Victim of seizures ended up having brain surgery

When I woke up in the ambulance, the first thing I saw was my boss, Elaine, holding my hand. "You've had a bit of a turn," she said. "We're just going to get you checked out."

One minute I had been sitting at my desk at Radar, a TV production company in east London, where I worked as a researcher, the next my body went stiff, my eyes glazed over, and I dropped to the floor, shaking violently from head to toe. After several minutes I lapsed into unconsciousness. Waking, I felt utterly confused.

It has been said that seizures are like running a marathon in two minutes and I can believe it: my legs and arms were like dead weights and I could barely raise my head.

After a few hours at the Royal London Hospital, a doctor appeared. He was about my age, mid-twenties. He explained the likely diagnosis - epilepsy - and told me that this is a general term for any condition which gives rise to seizures. Exactly what was causing mine was a mystery that further tests would help to solve. The second he was gone I had what some describe as a "lightbulb moment". Something just lit up inside my head like a big cartoon thought bubble, reading: I could do that.

Over the coming weeks I had tests, including an EEG, where the electrical activity of the brain is monitored, and an MRI scan, in which an detailed image of the brain is created. The neurology consultant, Oliver Cockerell, told me that the tests indicated an abnormal vessel in my brain, a cavernous haemangioma, or cavernoma, which has very thin walls that allow blood to leak into the surrounding tissue, causing a misfiring of electrical impulses and leading to seizures.

Since my first trip to A&E I had suffered several more fits, all at night. These were much scarier than the first: I would wake up alone and bewildered. My memory would be shot with holes, like Swiss cheese. I would not know what had happened to me, and there was also a weird feeling of not quite knowing who I was. It was a feeling of elemental terror.

Dr Cockerell decided to put me on Tegretol, an anti-seizure medication. He also told me that the law required me to surrender my driving licence as there was a risk I could seize while driving. It seemed I was destined to be on the Tegretol - and on the bus - for the rest of my life, but Dr Cockerell wanted me to speak to a neurosurgeon.

John Wadley explained that as the cavernoma was near the surface of my brain he could excise it. He warned me that although this was a relatively uncomplicated procedure, brain surgery is never 100 per cent safe; there is always the risk of paralysis.

Although the risk was small, the idea of paralysis gave me many sleepless nights. But after a great deal of soul searching, I decided to trust the surgeon's instincts.

The day for my operation came and I checked myself into Sofia Ward. A doctor attached rubber suckers to my head and drew round them in purple marker pen to guide the drilling equipment.
The next day I was taken down to surgery. Once I was under the anaesthetic, Mr Wadley removed a section of my skull, excised the cavernoma and refitted the skull portion with titanium screws.

When I woke up, a nurse was dabbing my head and I could see Mr Wadley taking off his surgical gloves. I couldn't stop crying. It wasn't so much relief - it was more that my emotions were so close to the surface; the tears just kept pouring out. The theatre nurse was stroking my head and squeezing my arm, and every time she squeezed, she squeezed out more tears.

Back on the ward, I caught a glimpse of myself in the mirror. Half my face was bright yellow, and my eye was black, purple and blue. I had a huge bandage wrapped round my head like a lobotomy patient and a blood-filled drain hanging from the side of my head. Peeping out from under the bandage I could see a row of surgical staples like a train track. I was exhausted, but every couple of hours a nurse would shake me awake and ask me my name, the name of the Prime Minister, the date, and where I was to check for brain damage.

After a few weeks of recuperation I was firmly on the mend. The operation had been a success, but I knew that my life was never going to be the same - my experiences had thrown a few things into sharp focus and I knew I wanted to make some changes - specifically, I wanted to change career.
Since I was hospitalised at the age of 10 with asthma I had always admired the skill of doctors and had wanted to be one. Unfortunately, when it came to choosing my A-levels I eschewed hard science for EM Forster. From there it was an easy passage to an English degree, but there was always a nagging doubt that there was something I'd forgotten to do. But even if I had answered that nagging voice in my head, surely it was too late?

With my condition throwing my priorities into sharp focus, I began to question this assumption - what if it wasn't too late? I had heard of accelerated, graduate-only medical courses, and now discovered that several of these are open to graduates in any subject, and can create a competent doctor in only four years.

The downside? These courses are horrendously oversubscribed. In 2005 the applicant-to-offer ratio for the graduate course at King's College, London, was 56:1. Some 1,350 applicants applied for 24 places. At St George's med school in south London, the figure was a little better, but still - 20 applicants for every one of their 70 places.

With a due sense of dread I registered for the entrance exams and, shocked by the difficulty of practice papers, began to spend my every spare moment studying stoichiometry, thermodynamics and 3D stereoisomerism. Now at the BBC, I would sneak off in my lunch hour to a rarely used meeting room to get stuck into the textbooks.

