Refined MRI scans allow location of seizures

An improvement in technology is allowing neurologists in Montreal to find and remove more lesions that cause epileptic seizures.

Dr. Andrea Bernasconi of the Montreal Neurological Institute has developed a unique computer program that refines MRI scans, meaning that lesions previously undetectable can now be seen.

A refined MRI scan in red shows more lesions. "There are approximately 20,000 people across Canada that could benefit from epilepsy surgery," said the neurologist.

"I think a significant proportion of these patients are actually not diagnosed properly. It means that maybe we miss some of the little lesions that are in the brains of these individuals."

Epilepsy is a neurological disorder that affects about one per cent of the Canadian population. In some cases, the seizures can be controlled by medication but other times surgery is needed.
The institute's epilepsy clinic sees some 2,000 people a year. Once patients are referred to a neurologist and they receive the refined MRI, it may be possible to bring the epileptic seizures under control.

"It could be a benign tumour that could be completely [removed]," said Dr. Andre Olivier, chief neurosurgeon at the Montreal Neurological Institute. "Then you're treating both the tumour, which is a lesion, and the epilepsy."

If brain lesions can be identified on an MRI, neurosurgeons say they can safely remove them 80 per cent of the time.

Dr. Andrea Bernasconi Michel Charrier hopes the new technique may help him. Charrier's seizures hit at night and can't be controlled by medication.

"I just go to bed," said Charrier. "And wake up in the hospital asking what day it is, what my name is and I say, 'how the heck did I get here?"

Charrier is waiting to find out if he is a candidate for surgery.

Former Heavyweight Champion hospitalized with seizures!

Former WBA heavyweight champion Greg Page, who sustained brain damage during a 2001 fight, was hospitalized and in critical condition.

Page, 47, was transferred Friday to the intensive care unit at Jewish Hospital a day after being admitted, hospital officials said. He has acute respiratory failure, sepsis, hypothermia and seizures.

"We are hopeful he will recover from this as well," said Page's wife, Patricia.

Page was left with brain injuries from his fight five years ago against Dale Crowe. He slipped into a coma, then had a stroke during post-fight surgery. He is paralyzed on his left side and uses a wheelchair.

Last week, Crowe was charged with murder in the death of a Cincinnati man.

TennCare dropped two drugs important to treat seizures

Most Tennesseans now recognize that TennCare reforms are here to stay and that those reforms will require tough decisions from the state and hardship on some TennCare enrollees.

But Tennesseans still should demand that tough decisions are also smart decisions. That may not be the case with a recent decision on two classifications of drugs.

Last month, TennCare dropped benzodiazepines, such as Valium, and barbiturates, such as Nembutal, from the pharmacy benefit. The move puts Tennessee in line with the federal Medicare program, which dropped the two categories on Jan. 1 at the insistence of Congress.

Most of the drugs in these categories have been on the market for years and are available in low-cost generic forms. A TennCare spokeswoman said that the drugs were very inexpensive and that patients could buy them. She said that continuing to provide them through TennCare would add administrative costs because of the new federal guidelines. TennCare also says that the drugs can be highly addictive and over-prescribed, and that the substitutes are safer.

But the pharmacy committee appointed to advise TennCare wasn't consulted before the drugs were dropped, and its members say the drugs are the most effective ones for certain conditions.
The reasons cited by TennCare for dropping the drugs seem petty next to the physical impact suffered by those people who need them, including people with epilepsy, cerebral palsy and mental retardation. One Nashville doctor said that withdrawal from the drugs could be fatal. Another doctor who treats epilepsy patients says there is no substitute for benzodiazepines in treating prolonged seizures.

TennCare is all alone on this decision: It doesn't have the backing of its own pharmacy committee. And the health-care programs for the poor in every other state continue to provide these drugs.
That could make Tennessee a leader — or it could mean Tennessee is just wrong. It would be a costly mistake for the program, and a devastating one to the people who need these drugs.

There is no reason to be off the Olympic Team because of Epilepsy

Chanda Gunn, goalie for the American women’s hockey team at the Winter Olympics in Torino, has won a string of awards and accolades anyone would be proud of.

But many people, including the media, have singled out her achievement because she also has epilepsy.

To find out how rare it is for those with epilepsy to be able to achieve such physical feats, UCSF Today interviewed Nicholas Barbaro, a professor of neurological surgery and principal investigator in UCSF’s Epilepsy Research Program.

Q. First, can you give us a brief overview of what epilepsy is? A. Epilepsy is a condition characterized by a patient having seizures requiring treatment with anti-epileptic drugs. Seizures vary from a momentary disruption of the senses, to short periods of unconsciousness or staring spells, to convulsions. Some people have just one type of seizure. Others have more than one type. Although they look different, all seizures are caused by the same thing: a sudden change in how the cells of the brain send electrical signals to each other.

Nicholas BarbaroQ. So, how unusual do you think Chanda Gunn is? A. She is, of course, a talented athlete, which in itself makes her unusual. But it is certainly not out of the realm of possibility for people with epilepsy to be able to accomplish many great things.

