Blindness vs. seizures

Look closely and John Bramblitt’s paintings are simply blobs of color: mustard yellow, peach, maroon, forest green, sky blue.

Take a few steps back, though, and the colors melt together to capture people in the everyday moments of life.

A bearded man looks to the side in deep thought. A group of women joke around, playfully choking each other. A baby’s striking blue eyes stare straight at you. A sad-looking old man holds his head in his hands.

John Bramblitt paints what he sees - in his head."The world's a lot more colorful now than when I had sight," he says.

Despite creating such arresting images, Mr. Bramblitt only started painting a few years ago.
Today, painting is practically an obsession. The 35-year-old stays up late into the night to paint. He now can’t imagine life without a paintbrush.

But John Bramblitt can’t see what he’s painted.

John Bramblitt is blind.

He says the world was a dark place when he lost his vision. He was angry. Sad. Frustrated.
But he turned to painting, which calms him and makes him happy. It gives him hope. It makes the days go by faster.

And now he’s come to this realization:

“The world’s a lot more colorful now than when I had sight.”

Turning to painting

About five years ago, Mr. Bramblitt realized his sight was going away. He couldn’t make out his friends when they approached.

One day, he crossed a street as a car drove by. The car’s side mirror brushed against his shirt buttons.

He realized he needed to see a doctor.

In 2001, he was told: Your eyesight is not going to get better. You’re going to go blind.
Growing up, going blind was one of his biggest fears.

“My heart just sank,” he said. “It seemed like the entire world went away.”

Doctors haven’t been able to determine the reason for Mr. Bramblitt’s blindness. There’s no firm diagnosis, said Dr. Stephanie Helm Fleming, an optometrist who worked with Mr. Bramblitt.
But Mr. Bramblitt wanted to let others know that he still had images in his head.

“If I didn’t let them out, I was going to go crazy,” he said.

Mr. Bramblitt, who had drawn and written before going blind, kept writing. But it wasn’t the cathartic experience he was seeking.

He thought about painting. He remembered watching his mother paint when he was a boy. When she painted, she was relaxed and calm.

He figured he’d try painting for a year and see where it took him.

“Even I won’t have to see it if it’s bad,” he said.

One big hurdle: How to apply paint on canvas in the right places.

A solution: Make a raised drawing — a bumpy outline you can feel with your hands — and form a map that makes it easier to determine the boundaries of the image.

He tried glue, but it cracked. Then he discovered fabric — or puffy — paint, which leaves a raised line after it dries.

He uses oil paints because each color has its own texture. He feels the paint in his hands to help guide him to the right colors.

He also uses his hands to see the canvas, moving them along the fabric to determine the boundaries.

One recent afternoon, in his cramped artist’s studio, he painted a close-up of a face, covered with red, black, green, yellow and orange.

Mr. Bramblitt is an easy-going guy, with thick sideburns and a batch of whiskers on his chin. He calls himself a nerd and likes to read, listen to National Public Radio and science fiction on television.

But he’s intense about painting. The University of North Texas student sometimes paints until 4 or 5 a.m., wakes up a few hours later, does his homework and continues painting.

He often listens to music while he paints, from Dave Matthews to techno to heavy metal.

But it doesn’t bother him that he can’t see his paintings. He says he can probably see them better than someone who isn’t blind.

Showing off

While Mr. Bramblitt started painting for himself, he eventually showed his work to friends and family.

On their way to see their son’s painting for the first time, Deborah Bramblitt warned her husband: “‘No matter what, we have to be supportive. No matter what it looks like,’” she said.

But when she saw the painting, she was blown away. Her son had painted a self-portrait.

When his friend, Jacqi Serie, saw his paintings, she joked that she thought he was faking.

“It’s hard [for others] to wrap their heads around the fact that he can draw that well without seeing,” she said.

Soon, Mr. Bramblitt showed his paintings throughout North Texas.

A representative from the Texas Governor’s Committee on People with Disabilities saw his paintings on his Web site, www.bramblitt.net. The office displayed one of his paintings — a church — on a poster designed to raise awareness about employing people with disabilities.

“We all have a collection of strengths and weaknesses and it doesn’t matter that some of them happen to be labeled as disabilities,” said Pat Pound, executive director of the governor’s disabilities committee. “It’s a matter of learning what your talents are and making the most use of them.”

Mr. Bramblitt said the attention embarrasses him — he said it’s hard to take a compliment — but it also makes him feel good.

“They might have found some hope in my paintings,” he said. “It blows me away that what I’ve done has touched people.”

Painting has helped him, too. He feels better about himself and his blindness.

Painting helps his mobility. He makes mental maps to help him walk around town and painting helps him make more vivid maps.

“He doesn’t like to be away from that easel,” Mrs. Bramblitt said. “When he’s painting, he’s seeing. I think he feels more alive.”
Into the future
Blindness hasn’t been Mr. Bramblitt’s only challenge. The El Paso native says he was about 14 when he first suffered from seizures. He believes that years of seizures stole his sight.

Mr. Bramblitt, who’s spent most of his life in North Texas, said he had a kidney removed as a kid. He’s also had pre-existing hearing loss, probably from the seizures, but it doesn’t concern him.
He attended community college after high school, but seizures kept him out of class. He ended up working on computers at a fuel injection and diesel repair shop.

But he wanted to go back to school and be an English professor. He likes English because it’s “painting with words.”

By 2000, he was attending the University of North Texas. He’s pursuing a bachelor’s degree and plans to graduate in the spring. He wants to go to graduate school at UNT next fall.

Mr. Bramblitt says he’s now used to being blind. In his dreams, he’s blind.

He hopes to get a guide dog. And he’s getting married to his friend, Ms. Serie, in March.
Ms. Serie said her future husband has taught her patience, to be humble and to make sure she doesn’t take things for granted.

Mr. Bramblitt says he’ll continue painting, even when he becomes a professor.

“I have to do it,” he said. “If I don’t, it makes life really hard for me. … If I don’t, I don’t feel I’ve done anything with my day.”

Mrs. Bramblitt picked up the paintbrush again after her son started painting. She said she wanted to be able to relate to him.

“That’s a gift he’s given back to me,” she said.

Mrs. Bramblitt said she’ll never fully accept that her son has lost his sight. She wants him to be able to see sunsets and sunrises, the moon and the stars.

But John’s positive spirit makes her feel better.

“I started coping … just by watching him live his life,” she said. “Not only does he handle it, he runs with it. He embraces it.

“I think he gets more out of life than a lot of people who see.”

A dream come true for a girl plagued by seizures

A GIRL who suffers from a rare disease and is not expected to live beyond her ninth birthday is to enjoy a dream holiday to Disneyland after a fundraising drive by friends.

Four-year-old Katie Hogg from Elphinstone, near Tranent, has Batten's Disease, an incurable condition which gradually destroys movement, sight and speech.

The plucky youngster is confined to a wheelchair, cannot speak and has to be fed through a tube into her stomach, yet still manages to attend a mainstream nursery.
Now friends of Katie's mum Charlene, 20, have raised £2910 to send the pair to Disneyland, Paris, along with Charlene's fiance Derek Lusk, 19, and her sister Jodie, ten.

Today, Charlene told how Katie, whose room is filled with Disney toys and DVDs, was looking forward to meeting Cinderella during her trip to Disneyland in January.

Charlene, a full-time mum, said: "It means Katie can get her wish granted to meet Disney princesses in Disneyland and so she can enjoy herself for five days and be a normal child.
"She can't speak but she smiles when I mention it.

"It will be her first time on a plane."

Katie was diagnosed with the disease in July after a series of severe epileptic fits left her on the brink of death.

After her first birthday her family noticed a squint in her eye and she began stumbling into furniture.
Then Katie began having seizures which severely taxed her heart and a CT scan showed that her brain had shrunk.

Eventually she was diagnosed with Batten's disease, from which sufferers generally die before reaching their teens.

Her mum said: "Doctors say Katie's outlook is not very good. She's likely to reach an age of between six and nine and will probably not make it to her teens."

Generous friends raised the money for the holiday through three fundraising events, including an Ann Summers night, a seven-mile sponsored walk and a race night in a local pub.

They presented Charlene with flowers and a card containing the dates and details of the trip at Macmerry Miners' Club in Macmerry, Tranent, at the end of last week.

"Friday was quite an emotional night," said Charlene.

"I can't thank people enough - all those who gave donations, shops who sponsored us and my friends who organised it."