As soon as I was fit enough, I also began working as a volunteer in an A&E department. I met some real characters, including Beryl, a frail, elderly lady with suspected MRSA and a disarming fearlessness. On one occasion, she looked me straight in the eye and said something I'll never forget: "Isn't it a shame we can't choose when we're ready to die." I have never been so stumped for something to say, but it was experiences like this that most excited me about medicine - it's a world of big moments and crises, of hope and despair, of life and death.

After eight months it was time for the entrance exams. My only chance of an interview was to get a mark in the top 10 per cent of applicants. To my total stupefaction, I came in the top 5 per cent and proceeded on to the interview stage at three schools. At each interview I told the story of my illness and how it had brought home my profound desire to practise medicine. I received offers from every school I applied to, and accepted a place at King's, where in a week's time I'll begin examining patients and performing dissections almost from day one.

It's now more than a year since the operation and I haven't looked back. In some ways, it's as though my cavernoma never happened, and yet it has changed my life: I'm now going to be a doctor rather than a TV producer, and I'm also no longer single; after my EEG I sent a Valentine's card to the pretty neurophysiologist who ran my test and, amazingly, got a date out of it. Sian and I have now been together 18 months and last weekend, we moved in together. I have so much to be thankful for, and it's all down to a tiny mischievous blood vessel in my brain. If that blood vessel were a man, I'd buy him a beer.

Seizures: facts and figures

* Epilepsy is defined as the tendency to have recurrent seizures. It affects one in every 131 Britons.

* Seizures occur when the brain's neurons misfire, disrupting the normal signals between brain cells.

* Some people will have epilepsy because of brain damage, but in many cases the cause is unknown

* Most people with epilepsy are treated with anti-seizure drugs.

* Only a small proportion of people with epilepsy will benefit from neurosurgery. This can only be considered if the seizures can be shown to originate in one area of the brain.

Mayor suffer from seizures due to infection

Mayor Bob O'Connor's condition deteriorated today and he was having seizures, according to officials at UPMC Shadyside.

Doctors said he was in serious condition.

O'Connor also has an infection in a shunt that is draining spinal fluid from his brain, the hospital said.

The infection was discovered by several tests, including a neurological exam, laboratory testing of his spinal fluid and a CT scan.

Doctors said he was being treated with anti-seizure medication and antibiotics.

To address the infection, O'Connor will undergo surgery late this afternoon to replace the shunt.

The shunt, which is about the size of a straw, was placed in one of his ventricles Aug. 6.

O'Connor, 61, is being treated for primary central nervous system lymphoma. He has been hospitalized since July 10.

New system seems to protect against seizures

The endocannabinoid system provides "on demand" protection against experimentally induced seizures and neuronal cell death, according to preclinical data published this month in the journal Neuron.Investigators at the Johannes Guttenberg University in Mainz and the Max Planck Institute in Munich reported that endocannabinoids, acting upon the brain's CB1 (cannabinoid) receptors, directly target hippocampal glutamatergic neurons to mediate against experimentally induced seizures and cell death in mice.

"CB1 expression on hippocampal glutamatergic circuits accounts for this protection and might represent a suitable target for the treatment of neurological disorders associated with excessive neuronal excitation," authors concluded.Separate preclinical studies have previously demonstrated that natural cannabinoids such as THC and cannabidiol (CBD) are neuroprotective against ethanol-induced cell death, cerebral infarction, and glutamate toxicity.

Glutamate, a neurotransmitter, may be produced at toxic levels following strokes or severe head trauma often leading to irreversible brain damage. In recent years, researchers have identified the endocannabinoid receptor system to be involved in the regulation of several primary biological functions including appetite, body temperature, mood elevation, blood pressure, bone density, embryonic implantation, learning capacity, and motor coordination.

Treatment of seizures in animals

A pet can experience a seizure for several reasons. It can be induced structurally – by a brain injury or tumor – or it can be caused by other conditions.

One source of seizures could be metabolic – due to hypoglycemia or diabetes. It could also occur because the animal is exposed to some sort of toxin or poison.

The third classification of animal seizure is called idiopathic, meaning the underlying cause is not understood.

Regardless of the cause, once a seizure has occurred in an animal, a veterinarian should do a thorough workup, including a neurological evaluation, X-rays of the skull and lab work (including a CBC, chemistry panel and urinalysis).

If an underlying cause can be identified, such as diabetes, the vet will address that. If not, the owner should start making a written chart of when seizures occur. That way, the vet can try to identify an underlying cause and a pattern.