I’ve read about Ms. Gunn, and she admits that there were times in her life when she did not take her medication faithfully, and that resulted in some problems. But when medication can control seizures well, there is no reason a person with athletic ability can’t participate and compete in many kinds of sports. I do recall reading that, as a child, she was not allowed to go swimming.

I can understand that, although I think people with epilepsy, as long as they are in the water with someone who could help them in the event they have a seizure, shouldn’t limit that activity. We have patients who drive cars and participate in many kinds of activities.

Q. Medication seems to be keeping Chanda Gunn’s seizures under control. Is that always the case? A. Because there are now more than a dozen anti-seizure medications, many epilepsy patients have their seizures under control with medication. But there are some with uncontrolled seizures and, no matter what medication they try, they just don’t get relief.

Q. What is the next step for them? A. There are several surgeries which have been successful in controlling seizures in some of our patients. One involves resecting an area of the brain. This follows an exhaustive evaluation process that can sometimes take as long as a year. Other surgeries, including vagus nerve stimulation and deep brain stimulation, are being performed on patients with epilepsy as well.

Q. Is there anything new on the horizon? A. We have just finished a study using Gamma Knife on patients. This protocol is called radiosurgery and uses the Gamma Knife to focus 201 beams of gamma radiation on the precise location of the brain responsible for the seizures. This is a noninvasive surgery, requiring no incisions or anesthesia or so many of the other things we associate with surgery.

When the beams converge, the targeted area of the brain receives a full-treatment dose of radiation. Gamma Knife radiosurgery spares healthy areas of the brain from high-dose exposure to gamma radiation. While this trial has ended, we hope to do an even larger study in the near future.

Q. The UCSF Epilepsy Research Program is celebrating its 20th anniversary. What kind of changes have you seen over the years? A. We have so many more tools available now. MRIs are better, medications have improved, and we are investigating new ways to treat this condition. The success we have seen in treating patients successfully is very gratifying. Our patients are competing in sports, succeeding in school, driving cars - many activities and accomplishments they didn’t think were possible.

Seizures condition caused death

The death of a Catholic woman in West Germany while undergoing the Catholic rite of exorcism in 1976 has inspired two films within the past few months. After the American "Exorcism of Emily Rose" in September comes "Requiem," a German film by Hans-Christian Schmid, whose estimable "Distant Light" lit up the Berlinale three years ago. While "Exorcism" focused on a murder-trial battle between the priest and a prosecutor, Schmid's film beautifully details the behavior, events and socio-religious pressures that lead to the decision to perform such an extreme ritual.

There are no spinning heads or pea soup, still so vividly recalled from William Friedkin's horror classic "The Exorcist." Rather, Schmid and writer Bernd Lange pay close attention to all things that help answer the most obvious question: Why would anyone submit to an exorcism?

After debuting in Berlin, "Requiem" could prove a sellable item for Bavaria International. A North American sale might be iffy, but in Europe the film should generate plenty of theatrical and, later, television and video interest.

Michaela (Sandra Huller in a marvelous feature debut) grows up in a small southern German town in the 1970s. Hers is a deeply religious family with a warm father (Burghart Klaussner) and a cold, disapproving mother (Imogen Kogge). She has long suffered seizures diagnosed as epilepsy without the doctors ever being entirely certain. Nevertheless, she is given a regimen of pills to swallow daily and then more pills to offset side effects of the earlier ones.

Michaela, 21, is desperate to go to the university to obtain a teaching degree. Her father supports her, but her mother is terrified something might happen because of her condition. Michaela prevails, but university life brings stress. She loves the freedom, but the pressure of studying, new friendships and a first love with Stefan (Nicholas Reinke), all away from the protective shell of her parents' home, take their toll.

During her first year, she suffers a mental breakdown. But her upbringing and a self-assured local priest (Jens Harzer) force her to see the condition in religious terms. During seizures she believes she sees faces and hears voices. Indeed, so great is her fear of the psychiatric, she actually takes refuge in the notion that she must be possessed.

Without judgment or condemnation, the film observes the descent into madness and the differing interpretations of this condition by her family, priest, boyfriend and best mate (Anna Blomeier). Schmid and Lange clearly care deeply for this heroine in such physical and mental anguish. In a sense, Michaela plays into the hands of the priest and her mother, who believe this is the work of the devil. She is determined to fit that mold rather than the one requiring confinement in a "loony bin." The father and village priest (Walter Schmidinger), who more clearly understand what ails the young woman, cannot stand up to the united front of true believers.

Designer Christian M. Goldbeck fuzzies period details so that the era is not important. Schmid allows no music other than source music so that nothing can pander to emotionalism. Bogumil Godfrejow's cinematography is straightforward, keeping the focus on the unfolding tragedy.

"Requiem" shuns finger-pointing and easy jabs at religion. Its heroine crumbles under the onslaught of sexual awakening, feelings of guilt, religious confusion and mental instability. Religion supplies a false answer, but it's an open question whether psychiatry would have helped her either.

