It is a plant-based extract with numerous therapeutic benefits, such as anxiety relief, pain relief, epilepsy, etc.
Cannabidiol or CBD has recently received so much media coverage, and you might have heard its name mainly for its association with the controversial marijuana plant. Although this plant has been around forever, it has suddenly become so popular, in a positive way. It is a plant-based extract with numerous therapeutic benefits, such as anxiety relief, pain relief, epilepsy, etc.
Contrary to popular belief, CBD cannot make you high, which is true for a fact. The CBD products you see people using are generally free from tetrahydrocannabinol (THC), the element in the cannabis plant responsible for its psychoactive properties. Having it removed from a product means that there will be no sedation, drowsiness, or other signs characteristic of the cannabis plant.
While there are so many options to buy CBD products, including gummies, tinctures, oils, and extracts, only a few of them are worth trusting. Not all of these brands follow the same protocol for extracting CBD from the plants; in fact, many of them fail to provide details about its ingredients, sources, and manufacturing information. Although these products are available without a prescription, in most states, there is no central control to regulate their brands, so choosing the best brand to buy CBD products requires self-evaluation and search before making a final decision.
It is necessary to remember that CBD affects every person differently, so before trying any product, make up your mind first and pay attention to every small detail in order to determine the efficacy and safety of a CBD product. To help you make a better decision and investment in health, here are a few options to buy the best CBD gummies, oils, and tinctures. All of these brands are
Full-spectrum CBD products with less than 0.3 THC values
Obtained from organic hemp plants grown locally
Tested and verified by third-party laboratories
Only suitable as per recommended use
Best CBD Gummies, Oils and Tincture brands selected include the following
- CBDfx (Best Overall)
- Sunday Scaries (Best For Auto-Subscribers)
- JustCBD (Best For Sugar-Free Gummies)
- CBDistillery (Best For Pure CBD Gummies)
- American Shaman (Best For In-Shop Availability)
- Charlotte’s Web (Best For Veterans)
- Extract Labs (Best For Vegans)
- Five CBD (Best Non-THC Gummies)
- Joy Organics (Best For In-Shop Availability)
- Medterra (Best For Beginners)
Before jumping to the best brands to buy CBD gummies, oils, and tinctures, here is a basic introduction to the CBD and different products created from this plant-based compound.
What is CBD and What Makes It Different From Marijuana?
Cannabidiol (CBD) is a natural compound (phytocannabinoid) found in the cannabis plant with a medicinal history of thousands of years old. Modern research has confirmed the therapeutic benefits of CBD, confirming it to be a safe and non-addictive compound, making it fit for everyday use. The World Health Organization confirms that CBD has no risks for abuse, dependence, or any side effects in humans and can be used as a therapeutic product. Interestingly, CBD is not the only compound present inside the cannabis (marijuana) plant, and there are many others that play a part in causing various beneficial effects. One of these other compounds is tetrahydrocannabinol (THC), which gives the famous ‘high’ effects of cannabis, making it illegal in many parts of the world.
THC and CBD both have therapeutic benefits, but CBD does not make its user intoxicated like THC. The reason is that these two phytochemicals act differently on the brain receptors causing similar effects, and this property makes them interchangeable for their usage. The CBD products available in the market use a minimal value of THC that is below the level capable of inducing a high feeling. Without these THC levels, no CBD product can sedate or cause a side effect. The fact that these products are now readily available makes them more desirable to consider in place of over-the-counter medicines. However, the users have to follow the usage instructions dosage guidelines for a safe experience.
How CBD Gummies Help?
CBD and THC target the human body in many ways, one of which is by acting like the naturally occurring compounds in the body, termed as “endogenous cannabinoids” that are a part of the human endocannabinoid system. This name is given to them for sharing similarities with the cannabis compounds.
The discovery of this system has changed the way scientists proceed with understanding diseases and devising treatments. The reason THC and CBD play such versatile roles and the high demand for cannabis, despite being a controversial plant, is the medicinal potential that scientists believe to exist.
This endocannabinoid system controls a number of physiological mechanisms that are functional in routine, for example, energy levels, mood development, sugar metabolism, immunity, blood pressure, hunger, stress response, pain, and much more. Any changes making this system slow indicate a functional flaw in all these bodily systems; likewise, a hyperactive endocannabinoid system does the same. Latest research has confirmed that any modulations to the endocannabinoid system can be used to control the disease progression that typically makes humans sick. Surprisingly, both THC and CBD can modify the endocannabinoid system; however, CBD is preferred to create these safe cannabis products, such as gummies, because of the non-drowsiness and low risk of side effects.
Types of CBD Products
There is a huge variety of CBD products, and you may see hundreds of brands making these products. The effects of these products are the same, and using any of them is a personal choice. Here are some common names used for CBD products; give them a reading first to understand the product and then look for the top brands to buy the best CBD gummies, tinctures, oils, and other products.
If this is your first time reading about CBD products, check the following glossary to understand the true meaning before you shop for the best CBD gummies, oil, and tincture.
- Psychoactive CBD: any CBD product having more than 0.3% of THC inside and causing sedative effects.
- Hemp plant: a species of cannabis sativa plant that is cultivated to produce legal CBD products and fabrics. CBD from hemp is similar to the CBD obtained from the marijuana plant, but unless it has THC inside, it is non-addictive and non-sedative.
- Full-spectrum CBD: it means that a particular CBD product is made of all cannabinoids, including the 0.3% THC in it.
- Broad-spectrum CBD: it means that all cannabinoids are present in a product excluding THC.
- CO2 extraction: it is a standard extraction protocol that uses different temperature and pressure settings to draw the CBD out from the plant material.
- CBD Isolate: a product containing 99% CBD inside and no trace of THC and other cannabinoids in it.
- CBD oil: it is a product created with a carrier oil to dilute CBD effects, making its absorption better. These oils could be coconut oil, MCT oil, hemp seed oil, or any vegetable glycerin base.
- CBD Tinctures: it is a product made of hemp-derived CBD dissolved in alcohol or a mixture of oil with alcohol or alcohol with glycerin.
The first name on the list is CBDfx, an established name in the CBD industry that has been around since 2014. The company has successfully made its fan following by providing high-quality CBD products mainly the CBD gummies. Starting from a small scale in San Fernando Valley, it has become one of the top brands to buy CBD gummies, oils, tinctures, and extracts.
It ensures full-spectrum CBD products are tested by third parties for safety. The company provides contact details and welcomes questions from everyone regarding the product, orders, or deliveries.
Here are a few things that you must know about CBDfx products.
- It sells high-quality gummies, oils and tinctures that have been used and confirmed for their benefits by hundreds of loyal customers.
- The company has a legit website and takes online orders. All the products are tested and verified, and you can even see the quality certificates posted on the website. You can even scan a QR code to check product details.
- All the products are made from 100% organic, pesticide-free, and pure hemp plants. These products are non-GMO and vegan/vegetarian friendly.
- The company uses the latest superficial carbon dioxide method to extract CBD from organic hemp plants.
- It sells a variety of CBD products such as vapes, topical CBD, bath bombs, salts, CBD drinks, CBD tinctures, CBD treats for pets, CBD skin creams, and much more.
- The company delivers to all locations in the US.
Extract Labs is another choice to buy the best CBD gummies with 100% satisfaction guaranteed. This brand is developed by a former combat veteran, Craig Henderson, who was focused on helping veterans using plant-based solutions. Today, Extract Labs stands tall among the top companies offering high-quality CBD products.
Here are the top features of this brand
- All products made by Extract Labs are prepared from high-grade and US-grown mature hemp plants.
- The company offers so many CBD products to meet every user’s needs, whether medical or recreational. It includes oils, tinctures, pet treats, coffee, gummies, topicals, soft gels, chocolates, bath bombs, and much more.
- It offers unparalleled, active, and prompt customer service to help all new customers.
- The company offers door-to-door delivery service easing the customers to go and find these products at local markets.
- It offers free domestic shipping, but international customers might have to pay small delivery charges.
- There are no harmful ingredients, additives, artificial coloring, or hormones added to the CBD products made by Extract Labs.
Charlotte’s Web is one of the most famous CBD brands that works on a simple goal; to make this world a better place for everyone living here. Established in 2013, CW is one of the pioneers of the CBD products that eventually gained fame when they were featured in a CNN special report presented by Dr. Sanjay Gupta. This report covered the story of a 6-years old girl named Charlotte Figi and her struggle with her Dravet Syndrome that was helped with CBD oil initially developed by the Stanley Brothers duo.
Here are a few things that make it a top choice to buy the best CBD gummies, tinctures, and oils online.
- It offers the highest quality CBD products made from US- hemp authority-certified sources.
- The products sold under the CW range from the potency of 210 mg to 6000mg, offering various solutions to every user.
- The CW CBD oil comes in various concentrations, flavors, and aromas according to every user’s liking. Some of the available options are mint chocolates, orange blossom, lemon twist, etc.
- The company adds no artificial colors to improve the appearance of the products, and the final look that a customer sees is the original color and look of the processed hemp products.
- CW is completely transparent about its products offering specialized certificates of analysis (COAs) for every batch on its official website.
- Charlotte’s Web offers relatively inexpensive CBD products compared to other CBD companies, making it an affordable brand.
Bonus: CW offers bundle packs, THC-free CBD products, and an option to bulk purchase these products. The company offers a huge discount for the veterans, making it an even more affordable brand to buy CBD gummies, oils, and tinctures.
The Final Word
CBD products are high in demand, and some of their benefits are confirmed through research. However, it is still a long way to discover the complete potential of this plant. Till then, do not believe anything that comes in front of you without scientific evidence. Most CBD benefits, especially for medical treatments, are based on user experiences and not clinically studied; the effects and intensity of these effects could also be different for every user.
This research on finding the effects of CBD oil and tinctures is still in progress, and there are chances that new therapeutic uses of these products will soon be discovered. There is still time needed to learn about the effective dosage planning and usage of CBD oil, finding a natural therapy for various health issues. CBD gummies, on the other hand are an enjoyable way to get the medicinal benefits of cannabis plant, but they are relatively safer than all other CBD products. Those interested in trying CBD products should choose a reliable source to make their purchase, preferably among the aforementioned CBD vendors. Learn about CBD products and select any that you find best. To know the latest pricing and details, visit the official websites of these CBD vendors today.