An important note on seizures is that vets cannot ever cure them – they can only control them.
One way to manage seizures is for the animal to undergo anti-epileptic therapy using a drug that will take the threshold for seizures and raise it so that it will take more of the stimulus for the seizure to occur.

If your pet has seizures or something that you may consider seizure-like activity, give your veterinarian a call.

Victim of seizures since beating, death ruled an homicide

A woman left permanently injured from a beating 14 years ago died after falling down stairs during a seizure, prompting the Hennepin County Medical Examiner to rule her death a homicide.

Theresa M. Keavy, 52, died June 13 in Minneapolis after striking her head during a fall.

In a ruling today, the medical examiner stated Keavy had been suffering chronic seizures since she was assaulted in the parking lot of Pearson's Bar on East 26th Street in Minneapolis on February 26, 1992.

One of the seizures was directly related to her death, the medical examiner concluded.

No information was available this afternoon on the status of any Minneapolis police investigation.

A drowning victim had history of seizures

Authorities in Scott County, Virginia are investigating a drowning in the Holston River. The body of 53-year-old Jackie Richard Bellamy was discovered by his uncle around 4 p.m. on Saturday. Authorities say his uncle had dropped him off earlier in the week.

Bellamy was camping on his own. When his uncle returned to pick him up, he wasn`t there. After searching the area, the uncle found him in the river and called 911. At this time no foul play is suspected. Authorities say Bellamy had a history of seizures and have ordered an autopsy.

How to deal with seizures in school

If you are a student with epilepsy, or the parent of a student with epilepsy, you may be thinking about the upcoming school year and wondering that if a seizure occurs in school how will it be treated. The development of an emergency seizure treatment plan is the best assurance that if you or your child has a seizure in school the staff will treat it appropriately.Almost 3 million people in the United States have epilepsy, a neurological condition characterized by unprovoked seizures.

Children under the age of 15 represent 326,000 of these affected persons. Most of these individuals will have complete seizure control by taking daily antiepileptic medications; about 30 % however, will continue to have seizures despite the use of these medications.Seizure emergencies are usually treated at the site with rescue medication and occasionally, for those persons with a vagus nerve stimulator, with an extra stimulation.

The only FDA approved medication for at home (or school) treatment by lay persons is rectal diazepam gel (Diastat AcuDial). This medication has been proven safe and effective in the treatment of prolonged and repetitive seizures. When developing an individualized seizure emergency plan, the school nurse must be apprised of the student’s seizure type, usual daily medication, usual seizure semiology (or what the seizure looks like), how long it usually lasts and any other effects that the child experiences when having a seizure.

A licensed medical provider must order any medication or other treatment to be given in the case of a seizure emergency. Medications must include name, dose and form, and must specify the situation in which the medication should be administered. For instance, if the child experiences a seizure lasting longer than 5 minutes, administer 5 milligrams of diazepam gel rectally. Individual school systems may have a standardized form that the medical provider must complete in relation to administering medication or other treatments in school.

The parent or guardian must supply the medication to be administered. If the state and school district approves administration of medication by a person other than a school nurse there must be proper training provided to that person. There should be a written protocol for them to review as necessary, as well as documentation of training. This can be completed by the school nurse with input from the treating physician, nurse or local epilepsy affiliate. Administering rectal medication in school presents some advanced planning.

Rectal diazepam gel should be contained in a secure, locked, well-situated storage location. Other items that may be utilized during a seizure emergency should be kept together and brought to the site when needed. These include a small blanket (or other material suitable to provide privacy for the student), under pad, gloves, small plastic garbage bag, medication record form with pen and the seizure emergency treatment plan/information. As in any emergency, staff should know at what point 911 should be called.

For seizures that do not stop with treatment at the scene, the child will require an emergency department visit. If seizures stop, the student may need to be observed or to rest in the nurse’s office for some time.For students with seizure disorders, the role of a school nurse is not only to respond to seizure emergencies, but also to provide an environment that enhances and encourages the student’s educational, social, and personal growth.

Generating an environment that allows for a flow of communication between the student, parent/guardian, physician or health care team, and the school nurse is an important factor for appropriate and effective student health care. The availability of a well-organized seizure emergency treatment plan permits effective management of seizure emergencies at school and decreases the potential for seizure-related complications.

An individualized treatment plan provides confidence to school nurses and other trained personnel while minimizing the adverse effects of seizures and potentially reducing the need for emergency hospital visits. An effective and safe seizure rescue medication is a key component in treating prolonged and repetitive seizures.

Parents and health care providers must advocate for children with epilepsy to receive the care they need in school while assuring that their education and extracurricular activities are not constrained by seizures. Development of detailed protocols and a seizure emergency treatment plan will enable a school nurse to give the best possible treatment to students with seizures within the school environment.

