Wednesday, December 28, 2005

Watering down baby formula can lead to seizures!

Infant formulas are a good alternative to breast-feeding for children less than 1 year old. But improper mixing can harm the baby, the University of Maryland Medical Center warns.

Side effects like abdominal pain and nutritional imbalance can result from not following the manufacturer's directions. Never water down the formula, the school's experts warn, as this can alter your baby's salt balance, which can lead to seizures.

Monday, December 26, 2005

New medication to help control seizures will be on the market soon!

Wockhardt has received United States Food & Drug Administration (USFDA) approval to market Zonisamide capsules. According to a release issued by Wockhardt to the BSE today, Zonisamide is the generic version of Dainippon's Zonegran capsules.As per IMS data, the current market of Zonisamide in the US is $174 million, the release added.

"Wockhardt will be the first company to launch generic Zonisamide in the US. We have received the ANDA approval in less than nine months from filing date," Habil Khorakiwala, chairman of Wockhardt, said. Zonisamide is the first compound of its class to be developed as an anti-epileptic agent.

"It has the broad spectrum of anti-epileptic activity, and is particularly beneficial in refractory partial seizures and to a more variable extent in generalised and compound / combination seizures," Khorakiwala added.

Little Britney needs your help!

Little Brittney Meunier might fight for her life every minute of the day, but she’s won her share of love and respect in this world. With a little help during the holidays, she may soon be able to see her buddy, Big Bird.

Larry Fisher/quad-city times The Meunier family, Brian, left, 22-month-old Brittney who suffers from Sturge-Weber Syndrome, Erica and Christopher.

“She has taught us a lot,” said her mother, Erica Meunier, who with her husband, Brian, and 7-year-old son, Christopher, live with Brittney in Clinton.

“I always thought strength was something that babies learned as they grew up, but she has more strength than most people I know,” Erica said with a fond look at her daughter.

Now 22 months old, Brittney was born with bilateral Sturge-Weber syndrome. Complications include wine red stains on her head and body, glaucoma that has claimed most of her vision and a loss of 75 percent of her brain capacity. She is normally sized for her age but lives like a baby younger than four months old. Her diagnosis is terminal.

She’s failed every vision test she’s been given but finds ways to compensate, her mother said, using the senses of taste and smell. “It’s kind of funny — she sniffs and licks at you like a little puppy,” she explained.

Brittney loves Big Bird and Dora the Explorer, her mother said. “She can see both yellow and red, and watches them on the television.” But the family’s TV is so old it’s lost the color capacity and the Meuniers would like to have a new set that’s got a large enough screen so Brittney can see it.
The toddler takes nutrition through a stomach tube and has consistent respiratory problems which precipitate seizures on a regular basis.

Brittney was born Jan. 19, 2004, and her medical problems were quickly apparent. Erica Meunier quit her career in human resources and cared for the baby without nurses for several months, shuttling her back and forth for treatment at University of Iowa Hospitals, Iowa City. She got help after the baby started having seizures several times a day.

But Brittney will be able to see Big Bird with a new television set and might even give him her special smile, even as she struggles to survive.

Courage is needed to face seizures...especially uncontrolled ones!

The seizures have come back. In 10 days, she will undergo brain surgery at John Hopkins Hospital in Baltimore.

Emily Olsen is 16. She is smart and funny and disarmingly direct. She has a disorder known as Rasmussen's encephalitis, a rare form of epilepsy that surfaced when she was 7. This will be her eighth adventure with brain surgery.

Two and a half years ago, in an attempt to end her debilitating seizures, a team of neurologists at John Hopkins removed the right side of her brain. It's called a hemispherectomy. As expected, Emily lost her left field of vision. Her left arm and left leg, already crippled by seizures, were further stiffened with paralysis. But the seizures stopped.

With just average luck that might have been the end of it, but it didn't pan out that way. Emily has been back in surgery twice, and she isn't out of the woods. The left hemisphere of her brain has shifted toward center and spinal fluid has filled the gap, increasing the pressure inside her skull. Her prognosis is uncertain.

Still, it has been a good year for this young hunter, even a great one.

In April, armed with special permit and a crossbow, she went turkey hunting with the Little Wolf Gobblers, a hunting club out of Marion whose members have become skilled and enthusiastic guides for individuals with physical disabilities. On the second day of the hunt, Emily's mentor, Dave Zachow, was calling in turkeys from every direction. Emily fired on a gobbler, her dart narrowly missing.

"I know that it's not that I can't do it," she said. "I think I'm anticipating the shot."

Zachow has some other ideas. He is working on a way to modify the chair she hunted from in the blind.

"Dave is determined," said Emily's father, Chris. "He wants her back next spring. He requested her."

A Shiocton-based organization called Challenge the Outdoors arranged for Emily to meet the Clintonville-area turkey hunters. CTO members are dedicated to overcoming the obstacles faced by disabled hunters and anglers, and they have programs throughout the year.

"They're just incredible," said Chris.

Through CTO, they learned about the annual "Helluva Hunt," based on the Gary and Jane Stearns ranch in Douglas, Wyo. It's a bunch of ranchers and volunteers who set aside more than 60,000 acres on the opening days of the antelope season. Each October, they invite 15 different disabled persons from all over the country to hunt, all expenses paid other than transportation to and from Douglas.

Emily applied and was accepted. On the last day of September, she and her father flew into Casper, Wyo., and were met at the airport by Gary Stearns. At the ranch, they met the other hunters and the guides and started making friends. More than 200 volunteers make the event possible, including four hunters from Chicago who take a week's vacation each year so they can offer their services as guides.