Manitoba government providing $2.5 million annually in operating funds
The province is establishing an adult epilepsy program so that children and adults with the neurological condition will no longer have to go out of province to receive life-changing surgeries.
The program will be run at Health Sciences Centre (HSC) Winnipeg where it is expected to perform 30 surgeries on adult patients per year once fully operational next year, officials announced Monday morning.
It will also increase the number of surgeries performed on children to 20 per year, up from the average of 15 that have been performed since 2017.
The Manitoba government will provide $2.5 million in annual operating funding for the program, in addition to the $4 million in funding announced last year to expand the adult epilepsy-monitoring unit at the hospital to four beds, up from two.
The province estimates that about 20,000 people in Manitoba have epilepsy.
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While it can be treated with medication, they often have serious side effects or don’t work for some patients, says Dr. Shawn Young, HSC’s chief operating officer.
This results in thousands of patients who end up in the emergency room each year due to seizures, he says.
“The health-care system can track the physical effects. What you don’t see is the emotional anguish it causes to the families and patients that suffer from this.”
The program is expected to start taking in surgical patients next spring, pending the successful recruitment of a neurosurgeon, provincial officials said Monday.
Last month, the acting head of neurology at the University of Manitoba sounded alarm bells over the state of neurology services in Manitoba due to the province’s inability to attract and retain specialists.
- Winnipeg mother presses province on long-awaited epilepsy gear needed by her son
- Mother of Manitoba epilepsy patient petitioning province for improvements in level of care
Young says he’s hopeful this new program can help, adding that the HSC has hired six specialists in the last 18 months, with three more coming.
“When you’re able to put together premier programs that we are planning on building and have built, you’re able to attract these specialists much more readily,” he said.
The Children’s Hospital Foundation of Manitoba is also contributing $1.2 million to purchase a robotic stereotactic assistance guidance system, which surgeons use to diagnose and perform surgeries on patients with epilepsy.
What if an already-Food and Drug Administration-approved drug could help treat a particularly troublesome disorder? Researchers at Washington University School of Medicine in St. Louis have found just such a use for one drug, according to a press release by the institution published earlier this month.
An old drug with a new purpose
The condition is neurofibromatosis type 1 (Nf1) and the drug is lamotrigine, an epilepsy drug. People suffering from Nf1 develop tumors on nerves throughout their bodies that are usually benign but can still cause serious medical issues such as blindness.
The new research reveals that neurons carrying a mutation in the Nf1 gene are hyperexcitable and that suppressing this hyperactivity with lamotrigine stops tumor growth in mice.
“Tumors are very common in people with Nf1,” said senior author David H. Gutmann, MD, Ph.D., the Donald O. Schnuck Family Professor and director of the Washington University Neurofibromatosis Center.
“We’ve shown that we can block the growth of Nf1 tumors by shutting off neuronal hyperexcitability. We’ve done it now a couple of different ways, and there’s no question that repurposing antiepileptics is an effective way to inhibit tumor growth, at least in mice. This underscores the critical role that neurons play in tumor biology.”
To test this new application of an older drug, the researchers studied neurons from mice with and without Nf1 gene mutations. They found that neurons from mice with tumor-causing Nf1 mutations fired electrical impulses more frequently than neurons from normal mice, releasing molecules that increased the growth of brain and nerve tumors.
Through further research, they were able to attribute this hyperexcitability to a dysfunctional ion channel that changed the baseline electrical activity inside the neurons. They then proceeded to also examine mice with an Nf1 mutation seen in people with NF1 who do not develop brain or nerve tumors.
Hyperexcitable Nf1-mutant neurons
The neurons from mice with this specific Nf1 mutation were not hyperexcitable and did not develop tumors. Since hyperexcitable neurons are also a feature of epilepsy, the drug lamotrigine, therefore, targets the same ion channel disrupted in hyperexcitable Nf1-mutant neurons.
To test if the drug could also work for Nf1, the researchers gave lamotrigine to a group of Nf1-mutant mice that develop optic nerve tumors. They then compared the results with a group of mice receiving placebos and found that the mice that had received the drug had smaller tumors, which were no longer growing.
“The mutation in the Nf1 gene changes the basic biology of the neuron,” Gutmann said. “During development, neurons form first and tell the rest of the brain how to form. If you have a mutation that affects how neurons behave, that may change everything about how the brain gets set up during development. Nothing we’ve tried so far to prevent learning disabilities has worked. Maybe this discovery could lead to new treatments for the learning and cognitive problems in children with NF1.
“I’m very excited about the scientific and medical implications of these findings. Not hyperexcited,” he added, “but excited.”
Neuronal activity is emerging as a driver of central and peripheral nervous system cancers. Here, we examined neuronal physiology in mouse models of the tumor predisposition syndrome Neurofibromatosis-1 (NF1), with different propensities to develop nervous system cancers. We show that central and peripheral nervous system neurons from mice with tumor-causing Nf1 gene mutations exhibit hyperexcitability and increased secretion of activity-dependent tumor-promoting paracrine factors. We discovered a neurofibroma mitogen (COL1A2) produced by peripheral neurons in an activity-regulated manner, which increases NF1-deficient Schwann cell proliferation, establishing that neurofibromas are regulated by neuronal activity. In contrast, mice with the Arg1809Cys Nf1 mutation, found in NF1 patients lacking neurofibromas or optic gliomas, do not exhibit neuronal hyperexcitability or develop these NF1-associated tumors. The hyperexcitability of tumor-prone Nf1-mutant neurons results from reduced NF1-regulated hyperpolarization-activated cyclic nucleotide-gated (HCN) channel function, such that neuronal excitability, activity-regulated paracrine factor production, and tumor progression are attenuated by HCN channel activation. Collectively, these findings reveal that NF1 mutations act at the level of neurons to modify tumor predisposition by increasing neuronal excitability and activity-regulated paracrine factor production.
Source: interestingengineering.com, Loukia Papadopoulos
Epilepsy complicates a woman’s reproductive life. However, improved diagnosis and treatment of this disease, as well as better social adaptation, have enabled most women with epilepsy to marry and have children.
The collaboration between the neurologist and the obstetrician is important in order to optimize the management of women suffering from epilepsy who wish to become a mother. And it is by planning the pregnancy and selecting the appropriate treatment before it in order to respond to the double challenge of maintaining control of convulsive seizures while minimizing any risk of teratogenic malformation that women with epilepsy can become mothers.
Compared to pregnant women without epilepsy, pregnant women with epilepsy have a higher mortality rate, a two to three times higher incidence (number of new cases) of preterm birth and other maternal and fetal complications.
Several complications can be added during the treatment, which require rigorous monitoring. Because antiepileptics are likely to cause malformative teratogenic effects in particular.
To avoid or minimize these complications, women with epilepsy must be accompanied from puberty.
The collaboration between the neurologist and the obstetrician is important in order to optimize the management of these patients by planning the pregnancy and selecting the appropriate treatment before it in order to meet the double challenge of maintaining seizure control. seizures while minimizing the teratogenic risk.
The choice of breast-feeding is individual, as there are no formal contraindications to breast-feeding in epileptic women undergoing treatment.
Compliance with these conditions builds confidence and promotes a reassuring reproductive life for Moroccan women with epilepsy, concludes the scientific work supervised by doctors M. Berrada, S. Ennigrou, S. Bellakhdar, B. El Moutawakil and MA. Rafai, published in the June 2022 issue of the Moroccan journal of practical medicine.
It should always be remembered that pregnancy and childbirth are precious moments in a woman’s life. However, they may be responsible for physiological modifications which may play a role favoring the onset or aggravation of certain neurological pathologies, such as the epilepsy mentioned above or other more or less serious ones.
So, with pregnancy, causing an acceleration of blood clotting, there is the risk of the occurrence of cerebral venous thrombosis.
Cerebral venous thrombosis corresponds to an obstruction, localized or diffuse, of the veins of the brain, by a blood clot. This can be the cause of cerebral edema, which can cause ischemia, namely the reduction or even the cessation of the blood supply to the brain.
Headaches are also a frequent complaint during pregnancy, their prevalence (ie number of cases of a disease in a population at a given time) is estimated at 35%.
The most common form of headache is migraine, which occurs mainly during the first trimester and postpartum (after childbirth).
Other potentially serious pathologies can be triggered during pregnancy, and therefore it is necessary to seek them out, diagnose them, in order to ensure adequate management. Because, some can engage, by their complications, the vital prognosis of the future mother.
A relatively common pathology in women of childbearing age is multiple sclerosis, whose relapses mainly occur in the first three months after childbirth, and whose therapeutic implications are not always easy to handle by medical teams. specialized.
Multiple sclerosis (MS), a neurological disease, is most often diagnosed between the ages of 20 and 40. More than two-thirds of MS patients are women. They are young and of childbearing age. And the influence of pregnancy on the evolutionary course of multiple sclerosis has been controversial. For a long time, women with MS were advised against having children, arguing that the disease worsened during pregnancy, but especially just after childbirth. This is no longer the case today.
In another scientific study coordinated by the teams of the department of neurology of the CHU Ibn Rochd of Casablanca, the laboratory of genetics and molecular pathology of the faculty of medicine of Casablanca and the laboratory of research on the diseases of the nervous system, neurosensory and handicaps of the same faculty, also published in the June 2022 issue of the Revue Pratique de Médecine, pregnancy is not contraindicated in the case of multiple sclerosis, but must be programmed, with a setting of the date of delivery .
And there are well-defined therapeutic protocols to bring the pregnancy to term and ensure delivery in the most optimal conditions.
The coordinators of this continuing medical education file on pregnancy and neurological diseases, Dr Malika Berrada and Pr Mohammed Abdoh Rafai, affirm that the various neurological diseases, discovered or triggered by pregnancy, require strict collaboration between neurologist, doctor general practitioner, pediatrician, and for certain situations, the anesthetist-resuscitator, for personalized care of each patient.
Source: oicanadian.com, Tammy Sewell
Lottie Wynn, 37, who is often left ‘black and blue’ after an epileptic fit, faces rude comments and stares from the public who assume she has been beaten up
A woman who is often left “black and blue” after an epileptic fit says strangers assume she has been in a fight.
Lottie Wynn, 37, is often faced with rude comments and stares from the public who assume she has been beaten up.
The customer service representative can be seen with black eyes and cuts after banging her head during a seizure.
