Saturday, January 28, 2006

Parent concerned that Aspartame may induce seizures

I have a three-year-old son named Zachary. He was born a happy healthy baby. In the summer of 2004, I became concerned over the amount of sugar he was getting in his juice. We live in the desert and he needs to drink a lot of fluid. Because of this, I decided to switch him to sugar free drinks at my home as well as my mother’s when she baby-sits.

I purchased crystal light and sugar free tang and began giving him these on a daily basis. I was an avid diet Pepsi drinker and he was getting sips of this as well. In December 2004, while out shopping with my husband Zachary experienced his first seizure. He had not been sick, nor had a fever. He stiffened up, turned blue and was transported by ambulance to the hospital.

He was observed for 24 hours and released. His CAT scan and MRI came back clear. The month of December we started experiencing some very concerning behavior with him. He began collapsing constantly. He would be walking across the floor playing, and just collapse. It became so bad that we had to buy a helmet to avoid a head injury, because he was hitting the floor hard and bruising. I was watching him become more ill as the days went by. I remember going in to his room one night and found him limp in his crib with a blank stare. I knew something was terribly wrong.

I put him in my bed because I was afraid to leave him alone. Eating became a problem. I would watch him pick up a spoonful of food and his hand would lose grip and the food would fall before it would ever made it to his mouth. He now had to be carried around the house because we were afraid he was going to injure himself, his falls were becoming worse. He began having seizures lasting up to five minutes at a time. On December 29th an ambulance was called and he was taken back to the hospital. He was now very ill.

A 24-hour EEG showed he was having 40 plus seizures a day. He was in a status seizure condition and was transferred to ICU where he had to be sedated with three different medications to break the seizures in his brain. It took three days to break his seizures and nine days later he was able to go home. Zachary spent one year on two different types of seizure medications to allow his brain to heal. The MRI and CT scans continued to come back normal.

There was no medical reason for these seizures. When we got home from the hospital I was going over everything that could have possibly caused these seizures. I knew we were missing something. The only thing different in his routine was all the sugar free products he started having in the summer containing aspartame. I began reading for several hours and days on this and discovered that Zachary’s symptoms were identical to those of an aspartame overdose. Everything from his types of seizures, collapsing, and the time frame he became ill.

Because it is metabolized as formaldehyde, aspartame causes your brain to become unbalanced therefore seizures are more likely to occur, especially in children. It can take up to a couple months to make a person critically ill, which also fit his profile. I have been in the medical field for 15 years and firmly believe that he was having aspartame induced seizures, which he could have died from. Zachary has returned to being a healthy three year old.

We will never allow any sugar free products in our house again. I wish more parents were aware of the dangers of this. Certain products like Pedialite, children’s vitamins, cold medicines, and foods like Jello which children love, all contain this horrible ingredient. It is a shame that the FDA still allows all these products on the shelf at the expense of our children. Mine could have died.

Do migraines with an aura are linked to Epilepsy?

Children who have migraine with aura are at substantially increased risk of developing epilepsy, researchers from the United States and Iceland report. However, they found no apparent relationship between seizures and migraine without aura.

Senior investigator Dr. W. Allen Hauser told Reuters Health, "a possible association between migraine and epilepsy has long been recognized, but the exact relationship is not clear."
This study, he added, shows that "the relationship between epilepsy and migraine is strong, but only for migraine with aura, which accounts for only about 30 percent of all migraines.

Epidemiological studies have shown that the risk of migraine is about twice as great in adults with epilepsy as it is in those without, Hauser of Columbia University, New York and colleagues point out. They therefore hypothesized that children with migraine may have a higher risk of developing seizures and epilepsy.

The researchers identified 94 Icelandic children between 9 and 15 years old who experienced a first unprovoked seizure and had newly diagnosed epilepsy. These children with matched for age and sex to another 188 unrelated children without a history of seizures.

The investigators used a structured interview to assess headache symptoms in the children. Rather than using five or more migraine-like headaches to classified children with migraine, as stipulated by the International Headache Society, Hauser's group used two or more episodes of migraine-like headache to diagnose migraine. Visual symptoms were used to define aura.