Guides are carefully matched to the guests. Emily was assigned to Gary Stearns' brother, John Stearns Sr., who was assisted by his son, John Stearns Jr. At the Douglas rifle range, they worked on marksmanship. Emily had her own .243-caliber rifle and was shooting pretty well, but not with the kind of accuracy you need for antelope, which are often targeted at great distances. Emily was struggling with the noise and distractions on the range.

"I was frustrated," she said. "I wasn't as accurate as they wanted me to be."

The elder Stearns, prone to neither distraction nor frustration, suggested a different rifle, one fitted with a double scope, the second mounted several inches higher. It allowed him to assist with aiming.

"Whatever I could see, he could see the same thing," Emily said. "It was cool."

At 4 a.m. the next day, Emily awoke to find her father leaning over her with his video camera running. By her standards, he was enjoying himself far too much for that hour of day. The four of them were soon in a beat-up old pickup truck, rolling over high-country plains where free-roaming cattle graze on short grasses.

If you ask a rancher how many head of cattle he owns, he might reply, "Well, 326, if they all show up."

Emily was in the back seat with John Sr., the window on her side rolled down and capped with a strip of foam so it could be used as a rifle rest. Her handicapped permit allows her to hunt from a vehicle.

In the twilight, she could see a herd of antelope, more than a hundred, feeding in groups. In Montana, Emily said, folks just call them "goats."

"Pick one out," John Sr. said to her.

She did, a buck, a hundred yards distant. She could feel her heart pounding. Behind her, John Sr.'s voice was deep and slow and soothing.

"He said, 'OK, we're not going to shoot. We're just going to get lined up on it.'"

Then John Jr. spotted a larger buck, at a greater distance. Emily shifted her attention. Again, John Sr. told her they were just practicing. They watched the antelope, studied it, watched it move. Emily lined up on it with the rifle. Her heart was still racing, but she felt calmer.

"Whenever you are ready," came John's voice.

She fired. The antelope, standing roughly 130 yards away, didn't move. She fired two more times. She didn't realize it, but she'd hit it with the first shot. Also the third. Belatedly, the animal fell over.
"He (John Sr.) told me they are a hard animal to kill," Emily said. "He said if it doesn't go down right away, that's normal."

Emily's was the first antelope shot on the hunt and it was the largest. Most adult antelope weigh about 100 pounds. Unlike deer, the bucks never lose their horns, which slowly grow thicker and taller. An animal is considered trophy size when the horns are 12 inches long. On the buck Emily shot, the horns were almost 15 inches.

The Douglas-area ranchers don't let anyone else hunt on their land until the guests of Helluva Hunt are finished, and so some other hunters were camped out, waiting, and when they saw Emily's trophy, they started giving her a hard time, good-natured but heartfelt. Apparently they had been scouting the area.

"They were mad at me because I shot the one they wanted," Emily said.

She was smiling, still pleased by the memory.

Among those whooping and hollering the loudest for Emily was a young volunteer named Eva Trusty, who had befriended her. Trusty is a firefighter from California who serves as the official hunt photographer. Another of Emily's new friends is a grizzled looking guy named Marvin Stotyn from Colorado. Stotyn uses a wheelchair and was a guest here 10 years ago. Ever since, he has returned as a guide. His wife runs the welcome desk.

Volunteer staff worked through the night to process the meat from 15 antelopes, as every guest eventually shot one. Emily and her father spent another day sightseeing around the ranch. They had the time of their lives, although in Wyoming, both attest, the verb "barbecue" apparently means, "burn to a charcoal-coated crisp."

A taxidermist is mounting Emily's antelope. It will be shipped this way in four to six months. She was able to cover part of the cost by applying a door prize to the project, but it's still an expensive piece of work.

Back home, they got a letter from Trusty, who heard about the mount. Trusty asked if she could please contribute to the cost of her friend's trophy mount.

Shortly after the hunt, Emily's seizures returned, just a few of them, milder than before and widely spaced, a week or two between episodes. On Wednesday, four days after the interview for this story, she was hit with six seizures.

Her mother, Joan, normally a bastion of positive mental attitude, is getting a little frantic. Their best hope is that the seizures are being caused by the pressure on Emily's brain and that when the pressure is relieved, the seizures will stop.

"We're hoping very, very, very badly that this is all tied up together," she said Thursday.

Emily has a bunch of letters from Montana. She made friends on that two-day hunt she will keep for life. She said unique experiences can form deep bonds in a short time.

No one has to explain that to Marvin, the mountain man in a wheelchair who gets around so well he guides for other hunters.

"This was the most enjoyable hunt ever," he wrote Emily, "because of you."

Seizures stricken family needs your help!

Today is the last day to read Holiday Help letters and consider supporting a family in need.
This year, the Ledger-Enquirer received almost 700 letters from families seeking help. The newspaper helps to match those in the community who need help with those willing to offer it.
Here are some excerpts from letters the newspaper has received:


• A Columbus mother of four tried to keep a job but couldn't after she was stricken by a staph infection and injured her hip. Her children didn't ask for much but she's trying to give them a better Christmas this year.


• A 54-year-old woman from Manchester is disabled and lives with her mother. "I can't help her in any way because I am not able. Any help you could give me -- food or clothes -- would be so much help."


• A 15-year-old girl is seeking help for her three brothers and parents. "We had a hard life every year. We had to get help for Christmas. My mom is the only one bringing in money. My dad can't get a job because he has seizures. So can you please help me have a better Christmas."

In 11 years, the program has given holiday hope to more than 5,000 individuals and families in Columbus, Phenix City and the surrounding area.

Thursday, December 22, 2005

Dog can sense seizures in advance

Some may think of a Lassie movie when hearing of a collie that watches over a child and alerts adults to possible danger.

But for a mother who fears her 9-year-old daughter, Nona, may be harmed at night while having an epileptic seizure, Cheryl Reynolds is comforted to know her four-year-old collie, Benny, is at her daughter’s side, ready to protect her even before a seizure can occur.

