New medication prevents seizures related to alcohol withdrawal

Tranquilizers work better than placebos at treating the symptoms of alcohol withdrawal syndrome but they may not work better than other drugs, according to a new review of recent studies. The class of depressant drugs known as benzodiazepines are especially effective at treating seizure in withdrawal patients, say Dr. Christos Ntais of the University of Ioannina School of Medicine in Greece and colleagues.

People given benzodiazepines were 84 percent less likely to have withdrawal-related seizures compared to those given placebos. “This might suggest that their [benzodiazepines’] current status as first-line treatment for alcohol withdrawal syndrome is justified,” Ntais and colleagues say.However, the researchers found no evidence that benzodiazepines are any better than other drugs used for treating alcohol withdrawal syndrome or that there are any differences between types of benzodiazepines for withdrawal treatment.“There was no conclusive evidence or even hints for superiority of specific drugs, but modest differences could have been missed due to limited data,” Ntais says.

Among the commonly known benzodiazepines are Halcion, Versed, Librium, Xanax and Valium.In a second review, Dr. Anastasia Polycarpou, also of the University of Ioannina School of Medicine, and colleagues found some evidence that anticonvulsant drugs such as carbamazepine (Epitol or Tegretol, for example) are more effective than placebo at treating alcohol withdrawal, but the difference was not statistically significant.

The reviews appear in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.Alcoholics can go through withdrawal when they stop or cut back on their drinking. Symptoms of withdrawal can include everything from insomnia, sweating and rapid heart beat to nausea, seizures and hallucinations.

The most severe form of withdrawal syndrome is called delirium tremens.Alcohol addiction affects certain neurotransmitter circuits in the brain, and the symptoms of alcohol withdrawal reflect the brain’s attempt to readjust those circuits. Benzodiazepines act on one particular type of circuit called GABA pathways.Ntais and colleagues examined 57 studies of benzodiazepine treatment for 4,051 people. Polycarpou and colleagues analyzed 48 studies of anticonvulsant treatment for 3,610 people.

Although the number of studies is relatively high for systematic reviews, the studies had a large variety of outcomes and measurements that made it difficult to combine and analyze the data as a whole, according to both review teams.Although not all of the studies reported side effects from the drugs, deaths and serious complications from the treatments appear to be rare, the reviewers say.“The extremely small mortality rate in all these studies is reassuring, but data on other harms-related outcomes are sparse and fragmented,” Ntais says.

Sarah Book, a professor at the Medical University of South Carolina who has studied the effects of both benzodiazepines and anticonvulsants for alcohol withdrawal, says there may be other reasons to be cautious about benzodiazepine treatment.“In general, benzodiazepines have the potential to increase the risk of [alcoholic] relapse,” Book says.Book also says “the combination of alcohol and benzodiazepines can be deadly,” a problem that does not occur with anticonvulsants, she adds.

According to Book, the majority of benzodiazepine prescriptions for withdrawal are made on an outpatient basis, with little opportunity to monitor a patient’s continued drinking.The Cochrane reviews were supported by the European Community, Directorate of Public Health.

Is Protofol the answer to control seizures?

Writing in the journal Neurology, researchers said the use of propofol is recommended before thiopental. Propofol and thiopental are widely used intravenous anesthetics which are also known to help control seizures.

Researchers in the Netherlands examined the effects of propofol and thiopental in 33 children with refractory status epilepticus -- a state in which seizures occur in rapid succession without recovery of consciousness between them.

Propofol effectively controlled seizures in 14 of 22 patients, with infrequent and minor side effects.
Twenty patients were treated with thiopental, including the eight in whom propofol was used first without success. Eleven were effectively treated and had seizure control, but serious side effects were noted.

"We suggest the use of propofol before thiopental in children with refractory status epilepticus," said study author Dr. J. P. J. van Gestel of the University Medical Center in Utrecht, the Netherlands.

A related editorial in the same issue of Neurology said the study underscores the need for a systematic, prospective study in children and adolescents with this disorder.

Organized benefit to foot the bill of medical expenses for uncontrolled seizures

Mike and Karen Todd need to know what ailment causes their 6-year-old son to have seizures and soaring temperatures nearly every two weeks.

During those bouts, Trevor Todd slips into a comatose state that can last up to five days, his father said.

Trevor's parents — both Cook County sheriff's police officers — have taken their son to numerous doctors and specialists. But the only diagnosis so far — labeling his seizures as myoclonic, a form of epilepsy characterized by brief muscle twitching — doesn't explain Trevor's recurrent fevers, his father said.

"We're going to keep trying until someone figures it out," Mike Todd said. "We need answers."
Trevor has two brothers, Kody, 10, and Connor, 1. Trevor is an outgoing boy who loves SpongeBob, American flags and playing in water.

"He is a very loving, personable little guy," said his grandmother, Elleneen Todd, of Palos Park. "He loves to be hugged and kissed."

Trevor is mildly autistic and developmentally delayed. He will start school next week at Elim Christian School in Palos Heights, which specializes in teaching children with disabilities.
His schooling soon could be interrupted, however.

Trevor is on a waiting list for a clinical study at the National Institutes of Health in Bethesda, Md. The study will take at least two months and require Karen Todd to take an unpaid leave of absence.

After the study, Trevor may be sent to other hospitals for additional tests and treatment, all of which could become a financial burden on the Todd family, his father said.

Trevor's family and friends are hosting a benefit Aug. 27 to raise money for his ongoing health care. The event will be held from 1 to 7 p.m. at 115 Bourbon Street, Merrionette Park.

Tickets are $20 and include food, beverages and live music. Raffles and a silent auction will be held. Direct donations can be made to Trevor Todd Benefit, TCF Bank, 9652 W. 131st St., Palos Park, IL 60464.