She added that Katie was already very excited about going to meet her Disney favourites.
The youngster manages to go to a mainstream nursery in Musselburgh, although she has to be pushed in a buggy-style wheelchair and is fed through a tube in her stomach.

Katie's seizures stopped for a while after her diagnosis but lately her health has dipped again and her fits have returned.

Charlene's friend Linda Bishop, 36, herself a full-time carer for her disabled son, spearheaded the fundraising efforts, with the race night raising the most money at just under £1000.

She said: "Katie is very ill and one of Charlene's dreams was to take her to Disneyland so myself and four friends set about helping.

"Katie has good and bad days. She's a very loveable girl.
"She's a wee happy soul, who sits and laughs.

"The family has a very worrying time when she's not well."

FACT FILE

Batten's Disease is a rare, aggressive and fatal brain condition. Named after the British paediatrician who first described it in 1903, it generally affects babies and young children, striking without warning in youngsters who have previously appeared healthy.

Early signs can be subtle and misleading, including slow learning, clumsiness and sight problems. It is often mistakenly diagnosed as epilepsy because of the seizures and convulsions it causes.
As it takes hold, the inherited degenerative disease gradually destroys sufferers' ability to move, see and speak. Victims become blind, bedridden and increasingly mentally impaired until they fall into a vegetative state and die.

There are two main types: infantile, which usually causes victims to die before they reach six years old, and late infantile where they live until they are about eight to 12. Few of the estimated one in every 150,000 people in the UK with the disease survive into their teens.

The illness is caused by a faulty gene. It leads to an build-up of substances in nerve cells throughout the brain and body, preventing the nerve cells from working properly.

Studies are being done using stem cells to try to combat the disease and treatments which slow the progress of the disease are available, but there is no cure.

How can you prevent seizures?

MIT researchers are developing a device that could detect and prevent epileptic seizures before they become debilitating. Epilepsy affects about 50 million people worldwide, and while anticonvulsant medications can reduce the frequency of seizures, the drugs are ineffective for as many as one in three patients.

The new treatment builds on an existing treatment for epilepsy, the Cyberonics vagus nerve stimulator (VNS), which is often used in patients who do not respond to drugs. A defibrillator typically implanted under the patient’s collarbone stimulates the left vagus nerve about every five minutes, which has been shown to help reduce the frequency and severity of seizures in many patients.

The MIT researchers and colleagues at Beth Israel Deaconess Medical Center, Children’s Hospital and Harvard Medical School seek to improve the treatment by combining it with a detector that measures brain activity to predict when a seizure is about to occur. The new device would sense the oncoming seizure and then activate the VNS. “Our contribution is the software that decides when to turn the stimulator on,” said John Guttag, a professor in the Department of Electrical Engineering and Computer Science.

Guttag developed the system along with Ali Shoeb, a graduate student in the Harvard-MIT Division of Health Sciences and Technology. This work was funded by the Center for Integration of Medicine and Innovative Technology, the U.S. Army and MIT’s Project Oxygen.

Soccer player is not off the field due to her Epilepsy

On Thursday, Seton Catholic senior Katie Blomberg had many reasons to be thankful.Although Blomberg suffers from epilepsy, she has a mild form (absence), and her seizures, which can occur as many as "25 to 30" times a day, hardly resemble the violent and uncontrollable shaking that sometimes afflicts those with the severest form (grand mal).

"On my bad days, I can kind of get a little tired because there's some strain on my brain," said Blomberg, a high-scoring forward on the soccer team. "But (the seizures) aren't even noticeable most of the time. At the worst, they may last five to eight seconds. When they happen, about the only thing I do is kind of flutter my eyes."

Blomberg, diagnosed about seven years ago when she was almost 10, hasn't let epilepsy prevent her from becoming an athlete at Seton, where she holds the school record in the 2-mile run. Blomberg, who is receiving interest from college soccer coaches, scored 26 goals and had 15 assists as she helped Seton collar a fifth straight Class 3A championship. She has played volleyball and run cross country, but it's her soccer that has opened eyes.

"She was a defender when I got here last year, but I moved her to forward because she's aggressive and I thought her ability to finish was better than most," Seton coach Casey Tate said. "She's quick, fast and one of our leaders. Whenever we need someone to step up, Katie does it."Katie was determined to not allow epilepsy to slow her on the field, her mother, Linda, said."The way it was explained to us by her neurologist is that she has a misfiring in her brain," Linda said. "But she's never once let it get her down. She's very motivated.

She's accepted it as her thing in life and deals with it on a daily basis. She understands it could be a lot worse. We're thankful it's not. She could have the full-blown seizures, and that would be really bad because she wouldn't be able to play sports."Katie not only plays, she does so with vigor and envied ability."It's never stopped me," she said. "I won't let it. I really don't even think about it a lot. When I get them, I can sometimes hear people talking to me and sometimes I can't. Sometimes I can still carry on a conversation and sometimes I can't."

"The only real bad side is I can't drive."Katie said she won't be able to drive a car until her seizures disappear for at least three months. At the moment, she doesn't know when or if that will happen, because in 5 percent of the cases, the symptoms never go away."My (neurologist) said people who have the mild form of epilepsy that I have usually outgrow them by they time they are 18," Katie said. "Some go into their mid-20s before they go away. But mine are actually getting worse and not really responding to medicine after a certain amount of time when I take them."

Katie recalls having a seizure during a soccer match only once."A lot of times I can't even tell," she said. "But one time I was dribbling the ball and I kind of shanked my kick because I started having a seizure. I had one playing volleyball once, but I was still able to set the ball."Seton midfielder Shannon Desmond, who has known Katie since kindergarten and often acts as her chauffeur, said her friend is a role model."She's a great soccer player and is as good as everybody else," said Desmond, who scored a team-high 31 goals last season.

"She's awesome. She's always positive."You can't even tell when she's having her seizures unless you're really close to her. Her eyes just kind of roll back in her head. It doesn't scare me anymore. I'm used to it."

Patients diagnosed with Epilepsy must wait two years to see a specialist

Epileptics have to wait for up to two years to see a specialist, an Oireachtas Committee heard today.The Brainwave support organisation told the all-party body that the state had less than half of the recommended number of neurologists.

Director of services Ava Battles said: “You’re talking about somebody who has to drive from Donegal to Dublin and they have to wait for two years to get that first appointment.“That’s a serious gap in services. You’re also talking about all the other difficulties for that individual. For that period of time they are being managed by their GP who does not have specialist expertise on the condition.”

Brainwave said that the international recommendation is that there should be 41 neurologists for Ireland’s 4.2 million population but there are currently only 17.Brainwave chief executive officer Mike Glynn said numbers of neurologists had increased in recent years but were still too low.He added: “If we get another 17, then we will be getting there.”

“There are many high quality Irish neurologists working in other countries like Britain, the US, Australia, Canada and South Africa.“They are out there. They could be recruited very quickly if the jobs were there in Ireland.” Epilepsy affects less than 1% of the population but can be often misdiagnosed, the Committee heard.Alcoholic seizures may often be mistaken for epileptic seizures.

Brainwave said that one of the misconceptions of epilepsy was that sufferers could not go to discos or cinemas because of strobe lighting, but in reality only about 5% are photosensitive.Ms Battles said that most epileptics should also be able to fly in planes unless it created personal anxiety for them and triggered a seizure.Committee chairman John Moloney said the issues raised at today’s meeting would be discussed with Health Minister Mary Harney and Health Services Executive chief Prof Brendan Drumm.

New treatment to treat seizures

The scenario is one of the most frightening in the current war-on-terror. Terrorists release toxic gas weapons on a subway or train or maybe at a shopping mall or sporting event. Within seconds dozens of people are near death, suffering from seizures, paralysis and respiratory arrest. Hundreds or thousands more people survive the ordeal, but suffer from long-term disabilities.
Unfortunately, for those who survive, only a rapid infusion of an antidote may prevent long-term effects of these nerve agents. Nerve agents are toxic chemicals that attack a person's nervous system. The most feared complication from nerve agent exposure is seizures, says Jaideep Kapur, M.D., Ph.D., associate professor of neurology at the University of Virginia School of Medicine.

In many cases, these seizures last minutes to hours, a condition known as status epilepticus. Approximately 20 percent of all people who develop the condition die and the majority of those who survive suffer some amount of brain damage.

Kapur recently received a 5-year, $2.3 million grant from National Institute of Neurological Disorders and Stroke to develop treatments for nerve agent-induced seizures.