Although Nona’s epilepsy, a neurological condition that makes people susceptible to seizures, can vary in intensity, Ms. Reynolds said Benny will begin to pace around Nona and act panicked about 15 to 30 minutes before Nona has a seizure.

“I really don’t know what we did before Benny,” Ms. Reynolds said. “When Nona has seizures or is about to have a seizure, I think Benny knows it’s his job to protect her and goes as far as to stand between her and the dresser or even lay on her to make sure she doesn’t hit her head or harm herself while shaking.”

Once the seizure passes, Ms. Reynolds said Benny calms down and moves away from Nona as she lies unconscious for 45 minutes to an hour to recover.

With Benny having no prior training as a service dog to alert her of Nona’s seizures, Ms. Reynolds said she could only speculate of how Benny came to be Nona’s alarm system and protector.

“When we first got Benny, I noticed that he was really afraid of thunderstorms and began pacing around the room sort of in a panicked state,” Ms. Reynolds said. “But then I noticed that he would act that way around Nona even when there wasn’t a thunderstorm.”

“Then soon after he started doing that, Nona would have a seizure,” Ms. Reynolds added. “I really think it has something to do with dogs being able to sense electrical currents.”

Although Ms. Reynolds has her speculations about how Benny senses Nona’s seizures, according to the Epilepsy Foundation Web site, a national voluntary agency dedicated to helping people and families with epilepsy, it is unknown how some dogs develop an aptitude to sense seizures while others are not as sensitive.

Ms. Reynolds said she has the luxury of knowing that through Benny’s ability to take care of Nona, she feels better about her daughter’s epilepsy as long Benny is close by.

“I’m not afraid,” Nona said about her seizures. “He (Benny) is fun and he likes to play with me.
“He makes me feel safe.”

Sunday, December 18, 2005

Autism and Epilepsy are big challenges for a young child!

My son is five years old. He was diagnosed with Autism Spectrum Disorder at the tender age of three. At four years old, another challenge in his life. He suffered from seizures which were diagnosed as febrile seizures caused by a sudden fever. About six months later, he had to go through an EEG which was a dramatic situation for him. You see, he is also non-verbal and hypersensitive to touch and textures plus being restrained and surrounded by strangers, even the nicest ones as well as submitted to this test without the myself, his mother, he was terrified until I was allowed back to his side. To soothe him, I sang the same lullaby over and over for the next hour, holding and kissing him to reassure him.

Then, there were the results. He had 50% chances of suffering from seizures again since I had myself a history of Epilepsy when I was a young child. Also, statistics show that an important percentage of people affected by Autism are also suffering from seizures. And to top it off, I was informed that my son's seizures may have been triggered by the fever but was not related to febrile seizures. More than likely, he suffered seizures that are related to Epilepsy.

About two weeks ago, my nightmare became reality. My son suffered from multiple seizures, more than likely related to Epilepsy. He was then prescribed some medication to control the seizures. In a few days, he will meet his neurologist for the first time. As a mother, I feel like my worst nightmare became reality when I genetically passed on Epilepsy to my child.

As if it wasn't enough, he seems to suffer from terrible side effects from the medication. Epilepsy can change at puberty as it did for me. I myself suffer now from pseudoseizures but for parents that just were announced that Epilepsy was affecting their child, please write down your questions prior to your appointment and search for all the information available on Epilepsy. When medically controlled, it makes it a lot easier on your child. Enquire about the possible side effects and the way to deal with them. Medic Alert bracelets are also a great option so your child can receive the proper care if unconscious.

I know that when my son's seizures will be controlled without him suffering from difficult side effects, his life will be back on track and his beautiful smile will light up his face like it usually does, most of the time. Show your love to your child and get all the information that you need on Epilepsy.

Thursday, December 15, 2005

Should licences of people suffering from Epilepsy be cancelled?

EPILEPTICS should have their driver's licences suspended after they suffer a seizure, a coroner said yesterday following an inquest into the death of a toddler.Jet Rowland was 22 months old when he was killed in a car crash on the Logan Motorway on Brisbane's southern outskirts on February 28 last year.

Deputy Queensland Coroner Christine Clements found that Ian McLeod, a chef who had suffered epilepsy since he was three, was having an epileptic seizure when his car veered across a median strip and ran into a four-wheel-drive vehicle driven by Jet's mother, Anita Rowland.

Jet was thrown from the vehicle and suffered multiple injuries. He died that night in hospital.
His seven-year-old brother Bailey was rendered paraplegic, while his mother suffered serious burns, internal injuries and fractures to both ankles, her left leg and her left knee. Her right knee needed reconstruction.

Mr McLeod told the inquest his last memory before the accident was of paying a toll at a booth several minutes earlier.

A motorist who saw Mr McLeod just before the accident said he was sitting rigid at the steering wheel, staring into space as his car careered across the median strip.

The inquest was told Mr McLeod was admitted to hospital after a chronic epileptic seizure about 2 1/2 months before the accident.

Ms Clements called for legislation "to spell out emphatically that when a person suffers a seizure, a driver's licence is automatically cancelled" until a doctor declares they are fit to drive again.
During the inquest, counsel for the Rowland family submitted that the coroner should have a reasonable suspicion that Mr McLeod had committed the offence of reckless driving causing the death of Jet and grievous bodily harm to Bailey and Ms Rowland.

But Ms Clements made no such ruling and declined to say whether she would refer her findings to the Director of Public Prosecutions.

She said, however, that she was obliged "to consider the information available and must give that information to the (DPP) if a reasonable suspicion is held that an indictable offence has occurred".
Outside court, a tearful Ms Rowland said she was disappointed Ms Clements had not referred the case to the DPP.

"Our beautiful son Jet was 22 months old. His life had only just begun and it was stolen from him and it was stolen from us," she said.