Lottie, from Cheltenham, Gloucestershire, is sharing her story to raise awareness of epilepsy injuries in a bid to prevent judgemental stares.
“Unfortunately, it is quite common for me sustain an injury when I have a seizure,” she said.
“I always seem to fall forward and bang my head. One time, I came round and blood was gushing down my face.
“It turns out, I had face planted a radiator when I had a seizure. I had to get stitches and I now have a scar on my right eyebrow.
“I have also been left with black eyes and a huge lump on my forehead following a seizure.
“I do my best to cover up bruises but it can be hard when my face is swollen. The bruises make people feel like they should be wary of me as they think I have been in a fight or hit by a partner.
“Nobody ever thinks it is an epileptic injury. I feel vulnerable and uncomfortable with the injuries in public. Someone has asked me if I had a fall out with my partner which made me feel very uncomfortable.”
The single woman explains there are many symptoms that come with the condition.
She suffers from losing awareness that causes her mind to go ‘completely blank’ along with twitches and seizures.
“Epilepsy is so misrepresented,” she added, “it is not what people think. It’s not just convulsions and blacking out, there’s other symptoms too.
“I have twitches daily but and my brain goes completely blank. I have probably had epilepsy for about 99 per cent my life and I didn’t know.
“I used to black out and faint a lot but it took years to get a diagnosis. I didn’t ever think it would be epilepsy until I was diagnosed in March 2022.
“Fortunately, I haven’t had a seizure for 12 months so I am hoping to get my driving license back soon.”
Lottie is now sharing her story to make people think twice when they see someone with bruises.
She said: I want to open up the bigger picture and remove the assumptions.
“It is taking a step back and looking at the bigger picture. I am hoping people can be more compassionate and sympathetic when they see someone with bruises on their face.”
Source: mirror.co.uk, Lucy Notarantonio, Adam May
Known for his role as a pilot in “Star Wars,” actor Greg Grunberg has traded in his flight suit to travel cross country to bring awareness to epilepsy care, treatment and patient needs.
In February 2022, Grunberg debuted the YouTube series “The Care Giver,” in which he travels the United States to share stories of those in the epilepsy community, while providing support for caregivers and advice that addresses their personal needs. The series is sponsored by Jazz Pharmaceuticals.
Healio spoke with Grunberg, as well as Michael G. Chez, MD, a pediatric neurologist at the Sutter Institute for Medical Research in California, to learn more about the series and how it aims to benefit the epilepsy community.
Healio: How did the idea for the series come about?
Grunberg: Our oldest son, Jake, has epilepsy, and he was diagnosed when he was 7. We had no knowledge of what epilepsy was, just the sort of knowledge that everybody thinks they have — I saw somebody in elementary school hit the floor and have a seizure.
We didn’t know that there were so many different types of seizures, and we didn’t have any history in our family. He’s 26 now, so we’ve been through what I call the rollercoaster of going through all of this. He is doing really well, thanks to great medications, great therapies, great doctors and all that. But at the time, it was really scary, and we didn’t have anybody to talk to. There’s such a stigma.
I hope I’ve made a dent in that stigma over the years, but I kept hearing the same thing over and over again — you’ve got to talk about this, not enough people are talking about it. And so, I bought the domain “talkaboutit.org.” I was like, I’m going to enlist the help of every one of my celebrity [friends], whether you’re in or out of the epilepsy community.
I wanted to get people educated so that there wasn’t ignorance, there wasn’t a stigma, there wasn’t misinformation out there. If you see someone have a seizure, you could really save their life if you did the right thing. It’s very simple.
Healio: How does “The Care Giver” series benefit those in the epilepsy community?
Chez: This is an inspiring video series that shows Grunberg traveling around the country to help tell the stories of others in the epilepsy community, from searching for an accurate diagnosis to exploring new treatment options.
However, more importantly, Grunberg provides these caregivers with a much-needed day of care. Unfortunately, a common theme that I’ve seen firsthand as a pediatric neurologist is that caregivers do not prioritize their own health as much as they should and tend to put themselves on the backburner.
It is important to remember that in order to be able to provide the best care for loved ones, it is just as crucial for caregivers to take the time to care for themselves. I am so glad to see that the series encourages caregivers to prioritize their own health and well-being.
Grunberg: Every time I talk to a caregiver, it is sort of this safe way in. It’s a great way to talk about what they’re dealing with, the person in their life, how much they love them, how much they care for them. All we want for our loved ones is for them to be healthy and happy. You just want that silver bullet. If you hear about something you go, “How do we fix this?” In the case of our family, we deal with things head on. And so, that was a big thing for us. When I’ve met all these people, I’ve always had it in the back of my mind — these caregivers are really interesting. I’m one of them.
I’m traveling all over the country now, and I’m meeting these incredible people. This also happened at a time when we all realized how important rare forms of epilepsy are. And my son didn’t respond to the first medication. He’s one of those people that’s difficult to treat. And I know that there are so many out there, and I understand their situation.
Healio: What can this series provide that a clinician cannot?
Chez: The series brings caregivers together to share stories and experiences that take place when caring for loved ones who are living with rare and severe epilepsies. Clinicians may not be able to personally relate to caregivers’ experiences, as we tend to prioritize and focus on each patient’s care. For the caregiver, the journey can feel quite isolating. The series aims to provide strength for other caregivers in knowing they are not alone on this journey, and that there are in fact others going through similar experiences — for both the inspiring and difficult moments.
Grunberg: Every situation is different. That’s the other frustrating thing that we learned many, many years ago is you want to talk to somebody, you need to talk to somebody, and therapy is great, but you want to talk to somebody immediately. You want to see somebody who’s going through exactly what you’re going through, but it’s not going to happen. And so, you get frustrated at times.
But when I meet these caregivers, no matter what situation or what form of epilepsy or seizures their loved one is dealing with, there are so many similarities.
Terms of Reference
As the International League Against Epilepsy (ILAE) recognises that climate change poses a significant threat to the lives and wellbeing of people with epilepsy and to the work of professionals in the field, the Climate Change Commission undertakes to:
- Ensure that as a responsible organization, ILAE quantifies and understands its entire direct and indirect greenhouse gas emissions (Scopes 1-3), and commits to reducing Scope 1 and 2 emissions to net zero by 2030, and Scope 3 by 2035, ideally with external certification.
- Promote and establish sustainable practices across all ILAE activities, including its own operation, meetings, congress venues (to the extent ILAE has power to do so), publications, sourcing and recommendations (e.g. of particular clinical or research practices in epilepsy).
- Raise awareness amongst, and educate, ILAE membership about the impact of climate change (including through the promotion of research, knowledge and understanding) on people with epilepsy and epilepsy professionals, and of their own professional contributions to climate change: achieving climate literacy.
- Demonstrate leadership in this field and to engage with, and influence, other organisations and colleagues to achieve the same ends.
- Elaborate strategies and policies for adaptation and mitigation and best practice according to these terms.
Combining single-cell transcriptomics with systems biology-based analysis, a team led by scientists from SingHealth/Duke-NUS Academic Medical Centre has uncovered new details about the role of Cin epilepsy. Aiming to further investigate the hypothesis that inappropriate pro-inflammatory mechanisms contribute to the development of epilepsy, the scientists used single-cell cellular indexing of transcriptomes and epitopes by sequencing, or CITE-seq, to analyze lesional brain tissues from patients with drug-refractory epilepsy. As they report in this week’s Nature Neuroscience, the researchers uncovered a pro-inflammatory microenvironment, including extensive activation of microglia and infiltration of other pro-inflammatory immune cells, in the tissues. The researchers then performed a ligand-receptor interactome analysis that demonstrated potential mechanisms of infiltration and evidence of direct physical interactions between microglia and T cells. “Together, these data provide insight into the immune microenvironment in epileptic tissue, which may aid the development of new therapeutics,” the study’s authors write.
A study examining the clinical impact of molecular tumor profiling (MTP) with targeted sequencing panel tests in pediatric solid tumor patients is presented in this week’s Nature Medicine, pointing to the benefits of such testing. While MTP is largely used with adult cancer patients, some pediatric patients with solid malignancies have targeted MTP performed. To better understand the potential benefits of such testing in children with cancer, a group led by Harvard Medical School investigators enrolled 345 patients with extracranial solid tumors in a prospective observational cohort study, finding that 298 percent of the patients had one or more genomic alterations with potential impact on care. Alternations with diagnostic, prognostic, or therapeutic significance, meantime, were present in 61, 16, and 65 percent of patients, respectively. “Impact on care included 17 patients with a clarified diagnostic classification and 240 patients with an MTP result that could be used to select molecularly targeted therapy matched to identified alterations,” the study’s authors report. “Of the 29 patients who received MTT, 24 percent had an objective response or experienced durable clinical benefit … [and] all but 1 of these patients received targeted therapy matched to a gene fusion.” The results of the study, which is ongoing, support the “development of management guidelines and insurance reimbursement determinations addressing MTP with targeted panel tests in advanced pediatric solid malignancies,” they write.
Using a multi-omics approach, a group led by University of Oxford scientists has identified neurodegenerative pathways involved in progressive multiple sclerosis (MS) that may serve as intervention points for future therapeutics. Current treatments for MS are highly effective for the relapse-remitting form of the disease, while progressive MS has proven difficult to treat. In order to better understand the complex pathogenesis of progressive MS, the researchers applied spatial transcriptomics and high sensitivity proteomics to fresh-frozen human MS brain tissue, revealing multicellular mechanisms of progressive MS pathogenesis and tracing their origin in relation to spatially distributed stages of neurodegeneration. “By resolving ligand-receptor interactions in local microenvironments, we discovered defunct trophic and anti-inflammatory intercellular communications within areas of early neuronal decline,” they write. Proteins associated with neuronal damage in the samples, meanwhile, showed mechanistic concordance with in vivo knockdown and central nervous system models in the literature, supporting their role and value as potential progressive MS drug targets. “Our study exemplifies the importance of understanding complex diseases directly within the affected tissue, permitting a wealth of new clinical insights and providing a unique biomedical source for new treatment modalities,” the study’s authors conclude.
Long-term use of Xcopri was safe and reduced seizures by more than 90% in adults with uncontrolled focal seizures, according to results of an open-label extension study published in Neurology.