Supplement of protein in the brain could help treating seizures

A naturally occurring protein in our brains could be the basis for a more promising epilepsy treatment - without the nasty side effects caused by many of the current medications, says EurekAlert quoting researchers.

Researchers at the Stanford University School of Medicine discovered that the drug valproic acid boosts the amount of the protein neuropeptide Y in the brain by about 50 percent. What's more, they found that the drug increased the protein in only two parts of the brain - the thalamus and hippocampus, areas associated respectively with petit mal and temporal lobe epileptic seizures. The neuropeptide Y levels in other parts of the brain were unaffected. "That was quite a surprise," said Julia Brill, a postdoctoral scholar in Stanford's neurology department who worked on the study.

VPA has long been a mainstay in treating epilepsy, although how it suppressed seizures was a mystery. It has a minimal sedative effect, but a host of other unpleasant side effects including weight gain, hair loss, upset stomach and liver problems, as well as causing birth defects if taken by pregnant women, so it's less than an ideal medication.

But discovering that VPA triggers an increase in neuropeptide Y not only helps explain how VPA works, it suggests a possible way to stimulate the brain to quell seizures: The key could be to increase the amount of this anti-epileptic compound in the brain. Neuropeptides are very small proteins that often help transmit signals between neurons, the specialized cells in the brain that generate and transmit thought.

"This finding really emphasizes that our brains have the inherent capacity to stop seizures," said John Huguenard, PhD, associate professor of neurology and neurological sciences and senior author of a paper describing the work published in June in the Journal of Neuroscience, on which Brill is first author. Although there may be more than one mechanism by which our brains stop seizures, an increase in neuropeptide Y is clearly one of them, he said, and he and Brill are already exploring other ways to trigger production of the peptide and prolong its action.

Dead teen had history of seizures

Today was supposed to be the first day of Anderson Maxey's senior year of high school at The Master's Academy in Oviedo.Instead, about 2:30 a.m. Tuesday, his parents requested the life-support machine that had kept him alive since he was found at the bottom of Lake Winona during a spiritual outdoor retreat Monday be turned off.

The 17-year-old Seminole County teen, who wanted to spend the rest of his life serving God as a pastor, died shortly after.Authorities are not sure why Anderson, a good swimmer, was found unconscious on the bottom of the 70-acre lake while swimming with schoolmates at YMCA Camp Winona in DeLeon Springs. His family said the teen had a history of epilepsy, and he may have suffered a seizure in the water."Once you have a seizure, you don't know where you are and you completely black out," said his father, Richard Maxey. "He slipped to the bottom and nobody saw it, not even the three lifeguards."

Anderson had epilepsy since he was 18 months old, his father said. During most of the past eight years, he had been seizure-free thanks to his medication. But in the past nine months, the teen had six seizures, Maxey said.Before his death, the Maxeys were looking into possible surgery to stop Anderson's seizures.Anderson's death is being treated as an accident, and it's under investigation by the Volusia County Sheriff's Office's Major Case Unit.

An autopsy, which may take weeks to complete, is being conducted by the Volusia County Medical Examiner's Office.Authorities are looking into whether Anderson's medical condition was a factor in his death.Sheriff's Office spokesman Gary Davidson said Anderson was swimming with a schoolmate as part of a buddy system, but he apparently became separated from his companion. Lifeguards later found him underwater sometime before 11:45 a.m. Monday.

Randy Brown, CEO of the Greater Daytona Beach Area YMCA, which oversees the camp in northwest Volusia, said the buddy system required swimmers to show the lifeguards where their partners were every so often. There were 60 swimmers and three lifeguards watching them.After 10 minutes of swimming, lifeguards blew their whistles and required the campers to show where their buddies were. During the first check, Anderson was fine, Brown said.

Ten minutes later, right before a second buddy check, Anderson's partner told the lifeguards he didn't know where the boy was, Brown said."Nobody saw him slip under the water," Brown said. "None of the swimmers or the [life] guards noticed any struggle."Carol Carmella, an education and prevention specialist with the Epilepsy Foundation of Northeast Florida, said it's possible for epileptics to have a subtle seizure in the water, lose consciousness and drown.

Such occurrences may not be noticed by others around them."Hopefully they can have someone there that can pull them out of the water," she said.It took lifeguards four minutes to find Anderson under seven to 10 feet of water, Brown said. The boy was not responsive to rescuers, authorities said.Lifeguards performed CPR. Deputies arrived and used an automated external defibrillator, while more CPR was performed by paramedics, Brown said.Anderson was taken to Florida Hospital DeLand and placed on life support.

Richard Maxey said he knows he and his wife made the right decision, and he doesn't blame anyone for the incident."According to a CAT scan, he had no activity in his brain," Richard Maxey said. "The only thing sustaining him was a pacemaker and a ventilator. There didn't appear to be any reason to prolong the agony."