"We can give antidotes to soldiers in the field before they go into combat which protects them from some nerve agents. But in a terrorist attack, it can take precious time to respond to the incident and to administer any antidote. By the time the seizures start, it's too late for any current treatments," Kapur says.

The first step in the process of developing the treatments will be to better understand how the nerve agents cause seizures. Kapur says there is an increase in the brain's output of glutamate when a person is exposed to nerve agents. He says excess glutamate can causes seizures. One way to treat the seizures may be to counteract the increased levels of glutamate with the same chemicals a person naturally uses to keep the balance in their brain.

Some people who suffer from status epilepticus that is not cause by nerve agents respond to some available drug therapies. Kapur says one goal of his grant is to improve the efficacy of these drugs to improve their success rates.

While most people think of chemical weapons being used in World War I, their use on the world stage has been far more recent. Seizures were observed in humans exposed to nerve agents in the Iran-Iraq War from 1980 to 1988 and the 1995 Tokyo subway attack, in which sarin gas was released on several lines, killing 12 people and injuring more than 1,000.

Neurologist is challenging Sir Isaac Newton's theory

Charleston neurologist Iraj Derakhshan has published a number of articles in medical journals about what he calls his “non-Newtonian” theory of the human brain. Derakhshan believes one side of the brain is dominant and controls movement for the whole body. He says his theory could change the way patients are treated for seizures and Parkinson’s Disease. Dr. Iraj Derakhshan has a tough fight ahead of him.

He's taking on Sir Isaac Newton.

Derakhshan, who calls himself the author of a new non-Newtonian model of the human brain, is a neurologist with offices in Charleston and Beckley.

Several of his articles on how the brain's hemispheres function in relation to the body's movement, vision and thought have recently been or soon will be published in some high-profile medical journals.

Derakhshan is hoping his work will now have a practical use treating patients in West Virginia and maybe soon, around the world.

"This is such a revolutionary point of view that at first I had rejection after rejection," Derakhshan said of his controversial theories. "It's going to take probably two decades before it's really accepted, but it has such important therapeutic ramifications right now."

Derakhshan argues that what Newton believed about the human brain -- that each hemisphere controls and represents the opposite side of the human body -- is inaccurate.

"That has been a point of common knowledge since 1704, and the fact is he was wrong," Derakhshan insists. "It has caused a chaos in the history of neurology for hundreds of years. But that is what Newton thought, and that is what I'm up against."

Derakhshan thinks, instead, that only one side of a person's brain is dominant and that hemisphere controls the movement of the entire body.

For most people, the dominant hemisphere is the one opposite the dominant hand. For instance, in a person who favors his or her right hand, the left hemisphere of the brain is actually dominant. But that's not always the case.

Sometimes people who are biologically hard-wired to be left-handed wind up favoring their right hand, or vice-versa.

"Nature tries to persuade you to assume your handedness according to what nature wants," Derakhshan said. "Since we are in control, however, a child might just decide instead to imitate someone they love or they might just be stubborn and decide to resist nature and use their other hand."

Derakhshan has developed a simple typing test that helps identify the biologically dominant hand and in turn, the dominant hemisphere in each person's brain.

This test, he says, could replace the need for intrusive surgical procedures used to determine the source of seizures and tremors. It also could minimize the use of seizure-control medications to treat some brain injuries and affect how patients with Parkinson's Disease and other maladies are treated.

For instance, a recent case at Beckley Appalachian Regional Hospital involved a man who had a large tumor in the right side of his brain.

Doctors believed the tumor would eventually lead to seizures and immediately put the patient on a regimen of seizure precautions.

Derakhshan urged physicians to stop the restrictive routines because the tumor, being on the non-dominant side of his brain, could never lead to such problems, he said.

Operating on Newton's theory that both sides of the brain play a part in motor and sensory control leads to confusion for doctors who are trying to identify the source of seizures in some patients, Derakhshan said.

Derakhshan's theory is that the source of the seizure always is in the dominant side of the brain, narrowing down the size of the potential problem area by 50 percent.

"Just a very simple test is going to replace procedures that make you shiver even thinking about them," Derakhshan said.

He describes in detail the process one must go through in an invasive encephalography, when surgeons must pick up portions of the skull and put tiny electrodes all over the brain.

"People have to go through these God-awful procedures," Derakshan said. "They spend hundreds of thousands of dollars on surgery, and 30 percent of the time they have the wrong hemisphere."
Derakhshan's theories build on observations made by musicologists for centuries.

Composers and music teachers have always understood that, with piano players for instance, one hand always moves faster than the other.

The speed differential only is possible if Derakhshan's theory is right, he said.

The difference in time between when a person's right and left fingers hit a key is the time it takes for the dominant side of the brain to send a signal to the non-dominant hand. That hand, therefore, moves just a fraction of a second more slowly.

It's a phenomenon also witnessed by drummers, referred to as "flam," Derakhshan said.

"One hand is always ahead of the other," he notes. "You watch them bring down their sticks, and it's never at the same time."

Derakhshan began thinking about the implications of his idea in the early 1980s, but he didn't publish his first report until 2001.

He wanted to be sure he was right, and he waited until he thought he had enough data that people would listen to him.

His approach might be working.

He has lectured on the topic at the Cleveland Clinic, and his work has been published, largely unedited, in 10 medical journals during the past three years.

He also has articles in about as many non-medical journals, especially those focused on the robotic implications of his theories.

He's using the typing test and software he has developed when it comes to treating his patients, and he's hoping other physicians and surgeons will consider his theory when working with their own.

"It's really earth shattering," Derakhshan said. "You, as a person, live in your major hemisphere. This is where humanity lies."

Derakhshan's body of work can be found on the National Library of Medicine's Web site, www.pubmed.com, and more information about his theories is available at www.mimickingman.com.

Man suffers fatal seizures a few hours following his imprisonment

About 2 p.m. Thursday afternoon, police arrested 24-year-old Humberto Torres in Colton.
About four hours later, he was dead.

Arden Wiltshire, a San Bernardino Sheriff's Department spokeswoman, said Torres had begun exhibiting seizure-like symptoms while being booked into San Bernardino's Central Detention Center.

After jail medical personnel called paramedics, Torres was transported to Loma Linda University Medical Center in Loma Linda, where he was pronounced dead about 6:30 p.m., according to the San Bernardino County Coroner's Office.

Cristina Torres, Humberto Torres's mother, said her son had been riding in a car with friends when police pulled them over Thursday.

Humberto Torres had been on probation for a drinking-related violation and was arrested for being drunk, she said.

Cristina Torres said that about 5 p.m., Humberto called to tell her what had happened.
"He never had any seizures before in his life," she said.

She said that when her husband went to the Coroner's Office on Friday morning, staff refused to allow him to see his son's body.

Instead, they gave him photographs showing bruises on the body, Cristina Torres said.
"They're hurting us so much, and I'm feeling like the police is the
one who has something to do with this," she said.

The sheriff's homicide detail is investigating the case, which is typical protocol when someone dies in custody, Wiltshire said.

She said she did not know details regarding the family's visit to the coroner's office.

Riverside County Coroner's Office will conduct the autopsy, which is also normal procedure, she added.

Friday afternoon, friends and family gathered at the Torres home in Rialto for a barbecue to support Humberto Torres' parents and siblings.

Cristina Torres said her son loved his family, worked hard and always relished a good party.
Contact writer Charlotte Hsu at (909) 386-3882 or via e-mail at charlotte.hsu@sbsun.com.

Epilepsy or seizures?

THE earliest medical writings mention epileptic seizures but the dramatic and intermittent nature of the affliction caused it to be masked in mysticism for many centuries.

Seizure or epilepsy

Seizure (often called fit, attack, turn or blackout) is an isolated episode, which could happen to anyone in certain circumstances. The affected person generally experiences alteration or loss of consciousness, has some abnormal involuntary movements of the face, arm, or leg, may fall to the ground, pass urine involuntarily, bite his tongue or suffer other injuries.

Epilepsy is a tendency to experience repeated spontaneous seizures without an obvious cause. Epilepsy is not just one condition and it is not therefore easy to explain in many people why seizures begin at a certain time or why the illness follows a certain course. It is important to understand that epilepsy is neither a disease nor is it transmissible from one person to another.
Seizures occur due to a sudden disruption (a short circuit) in the normal electrochemical activity of the brain. Recurrent seizures (Epilepsy) are a reflection of an increased liability to such short circuits.

While all of us are liable for seizures in certain extreme circumstances (brain injury or infections for example), we generally have a high resistance or high seizure threshold, which makes such an event unlikely.