Overall, children with migraine had a 3.7-fold increased risk of developing epilepsy. There was no increased risk in children with migraine without aura (odds ratio, 1.4) -- the increased risk was restricted to those who had migraine with aura (odds ratio, 8.2).

This finding, the researchers report in the January issue of the Annals of Neurology, "is consistent with the hypothesis that migraine with aura and migraine without aura may be different disorders."
Hauser added that "not only do the two conditions co-exist, but, at least in children, migraine precedes epilepsy."

Migraine with aura may cause epilepsy, a "plausible hypothesis" since blood vessel and possibly brain abnormalities can develop in association with migraine, or "migraine with aura and epilepsy share a common underlying mechanism. I prefer the latter."

Thursday, January 26, 2006

Another cheerleader affected by seizures

Natalie Oshin, a Penn cheerleader, was hurt during last night's basketball game at the Palestra.
The cheerleaders were performing on the sideline during a time-out when the College junior fell on her back after being lifted by another cheerleader.


She had seizures for about one minute and was then placed on a stretcher and removed from the building.

Oshin was transported to the Hospital of the University of Pennsylvania and her parents were notified.

A receptionist at HUP said that Oshin was in the surgical intensive care unit. A nurse in that unit said her condition was stable, but would provide no further information.

Supper to collect funds to help family pay for toddler's surgery!

The drive-thru window at David's Catfish had a steady stream of vehicles passing through Monday night. But only a handful were asking for catfish, the majority were dropping off donations for the Bryant McDonald benefit that was held inside the restaurant on Monday night.

"We didn't know what the response would be," Tracy McDonald said. "Everything went above and beyond our expectations."

The benefit was held for 4-year-old Bryant McDonald, a resident of Bratt, Fla., who was born with seven brain malformations. The young child's medical journey began when he underwent his first surgery at only one and half years old. On June 20, 2005 neurologist and neurosurgeons removed the "bad" part of Bryant's brain, a lobotomy, in order to reduce the number of seizures he was experiencing by at least 80 percent. Birmingham doctors had determined that Bryant was having an average of 8 seizures a minute.

Since the lobotomy, the young boy has been accepted as a candidate for a therapy program called Adeli Intensive Suit Therapy. The therapy intended to help children with Cerebral Palsy is new to the United States and is not covered by insurance.

The program, a four-week session, runs for five days a week, four hours each day. The cost per four-week session is $8,000, which does not include housing or food during the four-week period. The therapy will be held in Macon, Ga.

"Bryant will start his first round of therapy on Feb. 6," McDonald said. "The therapy will last through March 3rd. We will be traveling to Macon week by week," McDonald said. "I will take Bryant one week and Jason the next week, so we will each continue to work and keep in good standing there."
Monday's benefit was intended to help the McDonald's cover the expenses associated with Bryant's therapy. The chili supper drew in more than 450 people and raised more than $6000. A silent auction was held for more than 160 items that were donated by businesses from Atmore and the surrounding area.

Friends, family and church family of the McDonald's all pitched in to make the night a huge success. Bryant was also seen mingling with the guest.

"I don't know if anyone really knows how thankful I am," McDonald said. "Mr. Faircloth was so generous to allow the use of his restaurant. He wouldn't take a penny for it; he did it because he wanted to. Food Fair, Piggly Wiggly and B & J Meat Market in Century were also great. They donated so many items to help us out. And then the 30 plus workers who helped us out and made it all possible. Our friends, family and church family were great. We had a place for everybody that wanted to work. We had never done anything like this and the few minor glitches we had, were outweighed by the huge success. Bryant is such a social butterfly anyway, but he loved every minute of the benefit. He was so tired from the whole thing."

Donations can continue to be made at United Bank and the Walnut Hill Ruritan Club is planning a yard sale in the near future to help the family also.

New device may help to fight seizures and more...

According to a report in medicalnewstoday.com, researchers at the University of Pittsburgh have been credited with developing a wireless device that may soon become a useful treatment for depression and epileptic seizures.

The device, which is implanted in the neck, was developed in conjunction with a group of Pittsburgh high school science teachers.

Currently, the FDA has approved a wired version of what is ultimately planned to be a wireless device. There are, however, some risks and potential side effects associated with the wired device that include: infection (because of the surgical incision); restricted movement and adhesions (from the wire that runs from the left side of the chest to the left side of t he neck); hoarseness, shortness of breath, and voice alteration (all of which subside when the device is deactivated).

