Blood Biomarkers, Preeclampsia and seizures

A new study that examines the value of maternal blood biomarkers will help identify and monitor patients at risk of developing preeclampsia and is set to change the way expectant mothers are cared for in prenatal clinics around the world.

The study, conducted by scientists at the highly-respected Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institute of Health (NICHHD/NIH), set out to determine the diagnostic indices and predictive values of biomarkers measured in maternal blood in the first and second trimester of pregnancy. The goal of the study was to determine if the biomarkers could predict the subsequent development of preeclampsia.

"This study represents a very important step forward; for the first time ever, we are presented with the possibility, for clinical use, of a combination of factors to predict early onset preeclampsia with a reasonable degree of accuracy," says Professor Marshall Lindheimer, Professor Emeritus of Medicine and Obstetrics & Gynaecology at the University of Chicago.

Preeclampsia is the leading cause of infant death and the second leading cause of maternal death Around the world. Conservative estimates indicate that preeclampsia is responsible for some 76,000 maternal deaths and more than 500,000 infant deaths every year, according to the Preeclampsia Foundation. Early onset preeclampsia is the most dangerous form of this disease.

Known worldwide as 'the silent killer', preeclampsia is a disorder that occurs during pregnancy and after delivery. It is characterized by high blood pressure and the presence of protein in maternal urine. However, preeclampsia can affect other organs such as the liver, the kidney, the brain. Sometimes mothers develop seizures (eclampsia) and have intracranial haemorrhage which is the main cause of death. In some instances, women develop blindness when preeclampsia is severe. They may also suffer catastrophic complications such as liver rupture.

The findings of this new study are published in the November issue of the Journal of Maternal-Fetal & Neonatal Medicine.

"Left untreated, preeclampsia leads to serious - or fatal - complications for both the mother and baby," says Dr Kusanovic of the Perinatology Research Branch of the NIH and Wayne State University/Hutzel Women's Hospital in Detroit, Michigan and lead author of the study.

"Our study found that maternal plasma concentrations (of angiogenic and antiangiogenic factors) together with a combination of other demographic, biochemical and biophysical factors are useful in assigning risk for the subsequent development of early-onset preeclampsia," explains Dr Roberto Romero, Chief of the Perinatology Research Branch of the NIH, who is one of the world's leading experts on this condition and in the study of complications of pregnancy.

"The establishment of an accurate means to assess the risk for preeclampsia will enable health care practitioners to identify women who require more intensive monitoring to safeguard both mother and baby from this devastating condition," says Dr Romero.

Dr Mario Merialdi, Coordinator for Improving Maternal and Perinatal Health at the World Health Organisation (WHO) said: "The results of the study conducted by the international team led by Dr Romero have important implications for clinical practice and public health policies. Hypertensive disorders of pregnancy are one of the major causes of maternal and fetal mortality worldwide."

"Reliable screening tests that could identify women at risk for developing preeclampsia are not yet available and the findings of Kusanovic et al. provide the scientific basis for the development of such tests," explained Dr Merialdi.

"The World Health Organization, in collaboration with the Perinatal Research Branch of the NICHD, is presently analyzing samples collected in more than 10,000 pregnancies in eight countries around the world to further validate the results obtained by Dr Romero's scientific team."

Informa - publishers of the Journal of Maternal-Fetal & Neonatal Medicine - has made the full article available for open access on its website and invites visitors to log onto: http://informahealthcare.com/doi/abs/10.3109/14767050902994754

SOURCE Journal of Maternal-Fetal & Neonatal Medicine

Abused toddler suffered seizures

The 22-month-old girl who was admitted to the Tallahassee Memorial Hospital last week with life-threatening injuries is in stable condition, according to the Tallahassee Police Department.It was Hall and the child’s mother that brought the girl to TMH at about 1 p.m. last Thursday. The child was unreponsive and not breathing when she arrived at TMH.

Hall’s arrest papers detail what he told police, the child’s physical injuries and possible causes and how TPD established Hall as the suspect.

According to the arrest report, Hall initially told emergency room medical staff that he had been bathing the child when she fell face first into the water while Hall was getting a towel outside of the bathroom. He said the girl was unresponsive, so he began “hitting the child on the buttocks in order to elicit a response from the child.”

When he could not get her to respond, Hall contacted the girl’s mother, who came home to take the child to the hospital.

Once there, the girl was immediately placed on a ventilator because she was unresponsive and not breathing. The medical director for the Child Protection Team told investigators that the girl was having seizures and had severe bruising to her buttocks. In addition to finding extensive bruising, the girl had a body temperature of 88, which the medical director said indicated that some time had passed before the child was admitted.

Internal bleeding required doctors to give the girl a blood transfusion. Based on the injuries, investigators suspect the injuries occurred earlier in the day than reported.

The medical director told investigators that the seizures were a result of a subdural hematoma that caused the child’s brain to swell.

The doctor also told police said the child’s hematoma was a result of being shaken.

Investigators returned to the home with Hall, where he reenacted what happened with a doll.

Hall said he left the child standing in the tub while he grabbed a towel. After hearing a thud, Hall returned to the bathroom and found the child face down. With the child limp and unresponsive, Hall said he hit her buttocks four to five times, until he heard a noise from the child.

He then put her in bed, at which time the child began flailing her arms. Hall yelled the child’s name to get a response, but he couldn’t. He said he placed the child in bed because he thought the child could sleep it off, according to the affidavit.

He called the child’s mother, who left class at Florida State University to take the girl to the hospital. According to the investigator, Hall had been with the child since 8:45 a.m. that morning, when the mother left for school. The mother told police that Hall and the child wre sleeping when she left.