Diagnosis

People with epilepsy (PWE), due to a range of reasons like genetic factors, early brain injury, biochemical and hormonal abnormalities, antecedent neurological events, medical disorders generally have a low seizure threshold and go on to develop recurrent spontaneous seizures (epilepsy).

While in about 10 per cent of people with epilepsy there is a straightforward genetic cause affecting several people in the family, in most PWE the cause is multi-factorial.

Few people have peculiar forms of epilepsy that occur as a reflex to some stimuli (flashing lights, reading, eating, video games) the most important type in south India being Hot Water Epilepsy that follows the ritual hot water bath. Epilepsy is commonly a consequence of brain injury: road traffic accidents, infections, birth trauma, stroke or tumour.

Unlike most neurological disorders, there may be no physical signs. The diagnosis is, therefore, made on the basis of a history of more than one epileptic seizure. An accurate eyewitness account is crucial to making a correct diagnosis, as the person experiencing the seizure usually has no recollection of what has happened.

To help confirm the diagnosis, the doctor may arrange for a number of tests that may also help determine whether there is any identifiable cause.

EEG (Electroencephalogram): This test records the brain's activity by picking up the tiny electrical signals given off by communicating nerve cells. The EEG only gives information about the electrical activity of the brain during the period of recording. Other state of art technology employed to diagnose epilepsy include: ambulatory EEG, Videotelemetry, brain scans such as MRI/CT/SPECT/PET and in specialist centres combinations of the above.

Blood Tests: These check the general health and help exclude a metabolic cause for the attacks. People with new onset epilepsy or those under treatment in whom the course or manifestations of epilepsy have changed should have routine blood parameters such as sugar and electrolyte balance tested.

Treatment

People react to a diagnosis of epilepsy in different ways. Many people experience a range of different emotions and it is only natural. People often feel that they want to talk to others about their diagnosis and www.epi-life.org is an interactive portal offering support and information to people with epilepsy, their families and care givers.

Anti-epileptic medication is used to prevent seizures from occurring rather than treat the cause of epilepsy. It is, therefore, necessary to take medications regularly and consistently. In some people it may be necessary to do so for long periods. As different anti-epileptic drugs are effective for different types of seizures, the doctor will have to choose the most effective drug for the individual.
When a person starts taking anti-epileptic medication, the drugs are usually introduced gradually, and the dose increased slowly until it is at a level where it either controls the seizures or the person starts to experience side effects. It is therefore ideal to consult an expert for early diagnosis and initiation of treatment although treatment could thereafter continue under the supervision of a family physician.

It is important not to keep taking medication without ever consulting a doctor; regular treatment reviews by a physician are necessary and desirable.

Surgery

In some people, epilepsy is caused by a specific structural problem in a part of the brain. This may have resulted from some form of head injury, occurring either at birth or in later life, or from a cerebral infection. It is also possible that the brain did not develop properly or there is some form of brain scarring which the person was born with.

Good MRI scans today have the ability to detect subtle brain lesions and this may help in decisions about therapy. In particular some PWE may be helped by epilepsy surgery, which very simply means removing the abnormal or damaged part of the brain.

While this is major brain surgery and not undertaken lightly, it is quite safe in expert settings with over 70 per cent of people (who are judged to be good candidates for such surgery in a detailed expert work-up) becoming completely free of seizures.

Epilepsy has an impact on the mind, body and spirit. As a consequence, the best treatment centres are multi-disciplinary and involve: Comprehensive assessment by a multidisciplinary staff comprising epileptiologist, neurologist, neuro-surgeons, neuropsychiatrists, counselors and therapists, social workers, clinical psychologists and special educators; Appropriate anticonvulsant medication; Appropriate surgical procedures, if needed; Behavioural Therapies such as social skills, anger management, relaxation; Special / Remedial education in case of children.

The Vinothan Comprehensive Epilepsy Care Centre at The Institute of Neurological Sciences, Voluntary Health Services is a non-profit centre in Chennai.

For more information visit www.epi-life.org .

Medical negligence leads to seizures disorder and lawsuit

Patricia Newby filed a medical malpractice suit against the United States of America in federal court in East St. Louis Nov. 9, seeking $2 million in damages.According to the complaint filed by attorney Rex Carr, the suit is filed against the federal government because the alleged negligence was caused by a government employee at the Clay Medical Center on Nov. 18, 2004.

Newby claims she was at the clinic for a checkup and was seen by Jane James APN-CNP and Fred Cycholl, M.D.She claims she was provided substandard care when she was prescribed Triam/HCTZ, a sulfa drug used to treat high blood pressure."The medical records clearly show, Patricia Newby was allergic to sulfa drugs," the complaint states.Newby claims she told James that she had a reaction to sulfa drugs, but was reassured that the new medication would not be a problem.

Newby claims as a result she has suffered serious permanent injuries from grand mal seizures including ruptured disks in her back, a rotator cuff injury, and an injury to her jaw causing her to suffer extreme pain and suffering and wage loss.According to court records, two days after Newby took the drugs she was taken to the emergency room at Clay County Hospital with symptoms of nausea, shakiness and headaches.

She also was pale and weak and lab results done at the emergency room showed she had become hyponatremic and was suffering from hypoosmolality which results from excessive fluid retentions.Newby also suffered two seizures at the hospital and had to be airlifted to a Mt. Vernon hospital.

Surgery for Epileptic patients is a success!

Researchers at Mayo Clinic have found that 81 percent of patients with intractable epilepsy become totally or nearly seizure-free six months following epilepsy surgery. Ten years later, 72 percent remained totally or nearly seizure-free.The findings are published in the Journal of Neurosurgery.Epilepsy affects 3 million Americans.

Thirty to 40 percent have intractable epilepsy: medications alone do not control the seizures, and the seizures have a disabling effect on quality of life." All other forms of treatment, specifically maximum anticonvulsant treatment, have failed for these patients," says Fredric Meyer, chair of Mayo Clinic Department of Neurologic Surgery and study investigator. " Often these patients are on two to three anticonvulsants and are still suffering from intractable epilepsy prior to surgery."

To conduct this study, the researchers analyzed the cases of 399 consecutive patients who underwent epilepsy surgery to remove the focal region of their disease in the brain at Mayo Clinic in Rochester, between 1988 and 1996. There were 214 females and 185 males, and the average age at surgery was 30.Prior to surgery, quality of life is poor for these patients, the Mayo Clinic researchers explain." These patients typically can't drive or use dangerous machinery, have difficulties with work or can't work at all, or can't complete their education," says Gregory Cascino.

" They usually would have several seizures per month and may be prone to having spells with loss of consciousness. They can injure themselves from seizures, drown or have sudden unexpected death due to epilepsy."Quality of life typically improves dramatically after surgery, says Meyer. " If these patients have improved seizure control after surgery, which most of them do, then there is an incredible paradigm shift toward a better quality of life, " he says.

" These patients break out from the stigmata of epilepsy and find employment, often drive, and lead a productive life." Risk with epilepsy surgery is relatively low: 4 percent of patients studied had medical problems due to anesthesia or other neurological complications during surgery. Risk varies by seizure type, where the seizure focal region is located, and other factors, according to Meyer.Though epilepsy surgery is not risk free, Cascino notes that patients with intractable epilepsy are continually at risk already before surgery due to their disease.

"This is a big operation for a big medical problem," he says. " These patients are medically, physically and socially affected by their disease." Cascino says that it is cost-effective for society when surgery can stop a patient's seizures, due to the significant number of epilepsy patients who are unemployed or underemployed because of their seizures.An appropriate candidate for epilepsy surgery is in good health, with the exception of epilepsy; is not responding to seizure medications; the region of the brain affected by the disease can be pinpointed; and the affected region of the brain can be safely extracted without damaging the surrounding area.

Though 30 percent to 40 percent of epileptics might be candidates, the surgery is underutilized, according to Cascino. He says the surgery is available at medical centers designated level IV comprehensive epilepsy centers by the National Association of Epilepsy Centers. For those who are not surgical candidates, other treatment options are available, says Cascino.Source: Mayo Clinic, 2006

Seizure dog may be the answer for woman with history of seizures

The seizures are bad, hitting hard enough to knock her to the ground — helpless until someone arrives or she can gather her senses. But worse, says Heidi Lee Dias, is never knowing when the next one will hit, or where. Sometimes days will pass without one, “but yesterday I had two ... I had three last week.” It has happened when she was on the stairs and when she was out in town.
“There’s never a good time or place but some places are really bad,” she said. “It’s really scares me and it worries my family all the time.”