“The findings show that the notable improvement in seizure control that was seen in patients with uncontrolled focal epilepsy is sustained over long term,” Pavel Klein, MD, lead study author and epileptologist and neurologist at Mid-Atlantic Epilepsy and Sleep Center in Bethesda, Md., told Healio. “The study shows that a significant proportion of patients with uncontrolled epilepsy continue to remain seizure-free or have at least 90% reduction for a period of time that sustained over the duration of the study — for years.”
Klein and colleagues conducted a randomized, double-blind, placebo-controlled study of Xcopri (cenobamate, SK Life Science Inc.) and assessed data from 355 adult patients with focal seizures that were uncontrolled despite being treated with up to three antiseizure medications.
According to a press release about the study findings from SK Life Science, participants, who had at least eight seizures during the 8-week baseline period, completed the 18-week, double-blind phase and continued into the open-label extension.
The median treatment duration of cenobamate was 54 months (200 mg median daily dose, ranging from 50-400 mg). As of July 2019, 59% of patients (209 of 355) continued treatment.
During any 12-month period of the study, 13% to 16% of patients achieved seizure freedom, and among those, the median seizure-free duration during each 12-month interval was 48 months, 47.2 months and 45.1 months, the company reported in the release.
The study showed that all patients taking cenobamate experienced a median percent seizure frequency reduction over baseline that increased with each 6-month interval, up to 76% during months 43 to 48 of the study. Researchers further reported that 16.4% of patients achieved 100% seizure reduction during 36 to 48 months, and 39.1% of patients achieved more than 90% seizure reduction during the same period.
SK Life Science said in the release that no new safety issues were reported. Treatment was discontinued in 141 patients, with the most common reasons being a lack of efficacy (17%), withdrawal by patient (9%) and adverse events (8%). The most common treatment-related adverse events were dizziness, somnolence, fatigue and headache.
“The realization that we now have a medication that can bring about sustained seizure freedom for patients with uncontrolled focal epilepsy is very exciting and life-changing for patients who have that response,” Klein said. “It is a wonderful thing to be able to offer to patients.”
Source: healio.com, Ken Downey Jr.
Newswise — Most neurologists and epileptologists do their best to show compassion and empathy for their patients with epilepsy. But imagining yourself in the shoes of someone with epilepsy is different than actually being there.
Sharp Waves talked with a medical student in the United States who also has epilepsy. He took a year out of his medical training to be surgically evaluated and receive a responsive neurostimulator (RNS) device.
How does he manage his epilepsy and his medical training, and how is his epilepsy affecting the way he plans to practice medicine? Let’s find out.
The following is the transcript of the episode.
Most neurologists and epileptologists do their best to show compassion and empathy for their patients with epilepsy. But imagining yourself in someone else’s shoes is different than actually being there.
Sharp Waves talked with a medical student in the US who’s also done graduate coursework in neuroscience. He’s considering a neurology specialty; he’s 28 years old and is an avid rock climber, mountain biker, and skier. He also has epilepsy. He took a year out of his medical training to be surgically evaluated and receive a responsive neurostimulator (RNS) device.
How does he manage his epilepsy and his medical training, and how is his epilepsy affecting the way he plans to practice medicine? Let’s find out.
Richard Nolan: My name’s Rick Nolan, I’m a third-year medical student, rounding out my third year at West Virginia University. I’ve been here for undergrad, neuroscience in grad school, and now med school. I was actually in the neuroscience PhD program here. I didn’t end up finishing my PhD; I had some issues with my advisor leaving and it just worked out better for my interests to just kind of transition into medical school. I’m still able to do research and things like that, so it definitely checks all my boxes. I’m originally from Colorado but I’ve lived in West Virginia for quite a while.
Kind of a fun thing, I published a study about my own brain along the way – I have a cortical malformation, it’s called a paraventricular nodular heterotopia – it’s like a little bundle of gray matter that didn’t migrate out to the cortex, it just kind of stuck along my ventricle.
Oh, that’s cool – you were like your own research subject! …Can you talk a little bit about your epilepsy history?
Nolan: So I never had a problem with seizures until I was I think 21 or 22, I had my first seizure. I went into the epilepsy monitoring unit (EMU) just for routine EEG, and then ended up having a video EEG. I got kind of a workup there and ended up being managed by a general neurology clinic, and continued to have problems over the course of the next year, so I was eventually transitioned to a dedicated epileptologist. I had my care managed for a few years with her, and I was still having issues. This is when I was in medical school. I continued to have occasional seizures.
Luckily, I’ve had only two generalized tonic-clonic seizures ever, and they’ve both been in the EMU, so a pretty safe environment. I usually have either partial or complex partial seizures. I continued to have those in medical school and kind of decided with my neurologist that it was prudent to pursue a surgical option. I ended up having a (responsive neurostimulator) RNS device implanted, so I went through the whole intracranial EEG monitoring, which was a pretty terrible experience, but had that RNS placed. So now here I am, that was in between my second and third year of medical school so I had to take a year off.
So during your first couple of years of medical school, you were still having seizures.
Nolan: Yes ma’am. I had probably a seizure frequency of maybe between one to five times a month, something along those lines, during my first two years of medical school.
I tried to stay, I’m luckily just kind of a positive person so I tried to stay positive about the whole situation, but it’s definitely distressing. It would get in the way of my studies sometimes, and honestly, I was probably in kind of denial about it for a while, about the fact that this had gotten to the point where it was refractory to medications and further steps likely needed to be taken. But kind of toward the end of my second year, after some conversations with my neurologist, we came to the decision that we needed to pursue a surgical route. It was kind of hard to deal with. It’s been an interesting experience. Definitely had an impact on my mental state somewhat, somewhat on my studies, and things like that, but I’ve tried to stay positive about it.
Did your epilepsy affect your decision to go to medical school, and how is it affecting your training and how you’re thinking about interacting with patients?
Nolan: It definitely played a role in my decision to go to medical school. It was one thing that got me kind of really interested in neuroscience to begin with, before I went to graduate school. My advisor was one of the neurosurgeons here, so I ended up having a fascination with neurology and neurosurgery in particular, especially functional neurosurgery which is kind of ironic, with where my treatment course went. But I feel like it’s given me kind of a personal view, especially a chronic health condition that affects a lot of aspects of my daily life, in dealing with patients who have similar conditions. It doesn’t have to be epilepsy, really anything, I think it’s helped give me insight on how that affects them on a personal level as well as the medical side of things. It’s been beneficial in that regard.
Right. So you have a unique perspective as someone who’s going through medical training who’s also had a surgical workup and an invasive surgical procedure. Can you talk a little bit about that?
Nolan: After kind of deciding that the surgical route was probably a good option for me, especially with this known cortical malformation, because that may have been the cause of my seizures, I ended up having – COVID delayed all of this, I was only supposed to be out for a couple of months, but it ended up taking the whole year – but I had 13 intracranial electrodes placed. I had really nice long hair before, and I had to shave it off and donate it. I stayed in EMU for I think six days with those. That was actually by far the worst part of all of this in terms of treatment. I’m a really active person and you’re not even allowed to get out of the bed at all, so that was really difficult for me. It was a frustrating experience. It was physically uncomfortable, but the impact it had on my mental state while I was in there was probably the worst part for me.
A lot of my treatment team knew where I was in the process of my medical education and everything. It was nice to be spoken to at the level that I wanted. You know, at that point I’ve developed enough knowledge of what’s happening to kind of know what was going on. They all communicated with me super well, so that was very much appreciated and made the whole experience a little bit better.
That whole process, it was uncomfortable but not terribly painful. The biggest impact on me was… the physical manifestations were not as bad as how I was doing mentally in that position. That gave me pretty good insight from my perspective as a medical student and future physician, when I see people who’ve been in a bed for, this is their 14th day of admission or you know, whatever day it might be, it’s pretty easy to kind of blow that off, but that really does have a big impact on your psyche and how you deal with everything. At the time it was unpleasant, but it really did give me a pretty good insight on thinking about length of stay of patients and things like that.
So that was beneficial, definitely, and after they removed the electrodes, I had to wait for my results. That was kind of hard; that was another just waiting game. Getting my results back was a little discouraging too, because as I have this little cortical malformation, I was really hoping that the seizures were coming from that, because that may have been easier to address in terms of surgical resection or some sort of ablation, but my seizures weren’t stemming from that. I had some foci in my temporal lobes, so the resection was taken off the table at that point. That was kind of hard to deal with.
I think it was pretty soon thereafter we discussed the RNS treatment and after being explained the pros and cons of the treatment, the procedure, doing my own research on it, that seemed like the best option. Because, especially in this field, I want to have the best seizure control I can for myself, for my patients, for everybody involved.
So was that like a year ago?
Nolan: I had my intracranial EEG I think in April or May of last year, so about a year ago, and then ended up having the RNS implant in I think late June or early July. It was 2 ½ weeks before I came back to medical school, so that was something!
Yeah, how did that go? Was there much recovery time?
Nolan: Apparently I did pretty well with it. I only had to stay in the hospital overnight, was discharged the next day. This device sits in a little titanium tray, maybe 2 ½ inches by 3 or 3 ½ inches. I had a craniotomy, they put the titanium tray in, put the device in the tray, and I have two depth electrodes going to each of my temporal lobes. The recovery process from that… the first couple of days were pretty bad. They gave me some good painkillers and basically told me to lay in bed for a couple of weeks. I think I had 80-some staples in my head, so that was uncomfortable, definitely. But I ended up having a pretty good recovery period.
I got a little bit scolded for this, but I rode my bike to the clinic two weeks later to get my staples removed and when I showed up, the advanced practice provider who was removing my staples was like, “Why do you have a helmet?”
“Oh. Well, I rode my bike here!”
“People aren’t even up and walking around. What are you doing?”
“I’m going to go climb after this!”
So a bit atypical in that regard.
If you’re naturally physically active maybe that helps you bounce back, right?
Nolan: It’s definitely one of my coping mechanisms, my forms of enjoyment – I’ve been an action sports athlete all my life. Grew up racing bikes, skis, dirt bikes, climbing, all that kind of stuff.
Have you had seizures or aura since the RNS?
Nolan: Unfortunately I have, and with the RNS device its efficacy, how well it works, really improves over time, so I knew it was going to take a while. As much as I wanted it to be an instant fix, it wasn’t. It’s definitely improved my seizure frequency and severity, which has been really nice. I pretty infrequently now have any sort of loss of awareness, so that’s nice. But it’s not perfect. I’m working with my neurologist, playing with some medications and things like that. It’s an ongoing process.