The Child Protection Team medical director told police that, with the exception of the bruising on the buttocks, the injuries were inconsistent with Hall’s story.

Because Hall had been the only person with the child and because he told police he hit the child on the buttocks, investigators felt they had probable cause to press charges on Hall.

Hall was on probation at the time for burglary and other charges and had been released from jail on Oct. 2.

Epileptic seizures may cause memory lapses

JOHN was probably having a complex partial seizure at the time of the incident, said Dr Nigel Tan, senior consultant neurologist at the National Neuroscience Institute.

"Not every seizure involves a jerking of all four limbs with the person falling to the ground," he told The New Paper.

One of the key features of temporal lobe epilepsy, which John was diagnosed with, is that the sufferer has a lot of complex partial seizures.

Dr Tan noted: "During such a seizure, the person may appear dazed, stare into space, and his hand may move.

"Some people can do simple tasks. They can open doors, and wait for the "green man" before they cross the road.

"They can even get into fights, it's not uncommon. But it would be difficult for them to do complex tasks.

"And after that, they cannot remember what they've done."

This type of seizure can last between 30 seconds and five minutes, Dr Tan added.

A person has epilepsy when he has more than one episode of epileptic seizures.

Possible causes include brain injury, brain infection, brain tumour, stroke and genetic susceptibility.

In about half the cases, a cause cannot be found.

Possible triggers of seizures include forgetting to take medication, stress, lack of sleep, menstruation and an infection like flu.

All about Febrile seizures

As it is “sick” season and I have been seeing many children with fevers, I thought it would be a good time to talk about febrile seizures.

A febrile seizure is defined as a seizure associated with fever in the absence of other known causes of seizures. About 5 percent of children between the ages of six months and six years will have a febrile seizure. That doesn’t sound like a lot of children but seeing that I have a son that had febrile seizures it is that statistic that really doesn’t mean much when you have a child that is part of that statistical equation. Did that make sense? Reassuring a parent that a febrile seizure is benign and will not cause any long-term problems is a “hard sell” while they are watching their child seize. I even felt scared and helpless and I knew what was happening!

When my son had his first febrile seizure at about 18 months of age, I will never forget a nurse saying to me, “Didn’t you give him Tylenol or something, as he has a high fever?” She did not realize that I was a pediatrician, and I tell this story to other parents whose children have febrile seizures, as parents always feel guilty. (What is that with parental guilt?). I hope she did not have realized how guilty that might make a parent feel, for as I already thankfully knew, giving anti-pyretics (like Tylenol or ibuprofen) does not necessarily prevent a child from having a febrile seizure.

We know that febrile seizures may occur in some children with a fever of only 101 degrees, while another child may be running a much higher temperature and not have a seizure. About 30 percent of children that have a first febrile seizure will go on to have another. That is the concern of many parents who have children who experienced a febrile seizure. Parents will try to do anything they can to “ward off” another seizure when their child gets yet another fever.

I was reminded of this again while I was reading an article from the September issue of The Archives of Pediatric and Adolescent Medicine. The study, done in Japan, looked at giving children with a history of febrile seizures, extra doses of fever reducing medications. Despite this, fever-reducing medications did not appear to reduce the incidence of recurrences, even when children received an extra dose of medication.

It seems that children who have febrile seizures may respond differently to fever reducing medications during a febrile event. There seems to be an innate difference in mechanism of fever in those children who have seizures and those that do not. We have known that there is often a history of other family members having febrile seizures, so this may be further evidence or metabolic differences in some individuals with fever?

So, despite a parent’s best effort to lower a fever, especially in a child who has already had a febrile seizure, a seizure may still occur. Take home message: Febrile seizures are scary, but benign and children outgrow these seizures. Never feel guilty, even if you are asked if you gave Tylenol, or something to lower the fever. Looking at this study it probably wouldn’t have changed a thing.

That’s your daily dose, we’ll chat again tomorrow.

Infections caused by food can cause seizures and other health concerns

Fair warning: Put down that salad or medium-rare cheeseburger you're eating, pitch the brie cheese you enjoy with a glass of wine, and clear the chicken and leafy greens from the plate in front of Junior. Because you're not going to want eat or serve any of them after you read what a pair of reports released Thursday by the Center for Foodborne Illness Research & Prevention, have to say:

Long after the painful stomach cramps and bloody diarrhea of a brush with tainted food is over, many of us suffer long-term health effects, mostly unrecognized, that are the result of food-borne pathogens. These lingering effects can be very bad -- as bad as premature death, paralysis, kidney failure and a lifetime of seizures or mental disability. Many researchers believe these persistent health consequences cause more disability, lost productivity, doctor-office visits and hospitalizations than the acute illnesses that follow exposure to a food-borne toxin.

And while high-profile cases of food-borne illness have been caught, publicized and probably brought to an early end in recent years (think spinach, alfalfa sprouts, ground beef, peanut butter and tomatoes), the incidence of poisoning by tainted food is probably vastly understated.

As if all that isn't bad enough, food-borne pathogens cut their widest swath of destruction among the youngest of us. Children under 4 are disproportionately the victims of poisoning by the food-borne pathogens Campylobacter, E coli O157:H7, Listeria monocytogenes and Salmonella. And roughly half of all reported cases of food-borne illness affect kids younger than 15. Because younger kids are smaller, it takes a smaller dose of harmful bacteria to sicken them, and their less-experienced immune systems don't combat food-borne pathogens as effectively as do those of adults. They're more vulnerable, too, because their stomachs don't produce the volume of acids that adult digestive systems do.