The seizures have dominated her life since she suffered a stroke out of the blue seven years ago at age 29. She had undergone a doctor-recommended hysterectomy and was recovering in the hospital two days later when it hit.

“At first I could hardly do anything. I couldn’t talk — the only word I could say for awhile was ‘no.’”
Can dogs sense a seizure?

Although there is no question that trained dogs can assist people with disabilities in many ways, there is lively debate among scientists, epilepsy groups and even dog trainers over whether dogs can actually sense a seizure coming.

The Epilepsy Foundation states: Some dogs “may even be able to sense in advance when someone they’re close to is going to have an epileptic seizure. America’s interest in seizure dogs began in the mid-1980s, when a woman with epilepsy who was taking part in a ... project involving dogs discovered that one of the dogs seemed to know when she was going to have a seizure. The news media picked up the story, and the phrase “seizure dogs” was born. The Lifetime television drama, “Within These Walls,” is based in part on this experience.”

But at Epilepsy.com, veterinarian Deborah Dalziel says: “There is this misconception that any seizure dog can be trained to alert, which just isn’t true. A dog can cue in on minute behavioral differences, but can’t be trained to alert.”

In a 1998 study of 29 epilepsy patients, nine reported that their dogs responded to a seizure. These dogs remained close to their human companions, either standing or lying alongside them, sometimes licking the person’s face or hands during and immediately after the seizure. Of the nine dogs reported to respond, three were reported to also alert their human companion to an impending seizure.

Some believe the dog is able to alert by detecting subtle changes in human behavior, while others assert that a dog’s heightened sense of smell enables it to detect an oncoming seizure. “I think a lot of it is that people give off cues and dogs are more alert to body language,” said Mike Sapp of Paws With A Cause. “But there haven’t been enough scientific studies done.”

Gradually her strength and speech returned but there are still good days and bad.

Telling her story last week, she spoke clearly about what she’d endured.
“But some days I can hardly say a thing. My daughter can always understand me but sometimes she’s the only one.”

It’s the same with her strength. Her right side is weakened but she can usually get about reasonably well, except on the bad days. Or when a seizure strikes.

Veteran, EMT, now housebound

All this is quite a change for a young woman who had set a career path of helping others. After high school in Fall River she entered the Navy and was shipped off to serve in Operation Desert Storm when her daughter Bianca Lee Cardoza, now a senior at Westport High School, was but nine months old.

During the war she was among a special few selected to be a Marine Corpsman, tending to wounded soldiers. Back home she continued that line of work, becoming an EMT for private ambulance services.

“It was work I really liked,” she said. “I miss it, I was doing something important.”
These days the tables have turned. Since the stroke, she can’t work, can’t drive, can’t go out without fear of the seizures for which doctors can forecast no end.

She’s 36 now and gets help from her daughter, husband George Dias and daughter-in-law Kayla Dias.

“They are great about it (the experience has even played a part in guiding her daughter toward a career in nursing or similar field). But I know it’s hard on them, someone calling me every 10 minutes to make sure I’m all right.”

“I just want my life back, to be able to go places without being afraid of what might happen.”
It has been heart-wrenching to see the changes in her daughter, said Heidi’s mother Sandra Amarello who lives in Florida but makes trips north to help out.

“She went from a very outgoing, active person who loved to play sports outside with her daughter to someone who is afraid to leave her house,” Ms. Amarello said. “She doesn’t like to go out to her mailbox alone ... one time she had a seizure right out there in Route 177.” And whereas she used to take care of her daughter, “now it’s the other way around. Her daughter does so much for her.”

Seizure dog

Awhile back, Heidi learned from doctors about something that might help.

“I had never heard of seizure dogs before so I looked it up on the internet.” There she found a wealth of information about special dogs trained to help owners who suffer from seizures, dogs that can perhaps even alert them before the seizure hits.

Her research led her to Northern Indiana Service Dogs, a firm that trains dogs for the specific and varying needs of clients. Some are companions and helpers for wheelchair-bound and partially paralyzed people, and others are trained as seizure response dogs.

Ms. Dias is especially hopeful about the possibility that some seizure response dogs may actually sense the onset of a seizure before it begins.

“It may be something to do with their sense of smell, or with the fact that they know their companions so well but they can actually give warning before it starts.” This, she adds, would make all the difference and offer a measure of protection from falls or worse.

Northern Indiana Service Dogs makes no assurances along these lines:
“There is no guarantee that a seizure response dog can predict a seizure. However, we would expect that in time, and after bonding ... they will notice oncoming seizures and will alert you to them.”

The firm does say the dogs are trained to assist with balance, retrieve dropped or out-of-reach objects, open doors and even bring a phone to a fallen person.

Although she hasn’t yet raised anything close to the $5,000 she’ll need for her dog (actual cost is higher but a donor program provides some assistance) she has begun the process. Stevie, a yellow lab puppy, has begun training for her specific needs and will be available in several months.
She says she calls the trainers often to find out how it’s going.

“They say he’s going to be wonderful. I can’t wait to meet him,” she added.

Want to help?

A fund to help Heidi Dias with the cost of her assist dog has been set up through a restricted Bank of America account. Checks, made out to the Heidi L. Dias & Service Dog Fund may be sent to Sandra Amarello (trustee), 4 Lawtons Lane, Westport MA 02790. Under terms of the account, funds will be dispersed for the dog’s purchase and related expenses including transportation to and from Indiana.

Myths and Epilepsy

There are a number of thoughts, ideas and perceptions about the neurological disorder epilepsy, many of them untrue.

It's not true that epilepsy only starts in children, or that it's synonymous with mental illness. It's not contagious. And, despite popular myth, people having the seizures typically associated with epilepsy often aren't in danger of biting their tongues.

So why do so many people know so little about a disorder more than 2.7 million Americans are living with?"It's partly out of fear," said Linda Wallace, executive director of the Connecticut chapter of the Epilepsy Foundation, a national organization committed to epilepsy research, education and advocacy.

This is Epilepsy Month, and the foundation and other organizations

are looking to change these perceptions through public awareness campaigns. For instance, the foundation recently launched "Out of the Shadows," a campaign to increase epilepsy awareness, raise research funds, and end discrimination against people with epilepsy. People can learn about epilepsy through the campaign's Web site, www.outoftheshadows.com, and its hotline, (1-888-886-EPILepsy). Though there's been some progress in educating people about epilepsy, there are still many misconceptions about it, Wallace said. One fact few people know is how prevalent it is. About 181,000 people develop epilepsy and seizures each year. In Connecticut, there are between 45,000 and 50,000 people living with the disorder.

"One of the myths is that it's very uncommon," Wallace said. "Actually, it affects more people than cerebral palsy, multiple sclerosis and Parkinson's disease combined."

Epilepsy is usually diagnosed using a bran scan or an electroencephalogram (EEG), which electrically records brain activity. Though commonly associated with children, it can occur at any age.

There's no one cause for epilepsy, doctors said. It can be caused by a genetic vulnerability to the condition, or it can be the result of an event, such as a stroke, an accident, a tumor or an infection. Essentially, the result is that clusters of neurons in the brain signal abnormally, leading to the seizures that characterize the condition.There's a lot of confusion about epileptic seizures. Many people believe epilepsy and seizures are the same thing, said Dr. Srinath Kadimi, neurologist at St. Vincent's Medical Center in Bridgeport.

Though seizures are a defining trait of epilepsy, Kadimi said, not all people who have seizures have epilepsy. Many people have seizures caused by other conditions, including low blood sugar."Sometimes we use the words 'seizure' and 'epilepsy' interchangeably," Kadimi said. "But that's not necessarily true."

Also, most people have a set idea of what an epileptic seizure looks like — sudden stiffness, shaking, confusion afterward. But there are many different types of seizures, said Dr. Kanaga Sena, Bridgeport Hospital's chief of neurology services.

The varieties range from the "standard" seizure many associate with epilepsy to a facial motor seizure or a seizure, common in children, in which an individual momentarily loses awareness. Many people still believe bystanders should force a spoon or other object into the mouth of a person having a seizure, hoping that will keep him or her from biting his or her tongue. However, experts said most people having seizures aren't in danger of biting their tongues, and forcing something into a seizing person's mouth can actually hurt him or her.

In addition to such damaging misconceptions, the stigma attached to the epilepsy can prevent some people from even admitting they have it, Kadimi said. "People are embarrassed to come out with their diagnosis," he said.