So it sounds like you’re interested in neurology as a medical specialty – is that where you’re headed?
Nolan: I came into medical school thinking that neurosurgery was the coolest thing ever and that’s what I wanted to do. And I kind of unfortunately had to eventually kind of come to terms with the fact that a surgical specialty just wasn’t feasible for me. It’s not fair to your patients or really anybody if you were to have a seizure in the operating room. That was something I couldn’t — I came to terms with the fact that that wasn’t really an option for me.
But I really like brains! So definitely on the top of my list right now are neurology and psychiatry, I think the brain is super cool, the pathology is just fascinating, the room for advancements in therapeutics is mind boggling, especially with some of the interventions we have now.
Did you experience any stigma or discrimination, even from yourself? Like you said at one point you were in denial.
Nolan: During my first two years of medical school, and really before that too, I was not very forthcoming with this diagnosis. I really didn’t talk about it too much. I was afraid of the stigma. Epilepsy doesn’t have the best… the public doesn’t always perceive it in the best way. And I didn’t really like facing it, so I was pretty reserved. I didn’t talk much about it with a lot of people. Even in publishing the study about my own brain, I didn’t tell a lot of people that it was actually about me.
I dealt with that denial, the fear, stigmatization, everything, but after having the procedure, having this RNS implanted, that challenged me a lot to confront this on a personal level, and since then, I’ll tell pretty much anybody who’ll listen, because it’s kind of a fun story. It’s unique. So I’ll ramble on to people, especially about the medical side of it, that whole experience.
I was actually speaking about this this morning – in talking to you, this is one of the first times I’ve really kind of delved into the personal aspects of epilepsy and my experiences with it. I tend to still kind of keep it clinical, for lack of a better term. But I really appreciate you helping me bring this side of it out, too. It’s good to have both perspectives.
Well I appreciate you being willing to talk about it. Do you have any thoughts on how physicians could help people newly diagnosed to accept their diagnosis, accept treatment, generally speed the process of acceptance rather than denial?
Nolan: I think that kind of thought rings true for, epilepsy is an excellent example because it’s a hard thing to confront, it’s stigmatized in the public and all that, but this goes for a lot of things. Seeing a lot of this from the perspective of a medical student, future physician, it’s really easy and almost kind of protect yourself in some regards, to treat a disease and not a patient. It’s hard to think about the whole human sometimes and it’s really easy to say, “Okay, this person has epilepsy and they’ve tried this drug and this drug, so we should probably go for that, and if that doesn’t work… ” and then they leave the office and that can kind of be the end of it. But the personal side is a lot to deal with, and something a lot of physicians might not think about as much.
I think it’s really important and I’ve been trying to do this more and more, to think about not just a disease process that someone is experiencing but to really also try to consider their perspective on it is really important, in guiding treatment and to know where they are in the process, if they’re going to take their medication, things like that. So kind of promoting people to have some insight is really important, and even play a role in guiding their own treatment. I think this is kind of evolving too. We’ve spoken a lot about this in my training, shared decision-making type things, give patients options, I think that’s really important and sometimes easy to not do, because for lack of a better term, you might “know better” than them. It’s a hard problem to face.
In terms of specifically epilepsy, talking to patients too, it’s a hard thing to accept and deal with. Partly due to it’s kind of a scary condition, to know that you might all of a sudden have a seizure and whatever manifestation that might have, it’s distressing.
One thing that would be beneficial would be to develop better ways to communicate to patients, not just a seizure plan, if you’re having a generalized tonic-clonic seizure, what’s your significant other going to do, what’s your mom going to do, whoever it may be, but it would be nice to have a little bit more focus on how to deal with it yourself. Because that’s something I’ve found over this process that I’ve eventually come to terms with, but it was hard to do, and that was kind of self-guided. I don’t know how to do that, but if we could have a bit more focus on how to deal with the personal struggle with it, that would be nice, be that in a neurologist’s office or a referral to another specialty like psychiatry or whatever your needs might be.
As an adult with epilepsy, how has it affected your day-to-day life and your ability to do things independently?
Nolan: With the independence you know, a lot of people can’t drive, like I ride my bike everywhere. So that can be hard. Luckily I’m in a place where I can do it, but for a lot of people that is a lot of loss of independence.
My neurologist knows I engage in some kind of risky behaviors for someone with epilepsy. I ride my bike, I rock climb, I ski, and I understand that sometimes that’s not super smart, necessarily, but I gotta do it.
Do you have a typical seizure?
Nolan: I’ve been much better controlled with medication changes, the RNS device, so right now a typical seizure for me at this point, the most common symptoms I’ll experience is, more of the focal symptoms where I’ll feel a little bit of derealization, that déjà vu feeling, that can last for a little while, but then I’ll come back to normal pretty quickly.
I still do have occasional seizures where I lose a little bit of awareness, and luckily I have it pretty good, to be honest. I usually have to tell somebody if I’ve had a seizure. But if I have one where it’s a little worse, I’ll have a post-ictal period where I’m drowsy and confused and feel really poorly. That actually happened to me a few days ago, in the middle of an exam – of a neurology exam. But luckily the course director totally understood, and she extended my time and said, “You’re good – don’t worry about it”.
But it’s still a possibility. I’ve had a seizure in the clinic before, and I’ve just told who I’d been working with that it happened and you know, “I need a little bit of time.” Everyone’s been really permitting. I don’t feel I’ve experienced much if any overt discrimination and that’s nice.
I have an excellent support system. I have a significant other who’s wonderful, she’s taken care of me throughout all my surgeries, is really supportive of me, and I’m really lucky to have that, and I know some people don’t, and that must really make it more difficult, so I think it would be important to either educate and help whoever their support system is to understand what to do during a seizure, from the medical component, but also a personal side, because it’s hard to deal with for them, too, absolutely.
So getting that social support both for the patient and their support system is really important and something that is overlooked pretty frequently, in my opinion. That’s kind of my last thing.
That’s a very good point. Thanks again – much appreciated!
Nolan: Thank you so much!
Source: newswise.com, International League Against Epilepsy
Doctors are warning parents that the popular but controversial practice of “co-sleeping” puts babies at a higher risk of suffocating.
The American Academy of Pediatrics released updated guidelines Tuesday for safe sleeping with infants and toddlers after multiple suffocation fatalities linked to the now-recalled Fisher-Price 4-in-1 Rock ‘n Glide Soothers.
Every year, according to the AAP’s new parental alert, approximately 3,500 infants die of sleep-related fatalities, including sudden infant death syndrome, known as SIDS.
While the new version of the policy stresses that infants should sleep on a firm, flat surface that is not inclined, now, experts also report that even the most devout parents shouldn’t co-sleep or share a bed.
“The AAP understands and respects that many parents choose to routinely bed share for a variety of reasons, including facilitation of breastfeeding, cultural preferences, and a belief that it is better and safer for their infant,” the AAP stated. “However, on the basis of the evidence, the AAP is unable to recommend bed sharing under any circumstances.”
Instead, doctors recommend housing the child’s crib in the parents’ room – at least for six months — since this modified version of co-sleeping can significantly decrease the risk of SIDS by 50%.
“This arrangement also reduces SIDS risk and removes the possibility of suffocation, strangulation and entrapment that may occur when the infant is sleeping in the adult bed,” the report continued.
To further reduce the risk of SIDS, infants should also sleep on their backs, drink human milk, use a pacifier, and have supervised, awake tummy time.
“We’ve made great strides in learning what keeps infants safe during sleep but much work still needs to be done,” said Dr. Rachel Moon, a lead author of the report, in a statement. “A baby’s death is tragic, heartbreaking and often preventable. If we’ve learned anything, it’s that simple is best: Babies should always sleep in a crib or bassinet, on their back, without soft toys, pillows, blankets or other bedding.”
Meanwhile, there is “no evidence” that suggests swaddling reduces the risk of SIDS, according to the report — but if babies are swaddled, they should be placed on their back. To properly swaddle a child, it should be snug around their chest but with room at the hips and knees.
The updated guidance and announcement comes after at least 13 reported deaths from 2009-2021 due to Fisher-Price’s Infant-to-Toddler Rockers and Newborn-to-Toddler Rockers. Last week, the US Consumer Product Safety Commission and Fisher-Price released a statement regarding every parent’s worst nightmare.
“Rockers should never be used for sleep, and infants should never be unsupervised or unrestrained in the Rockers,” the statement read, adding that more than 17 million of the products have been sold since the 1990s. The joint statement also reiterated infant sleeping guidelines, saying babies should sleep on their back on a firm, flat surface with a fitted sheet.
Last month, President Joe Biden signed the Safe Sleep Act for Babies, which banned the manufacture, sale and distribution of inclined baby sleep devices and crib bumpers, which have been linked to infant deaths.
Source: nypost.com, Brooke Kato
A concussion is a traumatic brain injury (TBI) that can happen after a blow or a jolt to your head. It happens if the impact was strong enough to make your brain move rapidly back and forth inside your skull. This results in chemical changes in your brain that affect its normal function.
There are different grades of concussion severity, and they depend on how much damage your brain sustained during the impact. But, how common is epilepsy after a concussion?
It’s possible to develop seizures and epilepsy (repeated seizures) after a concussion. Seizures can happen right after the injury (early symptoms) or months and even years later (late symptoms). Different factors, such as concussion severity, increase the likelihood of seizures.
Keep reading to learn about the connection between concussion and epilepsy, early and late symptoms of seizures after a concussion, how to treat concussion-related epilepsy, and other useful information.
The connection between concussion and epilepsy
According to the Centers for Disease Control and Prevention (CDC)Trusted Source, among people 15 years or older hospitalized for TBI, around 10 percent will develop epilepsy in the following 3 years. The likelihood of developing seizures and epilepsy is higher if your brain injury is severe. Why does this happen?
Seizures can happen in response to drastic chemical changes in your nerve cells (neurons). Normally, neurons release molecules called neurotransmitters that act as chemical messengers between the cells in your body. They control everything that you feel and do, from your mood to the movement of your muscles.
However, during a concussion, the shaking of your brain in the skull may result in a discharge of neurotransmitters from the neurons in your brain that can lead to a seizure. If a seizure happens within the first week after the head injury, it’s called an early seizure. Most early seizures happen within 24 hours following TBI.