Prior research has found that, when stimulated, the vagus nerve that connects the brain to a number of major organs has the ability to offset even drug-resistant epileptic seizures.

The treatment of severe depression is another use for which the FDA has approved vagus nerve stimulation (VNS). At present, the VNS device produced by Cybertronics Inc. is the only one on the market.

Their version of the product is a pulse generator that is implanted into the left side of the chest. A wire then runs from there to the left side of the neck where it wraps around the nerve. A magnetic wand is used to turn the device on and off. When the batteries need to be replaced at between three and eight years, the patient must undergo additional surgery.

VNS has a number of benefits vis-à-vis existing treatments for depression. Among those is the absence or reduced severity of side-effects associated with drugs. VNS does not cause sexual dysfunction or memory impairment and sleep deprivation and weight gain are minimal.

The researchers’ goal was to create a device that would prevent seizures. Using a modified method for deep-brain stimulation (DBS), which helps treat diseases through the use of radio frequency technology, they came up with a new option for patients seeking alternative treatments for depression and epilepsy.

Their device known as a Radio Frequency-powered Neural Stimulator (RFNS) consists of a receiver implanted under the skin and a separate power supply placed near the skin in the neck area. This version, unlike VNS, requires only one surgical incision. This serves to reduce the risk of infection.

Another distinct benefit of the RFNS is that there is no need to run an internal wire from the patients’ shoulders to their necks. The external power supply eliminates the need for additional surgical procedures thereby reducing the risk of infection even further.

Sunday, January 22, 2006

Depression and seizures may be linked

A history of major depression and a past suicide attempt seem to be tied to an increased risk of seizures and epilepsy, according to the findings of a population-based study conducted in Iceland.
Dr. Dale C. Hesdorffer of Columbia University in New York and colleagues examined data for children 10 years of age or older and adults with newly diagnosed seizures. Standardized interviews were used to ascertain symptoms of major depression.


The study Included 324 seizure patients who were matched to 647 similar but unaffected "controls," and the results are published in the Annals of Neurology.

After factoring in age, sex, and cumulative alcohol intake before the onset of depression, and other psychiatric conditions, patients with a history of depression alone were 50 percent more likely to develop seizures than those with no depressive symptoms.

Moreover, the likelihood of having seizures was 11 times higher for patients with a history of attempted suicide alone, and more than 3 times greater with a history of depression plus an attempted suicide.

"There appears to be an underlying susceptibility to epilepsy and major depression and suicidal behavior," Hesdorffer commented.

"We plan to follow-up with studies designed to see whether the co-occurrence of these disorders is explained by shared genetic susceptibility, and with studies that examine possible common underlying neurotransmitter abnormalities," he added.

Saturday, January 21, 2006

Dog is helping owner during seizures

The old saying goes, "a dog is man's best friend." That's nothing short of the truth for one East Alabama woman. Ginny DeGroff has epilepsy, and her rottweiler is trained in many ways to get help if she has a seizure.

"She can tell before I have a seizure. Don't ask me how they do it. She also tells me when to take my medicine. She can hold me down because grand mal seizures can be so violent that we can hurt another human," said DeGroff.

Wolfia also has a handicapped-enabled cell phone.

"If you hold any of the keys down for five seconds or longer, it's usually carried in this pouch right here, and she'll roll over on it, and it gives you a tone. After those five seconds, it'll call 911," DeGroff said.

DeGroff suffered head trauma from a gunshot wound and when a horse fell on her. Now she's at the Achievement Center of Opelika improving her typing skills and trying to find an employer that will allow Wolfia to come along.

"Working around food, I could understand it more. But clerical and secretarial, there's no reason because, as you see, she stays where I tell her to stay," said DeGroff.

Achievement Center managers say the accidents did not affect her abilities.

"That's why it's so important for us to demonstrate that people can work with those type people even though they're disabled and have an assistance-type dog. There's nothing that prevents that person from being productive," said Frankie Mitchum, Achievement Center administrator.