Anderson was deeply religious, his father said. After graduation from the nondenominational Christian school, he planned to attend either Seminole Community College or the University of Central Florida, and then seminary.Maxey said his son had been excited about the spiritual retreat. About 90 juniors and seniors from The Master's Academy arrived at the camp Sunday for two days of bonding."We miss him so deeply, and it hurts so bad," Richard Maxey said.

"[But] I am absolutely convinced that the Lord called him home. . . . He's in the arm of Jesus."At Fellowship of Christian Life in Orlando, Anderson sang in the church choir. At school, he played the euphonium, an instrument similar to the baritone, in the band. This year, he was appointed band chaplain.Anderson, who lived in Oviedo his entire life, also loved to play the musical video game Dance Dance Revolution and study Latin.William Harris, The Master's Academy's superintendent, said Anderson was loved by other students and faculty."He was just an outstanding young man," Harris said.

Can Marijuana really prevent seizures?

They said their discoveries suggest that the "endocannabinoid" system might constitute a prime target for drugs against seizures of epilepsy and other neurodegenerative diseases. The findings were published by Beat Lutz and Giovanni Marsicano, of Max Planck Institute of Psychiatry and Johannes Gutenberg University in Mainz, and colleagues in the August 17, 2006, issue of the journal Neuron, published by Cell Press.

The endocannabinoid system--which includes the receptors, the natural cannabinoid compounds that trigger them, as well as the machinery for regulating the process--was already known to modulate the excitation of neuronal transmission, noted the researchers. However, it had not been established that such modulation might affect neurons in the hippocampus responsible for the "excitotoxicity" that underlies the uncontrolled activity of seizures.

Thus, Lutz, Marsicano, and his colleagues used genetic techniques to pinpoint the role of the endocannabinoid system on these neurons and on seizure activity. They used mice as their animal model and induced seizures in these mice with the chemical kainic acid (KA).

In particular, they wanted to explore the role played by the endocannabinoid system in hippocampal neurons that are responsive to the neurotransmitter glutamine. These neurons are known to play a central role in seizure activity. The endocannabinoid regulatory system is also active in another type of neuron triggered by the neurotransmitter gamma-aminobutyric acid (GABA).

Thus, the researchers conducted experiments in which they genetically knocked out the endocannabinoid receptor CB1 and analyzed the effects on seizure sensitivity. They found that, indeed, when they knocked out CB1 in glutamatergic, but not GABAergic neurons, the chemically induced seizures increased in the mice. In fact, their experiments all but ruled out the role of GABAergic neurons in the seizure-protection function, they concluded.

"Altogether, these results confirm that physiological endocannabinoid-dependent control of GABAergic transmission depends on intact CB1 signaling in GABAergic interneurons and suggest that the endocannabinoid system does not influence GABAergic transmission during the development of KA-induced seizures," they concluded. "Therefore, direct modulation of glutamatergic transmission by CB1 receptors expressed on cortical glutamatergic neurons appears to be the major mechanism of endocannabinoid-mediated protection against KA-induced seizures."

Furthermore, the researchers' experiments established that endocannabinoid receptors were also present in the same glutamatergic neurons in areas of the hippocampus known to be central to seizure generation. The researchers wrote that this finding "represents a novel step in understanding the progression of acute excitotoxic seizures and the development of epileptic states." And significantly, when the researchers used a targeted virus to knock out the CB1 gene for the endocannabinoid receptor specifically in the glutamatergic neurons of the hippocampus, the mice also showed strong worsening of chemically induced seizures in comparison to mice still expressing CB1.

"Altogether, these observations support a hypothetical scenario in which acute KA-induced excitotoxic seizures would activate the endocannabinoid system in respect to its ability to inhibit only 'harmful' glutamatergic transmission, but not 'protective' GABAergic release," concluded Lutz, Marsicano, and colleagues.

"In conclusion, our study reveals a mechanism through which the endocannabinoid system is able to provide on-demand protection against acute behavioral seizures. CB1 expression on hippocampal glutamatergic circuits accounts for this protection and might represent a suitable target for the treatment of neurological disorders associated with excessive neuronal excitation," they wrote.

Seizure treatment gets better

U.S. scientists say a naturally occurring brain protein might be the basis for a promising epilepsy treatment without side effects.

Stanford University School of Medicine researchers discovered the drug valproic acid, or VPA, boosts the amount of the protein neuropeptide Y in the brain by about 50 percent. What`s more, they found the drug increased the protein in only two parts of the brain -- the thalamus and hippocampus -- areas associated with epileptic seizures. The neuropeptide Y levels in other parts of the brain were unaffected.