"Bailey was seven years old. He spent three months in hospital with horrific injuries and through no fault of his own has been sentenced to life in a wheelchair."

Party pills may cause seizures

Party pills have been sold without regulation since 2000, and are now widely used by young New Zealanders.

The study by a group of Canterbury health professionals, reported in the New Zealand Medical Journal, found that between April and September, 61 patients were admitted on 80 occasions to Christchurch Hospital's emergency department suffering from adverse reaction to the pills.
The patients had taken an average of 4½ tablets or capsules, which have the main ingredient 1-benzylpiperazine (BZP).

The patients were found to be suffering from mild to moderate toxicity resulting in insomnia, anxiety, nausea, vomiting, palpitations, dystonia, and urinary retention, with some adverse reactions lasting up to 24 hours.

Of the 61 patients admitted, 15 suffered toxic seizures with two left in a life-threatening condition.
The study highlighted the case of a 16-year-old Christchurch teenager with no history of seizures or drug abuse who took four pills over a 1½ hour period.

She collapsed in a crowd suffering from a general seizure, and an ambulance was called.
After another seizure, the girl was given two doses of diazepam, which left her totally unresponsive and in an extremely deep coma.

The girl had three further seizures in Christchurch Hospital's emergency department, and was transferred to an intensive care Unit (ICU).

Twelve hours later she was still slightly comatose, and a week later she reported that she "felt unwell but better."

The study said of greatest concern was that BZP appears to induce toxic seizures in neurologically normal subjects.

Of the patients who had seizures after the ingestion of party drugs, one had known epilepsy, but the remainder had no past history of neurological disorders.

The study concluded BZP could cause unpredictable and serious toxicity in some individuals.
It said patients with seizure disorders, psychiatric illness or coronary disease should avoid BZP as should those taking prescription antidepressants.

Congestion with MDMA or amphetamine should also be avoided, as the combination could lead to fatal toxicity, it said.

The Journal said results from the study should be carefully considered in any discussion on the legal status of piperazine-based party pills.

The Ministry of Health has previously said there was inadequate information about BZP to put stronger controls on its distribution at present.

It has commissioned research into BZP toxicity and studies are under way at the National Poisons Centre and other centres.

A Misuse of Drugs (Amendment) No 3 Bill has also been enacted with a new category of controlled but not banned substances, which includes BZP.

Surgery for Epilepsy has other great results

New research reveals depression and anxiety both improve significantly in epilepsy patients after they have surgery to reduce or eliminate seizures.

Researchers at the New York University School of Medicine aren't sure why depression and anxiety improve after epilepsy surgery. However, they found both decreased by more than 50-percent up to two years after the surgery. Patients were even more likely to be free of depression and anxiety if the surgery got rid of their seizures.

"These results are important because depression and anxiety can significantly affect the quality of life," says study author Orrin Devinsky, M.D., a Fellow of the American Academy of Neurology with the New York University School of Medicine. "For people with refractory epilepsy, studies show that depression is more likely to affect their quality of life than how often they have seizures or how many drugs they have to take."

Study participants included 360 patients in seven U.S. epilepsy centers who were having epilepsy surgery to remove the area of the brain producing the seizures. Before the surgery, 22 percent of participants had depression compared to 9 percent two years after the surgery. Eighteen percent had an anxiety disorder before the surgery. Two years after the surgery, only 10-percent did.

Study participants who had no seizures after surgery had even greater benefits. Results show 8 percent had depression compared to 18-percent of participants who still had some seizures. Eight percent of participants who were seizure-free had anxiety disorders compared to 15 percent with ongoing seizures.

Seizures are unpredictable and can lead to dangerous outcomes

On 5 June this year, on a beach near Cannes, surrounded by my nearest and dearest, the day after the wedding of my younger daughter Flora, I had a fit. There was no warning, no lights flashing, no headaches, no out- of-body feelings. I just suddenly started having a violent seizure.

My limbs thrashed about, my face turned blue and then white. Blood came from my mouth, where I had bitten my lip. Not that I knew any of this at the time, as I'd passed out. I woke up about 20 minutes later in an ambulance, racing through the back streets of Cannes.

Looking back, I was so lucky that it happened in a fairly safe place, on a sandy beach where I couldn't do myself much damage and with lots of people around. It could very easily have happened when I'd swum out to a raft on my own, and presumably would have drowned.

Or two days earlier when I was bombing down the A1 at 80mph on the way to Newcastle airport. Each year, there are 1,000 seizure-related deaths - half of them the result of drowning or injury after the seizure itself.

Friday, December 09, 2005

Hospitals turn away Epileptic teenager

A 14-year-old epilepsy patient, who was shunted from one hospital to another and is awaiting care at the state-run JJ Hospital, presents a grim picture of the city's poor healthcare system. Marling Ratgal, a teenager from Nashik, who suffers epileptic seizures, has been shunted around city hospitals for a brain scan, thanks to administrative apathy and infrastructural lacunae.

Marling has suffered seizures for the past two years. "He suddenly blanks out. He gets nearly 48 seizures in a day," said Shivrai, his father. A beneficiary of the Employees State Insurance Scheme (ESIS), Marling should have received treatment at an ESIS hospital, but the Ratgals have not been so lucky. "He was admitted to an ESIS hospital in Nashik but doctors said they did not have facilities to treat him," says Shivrai.

Treatment diminishes effectively amount of seizures

Adjunctive lamotrigine effectively controls primary generalized tonic-clonic seizures (PGTCS) and is well-tolerated in adults and pediatric patients 2 years and older, according to results of a randomized, double-blind, placebo-controlled study."The median percent decrease in PGTC seizures became statistically significant after 5 weeks of treatment in the overall population, and after 3 weeks of treatment in patients > 12 years of age," said Victor Biton, MD, Arkansas Epilepsy Program, Little Rock, Arkansas, United States, in a presentation here at the 59th Annual Meeting of the American Epilepsy Society (AES).