Wherever DeGroff goes, Wolfia is her biggest supporter and lifesaver. She says Wolfia understands Spanish, two Indian dialects, English, some German and sign language. On average, DeGroff has a seizure every other month and may be only able to communicate by moving her hands.

Research for a less risky treatment

Researchers from the University of Pittsburgh, with the help of a team of Pittsburgh high school science teachers, have developed a wireless device that is implanted in the neck to fight depression and epileptic seizures. The U.S. Food and Drug Administration already has approved a wired version of the device, but that one carries risks and several undesirable side effects.
It has been known for several years that stimulating the vagus nerve, which connects the brain to several major organs, can offset drug-resistant epileptic seizures.


Last summer, the FDA approved vagus nerve stimulation (VNS) for use to treat severe depression as well. The only current manufacturer of a VNS device is Cyberonics Inc. of Houston. In the company's product, a pulse generator is surgically implanted into the left side of the chest, and a wire extends from the device up through the left side of the neck to wrap around the nerve. Patients must undergo additional surgery to change the battery every three to eight years. The device can be turned off at any time with a magnetic wand.

VNS has few of the side effects of traditional treatments for depression: no sexual dysfunction or memory impairment and minimal sleep disturbance and weight gain, which are often associated with antidepressants or shock therapy. However, there is a risk of infection due to the surgical incisions, and the long wire lead may cause painful adhesions and restricted movement. Additionally, side effects include hoarseness, shortness of breath, and voice alteration, although these are alleviated when the device is turned off.

Last summer, eight teachers from City of Pittsburgh high schools came to Pitt under a National Science Foundation-funded program in which they divided their time between Pitt's Learning Research and Development Center and a research project of their choosing. Four of the teachers chose to work on a device to prevent seizures under the guidance of Marlin Mickle, Nickolas A. DeCecco Professor of Electrical and Computer Engineering at Pitt, director of the University's Radio Frequency Identification Center for Excellence and John A.

Swanson Institute for Technical Excellence; Michael Lovell, associate professor of industrial and mechanical engineering and associate dean for research in Pitt's School of Engineering; Robert Sclabassi, professor of neurological surgery, neuroscience, psychiatry, electrical and mechanical engineering, and bioengineering and director of UPMC's Center for Clinical Neurophysiology; and Pitt electrical engineering graduate student Steven Hackworth.

The group hoped to treat seizures by modifying a method for deep-brain stimulation (DBS), which Mickle, Lovell, and Hackworth had developed, that uses radio frequency technology to help treat diseases such as Parkinson's. The major technical challenge they had to overcome was to convert the voltage source required for DBS to the current source required for the seizure treatment.

The solution they developed is the Radio Frequency-powered Neural Stimulator (RFNS). The RFNS is made up of a receiving device implanted under the skin of the neck and a powering device placed near the skin at the same site, under a collar. Because this requires only one surgical incision, rather than the two required by VNS, the risk of infection is reduced.

Other advantages of RFNS over the existing VNS system include no invasive tunneling from the shoulder to the neck region and an external battery, which reduces the need for subsequent surgeries and further lowers the risk of infection.

The next step for the researchers is to license the technology to a company, which would then need to obtain FDA approval.

Inaugural parade, special needs kids worst nightmare!

What does it take to organize a weekend trip to Williamsburg? Now, multiply those arrangements by 65, including lots of kids -- almost 30 with special needs.When Mary's Family was invited to participate in the governor's inaugural parade in Williamsburg, it was an honor for founding director Martha Toomey.

She had about 30 seconds to sit around feeling honored. Then the work started.Visions of her organization marching to band music under sunny skies, waving banners, quickly gave way to special-needs nightmares. Colonial Williamsburg, after all, is not exactly wheelchair-friendly. In order to authenticate a Colonial-period town, the stores, houses and restaurants are built with stairs -- not ramps -- leading to their entryways. And a parade, with its accompanying noise and confusion, is not conducive to children with autism, who can become upset by loud noises or crowds.

But Toomey is not easily deterred.Toomey spent countless hours arranging ADA-compliant hotel rooms, refrigerators for medications, and special permission to keep goats (they were walking with Mary's Family in the parade) in a $170-per-night hotel room; talking with parade organizers; arranging for tickets to the inaugural concert; setting up an appointment with Virginia's first lady Anne Holton; arranging for transportation in Williamsburg that could accommodate wheelchairs; and keeping the families in the loop.