Shaken-Baby Syndrome has seizures as one of the symptoms

An East Stroudsburg father who allegedly injured his son in a shaken-baby incident was charged with attempted homicide Wednesday, Stroud Area Regional Police said.

Police said Jermaine Rivera, 25, of 53 Borough St., was also charged with aggravated assault, simple assault and endangering the welfare of children. Rivera, who was released on $25,000 unsecured bail by District Judge Michael Muth of East Stroudsburg, allegedly shook his five-week-old son, Ryan, on Feb. 4 until the baby went limp and began having seizures.

Police said Rivera pulled the boy from a swing when the infant started to cry and shook the infant. Police responded with ambulance personnel to a 911 call at Rivera's home, where they received a report just before 10 a.m. that day of an infant having difficulty breathing.

The baby was treated at the Geisinger Medical Center in Danville, and doctors found the boy suffered from bleeding inside his head, brain swelling and retinal bleeding and that the infant had seizures as a direct result of these injuries, police said. Police said the infant was released this week from the hospital.

Principal back to school after tough fight against Epileptic seizures

Susan Ehlers is working again as a school administrator, free from the epileptic seizures that threatened to end her career.

But her return to health has not been quick or easy.

Ms. Ehlers, 51, of McCandless, had brain surgery in 2002 to relieve her complex partial seizures. She later resigned as principal of Perrysville Elementary School in the North Hills School District.
She believes she might still be employed there if her supervisors better understood the debilitating effects of the seizures, a common disorder that many people may not associate with epilepsy.

The popular image of epilepsy is a person with a grand mal seizure, "someone who is stiff or shaking," noted Dr. Kevin Kelly, Ms. Ehlers' neurologist and director of the Center for Neuroscience Research at Allegheny General Hospital.

But people with complex partial seizures often have more subtle symptoms, he noted. They may stare, smack their lips or fumble with their clothing, yet be unconscious of their actions.

Ms. Ehlers had lapses in awareness lasting less than a minute, often once or twice a day. During those spells, she might tap her fingers. Afterward, she might be disoriented or tired.

Complex partial seizures are different from petit mal seizures, also known as absence seizures, noted Dr. Mark Scheuer, a neurologist and director of the University of Pittsburgh Epilepsy Center. Petit mal seizures can cause brief lapses of consciousness but typically are not followed by confusion or disorientation.

Seizures are considered partial if they begin in one part of the brain and complex if consciousness is impaired, said Dr. Brien Smith, an epilepsy specialist at Henry Ford Hospital in Detroit. In some cases, partial seizures progress to grand mal seizures.

While many people may not associate complex partial seizures with epilepsy, they are quite common, accounting for about 36 percent of all seizures, Dr. Smith said.

Some patients experience auras that warn them of the seizures, such as a rising sensation in the pit of their stomach or a sense of deja vu.

Some, too, exhibit bizarre behavior during their seizures. Dr. Jack Wilberger, chairman of neurosurgery at Allegheny General, recalled one patient who would say curse words over and over. Others may laugh uncontrollably, he said.

Complex partial seizures can be precipitated by very specific stimuli. Dr. Smith noted that one patient's seizures apparently were triggered by eating sweet potatoes. Another patient had seizures after listening to phone messages from an automatic bank teller, looking at a wedding portrait or watching Bob Barker on "The Price Is Right."

But often, the seizures have no clear precipitating factor, Dr. Scheuer said. Many times, the cause of the seizures also is unknown, though they are sometimes linked to birth complications, high fever in infancy, penetrating head injury or brain infection.

Seizures are sudden changes in brain function caused by abnormal electrical discharges in the brain. Patients with recurrent seizures are considered to have epilepsy, a family of syndromes that affect 2.7 million Americans. It is the most common neurological disorder after Alzheimer's disease and stroke, according to the Epilepsy Foundation.

About two-thirds of patients with complex partial seizures respond well to medications, Dr. Smith said. For those who don't, a vagus nerve stimulator, an electrical device implanted in the neck and chest, may help.

But surgery may be the best option for many patients who have intractable seizures linked to a specific area of the brain.

Surgeons remove a small area of brain tissue after conducting tests to determine that vital functions like memory and speech will not be impaired. As many as 70 percent of patients with epilepsy localized to the temporal lobe, an area of the brain near the ears, may be cured by surgery, Dr. Smith said.

Ms. Ehlers began having seizures about six years ago. Family members noticed that at times, she seemed disoriented or unaware they were speaking to her.

Tests confirmed that she had complex partial seizures and she was placed on medication. But several medicines were ineffective in controlling her seizures and they often made her tired.
Often, she would have seizures in the evening or as she slept. But they also occurred at school.
She said she was able to perform her duties despite the seizures, but needed more time to complete tasks and sometimes had memory lapses. She also had to stop driving.

In August 2002, she had a portion of her right temporal lobe removed. The surgery was so successful in controlling her seizures that she soon had no need for medication.