Late seizures and epilepsy
If a seizure happens more than a week after your concussion, it’s called a late seizure. These seizures happen when the injury is more severe and causes more long-lasting or even permanent changes in your brain. For example, death of neurons or changes in connections between neurons. Late seizures are more likely to repeat, causing epilepsy.
Risk factors for seizures after TBI
Risk factors for early seizures after TBI include:
- age less than 5 years
- bleeding in the brain
- penetrating injury (something that breaks your scalp and enters your brain)
- brain swelling
- loss of consciousness or memory loss that last longer than 30 minutes
Risk factors for late seizures after TBI are:
- age over 65 years
- bleeding in the brain
- depressed skull fracture (a fracture that causes your skull to sink into the brain cavity)
- penetrating injury
- brain swelling
- early seizures after TBI
- abnormal electroencephalogram (EEG) reading
Signs of epilepsy after a concussion
Epilepsy that develops after a concussion or another TBI is called post-traumatic epilepsy. Its symptoms and signs depend on the type of seizure. You can have more than one type of seizure.
There are two main groups of seizures: generalized and focal, also known as partial. Generalized seizures affect both sides of the brain, while focal seizures affect one area. According to a recent study, about 73 percent of people with post-traumatic epilepsy have generalized seizures.
There are two main types of generalized seizures:
- absence seizures (“zoning out” for a few seconds)
- tonic-clonic seizures (muscle jerks and spasms, loss of consciousness)
Focal seizures can be:
- simple (or focal aware seizure) — twitching or change in sensation like strange taste or smell
- complex (or focal unaware seizure) — decreased level of consciousness, repetitive movements
- secondary generalized (or focal to bilateral tonic clonic seizure) — a focal seizure that progresses into a generalized seizure
When to get medical attention
If you suspect a concussion in yourself or your loved one, it’s best to see a doctor within 1 to 2 days after the episode. They can help evaluate the severity of the injury.
You should seek emergency care for any of the following symptoms after a brain injury:
- slurred speech
- trouble waking up
- confusion or loss of consciousness
- trouble walking or maintaining balance
- bouts of nausea or vomiting
- memory loss
- worsening headache
- penetrating head injury
If more than a week has passed after your concussion and you experience a seizure, make sure to see a neurologist.
How epilepsy is treated after a concussion
The main goal of treatment for post-traumatic epilepsy is to prevent future seizures. Based on your risk factors, your doctor may prescribe anti-epileptic drugs after a concussion to decrease the likelihood of early seizures.
If you begin experiencing late seizures, your doctor may prescribe medications to prevent future episodes. They will determine which medications will be the best for you and how long you will need to take them. Although it’s rare, your seizures may gradually slow down and even stop for good.
If you continue to have seizures despite taking anti-epileptic medications, surgery may also be an option.
The bottom line
Although most people will never have a seizure after a concussion, up to 10 percent can develop epilepsy (repeated seizures).
There are two types of seizures after a brain injury: early and late. Early seizures happen within the first week after a concussion. Late seizures appear after the first week and usually reflect more severe and long-lasting damage.
Any seizures after a brain trauma should be evaluated by a medical professional. Your doctor may prescribe medications to prevent future episodes.
Source: healthline.com, Olga Askinazi, PhD
Epilepsy is a chronic disorder in the central nervous system hence it is also called a neurological disorder.
This disorder usually causes abnormal brain activity, leading to seizures or periodic unusual behaviour, sensations, or loss of self-awareness.
According to Deegbea, Aziato and Attiogbea (2019), epilepsy interrupts the normal electrical activity of the brain to cause seizures, and globally about 50 million people suffer from epilepsy, accounting for 0.5 per cent of the global disease burden.
Empirical studies show that about 10 million people in Africa suffer from epilepsy. The incidence of epilepsy in Ghana is comparatively higher than the same in most Sub-Sharan countries.
Arguably, epilepsy is continuously misunderstood and people living with epilepsy (PLWE) are often stigmatised. In Africa, persons with epilepsy are shunned and discriminated against in education, employment and marriage because epilepsy is often perceived as a shameful and contagious disease.
It must be clarified that epilepsy is not contagious or infectious hence a person cannot contract the condition from an epileptic person.
However, all ages, genders, races and ethnic groups are susceptible to epilepsy.
Causes, symptoms and complications
It is a fact that epilepsy has no identifiable cause. In some other people with epilepsy, however, the condition may be attributable to various germane factors such as genetic (hereditary) influences, history of head trauma, brain abnormalities (e.g. tumors or vascular malformations), infections (e.g. HIV), prenatal injury and developmental disorders such as autism.
The topmost symptom of epilepsy is seizure with widely varied symptoms. Some epileptic patients simply stare blankly for a few seconds during a seizure, while others repeatedly twist their limbs.
Having a single seizure does not necessarily mean a person has epilepsy. Diagnostically, at least two unprovoked seizures that happen at least 24-hourly are generally required to say a person has developed epilepsy.
Mindful of the fact that epilepsy is associated with abnormal brain activity, seizures affect any process the brain coordinates.
Signs of seizure and symptoms may include but not limited to momentary confusion, a staring spell, stiff muscles, uncontrollable jerking of upper and lower limbs and loss of consciousness.
However, symptoms may vary from person to person and depending on the type of seizure. Clinicians generally classify the seizures as focal or generalised.
Whereas focal seizures start in one area of the brain and can spread across the brain depending on how the electrical discharges spread, generalised seizures begin at both hemispheres of the brain.
Epileptic seizures have complications for the person living with the condition. Some of these complications may include falling, drowning, road traffic accidents, burns, pregnancy complications, emotional health issues such as depression and suicidal thoughts, recurrent seizures without regaining consciousness (status epilepticus), sudden unexpected death in epilepsy (SUDEP) and many more. It is obvious that some of the complications stated here can be life-threatening
History and superstition
Some historical accounts point to the fact that epilepsy was first described in Babylonian texts more than 3,000 years ago and ancient Greeks referred to epilepsy as the “sacred disease” because they associated epilepsy with the divine.
Romans also believed that epilepsy was contagious and they referred to an epileptic person as moonstruck.
Throughout global history and even in Ghana and other parts of Africa today, epilepsy has been linked to witchcraft, the presence of an evil spirit, or the casting of a spell on a family by someone else.
In fact, an author called Malleus Maleficarum (1494) wrote a book dubbed “The Hammer of Witches” and asserted that witches had special powers that account for epileptic seizures.
The Bible also makes a famous reference to epilepsy by stating in the Gospel that Jesus healed the boy with seizures by driving out an evil spirit. One may refer to Mark 9:17-27 or Matthew 17: 14-18 or Luke 9:37-43.
This may explain why many modern-day Christians believe that epileptic seizures are caused by spirits rather than medical causes, especially when medicine also offers no cure for the condition.
In Christian religious circles, Saint Valentine is recognised as the patron saint for epilepsy hence every February 14, is deemed as International Epilepsy Day.
Perhaps the debatable question may be: is every epileptic seizure medical or spiritual? Did Jesus cure an epileptic seizure or a different type of seizure?
Have clinicians equally not been gifted by God to manage epileptic patients? Must contemporary clergy subject an epileptic patient to exorcism or just pray with the person?
In my scientific view, epilepsy is a common medical condition and is not caused by spiritual attacks in any way. Persons with this condition can live a normal and productive life under appropriate medical management.
To my mind, the scientific explanation of epilepsy takes precedence over the beliefs or superstitions used over the years to diagnose and proffer cure for the condition.
It is equally true that even though science has unmasked why epilepsy occurs, there is still no known cure for it.
However, there are many medications, medical devices, and surgical options to treat epilepsy in contemporary times.
Incredible advancements in research have equally helped us understand the mechanisms that cause seizures better than at any other point in history.
Advisedly, therefore, a person suffering from epilepsy or a family that has an epileptic member must visit the hospital for proper diagnosis and appropriate management of the condition.
Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away.
Some children with epilepsy may outgrow the condition with age. Above all, people living with epilepsy deserve care and compassion but not antagonism, marginalisation and stigmatisation.
Source: graphic.com.gh, Philip Afeti Korto
Melanie Griffith is among the most recent celebrities to talk about her diagnosis of epilepsy. By taking this courageous step, she has made the epilepsy room bigger, contributing to awareness and discussion of epilepsy around the world and helping others with epilepsy feel less alone.
Griffith said that her seizures were often triggered by stress, and that she has been able to manage her epilepsy with medication.
Stress is a common theme among MyEpilepsyTeam members. One member wrote, “My trigger is stress, stress, stress.” Another said, “After several stress-induced seizures last week, I was taken away from the stress and ordered into a Jacuzzi to relax. Was great to be a relaxed body!”
Members Make the Community Stronger
Since MyEpilepsyTeam launched in 2015, we have grown to become 93,000 members strong — that’s a big room! Just as Griffith’s announcement amplifies the voice of those with epilepsy, each new member on MyEpilepsyTeam makes our community stronger.
Without an epilepsy community, it can be easy to feel isolated, like you’re the only one struggling with seizures and the aftereffects. Whether you have spoken directly with other members or not, by joining MyEpilepsyTeam and reading shared experiences, you have become part of the community.
Talk With Others Who Understand
On MyEpilepsyTeam, over 93,000 people living with epilepsy come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.
Are you living with epilepsy? Share your experiences in the comments below, or start a conversation by posting on your Activities page.
Source: myepilepsyteam.com, Anika Brahmbhatt
Epileptics who sleep on their stomachs may be at a higher risk of an unexpected, sudden death, says the American Academy of Neurology.
Epilepsy is a brain disorder characterized by seizures. People with epilepsy who experience tonic clonic seizures (formally called grand mal seizures) that affect the whole brain are more likely to die suddenly than epileptics whose partial seizures affect part of the brain.
“Sudden unexpected death is the main cause of death in uncontrolled epilepsy and usually occurs unwitnessed during sleep,” said study author James Tao, MD, PhD, with the University of Chicago in Illinois and a member of the American Academy of Neurology.
After reviewing 25 studies, researchers examined 253 sudden, unexpected death cases that recorded the body position at the time of death. They found that 73 percent of the patients died while sleeping on their stomachs, while the other 27 percent slept in other positions.