"The data from this study -- which excluded patients with partial seizures -- add to previous findings demonstrating the broad clinical utility of lamotrigine," Dr. Biton noted.His team assessed the efficacy, time to onset, and tolerability of lamotrigine in lamotrigine-naïve patients older than 2 years and weighing 13 kg or more. Subjects had at least three PGTCS over an 8-week period on one or two antiepileptic drugs (AEDs) and evidence of generalized epileptiform discharges or no evidence of interictal expression of partial seizures.Subjects were randomized to lamotrigine or placebo in an escalation treatment phase that lasted 12 weeks for patients 2 to 12 years old and 7 weeks for patients older than 12 years.

All patients also underwent a 12-week maintenance phase.The most commonly used antiepileptic agents were valproate, phenytoin, and topiramate, followed by carbamazepine and phenobarbital.Overall, patients randomized to lamotrigine had a median 56% decrease in PGTCS after 5 weeks compared to a 30% decrease in placebo patients (P = .036). In patients who were older than 12 years, the decreases after 3 weeks were 63% and 33%, respectively (P = .045).For the entire treatment period, patients randomized to lamotrigine had a median decrease in PGTCS of 66% compared to 34% for the placebo group (P = .006), Dr. Biton reported.

The most common drug-related adverse events were dizziness (5% for lamotrigine; 2% for placebo), somnolence (5% and 2%), nausea (5% and 2%). The rate of non-serious rash was 3% in both groups. No serious rash was reported."We purposely excluded patients with partial seizures so that we could rigorously assess lamotrigine's efficacy and safety profile in PGTC seizures," Dr. Biton said."Our results from this study clearly demonstrate that lamotrigine is a broad spectrum antiepileptic drug which is efficacious and well tolerated in patients with generalized seizures," he concluded.

Thursday, December 08, 2005

How seizures progressively lead to Epilepsy

A major mystery in epilepsy research has been why infants are more prone to seizures than adults and how those seizures progress to chronic epilepsy. Now, researchers have discovered that central to those seizures in the developing brain are neurons triggered by the neurotransmitter GABA. They say their findings could lead to new ways to treat seizures in newborns. Also, they say, their findings suggest that the use of drugs that enhance GABA action may be particularly harmful to the newborn brain.

In adults, epilepsy is caused by hyperactivation of neuronal receptors triggered by the neurotransmitter glutamate. This excess activation unleashes the storm of uncontrolled nerve cell firing that underlies epilepsy. In contrast, in adults the neurotransmitter GABA acts on its receptors to inhibit neurons. Loss of this inhibition is also involved in epilepsy.

Neurotransmitters such as glutamate and GABA are chemical signals that one neuron launches at its neighbor across connections called synapses.

Yehezkel Ben-Ari and colleagues decided to explore a possible role of GABA-controlled neural circuitry in seizures in infant animals because it was known that, while GABA excites immature neurons, it changes to an inhibitory neurotransmitter in adult neurons.

In their experiments described in the December 8, 2005, issue of Neuron, they used a preparation in which they isolated in three separate compartments the left and right hippocampi of baby rats and the nerve fibers connecting them. The researchers studied the hippocampus because it is the brain area central to epilepsy.

With this experimental arrangement, they could use drugs to block GABA receptors and/or induce electrical seizure in one hippocampus and analyze whether such manipulations influenced seizure activity in the other. Such a spreading influence is a sign that individual seizures have caused development of a chronic epileptic state.

Their experiments revealed that the GABA-triggered neurons were involved in seizures in the immature brains and also that those seizures did lead to development of an epileptic state. They found that these GABA-triggered seizures featured so-called "fast oscillations" of electrical activity that are required to transform a "naive" network of neurons into an epileptic one.

In other experiments comparing immature and adult rat hippocampi, they found that although GABA-triggered neurons were also involved in seizures in adult brains, they were not required for development of epilepsy, as they were in immature hippocampi.

The researchers concluded that their studies showed that fast oscillations involved in seizures "are also directly implicated in epileptogenesis in the immature brain and lead to the production of a persistent chronic epileptic condition."

As the neuronal network matures, however, the density of synapses triggered by glutamate increases and the contribution of GABA-triggered synapses to fast oscillations and development of epilepsy decreases, they wrote.

"This information may be important both for understanding the deleterious consequences of seizures in newborns and for developing new therapeutic treatments for seizures in young infants," wrote Ben-Ari and colleagues. "Specifically, the permissive action of excitatory GABA suggests that GABA-acting drugs may exert deleterious actions at an early developmental stage in humans."

Study claims that modified Atkins diet help control seizures

A modified version of a popular low-carbohydrate, high-fat diet is nearly as effective at controlling seizures as the highly restrictive ketogenic diet, Johns Hopkins Children's Center researchers report.

"Our findings suggest relatively good efficacy compared to the ketogenic diet," said Eric Kossoff, M.D., a pediatric neurologist at Johns Hopkins Children's Center. "With 20 patients, our study wasn't large enough to say patients and physicians should replace the proven, but highly restricted ketogenic diet, but the results are encouraging and intriguing."

The common elements in both the ketogenic and Atkins diets are relatively high fat and low carbohydrate foods that alter the body's chemistry. The ketogenic diet mimics some of the effects of starvation, in which the body first uses up glucose and glycogen before burning stored body fat. In the absence of glucose, the body produces ketones, a chemical by-product of fat that can inhibit seizures. Children who remain seizure-free for two years on the ketogenic diet often can resume normal eating without the return of seizures.

