method can potentially open up a whole new possibility of localizing seizures with a… non-invasive approach,” Dhamala says. “That’s the idea.”

In the future, neurosurgeons may be able to locate foci without waiting for patients to have more seizures and do so even with less invasive techniques. The team is now conducting research on the use of functional magnetic resonance imaging, which measures low-frequency activity, as an alternative.

Sushma Ghimire, a recent graduate of the Georgia State doctoral program in physics, and Charles Epstein, a neurophysiologist and professor at Emory University are coauthors of the study, published in the Journal of Clinical Neurophysiology.

 

Source: Georgia State University, Anna Varela

Can Epilepsy Be Cured?

Can Epilepsy Be Cured?

There is no cure for epilepsy. However, many people can become seizure-free with the right type of treatment, which may include medication, management techniques, and a healthcare team on their side.

This article discusses the outlook for people with epilepsy and how medical providers can reduce seizure activity in those with the condition.

Outlook for Epilepsy

The outlook for people with epilepsy can be positive in many cases. Medications and other treatment interventions are available and are generally effective.

In newly diagnosed people, the outlook following their diagnosis is as follows:

  • 50–60% become seizure-free within a year after using medication.
  • 11–20% of people will become seizure-free after using an additional seizure medication.
  • 74% of children with new seizures will become seizure-free in the first two years after diagnosis.
  • 25% of newly diagnosed adults and 9% of newly diagnosed children will not find proper treatment and experience uncontrolled epilepsy.

People with epilepsy have a reduced life expectancy. On average, people with a seizure disorder can expect to live 10–12 years less than those without one. That said, with treatments and management techniques, people with the condition can live relatively normal lives.

Can Seizures Be Stopped?

Six out of every 10 people with epilepsy can become seizure-free within a few years of beginning proper treatment. Many who reach this remission may never experience an epileptic episode again.

Roughly 66% of people with epilepsy can control their condition using anti-epileptic medication. Surgery is the next best option for those who don’t respond to treatment with drugs. About 70% of people who have surgery for their seizures can become seizure-free or experience only rare seizures.

Factors That Can Increase Chances of Being Seizure-Free

Having a positive outcome after an epilepsy diagnosis depends on several factors. For example, if a person responds positively to the first or second medication they try, they are more likely to become seizure-free in the future. Other factors include:

  • Brain injury: People without brain injuries or abnormalities are more likely to reduce or eliminate their seizures with proper treatment.
  • Normal neurological exams: Those with typical results on an electroencephalogram (EEG) or other neurological tests are less likely to experience seizures after treatment.
  • Family history: People with a family history are less likely to reach seizure-free status.
  • Cause: When the cause of epilepsy is unknown, the chances of becoming seizure-free are higher.

Identifying Seizure Triggers

Certain things can bring on an epileptic seizure, such as missed medications, alcohol use, stress, lack of sleep, and menstruation. People can learn to identify their triggers by keeping a seizure diary that records when the seizure happens and any factors in their life or environment that occurred. New technology is making identifying seizure triggers easier, and smartwatches and apps have been used to track and compile trigger data for individuals with epilepsy.

Treatment Options

Many treatments for epilepsy are available. The type chosen will depend on various personal factors and how a person responds to their first-line therapy medication.

Medication

Medication is often the first choice when it comes to epilepsy treatment. There are 26 Food and Drug Administration (FDA)-approved medications to control seizures. These are usually prescribed after someone has one or two episodes during waking hours, one during sleeping hours, or an attack after which a magnetic resonance imaging scan (MRI) showed a structural problem with the brain.

Because there are many variations of epilepsy, medications are prescribed based on the type. Sex, age, and mental health status also play a role when choosing the right drug.7

Medications are prescribed based on several factors because some are viable in certain situations, and others are not. Medical providers want to get treatment right as quickly as possible and because drugs are the first and most common option, treatment according to those factors is the best method.

Surgery

According to research conducted in 2018, less than 1% of people with epilepsy will undergo surgery to control their condition.

Typically, surgery is considered when:

  • There is no change in seizure activity even after trying two or more medications.
  • Seizures are disabling and negatively affect a person’s quality of life daily.
  • Seizures occur from the same region of the brain each time, as is the case with focal epilepsy, and medication isn’t working.
  • There is an abnormality in the brain where the seizures start.
  • People have specific types of epilepsy, known as atonic or tonic.
  • People have an increased risk of injuring themselves or experiencing status epilepticus or sudden unexpected death in epilepsy (SUDEP).