But school officials kept her from returning to the Perrysville school in early 2003, saying they were investigating her job performance.

Dr. Kelly told school officials that her performance had been affected by her seizures and her medication.

Ms. Ehlers said officials seemed unwilling to consider that she had been struggling with a medical problem. "Had it been diabetes or some other medical condition, I don't believe I would have been treated that way."

She filed a complaint with the U.S. Equal Employment Opportunity Commission alleging that she was the victim of discrimination based on her disability. But in September 2003, investigators said they were unable to find evidence of a violation.

Ms. Ehlers said she reached a settlement three months later with the North Hills School District. Among other provisions, she said school officials agreed to cooperate in allowing her to regain her principal's certification, which had lapsed.

Tina Vojtko, a spokeswoman for the school district, declined to comment in detail about the case, noting it was a personnel matter.

Since 2004, Ms. Ehlers has been coordinator of student services for the Communities In Schools Academy in Pleasant Hills. The alternative school helps high school students who have left traditional schools complete their course requirements for graduation.

Feeling better than she has in years, she said she enjoys the opportunity to again work with students.

"I feel when one door closed, another opened," she said.

Her experience with epilepsy has taught her to "never lose your belief in yourself -- and to count on your family, your friends and your faith."

Bacterial Meningitis linked to seizures

A student at Edinboro University is being treated for bacterial meningitis.

The female student became sick over the weekend and was taken to an Erie hospital.
The medical director of Edinboro's Heath Center said she is in very serious condition.
The student's friends are being advised to take antibiotics as a precaution.

The student's name has not been released.

What Is Meningitis?Meningitis is an infection that causes inflammation of the three thin layers of tissue that cover the brain and spinal cord.

There are two types: bacterial and viral.

Viral meningitis is usually less severe and is usually treated with bed rest or over the counter medications.

Bacterial meningitis is more severe.

The infection can result in brain damage, hearing loss, learning disabilities and can be fatal if not treated properly.

Some symptoms include fever, neck and back pain, headache, confusion, sensitivity to light, seizures and nausea.

Cancer linked to seizures

Southern Illinois football coach Jerry Kill said Tuesday he had a cancerous tumor removed from one of his kidneys last month, having opted to wait a couple of months to have the operation until after the Salukis' season was over.Kill, 44, said he expects a full recovery and that doctors have found no evidence the cancer had spread.

"I'm doing fine," said Kill, whose cancer was first reported Tuesday by the Southern Illinoisan newspaper in Carbondale, home of the Salukis. Cancer "is just an obstacle that's come up, and now I have to overcome it."Kill, who told the Salukis of the cancer last week, said doctors have been scrutinizing whether the cancer was linked to a series of seizures Kill weathered last fall, including one on the sidelines in the waning seconds of an Oct. 15 home loss to Illinois State.

"There's a possibility" the medical issues are related, Kill said.At that time, the university attributed the seizures to an unspecified condition that occasionally manifested itself with such episodes but was not considered life-threatening.But on Tuesday, Kill said that while undergoing tests after the seizures, doctors uncovered the kidney problem not long after the Salukis notched their biggest victory of last season, knocking off Western Kentucky -- then Division I-AA's top-ranked team -- on the road Oct. 27.After that, "I coached a good six games thinking I had cancer," Kill said, ultimately deciding to put off addressing it because "we were in the heat of battle, in the heat of a playoff run. It kept my mind off it."

Paul Kowalczyk, the Salukis' athletics director, said Tuesday that Kill apprised him of the diagnosis from the outset, adding, "It was not something he wanted to make public because it would become too much of a distraction.""He knew he had a window to work with," Kowalczyk said. "It's his body, his issue, and I've respected that. With anything else Jerry's taken on, I have all the confidence he'll win this, too."The Salukis' season ended Dec. 3 with a loss to Appalachian State in the quarterfinals of the Division I-AA playoffs.

Kill had the cancer surgery about a month later, spending a few days in the hospital before he resumed recruiting.About 102,000 people worldwide die from kidney cancer every year. In the U.S., about 32,000 people are diagnosed each year with the disease, which accounts for 3 percent of all adult cancers and occurs most often in people aged 50 to 70, twice as often in men than in women.On Tuesday, Kill was back in the office, arriving in time for 6 a.m. workouts and planning to head home 12 hours later.

"I really haven't had any recovery time," Kill said as he continued preparing for spring drills that begin March 29. "I'm still swelling and a little sore. But I'm not one to sit around. The busier you stay, the less your mind worries about something you can't control."While saying "I'm going to have to find a way to pace myself a little better," Kill said he plans to press on as the same gung-ho coach broadly credited with resurrecting a Saluki program that last season -- his sixth at Southern -- won its third-straight Gateway Conference title and Southern's first I-AA playoff game in 22 years.Medical issues have never slowed Kill.