New medication for controling seizures is currently tested

Researchers in the Netherlands examined the effects of propofol and thiopental in 33 children ( 34 episodes total ) with refractory status epilepticus. Refractory status epilepticus is a state in which seizures occur in rapid succession without recovery of consciousness between them. These seizures are resistant to treatment and persist for more than 60 minutes.

Propofol effectively controlled seizures in 14 out of 22 patients. Side effects from propofol were infrequent and minor. Propofol was given at rates lower than 5 mg/kg/h, due to previous reports about potentially fatal side effects when the delivery rate was greater than 5 mg/kg/h. Two patients successfully treated with propofol died, but their deaths were attributed to severe neurological damage after bacterial meningitis. Twenty patients were treated with thiopental, including the eight in whom propofol was used first without success.

Eleven were effectively treated and had seizure control. There were serious side effects during thiopental treatment. Most patients required higher ventilator settings and supplemental oxygen due to suspected pneumonia. The respiratory problems with thiopental treatment were greater than expected, according to the researchers. Eight of the 20 patients died.

Two deaths could be attributed to thiopental, but the others were related to the underlying diseases that had caused the refractory seizures. The average duration of propofol treatment was about 2.4 days, compared to 8.6 days for thiopental treatment. "We suggest the use of propofol before thiopental in children with refractory status epilepticus," said study author J. P. J. van Gestel, MD, of the University Medical Center Utrecht, Wilhelmina Children's Hospital, in the Netherlands. "Propofol is a fast-acting drug, and little time is lost if it fails to control seizures."

A related editorial in the same issue of Neurology says this study underscores the need for a systematic, prospective study in children and adolescents with this disorder. "The study by van Gestel et al is retrospective, sequential, and historical in design which prevents definitive conclusions regarding effectiveness," said editorial author Nina F. Schor, MD, PhD, a pediatric neurologist at Children's Hospital of Pittsburgh. "Given the devastating nature of refractory status epilepticus, the search for newer and better treatments to control this condition safely and quickly is critically important."

The American Academy of Neurology, an association of nearly 19,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, epilepsy, Parkinson's disease, multiple sclerosis, and stroke.

Shock is always an emergency.

This is a victim of an accident that is suffering from shock.

If untreated, the state of shock can degenerate into seizures, brain damage, heart failure or even death.

Shock and seizures

What is shock? Shock is a possibly fatal and physical reaction of the body caused by a violent blow caused by either illness, injury, an important loss of blood and dehydration which makes blood circulation difficult affecting the body's tissues. It can also be caused by a violent emotional blow, hypothermia, fear and if being involved in an accident of some kinf. Sometimes, injuries are minimal but because the person goes into shock, his health is suddenly in jeopardy.

When the body does not receive enough blood, one of the body's reactions can be seizures. The amount of oxygen lowers while the level of carbon dioxyde rises creating physical problems. Some cells may die and later reproduce themselves when the person is on the health path again while some others will be destroyed permanently creating future health issues that can be very important.

Shock should NEVER be treated lightly. You call the emergency services at once at it must be treated rapidly to avoid worsening of the situation. This patient could suffer from loss of consciousness, seizures, brain damage and even heart failure. You should assess the situation, reassure them and wrapped them up in a blanket or warm clothes if possible. Take their pulse, notice any detail that may help the emergency attendants in their assesment and the care to be given to the victim. Do not try to "slap them out of it" like some people say. It will not help and can create more problems such as injuries. Let the emergency services provide the proper care.

If the victim suffer seizures, loosen their clothes, time the seizures and clear the surrounding area to make it safe. When the seizure(s) is or are over, put the person in the recovery position as they may throw up or lose consciousness. Cover them up if possible. Monitor their pulse and follow all instructions given by the emergency services if on the phone. Do NOT try to control the erratic movements during seizures. It is dangerous for both the person and you.

Hypoglycemia vs seizures

These are the main symptoms of hypoglycemia.

Hypoglycemia is a condition that occurs when the patient is suffering from low blood sugar level. It can be brought on by stress, fatigue, by skipping meals or not having a balance diet. If a patient is feeling confused, is pale, weak, dizzy and have a blurry vision, act immediately by providing him with a source of sugar that will quickly raise his blood sugar level such as: hard candy, orange juice, glucose tablets or some energy gel with water like the runners use during exercise.

If the blood sugar level is very low, it can provoke seizures, coma, brain damage or even death.
If the patient is helped out right away, such health consequences can usually be avoided easily.

If you have any doubts concerning the possibility of being affected by this condition, consult your physician, see him for a check up and have him send you for a glucose test just to make sure that if you are indeed affected, steps to avoid problems can be taken rapidly.

What is a glucose test? You must not eat or drink anything since midnight the night before. Your appointment should usually be in the morning. Make the necessary arrangements to stay there for approximately three hours. Then the first thing that they do is to take a blood sample and test the blood sugar level. Then they give you a beverage high in sugar content that may remind you of a very sweet tasting orange soda. Then each hour, for the first two hours, they take a blood sample and test it out. Then, for the last hour, they take a blood sample each half hour. Then, it is lunch time! Usually, you can have the results within a week or so. Please note, that sometimes this test may lightly differ but it should be quite similar.

What about seizures? Your brain is a muscle and like any other muscle, to get the amount of energy to work efficiently it needs both water and sugar. When the blood sugar level gets too low, the brain's reaction is to send a distressed message to the rest of the body. As of a result of sugar starvation, your body reacts by having seizures. Beware, sometimes you can feel them coming, other times, they may sneak up on you. You better be prepared and always have either on you or with you something that you can quickly ingest to raise your blood sugar level in case of having an hypoglycemia episode.