The modified Atkins diet is better tolerated by children and may be easier for parents and children to follow, said Kossoff, who presented the study's findings today in Washington, D.C. at a meeting of the American Epilepsy Society.

While the ketogenic diet has proven effective in controlling pediatric epilepsy since its introduction in 1921, it has several drawbacks and side effects. The highly restrictive regimen requires accurate measurement of all foods and liquids to ensure consumption of the proper ratio of fats, carbohydrates and protein necessary to produce ketones. The diet starts with a brief fast and hospital stay during which time families are trained in the rigors of the diet. Side effects can include kidney stones, constipation and slowed growth.

The modified Atkins diet also produces ketones, but requires no restrictions on calories, fluids and protein, and does not require a hospital admission and fast to begin. It also does not require the accurate weighing and measuring of foods, which may translate to better compliance with the regimen, researchers concluded.

"The key here is ketosis - the production of ketones - which both diets create," Kossoff said. "This study suggests that for some children, we need not be so restrictive in allowing protein, weighing foods and counting calories. That should make it a little easier for parents and children to do."

The Hopkins study examined 20 children (ages 3 to 18) who were having between 4 and 470 seizures a week and whose illness was unresponsive to drug therapy. The children were put on a regimen that included fewer carbohydrates than the standard Atkins diet, for six months. Of the 16 who completed the study, 13 had a greater than 50 percent improvement in seizures, seven had a greater than 90 percent improvement and four were seizure-free. A third of patients did not benefit from the diet. Side effects overall were low, with one child developing a complication that did not warrant stopping the diet, despite a brief hospitalization. The majority of children gained weight in the study.

Kossoff cautions that parents should not try any diet regimen for epilepsy without supervision and careful medical management by a specialized health care team. He and his colleagues also warn that the newly tested regimen should be seen only as a first step in acquainting families with the rigors of the ketogenic diet. It may also be an option for adolescents and adults, not typically offered the ketogenic diet.

The study was supported by a grant from the Dr. Robert C. Atkins Foundation. Co-investigators include Jane R. McGrogan, RD; Renee M. Bluml, RD; Diana J. Pillas; James E. Rubenstein, M.D.; and Eileen P. Vining, M.D., all of the John M. Freeman Pediatric Epilepsy Center at Johns Hopkins Children's Center.

Dog thief affects child's life

Carol Matney is like most mothers who would do anything for their child. Her son, 10 year old Shane, has cerebral palsy and suffers from seizures. Carol says Shane has been on the brink of death several times in his short life. He's set to undergo surgery right after Christmas.

Carol says one of the family dogs, Max, a boxer was special to Shane. She says he was Shane's constant companion and he seemed to have an uncanny ability to to calm his seizures. Her nine year old daughter says she saw three teenage boys snatch the dog from their front yard a month ago.

She is offering a reward for any information that leads to the return of the dog. Please call (502) 859-5500 or the Anderson County Sheriffs Department.

The Wish List is offering help to young woman suffering from seizures

The wish Kathy Williamson wants most is one nobody has been able to grant: an end to the epileptic seizures her 32-year-old mentally retarded daughter, Gina, has endured all her life.
But through the Wish List, people can help the Williamsons, whose Clermont County home needs repairs.


Their story is part of the 20th annual Wish List campaign, which begins today. The project is sponsored by The Enquirer and administered by the United Way.

Each year, the newspaper profiles less fortunate people in Greater Cincinnati and Northern Kentucky, and readers respond with cash or in-kind donations.

All money is distributed by participating social-service agencies to needy people in the community. Last year, 1,452 donors contributed $130,668, bringing the total since the project began to almost $2.7 million.

As in the past, this year's Wish List encompasses a range of needs, such as bathroom repairs for an elderly widow, hearing aids for a 24-year-old who dreams of playing guitar and a wheelchair ramp for a victim of degenerative joint disease.

Like many people assisted by the Wish List, Gina Williamson has faced lifelong challenges.
She suffered her first seizure when she was 2 months old. Soon after, she was diagnosed with epilepsy, a disorder in which nerve cells of the brain, from time to time, release abnormal electrical impulses.

Gina's parents split up when she was 3. That led her mother, with four older children to care for, to turn to welfare.

The other children have long since grown up and moved out, but Gina still relies on care from her mother, Kathy. It is a 24-hour-a-day job.

Kathy dresses Gina. Cooks her meals. Gives her medication. She provides her paper and pencils to write with and puzzles to do. She keeps handy DVDs of Gina's favorite television show, "The Jeffersons."

"I don't know what life would be like without Gina," Kathy says.

She doesn't want to know. She acknowledges that providing care for her daughter is difficult, but she dismisses any thoughts of placing Gina in a nursing home.

"I still have plenty of energy. I plan to try to take care of her as long as I can."

Early this year, Kathy thought she might lose Gina, who was hospitalized for several weeks with pancreatitis.

"I lived in fear," Kathy says. "I'd wake up at night thinking about it."

Gina recovered. But the mother and daughter continue their long struggle with epilepsy.

"Seizures are so scary," Kathy says. Neither she nor Gina knows when they will occur, day or night. They sometimes happen daily, sometimes a few weeks apart. Some are so violent that Kathy calls an emergency squad.

Given her medical problems and large size, Gina must often be taken to medical appointments on a stretcher in an ambulance. But the wooden walkway to their single-story home in Miami Township is less than two feet wide, too narrow to accommodate a rolling gurney. The wish is for a wider walkway.

What's more, there are no gutters on the home's back side, and the face board is rotting. The bottom half of a bathroom window has no glass; two other windows are cracked.

The home repairs would mean one less worry for Kathy, who has her hands full as a caregiver.
Gina has not spoken or shown any emotion during our interview. But when mention is made that she has a good mother, a smile spreads across her face.