A day after being released from the hospital after last October's sideline seizure, Kill was on the sidelines but largely an adviser when the Salukis beat Indiana State. Kill also had a seizure in November 2001 shortly after the Salukis lost to then-Southwest Missouri State, and he returned to coach the next week."I've been firmly committed to SIU, and I've given every ounce to SIU and its football program. I will continue to do that," he said.

"Am I a little slower and at a different pace right now? Yeah. But I can be right now."He expects to use the cancer as a motivator."When I tell the players, 'Hey, you've got to suck it up. Life's not always fair, and you've got to battle through adversity,' they can look at me and know," he said.

Paramedic attacked by patient with seizures

A D.C. paramedic has been injured, reportedly by a patient being transported in an ambulance Sunday.

D.C. Fire and Emergency Medical Services spokesman Alan Etter said the assault happened in the 600 block of Edgewood Street Northeast about 3:30 p.m.

Etter said the ambulance had been called to assist the man who was reportedly having seizures, but the patient reportedly got very violent on the way to the hospital and beat the paramedic.
The paramedic driving the ambulance called police for assistance.

The paramedic was not identified, but Etter said she had been on the job for five years. He said she suffered several injuries, including a possible broken leg.
Etter said this shows how dangerous a paramedic's job can be.

Toddler suffering from seizures had cocaine as well

Wichita police responding to a report Sunday of a 2-year-old boy having seizures learned that he had cocaine in his system.

The boy and an 8-month-old girl, possibly his sister, were taken into to protective custody, police said.

The boy had been admitted to Via Christi Regional Medical Center-St. Francis Campus, and a test showed cocaine in his system, police said.

There apparently have been no arrests.

Young infant suffers seizures after being shaken by nanny

An Allegheny County jury on Thursday convicted a former nanny from Dravosburg of endangering the welfare of a child and reckless endangerment for violently shaking a 10-week-old boy because he would not stop crying.

Sara Miller, 23, was acquitted of a more serious charge of aggravated assault, but still faces up to seven years in prison when she is sentenced in May. Common Pleas Judge Donald E. Machen revoked her bond and put her in jail pending her sentencing hearing.

Miller left court in tears, as did several jurors.

"There's no winners in this situation. It's a sad case," defense attorney Charles Schwartz said. He had argued that his client never meant to harm little Braden Ahmed Wahan, who suffered severe neurological damage and broken bones.

The boy's parents, Sharmila Ahmed and Serv Wahan, who are both doctors at Allegheny General Hospital, North Side, said they were shocked by the verdict.

"Essentially, we feel she got away with this," Wahan said, adding that he hopes Miller gets the maximum sentence. "I don't understand how you can have all the facts and not find her guilty of assault."

"This was such a brutal crime against an innocent child," said Ahmed, who called her son "an amazing baby. He's lucky to be alive, and we're lucky he's with us."

Ahmed testified that she and her husband hired Miller in February 2004 through Plum-based Sterling Domestic Placements for a live-in position in their North Side home to care for their newborn twins.

One day in early March 2004, Ahmed came home to find Braden crying loudly. She took him to their doctor's office, where the child's foot began twitching.

A week later, Braden became very listless and appeared to be seizing. She rushed the child to the hospital, where he went into full seizures. Tests showed he was bleeding in his brain and eyes and had suffered broken ribs.

Under questioning by police a few days later, Miller admitted she had shaken the child in a fit of emotion several days before he went into seizures.

"Most people would not treat an animal the way she did, and if they did, they would know it was wrong," Assistant District Attorney Jennifer DiGiovanni said during closing arguments yesterday. "Any reasonable person should know it was inappropriate."

After seven surgeries, Braden still can't see or talk, and he can barely walk, while his twin brother, Cailen, is developing normally, Wahan testified.

"His prognosis is still so unclear, because he does not respond," Ahmed said. "We're trying to do everything we can for him."

Infant suffers seizures caused by head trauma

The fate of a 27-year-old man is still unknown Thursday.

Jurors in the case of Freddy Ordonez are resting Thursday night, before they return to the courtroom to deliberate the future of the father.

On Thursday, Ordonez told jurors what happened hours before his 15-month-old son died.
He testified how the infant fell from his arms while the two were in the shower. Ordonez said that's when Uriah hit his head on the corner of the bathtub, before he went into seizures.

But during cross-examination, Ordonez admitted Uriah had been sick and throwing up for days. He said the only person he called was Uriah's mother.

"The defendant's testimony today didn't seem to maintain consistent theory as to how this child was injured from Tuesday and eventually died in the home with no emergency care," said Susana Martinez, district attorney.

The trial resumes at 8:30 a.m. Friday. If Ordonez is found guilty, he faces a maximum of 29 years in jail.

Seizures, results of a bad fall during fight

A 37-year-old Denver woman was in jail Thursday charged in the death of her boyfriend after they got into a fight at a downtown bar.

Police said the Reina Y. Gutierrez and her boyfriend traded punches at the El Charrito Bar in the 2100 block of Larimer Street Monday afternoon. The boyfriend fell and hit his head on the floor.