Epilepsy also can be disruptive to a person's daily routine and quality of life, Wallace said. "Say that a person is working, driving, involved with a family, and they're diagnosed with epilepsy," she said. "There's a good chance they'll lose their license until the seizures are under control." In a worst-case scenario, if the person doesn't get the license back, he or she could lose employment, which would lead to losing money and not being able to provide for a family. "It can be a downward spiral," Wallace said.

Thankfully, many with the condition can control epilepsy with medication or surgical techniques. The latter include the vagus nerve stimulator, approved by the Food and Drug Administration in 1997 for those who have trouble controlling seizures with medication.

Sena likened the vagus nerve stimulator to the pacemakers used in those with heart conditions. A wire is attached to a nerve, the vagus nerve, and is used to send mild electrical pulses to the brain. The pulses help control the seizures.

Generally, Sena said, epilepsy can be controlled with medications and some minor lifestyle changes, such as getting enough sleep and not abusing alcohol."Many of these people can have a normal, productive life," he said.

Febrile seizures keep boy out of school

An Athabasca-area mom has pulled her child from school because of a policy that prohibits bus drivers from giving him medication for a condition he suffers.

Rosealee Fulk is now paying $14 daily to send her son, Clayton, to a babysitter after informing Aspen View School Division of her intent to take her child out of school Oct. 24.

"I think it's terrible that a bus driver can't get out of her seat to help a child," said Fulk.

Clayton suffers from febrile seizures, a condition that sees him go into convulsions for between two and four minutes at a time.

When he suffers a seizure, the boy needs to be given a pill that prevents him from seizing again.

Fulk figures school bus companies don't want to assume the legal liabilities of giving medication.
She says the school division should change its policies to allow bus drivers to give medication to children in distress.

She said she's been told bus drivers are instructed to pull over and call an ambulance should one of their children need medical attention.

Fulk admitted the school board offered to give her child an aide to ride the bus from her home but she said she wants the worker to meet her and Clayton at her place of employment in the morning because she faces a 35-minute commute.

Now Clayton, in Grade 5 at Landing Trail Intermediate School, is "scared to death he's going to fail," Fulk said.

Aspen View School's board chairman David Dacyk said he wasn't aware of the situation and administration deals with such scenarios.

Dacyk said he would check into the situation. But he said the division's policy is to "do whatever is required to ensure safe transportation to school.

"We'll try our best to help."

During a febrile seizure, a child often loses consciousness, shakes and moves limbs.

Less commonly, the child becomes rigid or has twitches in only a portion of the body, such as an arm or a leg, or on the right or the left side only.

One in 25 children suffers from febrile seizures, according to the United States-based National Institute for Neurological Disorders and Stroke.

Gene Therapy vs. Epilepsy in animals

This press release issued by Eurekalert says that for the first time, researchers have inhibited the development of epilepsy after a brain insult in animals. By using gene therapy to modify signaling pathways in the brain, neurology researchers found that they could significantly reduce the development of epileptic seizures in rats.

"We have shown that there is a window to intervene after a brain insult to reduce the risk that epilepsy will develop," said one of the lead researchers, Amy R. Brooks-Kayal, M.D., a pediatric neurologist at The Children's Hospital of Philadelphia and associate professor of Neurology and Pediatrics at the University of Pennsylvania School of Medicine. "This provides a 'proof of concept' that altering specific signaling pathways in nerve cells after a brain insult or injury could provide a scientific basis for treating patients to prevent epilepsy."

Working in a portion of the brain called the dentate gyrus, the researchers focused on one type of cell receptor, type A receptors, for the neurotransmitter gamma-aminobutyric acid (GABA). When GABA(A) receptors are activated, they inhibit the repetitive, excessive firing of brain cells that characterizes a seizure. Seizures are thought to occur, at least in part, because of an imbalance between two types of neurotransmitters: the glutamate system, which stimulates neurons to fire, and the GABA system, which inhibits that brain activity.

GABA's inhibitory role is considered particularly important in the dentate gyrus because the dentate gyrus acts as a gateway for brain activity into the hippocampus, an area that is critical to generating seizures in temporal lobe epilepsy, the most common type of epilepsy in children and adults.

GABA(A) receptors are made up of five subunits--proteins that play important roles in brain development and in controlling brain activity. Previous animal research by Dr. Brooks-Kayal's group had found that rats with epilepsy had lower levels of the alpha1 subunits of these receptors and higher levels of alpha4 subunits. Therefore, the researchers used gene delivery to alter the expression of the alpha1 subunit to see if this would have an effect on later seizure development.
To carry the gene that alters the expression of the protein, they used an adeno-associated virus vector, injected into the rats' brains. The researchers later injected the rats with pilocarpine, a drug that causes status epilepticus (SE), a convulsive seizure, shortly after injection.

They then evaluated the rats for later development of spontaneous seizures or epilepsy, which usually occurs after an initial SE injury. Rats that had received the gene therapy had elevated levels of alpha1 proteins and either did not develop spontaneous seizures, or took three times as long to experience a spontaneous seizure, compared to rats that did not receive the delivered gene.
In this short-term study, said Dr. Brooks-Kayal, it was impossible to tell whether the increased alpha1 subunit levels were only suppressing seizures or whether they would permanently prevent epilepsy from developing.

"In people, an initial episode of SE or an injury such as severe head trauma is known to raise the risk of later developing epilepsy, so this study suggests that strategies aimed at modifying signaling pathways in the brain after such an insult may help prevent epilepsy," said Dr. Brooks-Kayal. "The approach would likely be different than in this proof-of-concept animal study that involved injecting agents directly into the brain. This study, does, however, lay the foundation for a potential drug therapy that might act on the same signaling pathways, to prevent epilepsy after a brain insult such as an episode of SE."

Epilepsy is difficult but you have access to a lot of helpful resources

During an educational medical symposium for patients with epilepsy last year, I was struck by a comment made by one of our participants. "The best thing about this event is having the chance to be in a room full of other people with epilepsy," she said.

For me, a physician and researcher who treats people with epilepsy, her remark was a reminder of how alone my patients often feel. People with epilepsy may look, think and act like anyone else, but they often carry a silent burden, never knowing when the next seizure will strike. This month, which is National Epilepsy Awareness Month, we take note of the 21,000 people in the Greater Cincinnati region who suffer from epilepsy and what is being done to help them cope with this unpredictable and potentially dangerous condition.

Epilepsy is a common but often misunderstood brain disorder characterized by recurrent seizures. The term "epilepsy" simply means that someone has had two or more seizures. Common symptoms of seizures include confusion, muscle twitching and loss of memory. Epilepsy can develop at any age and is most likely to first occur in people over the age of 60.

Most people with epilepsy are able to keep their seizures under control with medications, and in some cases the area of the brain responsible for seizures can be safely removed with surgery. But a significant number of people with epilepsy continue to suffer from seizures and the impaired quality of life that typically results. The threat that a seizure may strike, without warning, can force them to give up driving, prevent them from working at certain jobs, and lead to feelings of depression and anxiety.

Fortunately, the Greater Cincinnati community has excellent resources for patients and families confronting epilepsy. Our local affiliate of the Epilepsy Foundation (www.epilepsyfoundation.org and 513-721-2905) strives to ensure that "people with seizures are able to participate in all life experiences" while working to "prevent, control and cure epilepsy through research, education, advocacy and services." Meanwhile, neurologists who specialize in epilepsy management are at the national forefront of epilepsy research at the Neuroscience Institute at the University of Cincinnati and University Hospital, and at Cincinnati Children's Hospital Medical Center.
Dr. David Ficker is associate director of the Cincinnati Epilepsy Center at the Neuroscience Institute. He lives in Anderson Township.

Gene Therapy may help to control seizures

US researchers have shown through a study on mice, that using gene therapy to modify signalling pathways in the brain, can help bring significant reduction in the development of epileptic seizures. "We have shown that there is a window to intervene after a brain insult to reduce the risk that epilepsy will develop," said one of the lead researchers, Amy R Brooks-Kayal, MD, a paediatric neurologist at the Children''s Hospital of Philadelphia and associate professor of Neurology and Paediatrics at the University of Pennsylvania School of Medicine.

"This provides a ''proof of concept'' that altering specific signalling pathways in nerve cells after a brain insult or injury could provide a scientific basis for treating patients to prevent epilepsy," he added. The researchers focused their study, published in the Journal of Neuroscience, on a type of cell receptor that acts as a gateway for brain activity into the hippocampus, an area that is critical to generating seizures in temporal lobe epilepsy, the most common type of epilepsy in children and adults.