VPA has been a mainstay in treating epilepsy, although how it suppressed seizures was a mystery.

Discovering that VPA triggers an increase in neuropeptide Y suggests a possible way to stimulate the brain to quell seizures: increase the amount of neuropeptides in the brain.

The researchers -- John Huguenard, associate professor of neurology and postdoctoral neurology scholar Julia Brill -- are exploring other ways to trigger production of the peptide and prolong its action.

The study appeared in the June issue of the Journal of Neuroscience.

Esa Space Telescope is Cold-Tested

PARIS, Aug. 15 (UPI) -- The European Space Agency says its Planck space telescope has been successfully tested in a cold vacuum.

The telescope was removed last week from the Large Space Simulator at the European Space Research and Technology Center in Noordwijk, The Netherlands, after a 2-week test in temperatures to minus 178 degrees Celsius.

The ESA said the test is an important milestone toward the telescope`s launch in 2008.
Once in space, Planck will investigate cosmic background radiation -- the remnants of the Big Bang that occurred more than 14 billion years ago. The telescope will make observations in the far-infrared spectrum, which requires using super-cooled instruments.

'Central to this test is exposure of the mirrors and their structural frame to a very cold vacuum', said ESA scientist Philippe Kletzkine. 'The telescope is built at room temperature and then cooled to way below the freezing point. Even though the materials were chosen carefully, this makes each individual component of the telescope shrink to some small, but not negligible, extent.

'We need to know whether the resulting changes in shape match our predictions. We have to be spot on, so the mirrors line up properly.'

Brain Pacemaker may help control seizures

Sidelined by unpredictable epilepsy, Stephanie Tolle does not drive. So Monday, the 35-year-old Southeastside resident had a device implanted in her brain that could one day put her behind the wheel.

Indiana University School of Medicine surgeons inserted a small responsive neurostimulator system, or RNS, under Tolle's scalp as part of a clinical trial. Tolle is the second participant in the Indiana wing of the multi-center trial.

The trial tests the efficacy of the RNS for patients like Tolle who have not responded well to traditional epilepsy medications or treatments. Similar to what a pacemaker does for the heart, the RNS monitors brain waves for abnormal activity. When the device detects the start of a seizure -- before a patient knows it -- it delivers a brief, mild electrical stimulation to suppress the attack.
While the government already has approved the RNS for use in patients like Tolle, IU researchers along with colleagues at other medical centers around the country are conducting a study to see how well the device performs over time.

"The thinking is that, by controlling the patient's seizures, we can control their quality of life," said Dr. Vicenta Salanova, IU professor of neurology and principal investigator for the trial here.
That's certainly Tolle's hope. Since she was 14, she has had several petit mal seizures a month. Unlike many other people with epilepsy, though, she does not sense a warning "aura" before the symptoms strike. And her condition has not responded well to medication, making her an ideal candidate for this surgery.

Her frequent seizures -- currently she has about six or seven a month -- derailed her dreams of pursuing a career in nursing. She remains dependent on others for transportation, but if this new device keeps her seizure-free for six months to a year, she plans to start driving.

"This could really change my life quite a bit. I could end up with lots of freedoms I have never been able to experience," she said.

About 1 percent of the U.S. population has epilepsy, says Salanova, and about a third of those patients do not respond well to medication.

Only those who have seizures originating from two parts of the brain or from an area that cannot be surgically removed are candidates for the RNS.

Potential candidates must also undergo extensive neurological evaluation, have an average of three or more partial seizures a month that are uncontrolled by medicine, and be between the ages of 18 and 70.

Once the device is implanted, the investigators will be able to monitor participants' seizure history. That information will assist researchers in determining how best to program the devices.

Researchers hope to enroll about 200 patients across the country, Salanova says. IU hopes to enroll about 10 in the coming year.

Tolle, for one, is delighted to be among that number.

"I'm nervous about this," she said a few days before her Monday surgery, "but I feel like this could be my miracle. This could be what I've been waiting for forever."

Can Atkins diet help to control seizures?

The popular Atkins low-carbohydrate diet not only helps some people lose weight, it might have a role in preventing seizures in children with epilepsy, say researchers at the Johns Hopkins Children's Center.

In a study of six patients, including three patients 12 years old and younger on the Atkins regimen for at least four months, two children and one young adult were seizure-free and were able to reduce use of anti-convulsant medications, according to Johns Hopkins. Findings of the study also showed that seizure control could be long-lasting on the diet, with the three patients continuing to be seizure-free for as long as 20 months.

The researchers warn, however, that because of the small number of study subjects, their look at the relationship between the Atkins diet and seizure control should not lead to its routine use in children with epilepsy, nor at this point should the Atkins diet be used to replace the ketogenic diet -- the rigorous high-fat, low-carbohydrate diet already proven to reduce or eliminate difficult-to-control seizures in some patients.