The two made up but the boyfriend started having seizures after he fell and then became unresponsive.

Authorities were called and the boyfriend was rushed to Denver Health Medical Center where he was pronounced dead. His name was not released.

Guiterrez was arrested on suspicion of manslaughter.

Missing boy found and sent back home

Police found a 16-year-old runaway yesterday who had been reported missing after he failed to board a plane last week. Police found Kamuela Martin at 1289 S. King St. near Piikoi Street at about 12:20 p.m.

Last Wednesday Martin had been dropped off at Honolulu Airport to board a flight to Utah but decided not to get on the plane and then fled the airport area, police said.

Family members said Martin had a medical condition involving seizures and needed to be found as soon as possible.

Missing boy has history of seizures

Police are looking for a missing 16-year-old boy who is taking medication for seizures.

Kamuela Martin was last seen Feb. 1 at 11:45 p.m. at the Honolulu International Airport, police said. He was scheduled to leave for Utah but did not get on the flight, police said.

Martin takes medication for seizures but police did not disclose the medical condition that causes the seizures. Martin may be driving a 2002 Saturn four-door station wagon, license JWW-409, police said. He is known to frequent the Honolulu, Ala Moana, Waikiki and Kailua areas, police said.

He is 6 feet tall and 154 pounds, with blue eyes and blond hair. He was last seen wearing a black T-shirt, dark pants and a black baseball cap.

Anyone with information about this person is asked to call CrimeStoppers at 955-8300, or *CRIME on a cellular phone. Free cellular calls are provided by Cingular, Nextel Hawaii, T-Mobile, and Verizon Wireless Hawaii.

Questions and answers about febrile seizures!

Q. What is a febrile seizure?

A. A febrile seizure is a seizure provoked by a high body temperature.

Q. Why does one occur?

A. Some individuals are predisposed to have them. It's thought that different combinations of genetic factors contribute to the predisposition, which often runs in families.
It's not uncommon for a sibling, parent or cousin to also have febrile seizures or epilepsy.

Q. How common is the condition?

A. Febrile seizures occur in 2 to 5 percent of children in the United States.

Q. Who is at risk?

A. Febrile seizures occur in otherwise healthy children, usually between 3 months and 5 years of age.

Q. What do signs and symptoms include?

A. Most febrile seizures are generalized tonic-clonic seizures, also known as grand mal seizures. A generalized tonic-clonic seizure is a seizure involving the entire body, usually characterized by rigid muscles, muscle contractions and loss of consciousness.
Occasionally the seizures can involve certain parts of the body instead of the entire body, then they are called focal seizures. When the febrile seizure is focal, or if the generalized seizure lasts longer than 15 minutes, the person has a higher risk of developing epilepsy, or unprovoked seizures, later in life.

Q. How long does one last?

A. Generally less than 10 minutes.

Q. When should a child be taken to the doctor?

A. A first seizure requires an emergency-room evaluation, regardless of age or condition. After a person has been evaluated, the doctor will give recommendations regarding when the child needs medical attention or when the child can be cared for at home.

Q. How is a febrile seizure diagnosed?

A. Febrile seizures are diagnosed by recognizing the seizure happening in a person of the correct age group, who usually is ill with a fever, with a sore throat or ear infection and who does not have a brain infection like meningitis or encephalitis.

Q. What treatment options are available?

A. Currently, treatment is aimed at reducing the fever rapidly with acetaminophen and cool-water sponge baths.
Since only half the children with febrile seizures will have a second febrile seizure, daily preventative treatment is not recommended.

Q. Can febrile seizures cause brain damage, mental retardation or learning disabilities?

A. Prolonged febrile seizures, ones that last longer than 20 minutes, can but do not always lead to brain injury. Long febrile seizures do lead to a greater likelihood of developing epilepsy.

Q. How are febrile seizures and epilepsy related?

A. Febrile seizures are the most common type of provoked seizures.
The febrile seizure occurs as a reaction to the fever. Epilepsy is a general term indicating the recurrence of seizures without provoking factors. Epilepsy is very common; about one of every 125 people have epilepsy.
There are many different types of seizures and causes for recurring seizures.

Q. Are febrile seizures hereditary?

A. Febrile seizures tend to run in families. It's thought that different combinations of genetic factors contribute to the predisposition for febrile seizures.

Dog, trained to assist child suffering from seizures

Fergie, a black Lab, knows when the teenager she loves is about to suffer an epileptic seizure. The dog stares at Denise Morrissey for 30 minutes to an hour. Fergie's unrelenting gaze prompts the 16-year-old to get down on the ground where she will be safe.

Ms. Morrissey has had several seizures a day since she was 7, and Fergie was trained by the Lions Foundation of Canada to alert her mother or father when she did. The dog joined the family at their home on Conception Bay, Nfld., three years ago. Soon, Fergie was forecasting the impending electrical storms in the young woman's brain. With her dog at her side, Ms. Morrissey doesn't need a wheelchair to be safe at school, and she hasn't had a bad fall in three years.
“I don't know how [Fergie] does it, whether it is a smell she notices, or subtle changes in breathing,” says Ms. Morrissey's mother, Cindy.