They say that when GABA (A) receptors are activated, they inhibit the repetitive, excessive firing of brain cells that characterizes a seizure. Seizures are thought to occur, at least in part, because of an imbalance between two types of neurotransmitters – the glutamate system that stimulates neurons to fire, and the GABA system that inhibits that brain activity. The researchers say that GABA (A) receptors are made up of five subunits, proteins that play important roles in brain development and in controlling brain activity.

In their previous research, Dr Brooks-Kayal’s team had found that rats with epilepsy had lower levels of the alpha1 subunits of these receptors, and higher levels of alpha4 subunits. In the latest study, they used gene delivery to alter the expression of the alpha1 subunit to see if this would have an effect on later seizure development. To carry the gene that alters the expression of the protein, they used an adeno-associated virus vector, injected into the rats'' brains. They later injected the rats with pilocarpine, a drug that causes status epilepticus (SE), a convulsive seizure, shortly after injection, and then evaluated the rats for later development of spontaneous seizures or epilepsy.

The researchers found that rats that had received the gene therapy had elevated levels of alpha1 proteins, and either did not develop spontaneous seizures, or took three times as long to experience a spontaneous seizure, compared to their controlled counterparts. Dr Brooks-Kayal said that during the study it was impossible for the researchers to tell whether the increased alpha1 subunit levels were only suppressing seizures, or whether they would permanently prevent epilepsy from developing.

"In people, an initial episode of SE or an injury such as severe head trauma is known to raise the risk of later developing epilepsy, so this study suggests that strategies aimed at modifying signalling pathways in the brain after such an insult may help prevent epilepsy," said Dr Brooks-Kayal. "The approach would likely be different than in this proof-of-concept animal study that involved injecting agents directly into the brain. This study, does, however, lay the foundation for a potential drug therapy that might act on the same signalling pathways, to prevent epilepsy after a brain insult such as an episode of SE," he added.

Your child has seizures, what is it like for the parents?

ANY parent can understand the concern of David and Victoria Beckham last week when their three-year-old son, Romeo, was again rushed to hospital after suffering a series of seizures.
A combination of worry and helplessness affects even the most confident couples in a situation like this.

While it would be wrong for me to comment further about Romeo Beckham, because I do not know all the facts, seizures in young children with high temperatures are very common.

Such children do not usually need long-term medication and only a small number of such children go on to develop the condition we call epilepsy.

The brain is a complicated organ made up of millions of nerve cells. If something happens to interfere with its proper working, even for a brief moment, a seizure may occur.

Seizures may show themselves by causing anything from a brief loss of attention to what is going on in the outside world through disturbances of taste and smell to twitching of the limbs and total loss of consciousness. In a so-called generalised seizure, the person may bite their tongue and lose bladder control. Anyone can suffer a seizure if circumstances are right.

A very high temperature in children under the age of six is a common cause, because young brains are especially sensitive to heat. However, seizures can be triggered in adults also, such as after a blow to the head. It is reported that the Beckhams asked photographers not to use flash when taking pictures of the family but, fortunately, only a small proportion of seizures are triggered by flashing lights.

The chance of having a seizure is partly governed by your genes. Parents who experience seizures are more likely to have children with the same sensitivity.

Epilepsy is only diagnosed after a person has had more than one seizure. Blood tests, a variety of scans and an electro-encephalogram to read the electrical charges passing through the brain can all help in the diagnosis.

When epilepsy has been diagnosed, a decision is often made to treat it with drugs. Some do not respond so well and a tiny proportion may benefit from brain surgery. The average person with epilepsy can get on with normal life though there may initially be restrictions on things such as driving a car or using dangerous machinery.

What should you do if someone near you has a seizure? The most important thing is to prevent them from harming themselves, by keeping them away from open fires, for example. Usually, they soon get over the seizure without further help although medical assistance may be necessary if one persists for any length of time. A seizure lasting longer than 30 minutes is a medical emergency and needs urgent specialist treatment. If in any doubt telephone for advice.

Epilepsy is very common, it affects about 45,000 people in Scotland alone, so you are highly likely to know someone with this condition, even if not in your family. A most important thing to remember is that the vast majority of folk with epilepsy are normal in every other way. They are just as likely to be as intelligent or more intelligent as yourself. They are certainly just as likely to feel the pain of being socially excluded or treated as an object of fear or fun.

Ignorance of the condition amongst the general public can not only cause a great deal of unnecessary unhappiness, it can deny to the rest of us the full use of the talents that those with epilepsy can otherwise offer.

Son of soccer star was diagnosed with seizures disorder

The son of soccer superstar David Beckham and former Spice Girl Victoria Beckham is reportedly suffering from epilepsy.

The high-profile couple, who are followed by paparazzi wherever they go, are said to be terrified four-year-old Romeo will suffer an epileptic fit triggered by the flashing lights of cameras. Last week, Victoria was pushing Romeo in his pushchair through London's Heathrow airport when the boy was forced to shield his eyes from an onslaught of camera flashes.

British newspaper the News Of The World reports that worried mother Victoria shouted at the photographers: "Leave him alone. He's got epilepsy. All that flashing will start an epileptic fit. You can't do that."

A friend tells the publication, "(Victoria and David) are devastated - worried sick about Romeo. He is on medication to control the seizures but obviously things like flashing lights can trigger one at any time. "They only hope the medication limits the number of fits he suffers to a minimum and he can enjoy as normal a life as possible. They are just praying Romeo gets better."

Flash photography is one of the trigger factors for epileptic seizures. In extreme cases attacks can be fatal.

Teens charged for assaulting toddler with history of seizures

Three Connellsville-area teens are facing felony charges after they allegedly brandished handguns last week to demand a ride from a 22-year-old man, then assaulted his 4-year-old passenger who suffers from epileptic seizures.

The teenagers, whom Connellsville police have charged as adults, also are accused of stealing Halloween masks and makeup items from a Family Dollar store on Oct. 27 in what was described during testimony Thursday as a plot to rob the business.

Police filed charges against Seth R. Fisher, 15, of 235 E. Fairview Ave., Connellsville; Christopher Faith, 16, of 101 Tanyard Hollow Road, Bullskin Township; and Ryan S. Miller, 16, of 1200 Race St., Connellsville.

Each was charged with robbery, aggravated assault, kidnapping, recklessly endangering another person, terroristic threats, simple assault, harassment, retail theft and criminal conspiracy.

After a preliminary hearing yesterday, District Judge Ronald Haggerty Sr., of Connellsville, held Faith and Miller for trial on all of the charges. Fisher's hearing hasn't been scheduled.

According to the testimony, Fisher, Faith and Miller approached Malone and his 22-year-old friend, Dale Naugle, outside Rush's convenience store on North Pittsburgh Street at about 5:30 p.m.
Naugle said the boys ripped off his coat and hat and refused to return them until he gave them a ride to the Family Dollar off Route 119.

After he declined, Naugle said, Fisher and Faith pulled guns on him and Fisher threatened to shoot him. Miller didn't display a weapon, according to testimony.

"I was scared, really scared," Naugle testified. "I was nervous."

Inside Naugle's four-door Oldsmobile, Fisher and Faith kept their guns on Naugle and Malone.
During the drive, Naugle said, Fisher "cracked" him on the back of the head with a gun.

Malone also said he had a gun put against his neck during the ordeal.

After Naugle pulled up to the store, one of the boys hit Malone's head against the passenger door window, Malone testified.

Once the boys went into the store, Naugle went home and called police, who found the defendants in the 200 block of South Prospect Street within minutes of the report.

Each of the boys was questioned with a parent present and agreed to give a written statement that implicated all three in various aspects of the incident.

Miller and Fisher are free on $25,000 bond, while Faith is being held on that amount at the Fayette County Prison.

Malone's mother, Missy Showman, said her family hasn't been able to get much sleep since the incident, but she's proud of the courage Malone showed in talking with police and testifying.

"He's my hero in my eyes and he became a man in an instant," she said.

Besides the stress of the holdup, Malone suffered a couple of seizures in the past week.

"I just think about what could have happened," Showman said. "They could have killed my kid."

November is National Epilepsy Awareness Month

To show its support for the 124,000 Pennsylvanians who deal with epilepsy and seizures, state Health Secretary Dr. Calvin B. Johnson today said the state has invested $750,000 this year to provide programs and services for people who suffer with the afflictions.

This is National Epilepsy Awareness Month.