Johns Hopkins reports that the common elements in both diets are high fat and low carbohydrate foods that alter the body's glucose 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 byproduct of fat that can inhibit seizures.

Johns Hopkins reports that children who remain seizure-free for two years on the ketogenic diet often can resume normal eating and often their seizures don't return. The Atkins diet, while slightly less restrictive than the ketogenic diet, also produces ketones.

Intravenous form of Keppra was approved by US

Belgian pharmaceutical group UCB (UCBBt.BR: Quote, Profile, Research) on Wednesday said U.S. regulators had approved its intravenous formulation of the company's Keppra epilepsy medicine, as an alternative when oral forms of the drug are not appropriate for patients.

The new formulation must be diluted prior to use and administered as a 15-minute intravenous infusion.

Keppra is approved as an add-on therapy in the treatment of partial onset seizures in adults and children 4 years of age and older with epilepsy.

Drowning victim had history of seizures

An autopsy conducted Monday morning confirmed that 25-year-old Ernest Polley of Delton drowned in Gull Lake.

Polley was found floating in the lake at the northern boundary of Ross Township Park about 9:40 a.m. Sunday.

He was last seen at approximately 1 p.m. Saturday at the park, where he was attending a social gathering with friends and relatives, police said.

"There was no trauma to the body," said Lt. Terry VanStreain of the Kalamazoo County Sheriff's Department on Monday afternoon. "Apparently, he did suffer from seizures, and it didn't appear he was taking his medication."

VanStreain said the fact that Polley wasn't taking medication may have been the reason for the seizure and why he drowned.

The autopsy was completed at Sparrow Hospital in Lansing, VanStreain said.

Funeral arrangements are being handled by Williams-Gores Funeral Home, 133 E. Orchard St., Delton.

Polley's family declined to speak with the Enquirer on Monday, according to John Gores, funeral director.

Visitation will be held from 5 to 8 p.m. Wednesdayat the funeral home, Gores said.
A private family service is expected to be held at a later date.

New information helps in treating generalized tonic-clonic seizures

Data published in today's issue of Pediatrics show that lamotrigine (LAMICTAL) is an effective add-on therapy for the treatment of Primary Generalized Tonic-Clonic (PGTC) seizures in a subgroup of children and adolescents. This is the first published analysis of data from a randomized, double-blind, controlled clinical trial of PGTC seizures focusing on patients 2 to 20 years of age. PGTC seizures, also know as "grand mal" seizures, are the most common form of generalized seizures, occurring in approximately 20 percent of patients with epilepsy. Lamictal is not currently indicated for the treatment of PGTC seizures.

"PGTC seizures are more common in children than in adults, and are associated with increased risk of injury or death," said Edwin Trevathan, M.D., M.P.H., Director of the Division of Pediatric and Developmental Neurology at Washington University School of Medicine and Neurologist-in- Chief, St. Louis Children's Hospital, St. Louis, MO, key investigator of the clinical study. "These study findings are important since physicians and neurologists continue to have limited treatment options available for generalized seizures in this age group."

PGTC seizures usually occur without warning and are associated with wide- ranging physical and behavioral changes with potentially life-threatening complications.

Patients who experience PGTC seizures become stiff, lose consciousness, and jerk repetitively. Patients may fall to the ground, bite their tongue, and/or lose bladder control. Serious injury including bone fractures can occur. The seizure will typically last for a few minutes and then be followed by a period of drowsiness, confusion, headache, and sleep. For some people who have this type of seizure, it can take many hours to fully recover.

ABOUT THE STUDY

A randomized, double-blind, placebo-controlled study was conducted to assess the efficacy and tolerability of adjunctive therapy with LAMICTAL in the treatment of PGTC seizures among patients 2 years of age and older. Investigators evaluated 117 patients, ages 2-55 years, with PGTC seizures inadequately controlled on 1-2 current AEDs and with evidence of PGTC seizures on electroencephalogram (EEG) and no past evidence of partial seizures. The treatment period consisted of an Escalation phase (7-12 weeks) and a Maintenance phase (12 weeks).

In a subgroup analysis of 45 patients 2-20 years of age, the median percent decrease from Baseline in PGTC seizures during the entire treatment period was 77 percent among patients receiving LAMICTAL and 40 percent in the placebo group (p=0.044). The median PGTC seizure counts per month were significantly improved for all treatment phases in patients receiving LAMICTAL compared to placebo.