Planning to leave early Friday morning, Toomey received word Thursday afternoon that 5-year-old Emily Gutierrez, one of her parade leaders, had been airlifted out of Coleman Elementary with a severe seizure (see accompanying story). Heather Stubbs, whose brother Michael has autism and whose whole family planned to march in the parade, came down with a stomach virus at the last minute. The Rev. Jim and Dale Cirillo of Grace Episcopal Church had a parishioner lose a child, and then a volunteer lost his grandmother Friday morning.Just getting out the door would have been enough to force the faint of heart to throw up their hands.

But not the folks who make up Mary's Family. Every single family made the trip. Changes, challenges and shifting plans seemed the theme for the weekend, with Toomey's cell phone ring tone as the soundtrack.A delicious -- but dizzying -- dinnerTwelve of the Mary's Family entourage made reservations at the King's Arms Tavern, a fine dining restaurant in the heart of Colonial Williamsburg, complete with service staff in period costume and entertainment. With reservations set for 5 p.m., Toomey thought they would have plenty of time to eat before their next event -- the inaugural concert, featuring the Beach Boys, scheduled for 7:30 p.m.

"Some of us have autism, and some have wheelchairs, and let's see, what else? Spina bifida, and seizures and some of us are just plain crazy," Toomey explained to the waitress, relaxing into her chair.But just after the menus were distributed, Toomey's cell phone starting ringing again. This time, it was a representative for the governor-elect's wife. If Toomey and the kids planned to present Holton with the Hawaiian leis they had made for her to wear during the Beach Boys concert, they would need to be at the concert hall in exactly 35 minutes. That gave the party of 12 only 35 minutes to order, be served, eat, pay and get to the concert hall. Seven-year-old Chad Bobon, who has autism, had gotten his heart set on a cheeseburger, which was not available. Tearfully, he finally settled on just plain fruit.

As the group wolfed down their food and prepared to run out the door, one of the powdered-wig-wearing entertainers entered the room and began talking. Coats were snatched up and the party made a mad rush for the door."I did not mean to frighten you away," the surprised-looking entertainer apologized sheepishly to the fleeing backs. "You are a lovely man, and you truly did not frighten us away," Toomey called over her shoulder as she bolted from the room, accidentally leaving the Hawaiian leis under her chair.Party hearty, Beach Boys-styleAfter going back for the leis and then loading into the van, the company arrived at the concert hall a full 30 minutes late for their meeting with the first lady-elect.

Security still had to be passed and wheelchairs had to be guided over the electrical cords that were gathered into thick trunks backstage.As group members trickled through the security screening, Jeffrey McCord, Toomey's son, noticed a man standing just outside of the backstage area, and asked the man if he was a Beach Boy."No," the man replied, pressing something into McCord's hand. "But I work for them."McCord's face lit up as he looked at the Beach Boys' guitar pick in his palm, and he rushed to his father's side to show off his new prize.

While they waited -- and waited -- for Holton, the kids practiced their handshakes and greetings in preparation for meeting the first lady.Well over an hour passed before Holton and daughter Annella were finally able to make their way down, but the children were thrilled when she turned the corner.They proudly shook her hand, just as they practiced, and presented her with the leis. Then the kids scooted out to join the rest of their group in the arena, and slid into their seats that were right on the floor, less than 100 feet from the stage.

They danced the night away, cheering loudly for each of the acts, smiling and laughing, before sleepily piling into vans to return to their hotel rooms.Parade day pandemoniumSaturday morning, the parade participants awoke to a cold and rainy Williamsburg.At the 9 a.m. meeting time, only five of the roughly 65 participants were at Toomey's room. She had already rushed off in her pajamas to collect the parade credentials, leaving her husband Jeff McCord in charge of the restless families."I don't have a long-sleeve shirt to wear," young Jose Gutierrez told McCord."We have medicines we have to take with food.

We have to go get some kind of food. I can find you all later," said one parent. Helicopters passed endlessly overhead, causing problems for some of the children with autism.McCord passed out granola bars and spare shirts, hoping to keep some semblance of order until Toomey's return."We're just trying to put the 'fun' back in 'dysfunctional,' " he joked, while his son bounced on an exercise ball.