A study of a subgroup of 88 people revealed that people younger than 40 were four more times to be sleeping on their stomachs when they died suddenly than people older than 40. Researchers found that 86 percent of patients under the age of 40 slept on their stomachs, compared to 50 percent of patients over the age of 40.
“We’re not sure why this was more common in younger people,” Tao said. “It may be that they are more likely to be single and not have anyone with them during a seizure while sleeping.” He added that someone who is sleeping with an epileptic who is sleeping on their stomach should help them to shift onto their side or turn over during or after a generalized tonic clonic seizure.
In 11 cases of sudden death, people with epilepsy were monitored with a video EEG and the position in which they slept was reported. Most of them were sleeping on their stomachs before the terminal seizures occurred and they died in a prone position. Adults often have difficulty waking up after a seizure in a manner similar to infants in SIDS (Sudden infant death syndrome) cases.
“Our findings highlight an important strategy for preventing sudden unexpected death in epilepsy – that ‘back is best,’” Tao said. “Using wrist watches and bed alarms designed to detect seizures during sleep may also help prevent these deaths.”
Source: tunisiesoir.com, Janet R. Aguilar
Prevalence, Risks, and Survival
Epilepsy is a neurological condition that causes recurrent seizures (uncontrolled electrical activity in the brain). There are many types and causes of epilepsy, including brain damage and genetic brain diseases.
Epilepsy can be treated with medications or other interventions to help prevent seizures from occurring, and there are some ways to reduce the risk of epilepsy.
This article will describe the prevalence of epilepsy among different age groups, risk factors, causes, the impact of epilepsy on life expectancy, and more.
First-time seizures without a previously identified cause need medical treatment and a workup. Epilepsy is diagnosed when a person experiences repeated seizures. While there are different seizure patterns and symptoms, most people who have epilepsy experience one or just a few specific seizure patterns.
Epileptic seizures can either occur without a trigger or be triggered by certain factors, such as fever, infections, illness, sleep deprivation, alcohol, and drugs.
The most common symptoms of a seizure are:
- Decreased awareness of surroundings
- Lack of responsiveness
- Involuntary movements (muscle jerks, twitches, stiffening of arms or legs, rhythmic shaking)
- Decreased purposeful movements
Most seizures last for a few seconds and are followed by fatigue or sleepiness. Many people who have epilepsy can feel subtle symptoms before a seizure begins. Seizures lasting more than 30 seconds should be treated. If the activity continues for more than five minutes, or if there are clusters of seizures, it is a medical emergency.
How Common Is Epilepsy?
According to the Centers for Disease Control and Prevention (CDC), approximately one out of 100 people in the United States experiences epilepsy. This number has been fairly stable over the years and there are no specific indications that it would change in the near future.
Epilepsy by Ethnicity
Many factors can affect the incidence and outcome of epilepsy. There are cases of epilepsy in every country in the world. Ethnicity is not specifically associated with epilepsy.
Access to healthcare affects the risk and outcomes of epilepsy.
- Prenatal care is an important factor in epilepsy risk. Problems with pregnancy and delivery can cause a developing baby or a newborn to experience brain damage, which can cause some children to have epilepsy.
- Getting regular health checkups reduces the risk of stroke (a blockage of blood flow in the brain), which can cause epilepsy.
- Proper medical care after a stroke or head trauma can also help lower the incidence and severity of epilepsy.
Demographic features and race are associated with co-occurring conditions in people with epilepsy. This can add complexity to care and increase the risk of disability.
One large study found that of the people with epilepsy, American Indians and Alaska Natives had a higher prevalence of developmental disorders and that Black people had a higher prevalence of hypertension (chronic high blood pressure).
Epilepsy by Age and Gender
According to the CDC, epilepsy affects 3 million adults and 470,000 children in the United States.2 The condition can begin during infancy, childhood, adolescence, or later in life.
Many children who have mild or moderate epilepsy can have good seizure control with medical or surgical interventions. Some children may also have associated congenital (present at birth) neurological impairments, such as paralysis, speech difficulties, or learning impairment.
Young children who have severe forms of epilepsy may have significant disabilities due to the associated brain malformations or genetic changes that can cause severe types of epilepsy.4
Sometimes, the recurrent seizures and the high doses of medications that are often needed can interfere with many aspects of learning and development. Very severe early childhood epilepsy is also associated with a risk of early death.
Adolescents and adults who develop epilepsy as a result of brain damage can have a range in the severity of epilepsy. Those who have had a major stroke or substantial head trauma may also have severe neurological deficits, such as personality changes and loss of independence.
Males have a slightly increased incidence of epilepsy and unprovoked seizures than females.5 Some epilepsy drugs can damage a developing fetus and should not be taken during pregnancy.
Source: verywellhealth.com, Heidi Moawad, MD,
About 3.4 million Americans — including about 470,000 children — have epilepsy, according to the U.S. Centers for Disease Control and Prevention. People with epilepsy have spontaneous seizures, which are like an electrical thunderstorm in the brain.
Causes of epilepsy include brain injuries, infections, tumors and stroke. And while it has long been suspected that genetics contribute to epilepsy, until recently we were often unable to identify specific genetic disorders. Most commonly, genetic changes causing epilepsy affect how cells in the brain work or communicate, leading to the abnormal electricity in the brain. While some genetic epilepsies are familial or inherited, many are spontaneous changes or “de novo” occurring in families without any relatives with epilepsy. For some patients, we can identify a specific genetic cause via a test (typically blood or saliva).
The most common type of seizure caused by epilepsy is a whole-body convulsion with stiffening, shaking, loss of consciousness and breathing changes. Other seizure types can include unresponsiveness, sensory changes such as an odd smell or taste. While people can have more than one type of seizure type, most people tend to have the same type of seizure each time.
Primary care doctors will often refer children with these symptoms or similar symptoms to a neurologist to determine if a seizure has occurred. After taking a detailed history and doing a physical examination, the neurologist may have a patient undergo brain imaging or an electroencephalogram (EEG), which looks at electrical brain waves. In children and adults who continue to have seizures despite being treated with two antiseizure medications, they should be evaluated by an epileptologist, a neurologist with additional training in epilepsy, at a Comprehensive Epilepsy Center.
Medications are the first treatment choice for epilepsy. More than 30 medications are used to treat seizures, but the choice of which medication to try first is individualized for each patient.
My treatment goal is stopping seizures without medication side effects. While many people will respond well to their first or second medication, one-third of people with epilepsy continue to have seizures. In those patients, we consider alternative treatments such as medically supervised dietary changes (the ketogenic diet or modified Atkins diet) or devices such as vagal nerve stimulators that send electrical pulses to the brain to prevent seizures from occurring. In select patients, epilepsy surgery is an option that may safely cure their seizures. Some of the medications we use for seizures have been around for many years, but, fortunately, new medications and treatment options are coming out regularly.
At UVa Health, we are certified as a Level 4 center — the highest level of care — by the National Association of Epilepsy Centers, providing high-quality care to both children and adults. Our comprehensive care team includes neurologists and epileptologists, nurse coordinators, EEG technologists, neuropsychologists, a dietitian, neuroradiologists and neurosurgeons. At UVa, I am fortunate to have phenomenal colleagues who specialize in developmental pediatrics, genetics, behavioral health and psychiatry who I often call upon to help care for my patients.
SOurce: dailyprogress.com, Dr. Erika Axeen
Amid the challenges already faced by people with epilepsy, a new study reports another: steadily rising costs for brand-name anti-seizure medications, partly spurred by increased prescriptions for the drug lacosamide.
Doctors and patients need to be aware of how massively increased costs are for brand-name medications compared with generic equivalents. Dr. Samuel Waller Terman, the study’s lead investigator, told UPI (United Press International).
Terman is a neurologist and assistant professor at the University of Michigan.
Researchers found the cost of a one-year’s pill supply of brand-name epilepsy drugs skyrocketed by 277% from 2010 to 2018 — from roughly $2,800 a year between 2008 and 2010 to about $10,700 a year by 2018.
By contrast, the cost of a one-year’s pill supply of generic drugs for epilepsy decreased by 42% over the same period, says the study published in Wednesday’s online edition of Neurology, the journal of the American Neurology Association.
According to the study, brand-name drugs represented 79% of epilepsy drug costs, even though they comprised only 14% of prescriptions.
“Even if the patient doesn’t see a high cost if a brand-name medication is covered by insurance, huge brand-name costs still contribute to high U.S. healthcare expenditures,”” Terman said.
“We need to be mindful of when deciding what medications are worth the cost when frequently just-as-effective generic substitutes exist.”
In contrast to a century ago when very few treatment options for epilepsy existed, Terman said, “Nowadays, we have more than 30 prescription anti-seizure medications on the market as the research pipeline into drug discovery only continues, which only intensifies questions about which is the right drug for a given patient.”
“Unfortunately some other work has shown that most newer drugs haven’t necessarily shown improved seizure reduction compared with older drugs,” Terman said.
“But as far as I am aware, most of the time we feel that brand and generic medications for epilepsy work about equally well.”
Choosing the right medication for a given patient often has complexities, Terman said..
“Most of the time, we believe that generic and brand name medications are equally effective,” he said. “Occasionally, I will have patients who believe ‘dispense as written’ brand-only medications work better for them, but more often I counsel patients that it is typically hard to tell the difference.”
Nationwide, about 3 million adults and 470,000 children have epilepsy, according to the Centers for Disease Control and Prevention.
Terman and his colleagues used Medicare Part D data to analyze trends in anti-seizure medication costs and filled prescriptions for 77,000 to 133,000 Medicare beneficiaries with epilepsy per year in his study.
Researchers said their dataset consisted of a 20% random Medicare sample, so total Medicare costs for brand-name anti-seizure medications for beneficiaries with epilepsy alone likely rose to roughly $1.3 billion in 2018 from about $360 million 2010. That’s out of annual Part D expenditures that total roughly $180 billion a year.
While the study is limited to Medicare beneficiaries, Terman pointed to other research findings that pharmaceuticals may be the costliest component of neurologic care in the United States. So, he said, “my impression that our study illustrates broader trends in healthcare.”
“It is no secret that across other medications, brand-name alternatives can be considerably more expensive than generics, and epilepsy drugs appear no different,” Terman said.
“What I did not know before doing this study was just how much more expensive brand-name medications have become over time, compared with generic medications actually becoming cheaper,” he said.