Scientists don't know either. But Adam Kirton, a researcher at the Hospital for Sick Children in Toronto, wants to find out. He surveyed 122 families with both a child with epilepsy and a dog. Fifteen per cent reported their pets could tell when the youngsters were going to have a seizure. Now he'd like to test dogs more rigorously in the laboratory.

Dogs can detect more than epilepsy. A recent California study found that three Labradors and two Portuguese water dogs detected lung cancer in people with the disease with 99-per-cent accuracy. They sniffed out breast cancer 88 per cent of the time. Other studies have suggested dogs can detect melanoma and bladder cancer, although not with the same success rate. There are anecdotal reports of dogs detecting the onset of migraines and, for diabetics, changes in blood sugar.

For years, highly trained dogs have navigated for the blind and alerted the deaf to ringing phones and doorbells. Dogs have come to the aid of the physically disabled, helping them pick up dropped objects, pressing buttons for them in elevators, even pushing wheelchairs up inclines.
The role of pooches in medicine is also growing — both in the direct care of patients and in the lab.

Dog DNA may hold the key to understanding complex diseases such as epilepsy, and dogs who develop cancer are often given experimental treatments that one day may help man and his best friend.

Dogs are also helping autistic children. Experiments at the University of Guelph in Ontario and elsewhere suggest that highly trained dogs improve the lives of children with the disorder, helping them connect with the world around them.

“Animals are such a lovely social lubricant,” said University of Guelph professor Cindy Adams, who studied about 45 autistic children who were given trained dogs. The dogs are people magnets, and draw both children and adults in the community into conversations. Some of the autistic children transferred repetitive behaviour, such as persistent tapping or rubbing, to the dog, which is more socially acceptable. The dogs also kept younger children off the roads.

Pet therapy is now part of the weekly routine in many hospitals, more than 200 in Ontario alone. Studies suggest that contact with animals, especially dogs, can help lower blood pressure and cholesterol and ward off depression in sick people.

Dogs have provided comfort to dying patients. A golden retriever named Faith befriended a woman in the final stages of breast cancer, said Nicole Burgess, who works in palliative care on Vancouver Island. The woman had no family, and welcomed a warm, soft companion, who was trained by Pacific Assistance Dogs, a charity in Burnaby, B.C.

“I had to step out to see another client down the hall, but I left Faith so she wouldn't be alone. When I came back, my client had died, but she had not died alone. She had her arm cuddled around Faith,” Ms. Burgess said.

It is hard to argue with testimonials like that, and anyone who works with dogs and patients will tell you that the animals help people through difficult times in ways scientists would never be able to measure.

Fergie, for example, has not only kept Ms. Morrissey safe, but has also helped the teenager fit in at school. Fergie is the only dog at the school and students are drawn to her, and as result, to her owner.

“Seizures are not socially acceptable. But having Fergie is a cool thing for Denise. The dog is a cool extension of herself,” Mrs. Morrissey said.

Fergie also has given the teenager more independence and more dignity. She can find a safe, private place to have a seizure, where she doesn't have to worry about other people's reactions.
Her doctors trust the dog. The family once took Ms. Morrissey to hospital to be checked out after a major seizure; they were ready to go home, but Fergie wouldn't settle down. The doctors said the dog was telling them that they shouldn't leave, Mrs. Morrissey said. A few minutes later the teenager had another major seizure.

Many experts, however, remain skeptical about the usefulness of dogs in more technical areas, such as diagnosing disease.

Critics of the cancer-detection studies, for example, note that dogs may be responding to the chemical traces of chemotherapy on a person, rather than tiny amounts of compounds such as alkanes and benzene derivatives found in cancerous tissue.

Even in epilepsy, where the anecdotal evidence is strong that some dogs can predict seizures, the medical community remains unconvinced, Dr. Kirton said. He has had trouble securing funding for the second stage of his work, which would involve training dogs to detect seizures and then studying whether they can warn children in a laboratory setting. Training dogs is expensive, costing $30,000 to $40,000 for each animal. Eventually, he hopes to figure out how the dogs can tell a seizure is coming.

Dogs also get epilepsy, and studying the dog genome for clues about the disease is more mainstream — especially now that the dog genome has been sequenced, making gene hunts shorter and less expensive. The genetics of human epilepsy are difficult to decipher because many genes appear to be involved.

It is easier with dogs, said Berge Minassian, at Sick Kids in Toronto. Many purebred species have a distinct version of the disease, and perhaps a single gene that causes it. Humans and dogs share many genes, so once they find an epilepsy gene in dogs, they can look for something similar in humans.

“The dog model is going to be a fantastic way to find human epilepsy genes, and we are embarking on a major effort to do so,” he said.