When Toomey returned, she quickly gathered the entire company together as cold rain sprinkled down over the families. She promised them that the rain was going to stop.Families waited for hours until Toomey received the call to line up for the parade, and then everyone bustled down the street to the meeting spot. Even Heather Stubbs, who only moments before had been sleeping off a night spent awake with a stomach virus, joined the party. "Everybody smile," Carina Elgin reminded the participants. "Remember, we're jolly!

Even though it's cold and raining, we are so happy to be here!"The baby goats hid under wheelchairs to escape the rain. Families huddled under umbrellas. Service dogs plopped down beside their owners, resigning themselves to getting soaked.The kids were the next to embrace the rain, abandoning their umbrellas and the adults weren't far behind. With wind blowing the rain almost horizontally, the umbrellas weren't much help, anyway.Spectators, who had watched Kaine's inauguration just before the start of the parade, abandoned the streets of Williamsburg to seek warmth and shelter.

Though the parade route was labeled handicap-accessible, the unpaved Williamsburg streets quickly turned to mud. Wheelchairs sunk into the mud, leaving volunteers and family members to lift the chairs out while trying to keep up with the pace of the parade. As the Mary's Family group passed the grandstand, Gov. Tim Kaine propelled himself out of his chair and waved enthusiastically at all of them."Hi, Gov. Tim!" the kids called as they marched by, waving their congratulatory signs.

As they reached the end of the parade, cold and wet and hungry, the National Guardsmen directing the participants steered them in the wrong direction. The path, wide enough for a single wheelchair and made entirely of mud, sloped down two feet on either side. The participants slipped and slid down the path, only to end up in a parking lot, alone and in the rain. Toomey said, "We'll just keep hiking. Our hotel is around here somewhere."Volunteers had to lift wheelchairs over curbs and ditches, but the entourage finally made it to the hotel.

"I am so proud of everyone," Toomey said. "The bravery you guys showed today by sticking it out through the weather and everyone's illnesses and struggles is just amazing ... I could not be more proud."

Thursday, January 12, 2006

Boy who died in bathtub has history of seizures

Relatives of 6-year-old Hunter Robinson are anxiously awaiting autopsy results that could explain how he died Sunday night in his south Wichita mobile home.

Hunter was taking a bath while his mother was talking on the phone in the 3200 block of Southeast Boulevard, according to Wichita police. When the mother heard an unusual splash at about 10:25 p.m., she yelled into the bathroom to see if Hunter was OK.

When he didn't respond, police said, she went in and found him lying on his side in the bathtub, his head partially underwater.

She pulled him out of the tub and called 911, and an operator walked her through CPR, according to police. Paramedics arrived and attempted to revive him, but he was pronounced dead at Via Christi Regional Medical Center's St. Joseph Campus at 11:06 p.m.

Debbie Reese, Hunter's aunt, said the boy "was standing up just fine" when his mother took him out of the tub. But he went into convulsions and stopped breathing, Reese said.

Hunter had a history of seizures, she said. He was born three months early, had seizures until he was 2, and had had a seizure as recently as two weeks ago.

"We do not know why" he died, she said. "We're waiting for answers."

Those answers may not be available until late in the week, officials said.

"He couldn't have been more loved or better taken care of," Reese said.

Tuesday, January 10, 2006

Epilepsy surgery has good influence on depression and anxiety

Depression and anxiety are common problems for people whose epilepsy cannot be controlled by medication.A study found that depression and anxiety improve significantly after epilepsy surgery.The study, which is published in the Neurology, found that the rate of depression and anxiety disorders decreased by more than 50 percent up to two years after the surgery.

People who no longer experienced any seizures after surgery were even more likely to be free of depression and anxiety." These results are important because depression and anxiety can significantly affect the quality of life," said study author Orrin Devinsky.. " 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."

The study involved 360 people in seven U.S. epilepsy centers who were undergoing epilepsy surgery to remove the area of the brain producing the seizures. Epilepsy surgery is generally reserved for those whose seizures cannot be adequately controlled by medication.The majority of participants had surgery on the brain's temporal lobe.