In addition to urging public health officials, physicians and researchers to do a better job of understanding and stopping outbreaks of food poisoning, the American Academy of Pediatrics, in a campaign called Make our Food Safe for the Holidays, urges the following steps for consumers:

• Cook meat thoroughly.
• Clean work surfaces, cutting boards and bowls thoroughly after using them on uncooked meats or eggs to prevent contamination of other foods.
• Wash produce before consuming it.
• When buying milk and juice, make sure they're pasteurized, and make sure that products made from milk are made with pasteurized milk.
• Report any food-borne illness to a local health department.

The Food & Drug Administration and the U.S. Department of Agriculture, which have shared responsibility for preventing, detecting, tracking and responding to food-borne illness, are exploring ways to improve their performance in tracking the sources of outbreaks. Meanwhile, here's a list of the chief culprits, the foods in which they're most commonly found and some of the possible long-term consequences of infection, all from the Center for Foodborne Illness Research & Prevention report:

Salmonella. The leading cause of food-borne illness in the United States, salmonella is harbored by foods with animal origins, including beef, poultry, milk and eggs. It causes 16,000 illnesses and 556 deaths per year. It can cause reactive arthritis -- painful and swollen joints mainly in the lower limbs -- from which patients generally recover in two to six months. Eye irritation and painful urination can also be long-term effects.

Campylobacter: Food-borne sources are raw and undercooked poultry, unpasteurized milk and contaminated water. It causes an estimated 2 million acute human illnesses (the vast majority in children under 4) and 124 deaths yearly. Long-term effects can include Guillain-Barre Syndrome, an acquired and sometimes permanent paralysis, reactive arthritis (like Guillain-Barre, an autoimmune reaction) and chronic arthritis.

E. Coli O157:H7: Disproportionately affecting children under 19, E. Coli can taint ground beef and other meats, green leafy vegetables, unpasteurized (or raw) milk and cheeses made from such milk. About 15% of children infected with E. coli O157:H7 develop hemolytic uremic syndrome, which can lead to kidney failure, chronic kidney problems, diabetes, high blood pressure, gallstones, irritable bowel syndrome, narrowed gastro-intestinal passages and neurological problems -- including seizures -- that can take as long four years to resolve.

Listeria monocytogenes: An estimated 2,500 in the U.S. are infected with Listeria each year, and roughly 500 of them die. Listeria monocytogenes taints vegetables grown in contaminated soil or fertilizer, contaminated meat or poultry products. Cold cuts, hot dogs, smoked seafood, raw milk and soft cheeses made from such milk are common sources. In pregnant women -- roughly one-third of those victims -- listeriosis can cause miscarriage, premature death or stillbirth. Surviving fetuses may have mental retardation, hearing loss or brain damage. Adults infected with listeriosis can suffer neurological effects, including seizures and impaired consciousness. About a third experience cardiorespiratory failure.

Scabies and seizures

Scabies is a skin infestation caused by the scabies mite. It often causes intense itchiness.

The scabies mite, or Sarcoptes scabies, is specific to humans and spread by skin-to-skin contact. The mites live just below the skin's surface in an infected person. Generally, with the first episode of scabies, itching and skin lesions begin 1 to 1 1/2 months after infection. With reinfestation, symptoms often begin immediately. Scabies symptoms may continue for weeks or months prior to diagnosis and can continue for years if left untreated.

What are the causes and risks of the condition?

Scabies is caused when a person picks up the mites on his or her skin. Children under the age of 2 years are at high risk for scabies, as are their mothers. Soldiers, nursing home patients, and prison inmates in crowded conditions can also contract scabies readily.

What are the treatments for the condition?

Scabies is treated by applying permethrin cream or lindane lotion to the skin. Other medications include crotamiton and sulfur ointments. Antihistamines, such as diphenhydramine, may be used to relieve itching.

What are the side effects of the treatments?

Infants and children with a prior history of seizures have been known to have a seizure when lindane is used. Some individuals may have an allergic reaction to the lotions and creams used to treat scabies. Diphenhydramine can cause drowsiness or dry mouth.

What happens after treatment for the condition?

In general, symptoms of scabies are quickly relieved. Sometimes the skin irritation can continue. Occasionally, an individual may develop a secondary bacterial infection or skin inflammation that requires treatment. Any new or worsening symptoms should be reported to the healthcare provider.

People who have been in close contact with the infected person, such as family members, baby-sitters, or sexual partners, should also be treated for scabies.

How is the condition monitored?

Any signs of infection, or other new or worsening symptoms, should be reported to the healthcare provider.

Get some information on seizures

Seizures are caused by sudden, large discharges of electrical impulses from brain cells. A seizure may involve a wide variety of symptoms, depending on the part of the brain affected and the type of seizure.
What are the causes and risks of the injury?

Seizures may be caused by many conditions, diseases, injuries, and other factors. These may include conditions such as the following:
_ abnormalities in the blood vessels of the brain
_ atherosclerosis, or hardening of the arteries supplying the brain
_ bleeding into the brain, such as a subarachnoid hemorrhage
_ brain tumors
_ chromosomal abnormalities
_ congenital diseases or conditions
_ high blood pressure
_ pregnancy and problems associated with pregnancy
_ stroke
_ transient ischemic attack, which is also called a mini-stroke

Diseases also can be a factor in seizures, for example:
_ advanced liver disease
_ Alzheimer's disease and other types of dementia
_ epilepsy, or a disease of the nervous system
_ hereditary diseases
_ infections involving the brain, including encephalitis, brain abscess, and bacterial meningitis
_ kidney failure, such as chronic renal failure

Injuries that may cause seizures include the following:
_ choking
_ head injury, such as a motor vehicle accident or sports injury
_ electrical injuries
_ injury during birth or in the uterus
_ poisonous insect bites or stings

Additional factors that may cause seizures include the following:
_ alcohol withdrawal
_ craniotomy, which is brain surgery
_ high fever, especially in young children
_ illegal drugs, such as cocaine
_ lead poisoning
_ overheating
_ withdrawal from some medicines, including those used to treat seizures

What are the treatments for the injury?