Therapies

Other therapies, including implantable devices, vagus nerve stimulation, and seizure alert systems, are all options to help manage epileptic seizures.

In 30% of people, medications do not work to control seizures or cause side effects for which coping proves too difficult. If surgery is not an option in this case, devices may work to help control their epilepsy. Devices, also known as neuromodulation, are implanted into the brain. While there, they can send electrical currents that encourage the proper functioning of brain cells.

Research shows that as many as 67% of people who use neurostimulation devices can experience a reduction in seizures as well as a shorter duration of each episode that does occur. It’s important to note that the study that references these results was on a small scale.

Vagus nerve stimulation sends electrical impulses to the vagus nerve, the longest cranial nerve. It is a form of neurostimulation, and roughly 45–60% of patients who receive this therapy can expect a 50–100% reduction in seizures after six months of treatment.

Another possible therapeutic device that can alert caregivers to an attack is a seizure alert system. A person with epilepsy can wear this device to track movements and electroencephalogram (EEG) activity. Though this doesn’t help to manage the condition, it can make someone with epilepsy feel a bit safer in knowing that their caregiver will be notified if they do have a seizure.

Brain Stimulation and Seizures

Though some effective devices and therapies use brain stimulation to lessen seizure frequency, not all brain stimulation is helpful. Some treatments that utilize the changing of brain waves may bring on seizures, as is the case with some people who undergo transcranial magnetic stimulation (TMS).

Diet and Lifestyle Changes

Diet and lifestyle can play a role in seizure activity, and making specific changes in this department can help to manage epilepsy effectively. Alongside medications, the low-carbohydrate ketogenic and modified Atkins diets have shown promise in helping those with seizures control their condition. Though it’s not clear how these diets can work for epilepsy, they seem to encourage changes in neuronal metabolism, which is the process by which brain cells get their energy.

Eating the ketogenic diet is also thought to reduce seizure frequency because it dampens neuronal excitability, which is when neurons generate a large burst of electrical activity after light stimulation.

Other lifestyle changes that can help lessen the frequency of seizures include:

  • Getting enough sleep
  • Eliminating the use of alcohol and drugs
  • Managing stress levels
  • Getting regular exercise

New Treatment Breakthroughs 

New treatments for epilepsy and seizures are researched all the time. The Epilepsy Therapy Project of the Epilepsy Foundation is a branch of research that aims to spread awareness about new options for those who may not have controlled seizures with medications or other therapies.

Nearly 300 clinical trials are recruiting new patients to determine the efficacy of breakthrough treatments in medications, testing, procedures, and devices.

One of the latest clinical trials to gain traction has found that gene therapy is an effective option for those who experience uncontrolled seizures due to specific genetic mutations. The study results are promising, but researchers have yet to test them on humans.

Working With Your Healthcare Provider

To find the proper treatment that works for you, you must work with a neurologist and healthcare team. They will examine your specific case, type, and other factors to determine your best possible option.

There are many types and causes of epilepsy, and their degrees of severity also vary. By working with a trusted healthcare team, you will likely find a therapy option that reduces or eliminates your seizures.

Summary

There is no cure for epilepsy, and people with the condition have an average reduced life expectancy of 10–12 years. That said, people with the disorder can live completely normal and seizure-free lives if they find the right type of therapy.

There are many options for this, including medication, surgery, implantable devices, and lifestyle interventions. To find the one that works best for you, work with your healthcare team.

 

FREQUENTLY ASKED QUESTIONS

  • What causes epilepsy?

    There are many causes of epilepsy. Genetics, neurological issues, brain infections, or developmental disorders may play a role.

  • Are there any natural treatments for epilepsy?

    Though diet and lifestyle interventions can help reduce the frequency of seizures, they are not considered standalone treatments. That is because no natural treatment seems able to reduce or eliminate attacks as well as other treatments. Medication is currently the No. 1 therapy available for those with epilepsy.

  • How long do people with epilepsy live?

    The life expectancy of people with epilepsy is reduced. However, many people can live completely seizure-free lives with the proper treatment. On average, people may have a reduced life expectancy of roughly 10–12 years.