He has already found one faulty gene that causes epilepsy in miniature wirehaired dachshunds. He and colleague, Hannes Lohi, are now looking for the mutation that causes a form of epilepsy in Finnish spitz dogs, the national breed in Finland. With luck, different breeds will fill in different parts of the human genetic picture for epilepsy, Dr. Minassian said.

Dog genetics may illuminate the pathology of other diseases as well. The chromosomes of Doberman pinschers may hold clues for treating heart disease and narcolepsy. Spaniels may help scientists understand a degenerative neuromuscular disease called spinal muscular atrophy.
It is not just canine genes that interest scientists. Dogs with arthritis are used to test artificial hips. At the University of Guelph, dogs with melanoma have been given a new therapeutic vaccine that might stimulate both the canine and human immune system to kill cancerous cells.

Melanoma, a deadly form of skin cancer, is similar in humans and canines, said Steve Kruth, a professor of internal medicine at the Ontario Veterinary College at the University of Guelph.
“They share our lives with us, they have similar diseases,” he said. Dogs are large mammals, closer to humans than rodents. They also get cancer spontaneously, while many lab rats or mice are bred to be susceptible to a specific form of the disease. Dogs tend to have more aggressive cases of cancer. This is bad news for the dogs and the people who love them, but it means scientists can quickly see if the drug or therapy they are testing is working.

With the vaccine, only six dogs were tested, enough to suggest it was safe to try in humans, but not to know if it worked.

“This is a brand-new therapy, it has not been attempted before,” said Jack Gauldie, a researcher at McMaster University in Hamilton who worked with Dr. Kruth and is now testing the vaccine in humans. “The dogs gave us more surety that we had something safe. It was very important.”
If the vaccine works, it will help dogs as well as people.

But that is not the case with all the experiments involving dogs in Canada. Roughly 3,000 were used in research in 2004, according to the Canadian Council on Animal Care, which sets the standards for the use of animals in research. Most of them would have been euthanized, and a small number would have come from pounds or pet shelters, said Michael Baar, a veterinarian with the organization.

In some experiments, there is something in it for the dog, said Elizabeth Stone, dean of the Ontario Veterinary College at the University of Guelph. Dogs have also benefited from work in humans. She notes that techniques for removing cataracts were first perfected in humans, and many cancer treatments now available to dogs were first tested in people. In the United States, she added, people sometimes stipulate that after they die they want their pacemaker to go to a dog with heart problems.

Researchers are also concerned about the health and happiness of service dogs. It is important that they get down time, said Dr. Adams, the Guelph researcher who studied autistic children. “They can't be a service dog 24-7. They need to pee, they need to run, that kind of stuff.”

They also need to be loved. A strong bond is important, said Michelle Wright, who trains special-skill dogs for the Lions Foundation. Her organization has trained more than 30 dogs to help people with epilepsy, and the animals are donated to families such as the Morrisseys.

The dogs are taught to recognize seizures and to get help, either fetching someone in the home, or hitting an alert button that connects the house to a emergency department by phone. Like Fergie, some of the dogs develop the ability to warn that a seizure is coming.

Fergie goes everywhere with Ms. Morrissey, and is well loved. The dog gets a play period every day when she can run around with the kids at school. The teenager feeds her, grooms her and makes sure she gets bathroom breaks.

After Ms. Morrissey has a seizure, Fergie lies down beside her and licks her face. When she is coming out of one, it is Fergie she reaches for first.

Says her mother, “Fergie is her best friend.”

Specially trained dogs can predict seizures

Man's best friend is moving into medicine and saving lives. There are a small number of dogs that can warn a person that a seizure is coming. Barbara Roberts has epilepsy. Her seizure alert dog, named Eric, warns her to a possible seizure five or six times each day. On the day we visited her, Eric alerted her twice by sitting or standing in front of her and not letting her move.

According to Barbara, "I will stop. I will start relaxing. I will not move. He won't let me move. Any command I give him he won't do." The "stopping and relaxing" can often derail the seizure. Then Eric moves in order to cue Barbara that it's okay for her to get back to whatever she was doing. "I'll be in a meeting at work and all of a sudden I'll look over and he's standing straight and I'm realizing I'm getting a little stressed and I have to back off from what I'm doing," according to Barbara.

"I think it's remarkable," she adds.Eric is one of just two seizure alert dogs in Massachusetts trained by Canine Partners for Life, an organization based in Pennsylvania. "This is kind of a natural instinct that the dog has," according to Darlene Sullivan who heads the group. "We don't know what the dogs are detecting for sure. We believe that they are picking up on electrical and chemical changes that are going on in the person's body, and we think that they are doing this through scent," says Sullivan.Barbara Roberts admits that at first she was skeptical.

"I came from something going, oh I don't believe this. Within the second week, when I was realizing he was alerting me, and I would sit down and relax, I realized I was catching myself," says Roberts.The dogs are also taught to open doors, and carry briefcases. It's an intense two year training program before they're placed.

"I feel like now it's making a big difference in my life," according to Barbara.Only 28 of these service dogs are available each year, and there's a long waiting list. The training costs for each dog are about $20,000, all supported through donations.