When a seizure occurs, the first treatment is to keep the person safe. Anyone giving first aid to a person having a seizure should follow these steps:
_ If possible, move furniture and other sharp objects away from the person.
_ If the victim starts to vomit, roll him or her on his or her side.
_ Protect the person from falling and from hitting his or her head.
_ Stay with the victim and get help from his or her healthcare professional.
_ Try to prevent the victim from hurting him or herself or someone nearby.

When someone has a seizure, it's important that bystanders do not:
_ move the victim, unless he or she is in serious danger
_ place fingers in the victim's mouth
_ restrain the victim
_ slap the victim or try to stop him or her from convulsing
_ try to give rescue breaths or CPR during the seizure

If an infant or a child is having a seizure that seems to be caused by a high fever, it is important to cool the body slowly. Do not immerse the child in a cold bath. Instead, use a sponge or cool compress with lukewarm water.

After a seizure is over, the victim will probably want to sleep. This is OK. He or she will also be somewhat disoriented. The period following a seizure is called the postictal phase.

Contact emergency medical services right away if:
_ seizures are lasting longer than 2 minutes
_ the victim had a seizure while in water
_ the victim has never had a seizure before
_ the victim has other health problems such as diabetes or high blood pressure
_ the victim is having many seizures
_ the victim is ill, has a fever, seems very weak, or is drunk
_ the victim is not able to be awakened between seizures

What are the side effects of the treatments?

Seizures can injure the person and anyone giving first aid. The person can end up with head injuries, cuts, abrasions, scratches, and injured limbs. The person's flailing arms or other body parts can hurt anyone who is helping. Sometimes seizures last so long that the person loses consciousness. And rarely, the person can have brain damage.

What happens after treatment for the injury?

A healthcare professional may prescribe medicine to prevent future seizures. It is also important to control high blood pressure or heart disease. Any new or worsening symptoms should be reported to the healthcare provider.

Epilepsy, a misunderstood condition

Sierra Adams fears the next time she’ll have a seizure, not knowing when or where it could happen.

The 11-year-old Kitchener girl suffered her first big seizure a couple months ago. She was at a neighbour’s house when she fell, cutting her head on the concrete porch.

“I feel mostly scared in case I have another one,” Sierra said. “And I also feel bad for the people there who had to see that.”

Her second intense seizure was at school in the playground, but luckily that time she didn’t hurt herself when she dropped to the ground. When she woke up, she was surrounded by fellow students.

“It’s kind of scary because you don’t know you had one and then you see all kinds of people crying,” Sierra said.

There’s a lot of misunderstanding and fear about the disorder, said Catherine Bodden, executive director of Epilepsy Waterloo-Wellington.

Epilepsy is a brain disorder in which there are disturbances in the normal activity of neurons, causing strange sensations and seizures. Epilepsy has many possible causes, such as abnormal brain development, illness and brain damage. Often the cause is unknown.

To combat the misconceptions, a special broadcast advertising campaign starts this month called End Trash Talk. The television and radio ads, sponsored by the Canadian Epilepsy Alliance, feature youth with the disorder sharing their stories and information.

Most people think of epilepsy as severe seizures that cause a person to collapse, lose consciousness, and have violent shaking of the whole body, Bodden said. But those tonic-clonic seizures, previously known as grand mal, are not the most common.

Tonic seizures cause muscles to stiffen, while clonic seizures cause repeated jerking of muscles. People with tonic-clonic seizures experience both.

There are many different types of seizures ranging in severity.

“Every individual has a different type of seizure,” Bodden said.

Bodden herself had complex partial seizures, short-lived episodes that basically cause her to zone out temporarily.

Her epilepsy was caused by a long fall in a barn when she was a teenager. Scar tissue from the injury caused her as many as 30 seizures a day, and her life was in jeopardy. Surgery in 1995 removed the affected parts of her brain and dramatically reduced the seizures.

Epilepsy is not only tough on the people with the disorder.

“The family members actually have a harder time dealing with it,” Bodden said.

The organization gets up to 10 calls a day from people looking for information and support, both people with the disorder and family members. Many people with epilepsy face discrimination at work.

“We have a lot of people fired from their jobs,” Bodden said.

For that reason, many people keep their epilepsy secret. Often that silence extends to friends and acquaintances because many people know little about the disorder and are even afraid of what may happen and how they’ll deal with a seizure.

That apprehension is certainly an issue encountered by Ashley Johns, who had her first seizure in Grade 10.

“People don’t really understand,” the 22-year-old said.

Although Johns, too, knew little about the disorder until she was diagnosed after suffering a second severe seizure in just a couple months.

Both lasted five minutes. The first was frightening for Johns, who woke up in the middle of the night and went to the bathroom to get a drink of water.

“I just remember looking at myself in the mirror and seeing nothing. I was really confused,” Johns said.

Her father caught her before her head hit the floor, and she was taken by ambulance to hospital.

Five years passed before finding the right combination of medicine to control her seizures — not an unusual length, Bodden said.

Now a fourth-year student at Wilfrid Laurier University, Johns has to be careful to look after herself. She’s prone to seizures — occasionally big ones and also smaller ones where she’s unresponsive for a few minutes or seconds — when she’s tired, stressed or not eating well.