The participants' mental health and any symptoms of depression and anxiety were evaluated before surgery and at three months, one year, and two years after surgery.Prior to the surgery, 22 percent of the participants met the criteria for a diagnosis of depression, compared to 9 percent two years after the surgery.For anxiety disorders, 18 percent met the criteria for a diagnosis before the surgery, compared to 10 percent two years after the surgery.

Of those who had no seizures following surgery, 8 percent met the criteria for depression, compared to 18 percent of those who still had some seizures after surgery. For anxiety, 8 percent of those who were seizure free had depression, compared to 15 percent of those with ongoing seizures.Researchers aren't sure why depression and anxiety improve after epilepsy surgery."

Removing dysfunctional areas of the brain may be critical," Devinsky said. "Whether the benefit comes from reducing or eliminating seizures or other effects is not clear. People may also be benefiting from an improved sense of self-control, less fear of seizures, higher activity levels and a lessened burden from medications."

From seizures to Epilepsy

A 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.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 journal 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."

Saturday, January 07, 2006

Can modified Atkins diet help reduce seizures?

Researchers at Johns Hopkins Children's Center have found that a modified version of a popular low-carbohydrate, high-fat diet is nearly as effective at controlling seizures as the highly restrictive ketogenic diet." Our findings suggest relatively good efficacy compared to the ketogenic diet," said Eric Kossoff, 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.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.

Can man with history of seizures be at fault?

Durango police say a man with a history of seizures is at fault for a Tuesday night head-on collision near Home Depot. The accident sent both drivers in the hospital.

Sgt. Tony Archuleta, police spokesman, described the scene:

The wreck occurred at approximately 5:45 p.m. in the 26000 block of U.S. Highway 160.
Brandon Lee Craig, 21, a Durango resident, swerved his 2004 Toyota Tundra into the northbound lane.

Craig's vehicle struck a 1984 Ford semitrailer driven by Robin Scott Chamness, 44, a resident of Northglenn.

Both drivers were taken to Mercy Medical Center. On Wednesday, Durango police had no updates on their condition.

Detective Ron Wysocki said Craig may have been airlifted to a larger hospital. Wysocki said Craig's parents told him their son had a history of seizures, but they did not specify his medical condition.

Craig swerved into the median, drove atop it for a while and returned to the southbound lane before crossing into the northbound lane and striking Chamness' truck, said Police Sgt. Tony Archuleta.

Wysocki said Chamness' also swerved, to avoid the impact and accidentally entered a roadside ditch past the shoulder.

That, combined with the force of Craig's vehicle, turned the Ford semitrailer on its side.

Can new device help control seizures?

Kellen Bensing has had a bump bigger than a silver dollar on his chest for more than a year.
This wasn't one his parents had to worry about, though.


For 5-year-old Kellen, who lives in Hudson, seizures that began two years ago have sometimes left him with the bumps and bruises that come from injuries.

This one, however, is from what the Bensings call his ``clicker,'' a pacemakerlike generator implanted in his chest for Vagus Nerve Stimulation (VNS).

Although it's unclear exactly why VNS works, it helps control seizures by sending electrical impulses to the brain through the vagus nerve in the neck.

VNS was approved for treating depression in July but has been used for epilepsy since 1997.
It's been working for Kellen, a kindergartner at Evamere Elementary School, and one of his schoolmates, 8-year-old Thomas Rice, who also has epilepsy and uses VNS.

The device hasn't stopped the drop seizures in which Kellen will, in a split second, go from standing to lying on the floor. To protect himself from those, he always wears a helmet, and someone keeps a hand on him at all times to try to catch him.

But the device has made Kellen more alert by reducing absence seizures, in which his body will stop in its tracks and he will stare for a period of seconds.

When Kellen begins to convulse from grand mal seizures, his parents can calm his body by swiping a magnet over the generator in his chest to increase its electrical signal.

Every moment that passes without a seizure means less damage that has been causing developmental delays to Kellen's body and brain, say his parents, Kathleen and Keith.

With two students now using VNS in Kellen's Hudson school, teachers and staff there were trained this year on how to use the VNS magnet.