The most commonly reported adverse events in this analysis were headache (10% LAMICTAL, 25% placebo), nasopharyngitis (14% LAMICTAL, 4% placebo), and convulsion (10% LAMICTAL, 17% placebo). One patient from each treatment group discontinued due to an adverse event. No serious rashes occurred among patients taking LAMICTAL or placebo. No patient experienced worsening of myoclonus.

Overall, adjunctive therapy with LAMICTAL appeared to be effective in controlling PGTC seizures among patients 2 to 20 years of age and was associated with a favorable tolerability profile.

ABOUT EPILEPSY

Epilepsy, defined by recurrent unprovoked seizures, is a change in sensation, awareness, or behavior brought about by an electrical disturbance in the brain. The kind of seizure a person has depends on which part and how much of the brain is affected by the disturbance that produces seizures. Generalized seizures are seizures that involve the entire brain from the outset. In most cases, the cause of epilepsy is unknown. According to the Epilepsy Foundation, epilepsy affects more than 2.5 million people in the United States of all ages.

ABOUT LAMICTAL

LAMICTAL is indicated

1) as adjunctive therapy in patients as young as 2 years with partial seizures or the generalized seizures of Lennox-Gastaut syndrome (LGS) and

2) for conversion to monotherapy in adults with partial seizures taking carbamazepine, phenytoin, phenobarbital, primidone, or valproate as the single AED.

- Safety and effectiveness of LAMICTAL have not been established

1) as initial monotherapy,

2) for conversion to monotherapy from AEDs other
than carbamazepine, phenytoin, phenobarbital, primidone, or valproate,

3) for simultaneous conversion to monotherapy from 2 or more concomitant
AEDs, or

4) in patients below the age of 16, other than those with
partial seizures and the generalized seizures of LGS.

LAMICTAL is also approved for maintenance treatment of bipolar I disorder to delay the time to occurrence of mood episodes (depression, mania, hypomania, mixed episodes) in adult patients treated for acute mood episodes with standard therapy. The effectiveness of LAMICTAL in the acute treatment of mood episodes has not been established.

Serious rashes requiring hospitalization and discontinuation of treatment have been reported in association with the use of LAMICTAL. The incidence of these rashes, which have included Stevens-Johnson syndrome, is approximately 0.8 percent (8 per 1000) in pediatric patients under the age of 16 years receiving LAMICTAL as adjunctive therapy for epilepsy, and 0.3 percent (3 per 1000) in adults on adjunctive therapy for epilepsy.

In clinical trials of bipolar and other mood disorders, the rate of serious rash was 0.08 percent of adult patients who received LAMICTAL as initial monotherapy and 0.13 percent of adult patients who received LAMICTAL as adjunctive therapy. In a prospectively followed cohort of 1,983 pediatric patients taking adjunctive LAMICTAL, there was one rash-related death.

ABOUT GLAXOSMITHKLINE

GlaxoSmithKline, with U.S. operations in Philadelphia, P.A. and Research Triangle Park, N.C., is one of the world's leading research-based pharmaceutical and healthcare companies.

GlaxoSmithKline is committed to improving the quality of human life by enabling people to do more, feel better, and live longer. More information on GlaxoSmithKline is available at the company's Web site at www.gsk.com.

Laughing seizures, a rare seizures disorder.

A Utah woman who couldn't stop laughing is cured! We first reported on Rebecca Laws more than two years ago as she searched for a way to end this rare form of a seizure.

For Rebecca Laws, laughing in the absence of anything funny would come on without warning, sometimes as much as twenty times a day. For most of us, laughing is a natural human emotion
and appropriate. But Rebecca Laws would do it frequently and at the most inappropriate times.

At St. Joseph's Hospital in Phoenix, Doctors monitored the events. She starts smiling. The head turns to one side. The laughing begins. They're called Gelastic seizures, the name stemming from the Greek word - laughter. But that was then.

Rebecca Laws: "I don't have to worry about what's going to happen next. Am I going to have a seizure? Am I going to remember? Am I going to get hurt? It's a whole new scenario."

Rebecca's life has changed dramatically. She rides a bicycle with her husband Scott and is getting her drivers license, things she could never do before. In addition to a Masters Degree, she went back to school and is now certified in medical transcription.

Scott Laws: "She's more able to remember and to connect events now."

Rebecca Laws: "I haven't had anything close to a seizure since the 19th of November."

That's when surgeons at the Barrows Neurological Institute drilled a little hole in the top of her head and removed a small benign tumor near her hypothalamus. Like a Dr. House mystery, this was a tumor nobody knew was there.

So after all these years, the laughing seizures have ended. And her memory...

Rebecca Laws: "I had to work extra hard to remember things that a typical person would not have a problem with. And now that isn't even an issue."

After all she's been through, this cure was such a simple procedure, one Rebecca laughingly says has now turned her life upside down, but strangely right side up.