“I have to know my limits and be able to take care of myself,” Johns said.

The main thing she was concerned about when she was diagnosed was not being able to drive. A person’s licence is suspended for a year after suffering a debilitating seizure.

Johns had her licence for just four months before having a big seizure in March.

“It’s frustrating to have to rely on people to get around,” she said.

Sierra has to look after herself too, wearing a hat and sunglasses outdoors on bright days because sun seems to trigger seizures for her.

She was diagnosed at nine, after experiencing seizures where she would wave her arms in front of her face. Myoclonic seizures are brief jerks of muscles.

“We went to this doctor and he said it was epilepsy,” said the Grade 6 student who now takes medicine morning and night.

“I didn’t even know what that word meant, so I had to ask them.”

Find out more about the neurological disorder at www.epilepsymatters.com, and the awareness campaign at www.endtrashtalk.com.

By Johanna Weidner, Record staff

jweidner@therecord.com

Epilepsy is "rarely" fatal but it still can take away loved ones

Doug and Julie Hutchison knew that for their daughter, living with epilepsy would never be an easy thing. But the family's neurologists, doctors and research never explained that an epileptic seizure could result in the Chelsea's death.
"We tried to do everything in our power to find out why she was having seizures," said Julie Hutchison, Chelsea's mother. "Never in our wildest imagination did we think we would lose her."

Chelsea was diagnosed with epilepsy shortly after her 11th birthday. For nearly five years, Chelsea experienced two or three epileptic seizures every year. Early this year, things got much worse. The number of seizures increased dramatically.

Then in April, for a reason that is still unexplained, Chelsea died during a seizure. She was just 16 and a half years old.

The family's grief counselor, Linda Coughlin Brooks, can empathize; her daughter, Carrie Ann, died with the same unexplained circumstances as Chelsea did. Carrie Ann died 12 years ago this December at just 17 years old.

"I felt totally blindsided. I had no idea," said Coughlin Brooks, a counselor at The Grief Journey in Greenwood Village. "It kind of set me on a path to learn more about it and why I hadn't heard about it. It was totally foreign to me. I felt betrayed that you could die from it. I believed epilepsy was something you lived with, not something you died from."

After researching Carrie Ann's death and discussing possible causes with Arapahoe County Coroner Dr. Mike Doberson, Coughlin Brooks discovered a syndrome called SUDEP, or Sudden Unexplained / Unexpected Death in Epilepsy.

"Typically our bodies don't read the textbooks," said Doberson. "They don't always follow the rules. It's up to us to try and come up with answers."

Earlier this year, after a collaborative study about SUDEP in Colorado, Hutchison says more than a dozen unexplained deaths were pinpointed to unexplained death in epilepsy.

"Very quickly what we found were that the major at risk factors included being a male, being through a recent stressful event or not taking medications appropriately, to the point where anti-seizure medications are at a sub therapeutic level," said Doberson.

While research cannot bring Chelsea or Carrie Ann back, their parents hope that it will inform parents or family members to those with epilepsy of the deadly circumstances that could come from a seizure.

"We're so strongly committed to doing something on her behalf because she was such an extraordinary girl," said Doug Hutchison, Chelsea's father.

To make a donation to SUDEP awareness, or to simply get connected to a SUDEP community in the Metro Area, click onto http://www.griefandgrowth.com/

Anti-epileptic treatment was launched in the UK

Eisai (London; Managing Director Nick Burgin), today announced that the novel once daily anti-epileptic Zebinix(R) (eslicarbazepine acetate) was launched in the UK as adjunctive therapy in adults with partial-onset seizures, with or without secondary generalisation.

Epilepsy is one of the most common neurological diseases, affecting approximately 1 in 100 people - and the successful treatment of partial-onset seizures (the most common type of epilepsy) remains a challenge. Up to 40% of patients with partial seizures do not achieve seizure control with current anti-epileptics (1).

Developed from the current 'gold standard' treatment carbamazepine (launched in 1965), Zebinix (eslicarbazepine acetate) offers patients improved seizure control with a favourable safety profile. Patients also report improvements in health-related quality of life measures such as 'seizure worry' and 'cognitive function' as well as improvement in the MADRS (Montgomery-Asberg Depression Rating Scale) depressive symptoms scale. Depression is often reported by patients with poorly controlled epilepsy.

"Epilepsy continues to place a huge burden on individuals with the condition across the UK. Unfortunately despite advances in treatment and investigation many such patients continue to have seizures. Continued seizures bring significant risk of poor quality of life, reduced employment and the development of mental illness such as depression or anxiety. New drugs offer potential hope and choice for these patients. The launch of eslicarbazepine acetate should offer a new choice for patients and clinicians in reducing the burden of epilepsy," said Mike Kerr, Professor of learning disabilities at Cardiff University, who has a special interest in the treatment and psychological impact of epilepsy.

The efficacy, safety and tolerability of eslicarbazepine acetate (ESL) has been demonstrated in three phase III double-blind, randomised placebo-controlled trials in 1,049 adult patients with partial onset seizures (2-4). For each randomised control trial patients were given the option of entering a one year open label extension study.

In these studies eslicarbazepine acetate demonstrated significant and sustained reductions in seizure frequency and significant increases in responder rates. These studies also demonstrated that patients continued to take eslicarbazepine acetate with retention rates ranging from 68-79% at one year (5-7). The median daily dose throughout this one year treatment was 800mg. Treatment-emergent adverse events affecting >10% of patients in the pivotal studies were dizziness, headache and somnolence. (8)

Eslicarbazepine acetate is also novel in that it can be given as a true one tablet once a day regimen at its median daily dose as defined in clinical trials as 800mg (5-7).