To date, the device, which is meant for patients for whom other treatments have failed, has been implanted in more than 32,000 people worldwide, according to manufacturer Cyberonics.
Few side effects

Margaret McBride, Kellen's neurologist at Akron Children's Hospital, has been offering VNS to child patients for five years.

She likes that the therapy tends to work better with time and that its side effects are minimal, unlike with many medications.

Because the device does not react with drugs, side effects generally are mild reactions to the stimulation, such as hoarseness of voice and coughing.

Cyberonics' local office was flooded with inquiries when VNS was approved for depression, said Josh Mazanetz, a VNS therapeutic consultant. Now, several implants for depression are planned in the Akron area, he said.

Christopher Durner, director of outpatient psychiatry services with Summa Health System, has begun considering VNS for the most serious cases of depression.

But he remains cautious.

The treatment is extremely invasive and more risky, in his eyes, than medication.

According to Cyberonics, VNS was shown in studies to reduce seizures by half for 43 percent of users after two or three years of use.

For depression, VNS was shown to help for about 30 percent of users after a year.
Because the therapy works at a relatively low rate and takes a relatively long time to work compared to drugs, Durner sees VNS as best for patients at greatest risk without the treatment -- those who might otherwise attempt suicide.

Still, it's good to have as an option, he said.

``The world's a better place... for those people who we don't have any answer for,'' he said.

Slight improvement

Tom Enlow, director of Akron Children's Hospital's epilepsy center, said he's been happy to see VNS working for most of his patients.

The Bensings say they are pleased with their son's results, too, but they would like to see more improvement.

Kellen's seizures have remained unpredictable.

``One day we can wake up and he can't walk or talk, and one day he may have no seizures at all,'' Kathleen Bensing said.

The Bensings also had expected Kellen's drop seizures to have stopped by now, as they often do with time and treatment for other patients.

Soon, his parents plan to turn to a ketogenic diet for him, which is high in fat and low in carbohydrates and protein. This has been shown to help with epilepsy.

When people ask Kathleen Bensing what she would do if the device were to stop working, she says they might then turn it off, but it would have been worth the try.

``For us, we had to try it,'' she said.

And besides, she jokes, if VNS stops working for Kellen's epilepsy, they still could switch it back on when he becomes a surly teenager -- to control his moods.

Tuesday, January 03, 2006

Experst try to treat seizures with cost-efficient medecine!

In a comprehensive analysis and mathematical model of the available scientific data, researchers at the University of York on behalf of the National Institute of Health and Clinical Excellence (NICE) in the United Kingdom found that newer drugs used to treat the most common forms of epilepsy are more expensive than older drugs, but produce similar health benefits.

The analysis, published in the September 2005 issue of Medical Decision Making (MDM), a publication of the Society for Medical Decision Making, focuses on the cost-effectiveness of epileptic drugs licensed for adults in three specific situations. The objective of the study was to consolidate available evidence, to bring it together within a decision model, and to quantify the uncertainty associated with cost effectiveness.

Comparing different drugs for epilepsy has been difficult because there are few head-to-head trials of different agents, and because the observed rates of patient withdrawal from the drugs change over time. The investigators applied new methods of analyzing drug effectiveness data to overcome these problems. These methods, they argue, will be of value for evaluating the effectiveness and cost of drug therapies for other chronic conditions.

Epilepsy affects almost 3,000,000 people in the US and UK alone. The study by Hawkins et al compared three situations: monotherapy for newly diagnosed patients, monotherapy for refractory patients, and combination therapy for refractory patients. The analysis separately considers partial and generalized seizures. Drug therapy is the main treatment for epilepsy, but there is not a uniform approach to the selection or sequencing of anti-epileptic drug (AED) therapies.

The analysis showed that, based on existing studies, two older drugs, valproate and carbamazepine, are likely to be more cost-effective than newer agents for newly diagnosed patients with partial seizures. Valproate was shown to be most cost-effective for newly diagnosed patients with generalized seizures.

For some other groups of patients, such as those who did not respond well to a single agent, newer drugs such as topiramate, Oxcarbazepine, or Lamotrigine, were cost-effective. For example, oxcarbazepine is probably the most cost-effective adjunctive therapy for refractory patients with partial seizures, and adjunctive topiramate was more cost-effective than monotherapy for refractory patients with generalized seizures.