"I have really never regretted taking care of her for one day, because there is great love," Kathy says. "I've always loved Gina. I sure don't know how I could live without her."

Saturday, December 03, 2005

New surgery brings hope to people suffering from Epilepsy

Dana Doyle used to ride her bicycle and drive a car. She led the typical active life of a teenager. But when she was 19, epilepsy came on suddenly, limiting her lifestyle and restricting her independence. No treatment in the subsequent eight years could c urb her temporal-lobe seizures.

When the 27-year-old student was offered a new procedure that held great promise for the control of her epilepsy, she didn't hesitate. Last week, Doyle became the first Seattle-area patient to receive an NCP System implan t, or vagus nerve stimulator (VNS) at the University of Washington Regional Epilepsy Center at Harborview.


The device, a disk the size of a silver dollar, was surgically placed under the skin of the patient's chest with an electrode connected to the v agus nerve in her neck. The VNS reduces epileptic seizures by sending low-level electric impulses to the brain through the vagus nerve.

Dr. Daniel Silbergeld, UW associate professor of neurological surgery, implanted the device during the two-hour proc edure at Harborview Medical Center. Mark Holmes, UW associate professor of neurology, is Doyle's epileptologist, and will follow up with her and make any needed adjustments to the device.

"I envision this being the future of treatment for certain types of epilepsy and am proud we can offer this to the people of the Seattle area," said Silbergeld.

Holmes and Silbergeld say the frequent and violent seizures characteristic of refractory epilepsy can often control a patient's life. "The vagus nerve stim ulator brings new hope to patients with uncontrollable epilepsy for a higher quality of life," said Holmes. "Dana was a perfect candidate for our first procedure of this type, and she is doing well."

Doyle is now recuperating at home in Redmond. The UW senior hopes to complete her schooling, hold a regular job, and gain her independence behind the wheel of a car again.

The University of Washington Regional Epilepsy Center at Harborview Medical Center has been a leader in researching, diagnosing, controlling and treating epilepsy for more than 20 years. An interdisciplinary team of University of Washington Physicians provides complete resources for seizure control for both inpatients and outpatients.

Services include: ultra-high-resolution MRI, SPECT brain imaging; advanced quantitative digital EEG analysis; 128-channel long-term video monitoring; diagnosis and treatment of psychogenic seizures; epilepsy surgery, including intracranial mapping; investigati onal drugs and vocational counseling.

Epilepsy is a neurological disorder characterized by brief disturbances in the normal electrical functions of the brain, often resulting in seizures. 2.5 million people in the United States have epi lepsy, making it the nation's second leading neurological disease. While an individual can develop epilepsy for a variety of reasons including genetic predisposition, head injury, or stroke, in more than 70 percent of cases there is no known cause.

The NCP System is intended for patients with refractory partial onset seizures, that is, those patients whose seizures cannot be controlled with antiepileptic drug treatment or surgery. Like a pacemaker, the pulse generator is implanted under the skin in the chest. The lead wire is then tunneled under the skin to the lower neck, where it is placed around the vagus nerve.

Using an external programmer, the neurologist can set or reset the stimulation parameters of the device. The NCP System del ivers preprogrammed, intermittent electrical pulses to the vagus nerve 24 hours a day. Additionally, when a patient senses a seizure coming on, he or she is able to activate the system to deliver an additional dose of stimulation by passing a magnet over the device. The device lasts 3-5 years before requiring a battery replacement.

News on pediatric Epilepsy

A free public forum on pediatric epilepsy will be sponsored by the University of Washington Pediatric Epilepsy Research Center.

It takes place from 4 to 7 p.m. on Tuesday, April 4, at the UW's Center for Urban Horticulture, 3501 N.E. 41st, Seattle. Parents of children with epilepsy are especially invited to attend.

The featured speaker is Dr. Gregory L. Holmes, professor of neurology and director of clinical neurophysiology at Harvard Children's Hospital in Boston. A leader in the study of how seizures affect the immature organism, he has developed a number of models to analyze factors that may lead to seizures, and has studied the effects of repeated early seizures on brain structure and function, as well as on behavioral and cognitive capabilities.

The forum schedule includes the following:

3 p.m. Registration, reception and exhibits

4 p.m. What is Pediatric Epilepsy?Holmes

4:30 p.m. Insights into Pediatric Epilepsy and its TreatmentsDr. John Rho, assistant professor of neurology and pediatrics, and Children's Hospital and Regional Medical Center

5 p.m. Key Problems in Pediatric Epilepsy: What Research is Being Done?Dr. Philip Schwartzkroin, professor of neurological surgery, UW

5:30 p.m. Workshop 1: Alternative Medical ApproachesDr. Marcio Sotero, Kathy Adamski and Renee Williams, Children's

Workshop 2: Psychosocial Issues in Childhood EpilepsyDr. Molly Warner, Dr. Hillary Shurtleff, Tim Humes and Patti Murphy, Children's

Workshop 3: New Anticonvulsant MedicationsRho, Dr. Joseph Pinter and Dr. John Kuratani, UW Department of Neurology and Children's

Workshop 4: Pediatric Epilepsy Research Center (PERC): Who We Are, What We DoSchwartzkroin; Linda Jaech and Rhoda Altom, parents and co-chairs, PERC External Relations Board; Shari Ireton, program assistant

7 p.m. Reception

PEDIATRIC EPILEPSY RESEARCH CENTER

The UW Pediatric Epilepsy Research Center (PERC) was established through joint efforts of the UW School of Medicine and parents of children with epilepsy. It draws on multidisciplinary expertise in neurosciences at the UW and Children's Hospital and Regional Medical Center. Its goal is to advance the understanding and treatment of pediatric epilepsies through basic laboratory and clinical research.