Eslicarbazepine acetate is a voltage gated sodium channel blocker that has a higher affinity for the inactivated state of the channel compared with the resting state. This suggests an enhanced inhibitory selectivity for rapidly firing neurons over those displaying normal activity. (9) Eslicarbazepine acetate has been developed to avoid formation of the epoxide metabolite which has been associated with neurological side effects.

Nick Burgin, Managing Director Eisai in the UK, said "The effective treatment of patients with partial-onset seizures remains a major challenge for clinicians as well as for patients with epilepsy and their families. We are delighted to be bringing patients such a promising new treatment. The launch of eslicarbazepine acetate will further help us to fulfil our Corporate mission of 'human health care' (hhc) by providing innovative, high quality medicines to meet the ever changing unmet medical needs of patients and their families as well as health care professionals."

Notes to Editors

Zebinix(R) is the EU trade name for eslicarbazepine acetate.

Zebinix(R) is under license from Bial.

Further information can be found at: http://emc.medicines.org.uk/medicine/22376/SPC/Zebinix+800mg+tablets/

About epilepsy, partial-onset seizures and their treatment

Epilepsy is one of the most common neurological diseases, affecting approximately 1 in 100 people.

Epilepsy is a chronic neurological disease characterised by abnormal discharges of neuronal activity causing seizures. Clinically, these manifest as convulsions or jerking of muscles. Depending on the seizure type, seizures may be limited to one part of the body, or may be generalised to involve the whole body. Patients may also experience abnormal sensations, altered behaviour or altered consciousness. Epilepsy is a disorder with many possible causes. Often the cause of epilepsy is unknown. However, anything that disturbs the normal pattern of neuron activity - from illness to brain damage to abnormal brain development, can lead to seizures.

Epilepsy is characterised by abnormal firing of impulses from nerve cells in the brain. In partial-onset seizures, these bursts of electrical activity are initially focused in specific areas of the brain, but may become more generalised; the symptoms vary according to the affected areas. Nerve impulses are triggered via voltage-gated sodium channels in the nerve cell membrane.

Treatment of partial-onset seizures, the most common type of epilepsy, presents a constant challenge - up to 40% of patients with partial-onset seizures do not achieve seizure control with current anti-epileptic drugs.(1)

Furthermore, adverse events, such as lightheadedness (dizziness), somnolence (sleepiness), and cognitive slowing, are highly prevalent with existing anti-epileptic agents. Hence, there is a need for new anti-epileptic agents that offer effective reduction in seizure frequency combined with a favourable safety profile.

About Eslicarbazepine Acetate

Eslicarbazepine acetate is indicated as adjunctive therapy in adults with partial-onset seizures with or without secondary generalisation. Eslicarbazepine acetate (ESL) is a novel voltage-gated sodium channel blocker. It specifically targets the inactivated state of the ion channel, preventing its return to the active state, and thereby reduces repetitive neuronal firing. The efficacy of ESL has been demonstrated in 3 randomised, placebo controlled studies in 1049 patients with refractory partial onset seizures. ESL also significantly improved patient's health related quality of life (HRQoL) as measured by the QOLIE-31 score during a one year open label extension of the above 3 studies. ESL is given orally once daily. ESL can be used as an add-on to carbamazepine (one of the most commonly utilized therapies for partial onset seizures) or with other anti-epileptics.

Clinical data

The EU approval was based on data from phase II and three phase III, double-blind, randomised, placebo-controlled, multi-centre trials involving 1,049 patients from 23 countries. Patients had a history of at least four partial seizures per month despite treatment with up to three concomitant anti-epileptic drugs.

During the trials, patients were randomised to various dosages of ESL or placebo and after a 2-week titration period, were assessed over a 12 week maintenance period, with continued follow-up over a one year open-label period.

Efficacy

Over the 12 week maintenance period, ESL 800mg and 1200mg once-daily reduced seizure frequency by over one third,(8) and was significantly more effective than placebo. This significant decrease in seizure frequency was sustained over the one-year open label treatment period and was consistent regardless of baseline therapy.

Tolerability

The safety profile of ESL was favourable. The majority of treatment related adverse events were mild or moderate in intensity. After 6 weeks of treatment, there were no observed differences in the incidence of side effects between patients treated with ESL and the placebo group. Treatment-emergent adverse events affecting >10% of patients in the pivotal studies were dizziness, headache and somnolence.(8)

Quality of life and depressive symptoms

The effect of ESL on quality of life was assessed using the Quality of Life Epilepsy Inventory-31 (QOLIE-31) scale. There was a statistically and clinically significant improvement from baseline during long-term open-label therapy, including a mean relative improvement in overall quality of life (p<0.001>

Improvement in depressive symptoms was also measured using the Montgomery Asberg Depression Rating Scale (MADRS). During long-term, open-label therapy, ESL demonstrated a statistically significant improvement from baseline in the overall MADRS score (p<0.0001)>

These data were presented at the 8th European Congress on Epileptology held in Berlin last September 2008 and at the Annual Meeting of the American Epilepsy Society (AES) in December 2008, Seattle, WA, USA.(10-12)

License Agreement

Eisai Europe Limited (Headquarters: London, President & CEO: Folker Kindl), a European subsidiary of Eisai Co., Ltd. (Headquarters: Tokyo, President & CEO: Haruo Naito), announced in February this year that it had entered into a license and co-promotion agreement with Bial - Portela & C(a), S.A. (Headquarters: São. Mamede do Coronado, Portugal, CEO: Luís Portela, "Bial"), which gave Eisai Europe Limited. rights to sell Bial's anti-epileptic drug Zebinix(R) (eslicarbazepine acetate) in Europe.