"More people are diagnosed with epilepsy or seizure disorders than with Parkinson's disease, cerebral palsy, multiple sclerosis and muscular dystrophy combined," Dr. Johnson said. "That is what makes our collaboration with the epilepsy foundations of Western/Central and Eastern Pennsylvania so important. We are working to increase awareness and eliminate negative stereotypes associated with epilepsy and seizure disorders."

Epilepsy/seizure disorder is a neurological disorder that affects more than 2.5 million people nationwide, with 181,000 newly diagnosed each year. It is a physical condition caused by sudden, brief changes in the brain's electrical balance.

"Seizures often first develop during the pre-school and elementary school years," Dr. Johnson said. "While the cause of epilepsy/seizure disorder is not known, and is generally a chronic and/or lifelong condition, seizures can often be controlled with anti-epileptic medications, special diets or surgery."

The Epilepsy Foundation of Western/Central Pennsylvania received $475,000 and the Epilepsy Foundation of Eastern Pennsylvania received $275,000 to provide support services for children and adults with epilepsy/seizures and their families. For more information about epilepsy, or to locate available services in your community, go to the Department of Health's Web site at www.health.state.pa.us.

CONTACT: Troy Thompson

(717) 783-1116

Lack of sleep and seizures

Southern Illinois football coach Jerry Kill has returned to full duties, less than a week since being released from a hospital after having another seizure he says may be linked to his recent sleep problems.

In announcing his complete return to the program Tuesday, the 45-year-old Kill said he has had difficulty sleeping since he had a small tumor removed from one of his kidneys in January. His doctors are working with him to alleviate discomfort so he can rest properly.

"I want to assure everyone at the university and the entire Saluki nation that I am doing everything I've been told to do by my doctors," Kill said in a statement. "I feel like I have a lot still in me. If I ever thought I was a hindrance to the program, I promise I'd step away."

Kill was released from a St. Louis hospital Oct. 26, four days after having a seizure after the taping of his weekly television show at WSIL-TV near Carbondale.

The seizure was the latest for Kill, who also sustained one on the sidelines of a game last year and another one in November 2001. In both cases, Kill returned to the sidelines in time for the next game.

While hospitalized briefly after last year's seizure, Kill was diagnosed with kidney cancer. He continued coaching without telling the team, and had a tumor removed from one of his kidneys after the season.

Kill watched Southern Illinois' 27-17 victory Saturday at Missouri State from a stadium suite and did not actively coach the Salukis (6-2, 3-2 Gateway).

On Tuesday, Kill said his health issues are being treated by a local doctor and a St. Louis specialist, who the coach said "told me the seizures are brought on by fatigue and lack of sleep."
"My case is not unusual," Kill said.

Kill said he was overwhelmed by the outpouring of support from friends and fans.

"I have read every card and note," he said. "I wish I could send a personal response to each one, but right now I need to give all of my energy to our players and help them prepare" for Saturday's game at Youngstown State (7-2, 4-1 Gateway).

Warning: Party pills can cause seizures!

Doctors are warning against the use of party pills as doubt grows about their safety.
Pills containing the ingredient BZP are legal in New Zealand, but medics question that status.
The Medical Association says the pills can cause seizures, paranoia and hypothermia.

Chairman Ross Boswell says a recent study at Christchurch Hospital showed that over a five month period 80 people were treated for adverse effects. One in five were admitted to intensive care.

Dr Boswell says the tablets are often marketed as herbal highs, but there is nothing herbal about them. He says BZP was developed as a worming treatment for cattle, but could not be used for that purpose because of the side-effects. He says until further evidence about the safety of the pills is available, people should avoid them altogether, but if they insist on taking them, use should be limited.

Medecine to treat migraines and seizures can affect kidneys

Newswise — Topiramate (Topamax), a drug commonly prescribed to treat seizures and migraine headaches, can increase the propensity of calcium phosphate kidney stones, researchers at UT Southwestern Medical Center have found.

A study – the largest cross-sectional examination of how the long-term use of topiramate affects kidney-stone formation – appears in the October issue of the American Journal of Kidney Diseases.

Several case reports have described an association between topiramate and the development of kidney stones, but this complication had not been well recognized and physicians have not informed patients about the risk, the UT Southwestern researchers said. More important, the mechanism of stone formation was largely unknown previously.
“The wide-spread and escalating use of topiramate emphasizes the importance of considering the long-term impact of this drug on kidney-stone formation,” said Dr. Khashayar Sakhaee, senior author of the study and chief of mineral metabolism at UT Southwestern.

More than 29 million Americans suffer from migraines, with women being affected three times more often than men, according to the National Headache Foundation.

“Topiramate is probably one of the most commonly prescribed and most effective neurological medications right now,” said Dr. Dion Graybeal, assistant professor of neurology and an author of the study.

Dr. Graybeal and other researchers at UT Southwestern say the next step is to develop a way to block the development of kidney stones for users.

The study comprised two phases. Thirty-two individuals already being treated with topiramate and 50 normal volunteers were enrolled in a cross-sectional study in which their blood and urine were tested for kidney-stone risk. A short-term study also was conducted in seven individuals to assess stone risk before and three months after taking topiramate. All patients were evaluated at UT Southwestern’s General Clinical Research Center.

Researchers found that taking topiramate on a long-term basis, or for about one year, caused systemic metabolic acidosis – a buildup of excessive acid in the blood – as a result of the inability of the kidney to excrete acid. Topiramate use also increased the urine pH and lowered urine citrate, an important inhibitor of kidney-stone formation.

“These changes increase the propensity to form calcium phosphate stones,” Dr. Sakhaee said.
In the short-term study, urinary calcium and oxalate – a chemical compound that binds strongly with calcium and is found in most calcium stones – did not significantly change in people taking topiramate.

Kidney stones are solid deposits that form in the kidneys from substances excreted in the urine. When waste materials in urine do not dissolve completely, microscopic particles begin to form and, over time, grow into kidney stones.

Before this study, the rate of kidney-stone formation with topiramate was reported as 1.5 percent. The low incidence rate may be an underestimation due to the short length of observation and the lack of ongoing kidney-stone surveillance and data collection for this drug, said Dr. Sakhaee, holder of the BeautiControl Cosmetics Inc. Professorship in Mineral Metabolism and Osteoporosis.

“There is a legitimate concern for the occurrence of kidney stones with long-term topiramate treatment,” said Dr. Sakhaee said. “Studies are needed to explore optimal measures to prevent kidney-stone formation with topiramate use.”

Other UT Southwestern researchers contributing to the study were Dr. Orson Moe, director of the Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, Dr. Naim Maalouf, assistant professor of internal medicine and Dr. Brian J. Welch, a postdoctoral fellow in internal medicine.

The research was supported by the National Institutes of Health.

UT Southwestern Medical CenterUT Southwestern Medical Center, one of the premier medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education.

Its more than 1,400 full-time faculty members – including four active Nobel Prize winners, more than any other medical school in the world – are responsible for groundbreaking medical advances and are committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to nearly 89,000 hospitalized patients and oversee 2.1 million outpatient visits a year.

Seizures and driving

Many people with epilepsy whose seizures are poorly controlled continue to drive, even though they're at high risk for crashes, Florida researchers report.

In most cases, these individuals get behind the wheel because it's the only way they can get to work, according to a team from the University of Florida. That suggests that more must be done to help people with epilepsy stay both productive and safe.

The researchers surveyed more than 300 epilepsy patients in northeast Florida and southeast Georgia. They found that nearly 20 percent of those who had at least one seizure a year drove. Even more alarming, nearly 25 percent of patients who suffered daily seizures still drove occasionally.

"I thought the statistics would be lower than that and was surprised that so many with poorly controlled epilepsy continue to drive," study co-author Dr. Ramon Bautista, an assistant professor of neurology at the UF College of Medicine-Jacksonville, said in a prepared statement.

"This has always been a problem for epilepsy patients because driving serves both a social and a practical purpose. And if motorists with epilepsy are caught driving when they're not supposed to be, their license can be taken away," he said.

Most of the patients in the study said they continued to drive -- not because they had achieved good seizure control or did not suffer any side effects from their medications -- but because they had to get to work.

"In many ways, we have all these nice rehab programs for epilepsy patients but part of the reason they don't become fully successful is because we fail to consider the more practical things -- like how they're going to get to work," Bautista said.

"These folks are not bad folks. They're not (driving) because they want to hurt someone. They're doing it because they need to work," he said.

The study appears in the current issue of Epilepsy & Behavior.

More information

The Epilepsy Foundation has more about epilepsy.