Dr. Philip Schwartzkroin, professor of neurology and biophysics, is PERC's director for research; he is a past president of the American Epilepsy Society. Dr. Jong Rho, assistant professor of neurology and pediatrics and a clinician at Children's, is co-director for translational research. Dr. Richard Winn, chair of neurosurgery, and Dr. Bruce Ransom, chair of neurology, serve as co-chairs of PERC's advisory board.

The cornerstone of the center is development of major interdiscplinary research studies. With PERC support, scientists from several departments are investigating the mechanisms by which the keogenic diet -- a high-fat/low-carbohydrate diet -- reduces frequency of seizures in some children with medically intractable epilepsy. In addition, PERC has awarded four grants for pilot projects to UW researchers studying other issues important for understanding epilepsy in the immature brain.

FACTS ON EPILEPSY

Epilepsy is a disorder consisting of chronically recurring seizures: sudden and unpredictable alterations of brain function associated with aberrant electrical activity. Seizures can result in uncontrollable movements, changes in memory, alterations in thinking and reasoning, and/or changes in consciousness.

Epilepsy can be triggered by a blow to the head, a brain tumor, stroke or infection. Genetics undoubtedly play a role in who develops epilepsy. For most people with epilepsy, however, the cause is unknown.

Approximately one out of 100 people suffers from epilepsy. The first signs are usually seen in childhood or adolescence.

Available medications provide significant seizure relief for 50 to 70 percent of people with epilepsy. However, many drugs have significant undesirable side effects. Surgery can help only a small fraction of individuals with medically intractable seizures. Basic research is the best hope for developing new and better approaches to prevent, treat, and cure epilepsy.

Some visual media may be responsible for some seizures

We can't escape the high-tech revolution: computers, video games and television. The vivid images are hard to turn away from, but doctors say some people should.

"The video arcades can be a breeding ground for a number of problems. There is a lot of visual stimulation around you that can cause headaches or seizures," Scripps Mercy neurologist Dr. James Santigo Grisolia said.

Flashing images and certain patterns on televisions, video games, computers and other video screens can trigger seizures in people who may be unaware they have sensitivity to visual stimulation or photosensitivity.

"If you are looking at flashing lights that are coming at five times a second, then maybe 25 times a second, there is an increased risk of causing seizures," Grisolia said.


Eight years ago, a Pokeman cartoon made hundreds of Japanese children sick.

"There was a certain frequency of flashing and 700 Japanese school children ended up in the emergency room," Grisolia said.

Now, children are exposed to this type of stimulation much more frequently.

"People that could have gone their whole lives without having a seizure, now there is a bigger chance of them having a seizure then some years ago," Grisolia said.

Teresa Quiroz has epilepsy and her seizures sometimes happen when she is scrolling a document on the computer.

"I throw myself around, all my muscles jerk, and I fall to the floor," Quiroz said.

She said she limits both her time on the computer and watching television. Video games are definitely out.

"I don't play videogames because they make me feel very ill," she said.

The Epilepsy Foundation is so concerned, the organization has issued new recommendations for families on how to limit the risk of seizures. They are:

Children should take frequent breaks.

Reduce the brightness of the screen.

Stop playing if strange or unusual feelings or twitching or body jerks develop.

Use a flicker-free computer monitor.

Watch television in a well-light room.

Watch television and play video games as far back as possible.

Avoid watching television or playing video games when you are tired.

"The movie industry, the videogame industry have been looking very closely at the scientific information the Epilepsy Foundation has put together and trying to modify things so that there is less problems in the future," Grisolia said.

If you are concerned about flashing lights and believe you or your child may have photically triggered seizures, check with your doctor. A test called an EEG can assess how you respond to flashing lights.

Is there a successful cure for Epilepsy?

Former epilepsy sufferer Natalie Wright is looking forward to doing the things most teenagers take for granted.

"Swim is a big one, go back to school and my job, just hang out with my friends," the 15-year-old aspiring hairdresser said in Brisbane.

Those simple youthful pleasures were once impossible.

But the teenager has begun a new and healthy chapter of her life after undergoing groundbreaking surgery to remove a part of her brain which was causing up to 30 seizures a day.

Natalie, from Airlie Beach on the Whitsundays coast, is the first child in Queensland to undergo brain surgery to cure intractable epilepsy - the most severe form of epilepsy which does not respond to medication.

She underwent a craniotomy at Brisbane's Royal Children's Hospital on November 4, which involved inserting electrodes deep into her brain to closely monitor the effects of her seizures.
Electrical activity in Natalie's brain was monitored for nine days until the exact location of the epileptic activity was located.

Neurosurgeons then removed the affected area - all while Natalie was awake.

"I couldn't wait (to have the surgery) `cause I was just sick of having seizures," said Natalie as she prepared to leave hospital.

"It did (frighten me) but I was sort of like, well, it's a good thing that they're doing this, because nothing else was working."

Two earlier operations to remove abnormal brain tissue failed.

Natalie's painful seizures, which began at age eight, continued and eventually crippled the right side of her body.

Jenny Gaylard said her daughter, who spent the past five months in hospital, had been unable to attend school or do activities with friends such as shopping, swimming or going to the movies.
"(Her friends) were going to school ... they were going to the movies and they were going shopping and gibbering about boys - all the things that teenage girls do and she was basically stuck at home," Ms Gaylard said.

"(But) now she can walk and be independent again, she can clean her own teeth and brush her hair.

"And now she wants to go home and go shopping with her girlfriends, like teenage girls like doing."

Consultant paediatric neurologist Kate Sinclair said Natalie's seizures were occurring in a "very unusual" part of her brain not easily accessible by the electrodes.

Surgeons had to exercise extreme caution during the operation because the affected tissue was near parts of the brain which allowed her to walk or speak, she said.

"For her, the success is extremely good," Dr Sinclair said.

"... Hopefully she's got a very good outlook."