About Eisai

Eisai is one of the world's leading R&D-based pharmaceutical companies, that has defined its corporate mission as "giving first thought to patients and their families and to increasing the benefits health care provides," which we call human health care (hhc).

   
   Eisai concentrates its R&D activities in three key areas

   - Integrative Neuroscience: Alzheimer's disease, multiple
     sclerosis, neuropathic pain, epilepsy, depression, etc

   - Integrative Oncology: Anticancer therapies; tumour
     regression, tumour suppression, antibodies, etc and Supportive
     cancer therapies; pain relief, nausea, etc

   - Vascular/Immunological Reaction: Acute coronary syndrome,
     atherothrombotic disease, sepsis, rheumatoid arthritis, psoriasis,
     Crohn's disease, etc

With operations in the U.S., Asia, Europe and its domestic home market of Japan, we employ more than 10,000 people worldwide, and reported consolidated sales of over GBP3.53 billion in FY2007, an increase of 8.9% year on year. In Europe, Eisai undertakes sales and marketing operations in over 20 markets, including the United Kingdom, France, Germany, Italy, Spain, Switzerland, Sweden, Ireland, Austria, Denmark, Finland, Norway, Portugal, Iceland, Czech Republic, Hungary, and Slovakia.

For further information please visit our web site http://www.eisai.co.jp

About Bial

Founded in 1924, Bial is an international pharmaceutical group with products available in over 30 countries throughout four continents. BIAL is the largest Portuguese pharmaceutical company and is based in S. Mamede do Coronado, Portugal.

It is the partner of choice for many companies, having a strong presence in the Iberian peninsula as well as in over 10 countries in Latin America and in around 20 French or Portuguese speaking African countries.

Bial is strongly committed to therapeutic innovation investing approximately 20% of its turnover in research and development every year. Key research areas for BIAL are the central nervous system, the cardiovascular system and allergology. Bial currently has several other innovative programs under development, which the company expects to bring to the market within the next years, thereby strengthening its position throughout Europe.

Further information about Bial can be found at http://www.bial.com

References:

1. 1. Brodie MJ. Management strategies for refractory localization-related seizures. Epilepsia 2001; 42(Suppl 3):27-30.

2. Elger C, Halász P, Maia J et al. Efficacy and safety of eslicarbazepine acetate as adjunctive treatment in adults with refractory partial-onset seizures: A randomized, double-blind, placebo-controlled, parallel-group phase III study. Epilepsia 2009; 50(3):454-463.

3. Hufnagel A, Ben-Menachem E, Gabbai A et al. Efficacy and safety of eslicarbazepine acetate as add-on treatment in adults with refractory partial-onset seizures: BIA-2093-302 Study. Poster presented at the 8th European Congress on Epileptology, 21-25 September 2008, Berlin, Germany.

4. Lopes-Lima J, Gil-Nagel A, Maia J et al. Efficacy and safety of eslicarbazepine acetate as add-on treatment in adults with refractory partial-onset seizures: BIA-2093-303 Study. Poster presented at the 8th European Congress on Epileptology, 21-25 September 2008, Berlin, Germany.

5. Halász P, Elger C, Guekht A et al. Long-Term Treatment of Partial Epilepsy with Eslicarbazepine Acetate (ESL): Results of a One-Year Open-Label Extension to Study BIA-2093-301. Poster presented at the American Epilepsy Society (AES) Congress, 5-9 December 2008, Seattle, WA, USA.

6. Gabbai AA, Ben-Menachem E, Maia J et al. Long-Term Treatment of Partial Epilepsy with Eslicarbazepine Acetate (ESL): Results of a One-Year Open-Label Extension to Study BIA-2093-302. Poster presented at the American Epilepsy Society (AES) Congress, 5-9 December 2008, Seattle, WA, USA.

7. Lopes-Lima J, Gil-Nagel A, Maia J et al. Long-Term Treatment of Partial Epilepsy with Eslicarbazepine Acetate (ESL): Results of a One-Year Open-Label Extension to Study BIA-2093-303. Poster presented at the American Epilepsy Society (AES) Congress, 5-9 December 2008, Seattle, WA, USA

8. Elger C, French J, Halasz P. et al. Evaluation of Eslicarbazepine Acetate as Add-On Treatment in Patients with Partial-Onset Seizures: Pooled Analysis of Three Double-Blind Phase III Clinical Studies. Poster presented at the American Epilepsy Society (AES) Congress, 5-9 December 2008, Seattle, WA, USA.

9. Almeida L and Soares-da-Silva P. Eslicarbazepine Acetate (BIA 2-093). Neurotherapeutics 2007;(4):88-96,

10. Cramer J, Elger C, Halász P et al. An Evaluation of Quality of Life and Depressive Symptoms During Long-Term Treatment with Eslicarbazepine Acetate: BIA-2093-301 Study.QOL 301. Poster presented at the American Epilepsy Society (AES) Congress, 5-9 December 2008, Seattle, WA, USA.

11. Soares-da-Silva P, Martins-da-Silva A, Gabbai AA et al. An Evaluation of Quality of Life and Depressive Symptoms During Long-Term Treatment with Eslicarbazepine Acetate: BIA-2093-302 Study. Poster presented at the American Epilepsy Society (AES) Congress, 5-9 December 2008, Seattle, WA, USA.