Source: verywellhealth.com, Angelica Bottaro, Nicholas R. Metrus, MD

New Clues About the Development of Epilepsy

New Clues About the Development of Epilepsy

Summary: The activation of dentate granule cells in the hippocampus plays a key role in alterations that occur during the development of post-traumatic epilepsy.

Source: Colorado State University

Traumatic brain injury is a leading cause of epilepsy, a chronic neurological disorder characterized by recurrent seizures that affect around 50 million people.

A research team led by Bret Smith, professor and head of the Department of Biomedical Sciences, discovered specific neuronal processes that could help advance future preventative treatments for post-traumatic epilepsy.

The findings, published in The Journal of Neuroscience, show that activation of a subset of hippocampal neurons plays a key role in the changes that occur during the development of post-traumatic epilepsy and may be restorative.

“We know that trauma induces a cascade of events that can cause epilepsy,” says Smith. “We want to understand exactly what is occurring, and what the endpoints are, and then work backwards to try and stop epilepsy from developing after a brain injury.”

Neuroscience research in Smith’s lab focuses on two distinct programs; one is aimed at identifying neural changes related to the development of epilepsy, which the team has created leading models in the field to study, and the other examines how the brain is influenced by and contributes to hyperglycemia in diabetes.

For this study, Smith’s team looked at neurons called dentate granule cells, which continuously regenerate in areas of the brain that are crucial for learning and memory and are also commonly impacted by epilepsy.

The team was surprised to find that when they were activated, the activity of other brain cells involved in epilepsy were inhibited. And that the cells that were formed just prior to a traumatic brain injury were much more likely to activate this circuit than those generated at other points in time.

“We have been looking at how these synaptic connections reorganize in epilepsy for a long time,” says Smith. “Now, we can look more closely at specific connections of these cells that form at different times.”

Next, Smith’s lab will investigate whether this new connection is restoring function and if it occurs in other types of epilepsy.

“If we can get to a point of understanding the changes that occur in the development of epilepsy well enough, we may be able to prevent or reverse them.”

 

Source: neurosciencenews.com, Colorado State University

Netflix’s ‘Dogs’ Season 1 Episode 1 Recap

Netflix’s ‘Dogs’ Season 1 Episode 1 Recap

Netflix’s ‘Dogs’, despite being a new series, has already received heaps of praise for the show’s portrayal of the human-canine bond. Each episode unpacks the story of a different dog and their person. Netflix’s new show begins with Corrine, a young girl residing in Ohio who lives with epilepsy. After a yearlong wait, Corrine is finally matched with her service dog – Rory, a standard Poodle.

Girl’s Best Friend

Having a service dog isn’t just life-changing for Corrine – it will be life-changing for her family. Corrine hasn’t responded well to multiple medications. Out of concern, her mom sleeps in her room most nights. It took a while to find a perfect match, but when 4 Paws for Ability introduces Rory, it’s love at first sight.

Rory is a standard Poodle, and he may be young, but he’s focused on his crucial job. Rory was chosen due to having a strong personality – he is not frightened by seizures, and dangerous situations do not impede his abilities.

While Rory is well-loved, it isn’t all smooth sailing. Carly, Corrine’s sister, understandably struggles with Rory’s arrival. It’s not that she doesn’t like him. To enforce his training and mentality that he must focus on Corinne, she has to have little interaction with him. However, in time, Carly comes to understand Rory’s presence as an aid, not as a pet.

“Life with Rory has been awesome. It’s been really good for my whole family, because they don’t, like, have to watch over me every second.” Corrine explains. Given Rory’s constant presence at Corrine’s side and frequently wagging tail on Netflix’s new show, he agrees.

Supporting Service Dogs

Service dogs are an important medical aid to many, and can without question improve lives. However, the training process is long and expensive – recently, there has been a shortage of available dogs post-quarantine.

If you’d like to help, consider donating financially or donating your time to a local service dog training facility. Volunteering could be as easy as coming in for an occasional session as a ‘distraction’, or you could commit to taking a puppy home with you.

In your day-to-day life, you can help service animals by being respectful. Do not approach a working service dog. (Not sure? Just ask – it’s a good rule of thumb to ask before petting anyway!) And never disguise your own pet as a service animal to bring them into pet-prohibited buildings. Not only is this illegal, but it is also detrimental to the reputation of real service animals.

 

Resource: Netflix, yahoo.com.

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