Terman attributed much of the increasing drug cost in the study to clinicians’ increased prescribing of Vimpat (lacosamide). The anti-epileptic drug was approved by the Food and Drug Administration in 2008, and then given the agency’s green light for expanded use in November 2020.
“In our manuscript. we cite some literature suggesting [Vimpat’s] cost-effectiveness, but keep in mind those reports were from European countries where drug costs can be much lower than in the U.S., so the cost-effectiveness may not be as good in the U.S.,” he said.
“Though a major caveat is that particular medication just went generic in the U.S. as its patent has just recently expired.”
“Regardless, other newer brand-only medications have come online recently, where this remains an ongoing issue balancing cost versus benefit,” Terman said. “Every patient will inevitably respond differently to different drugs, and finding the right one for a given patient remains somewhat of a trial-and-error process.”
Generic drugs usually are used whenever possible for people with epilepsy, Dr. Michael Privitera, past president of the American Epilepsy Society, told UPI.
“The FDA has stated for decades that any generic product it approves for epilepsy is equivalent to the brand,” said Privitera, director of the Epilepsy Center at the University of Cincinnati Gardner Neuroscience Institute.
Privitera said he and his colleagues “performed a series of rigorous studies on generic lamotrigine products and found no clinically important differences. These generic equivalence studies and the work of others “provided important additional evidence to that of FDA that generic substitution of anti-seizure medications is safe.”
So, Privitera said, the main approach to lower prices is to use generic drugs whenever possible.
But he cautioned there are many people with epilepsy whose seizures are only controlled by a particular anti-seizure medication. So, if that medication is not available as a generic, there are not many options.
Another cost-saving approach is to evaluate on a regular basis whether the anti-seizure drug combinations a particular patient is on are necessary.
“Reducing the number of anti-seizure drugs, when possible, may lead to reduced side effect burden and decreased cost,” he said.
Source: upi.com, Judy Packer-Tursman
Chinese Academy of Sciences
Epilepsy is a serious neurological disease. More than 50% patients have the onset during childhood. Effective treatment of epilepsy can avoid serious long-term effects such as brain dysfunction.
Recent study has shown that epilepsy is a brain network disease. Construction of epilepsy networks is therefore significant to the mechanism research as well as clinical diagnosis and treatment of epilepsy.
Researchers from the Suzhou Institute of Biomedical Engineering and Technology (SIBET) of the Chinese Academy of Sciences recently proposed a whole-brain dynamic resting-state functional network (DFN) computation method to better construct epilepsy brain networks. The method is based on resting-state low-density electroencephalogram (EEG) recordings in scalp space.
Their study was published in IEEE Journal of Biomedical and Health Informatics.
At present, functional magnetic resonance imaging (fMRI) and EEG are commonly used to construct the epilepsy brain networks. EEG is non-invasive, wearable, cost-effective, and especially suitable for children’s brain function monitoring.
Benign epilepsy with centrotemporal spikes (BECTS) is the most common type of epilepsy among children. Both fMRI and EEG source imaging (ESI) studies have indicated that BECTS is associated with static resting-state functional network (SFN) alterations (e.g., decreased global efficiency) in source space.
However, the abovementioned alterations are not significant when the SFN calculations are performed in the scalp space using only clinical routine low-density (e.g., 19 channels) EEG recordings.
Based on the concept of EEG microstates, LIU Yan and his colleagues from DAI Yakang’s group from SIBET proposed the DFN computation method.
“The method helps better analyze the dynamic properties of the whole-brain functional states, and on the other hand, realizes the display of the functional subnetworks’ topologies in each microstate,” said LIU.
Results show that the proposed DFN can reveal significant differences between individuals with BECTS and healthy controls, with lower global efficiency in Microstate C – β frequency band. This makes it superior to traditional SFNs, and enables it match traditional fMRI and ESI methods in the source space.
“The networks of individuals with BECTS have poorer integration capabilities than those of healthy controls,” said LIU.
The new method directly performs DFN computations from clinical routine low-density EEG recordings and avoids complex ESI computations, making it promising for clinical applications, especially in the outpatient diagnosis stage.
In addition, this method may be applied to explore the mechanism of other brain diseases and assist clinical diagnosis and treatment.
Research has helpful insights on why ADHD and epilepsy often occur together and how to approach treatment.
Attention deficit hyperactivity disorder (ADHD) and epilepsy often occur together. People living with ADHD have an increased risk of seizures.
ADHD is the most common co-occurring condition with epilepsy, with 1 in 5 adults with epilepsy self-reporting symptoms of ADHD. For comparison, 4.4% of adults in the United States have ADHD.
Studies have found that 20% to 50% of children with epilepsy have ADHD, compared to 7% to 9% of children overall.
Research has provided some insights into this two-way link between the conditions, though more studies are needed to fully understand the relationship.
Learning about considerations around treatment can help you best manage symptoms of either condition, whether you live with one or both.
Do epilepsy and ADHD affect the same brain areas?
It’s unclear whether ADHD and epilepsy share affected brain areas. More research is needed.
A 2018 study using magnetic resonance imaging (MRI) revealed that participants with both conditions showed reductions in size for several brain areas:
- cortical thickness (frontal, parietal, and temporal areas)
The same size reductions weren’t present in the group with epilepsy alone. Epilepsy is a medical condition affecting the brain in which irregular electrical activity causes seizures.
ADHD is a neurodevelopmental disorder that affects the way a person behaves and thinks. It causes three main categories of symptoms:
Some doctors speculate that seizures can heighten the disruption of messages about behavior, potentially increasing ADHD symptoms
Do seizures cause attention deficit or hyperactivity?
People living with epilepsy have a 3.47-fold increased risk of ADHD. Such a large increase may make it seem like there’s a causal link. That doesn’t seem to be the case, though both conditions affect the other, according to research published in 2017.
Studies show that signs of ADHD often exist prior to the onset of seizures in epilepsy, which suggests that ADHD is a separate condition and not a result of seizures.
Parents of kids with epilepsy describe their child’s ADHD as the inattentive type. In the general population, combined type ADHD, with both inattentive and hyperactive symptoms, is the most common.
But when researchers excluded study participants with IQs lower than 80, inattentive ADHD and combined ADHD occurred at the same rate.
While there’s no proof seizures cause ADHD symptoms, sometimes the conditions can imitate each other.
An absence seizure (or petit mal) can look like a zoned-out moment of ADHD inattention. But there’s a clear difference between the two.
A person experiencing an absence seizure doesn’t respond to their environment during the episode, but someone with inattentive ADHD can and will.
Seizures and hyperactivity can sometimes occur in epilepsy that isn’t fully managed by medication, according to research from 2016.
Genetic and environmental factors
While epilepsy doesn’t seem to cause ADHD or vice-versa, there may be common underlying factors at play.
A recent study found that within a cohort of people living with both epilepsy and ADHD, their family members with epilepsy also had a significantly increased risk of ADHD. This suggests the contribution of genetic factors in cases of ADHD and epilepsy co-occurrence.
Researchers also found evidence that family members with similar environmental factors as the cohort were also more likely to live with both conditions.
Can ADHD medication lead to seizures?
Stimulant medication is a common and often helpful treatment for ADHD. It works by increasing the effect of neurotransmitters in the brain.
According to a different 2018 study involving children with epilepsy, stimulant use doesn’t increase the rate of hospitalization from seizures.
In fact, the seizure hospitalization rate was slightly lower for stimulant users and former users than it was for nonusers, hinting at a possible seizure-protective effect from stimulant medication.
Stimulants remain a best practice for the treatment of ADHD, even with an epilepsy diagnosis.
Epilepsy medication and ADHD
While stimulants to treat ADHD are considered safe, research found that they may be less effective in children with epilepsy.
Epilepsy medications are also thought to worsen attention in some patients.
How are epilepsy and ADHD treated?
ADHD and epilepsy have treatment similarities and differences. Each condition requires a different approach, so talking with your doctor about prioritizing and balancing your overall treatment approach can be key.
Medication is a primary treatment for both ADHD and epilepsy. In both conditions, medication works to correct differences in the brain.
Sometimes seizure medication can cause ADHD symptoms. Talk with your healthcare team about making sure epilepsy medication doesn’t negatively impact ADHD symptoms. It may be best to select an anti-epileptic medication with positive or neutral psychotropic properties.
When there’s a diagnosis of both ADHD and epilepsy, the treatment priority is seizure control.
In some cases, medication doesn’t work to control seizures because epilepsy is refractory, which means it’s not fully controlled by medication.
In other cases, epilepsy medication may not stop seizures because they’re from psychological factors rather than epilepsy. These events are referred to as psychogenic nonepileptic spells or seizures (PNES).
It’s important to know if someone is experiencing PNES instead of epilepsy. Anti-seizure medication doesn’t work to treat PNES and increasing the dose can cause unwanted side effects.
While research is limited, dietary changes may help both ADHD and epilepsy.
Some research supports the role of the ketogenic diet in the treatment of epilepsy that doesn’t respond to medication.
This diet is thought to reduce seizure frequency by changing the metabolism and excitability of brain cells. One of the ways it does this is by reducing the brain’s blood glucose levels which fuel seizures.
Eating for ADHD involves choosing foods like protein and complex carbohydrates, plus nutrient-dense options like fresh fruits and vegetables. On the list of items to avoid are things like refined sugar, simple carbohydrates, and artificial additives.
There are alternatives to medication and diet for targeting brain differences in epilepsy.
- Vagus nerve stimulator. This is a small, implanted device that sends electrical impulses to your brain through your vagus nerve.
- Brain surgery. This surgery can remove the area of your brain that’s causing your seizures. When the surgery is successful, it’s considered curative.
Treatment for epilepsy and ADHD symptoms requires different medications. Talk with your doctor about choosing the right medications and dosage for you.
Cognitive behavioral therapy can work well for coping with ADHD, particularly when combined with medication. Therapy or ADHD coaching can teach skills that help reduce the impact of ADHD symptoms on daily life.
ADHD and epilepsy are different conditions, but they’re strongly connected. If you have one of these conditions, you have a higher chance of also having the other.
They’re both typically treatable with medication. Unlike ADHD, epilepsy is sometimes curable with surgery.
Although there’s no surgical treatment for ADHD, therapy has helped many people by teaching valuable skills for managing symptoms. It can be very effective when used along with medication.
Source: psychcentral.com, Nancy Hammond, Nancy Lovering