12. Pereira H, Lopes-Lima J, Gil-Nagel A et al. An Evaluation of Quality of Life and Depressive Symptoms During Long-Term Treatment with Eslicarbazepine Acetate: BIA-2093-303 Study. Poster presented at the American Epilepsy Society (AES) Congress, 5-9 December 2008, Seattle, WA, USA.

What you need to know about H1N1

Getting infected with the H1N1 virus that causes swine flu is a real possibility since the virus is continuing to spread and there's still not enough vaccine to go around. Being informed, though, can help you reduce your risk. Here's what you need to know to protect yourself and your family.

1. Pregnant women need one shot; young kids, two. Initial results from clinical trials show that pregnant women mount a healthy immune response after just one dose of the vaccine. They do, though, need the injectable version—which contains a dead virus—rather than the nasal spray, which contains a live but weakened virus. Other adults and children ages 10 and over also need only one dose for full immunity. (They can have either the shot or nasal spray Children 6 months through 9 years, however, need two doses—spaced about a month apart—in order to mount a strong enough immune response if exposed to the virus. And kids under age 2, like pregnant women, should have only the injectable vaccine.

2. Hand sanitizer works better than soap when it comes to the flu virus. While you should still wash your hands to get the grime off or after using the bathroom, hand sanitizer is the cleanser of choice when trying to keep your hands germ free for hours. The Food and Drug Administration recommends products that consist of at least 60 percent alcohol. Look past the "Kills 99.9 percent of germs" on the front of the package and instead check the "drug facts" label on the back. It should list the active ingredient as some form of alcohol and the percent. (The drugstore brand on my desk says "ethyl alcohol 62%".) And use the sanitizer correctly: Make sure your hands are clean and then apply a palmful of the product, rubbing vigorously for 20 to 30 seconds under your nails and jewelry, up to your wrists and on the backs of your hands. Interestingly, hand sanitizer leaves skin less dry than soap because most products contain emollients.

3. Many swine flu remedies are too good to be true. The FDA recently warned against buying non-FDA-approved swine flu products on the Internet and in health food stores. These include bogus versions of the antiviral drug Tamiflu. Real Tamiflu is available only by prescription. The FDA analyzed one "Tamiflu" product ordered online and found that it contained not the antiviral drug but talc and acetaminophen. Other bogus products include shampoos or dietary supplements purporting to protect against the flu virus. Here's a complete listing and other bogus swine flu remedies to avoid.

4. Certain warning signs warrant an emergency room visit. The American College of Emergency Physicians says that most folks with flu like symptoms (fever, sore throat, chills, cough, and fatigue) don't need to head to the emergency room—or even to the doctor. But people should seek out emergency care immediately if they experience the following symptoms: difficulty breathing or chest pain; rapid breathing (over 24 breaths per minute); purple or blue discoloration of the lips; inability to keep liquids down; signs of dehydration (headache, extreme thirst, dizziness, or decreased urination); confusion; or convulsions or seizures. Pregnant women, those over 65, and those with certain health conditions (such as obesity, organ transplant, diabetes, and lung problems) also should seek medical attention from their doctor or a walk-in clinic, even if they have mild symptoms.

[More on dealing with the swine flu threat during pregnancy]

5. The vaccine is as safe as the seasonal flu vaccine. Anthony Fauci, who's heading the H1N1 vaccine clinical trials for the National Institutes of Health, said Tuesday that people have no reason to fear the vaccine. All evidence collected so far in the trials suggests that it poses no health risks—not in children, pregnant women, or older folks. There have been some reports of adverse reactions, but they've been mild, like swelling or pain at the injection site.

6. High-risk individuals—like pregnant women and babies—should possibly avoid travel. Since the flu epidemic has yet to reach its peak, those at higher risk of developing severe complications from an H1N1 infection should consider putting off air travel if they haven't been vaccinated, the Centers for Disease Control and Prevention says. That's because many folks can pick up the infection from a crowded airport or airplane. If you're in a high-risk category and must travel, talk to your doctor about whether to take along antiviral medications just in case you get sick and can't get quick medical care.

7. If you've already got a fever, definitely stay home. Traveling with a fever is a no-no, since that's when you're most contagious. You also don't want to put extra stress on your body when it's calling for you to crawl into bed. While U.S. airports don't have temperature sensors, foreign airports often do. If you set off the sensor while abroad, you could be forced into quarantine until your illness runs its course.

Deadly EEE virus can affect white-tail deers, horses and humans

The immediate threat is over, but a Middleton vet is urging horse owners to remain cautiously alert for a rare and deadly virus next spring.

Thirteen horses have now died in Nova Scotia as a result of Eastern Equine Encephalitis (EEE). EEE, or sleeping sickness, is a virus that affects the brains of horses and humans. So far this year no horses in Annapolis County have been infected.

Deer hunters in Lunenburg County were asked to help gauge the extent of the virus by obtaining blood samples from deer before Nov. 4. Because the same mosquitoes that attack white-tailed deer also attack horses, it’s hoped that blood samples can help determine the scope of the affected area.

Hunters are being provided a special package to collect the blood samples that are returned to drop-off stations where the samples are screened for EEE by a special field teams of members of the Public Health Agency of Canada. This monitoring program may help identify the extent of the infection in Lunenburg.

Dr. Dave MacHattie, a large animal veterinarian at Middleton Veterinary Services, said that while the number of confirmed EEE cases did sharply rise this year, he doesn’t see any reason to begin immunizing any new horses this season.

“As the weather gets colder and mosquitoes die down for the winter, there’s no point in vaccinating any new horses,” he said. “But in the spring we’ll proceed cautiously with a vaccination program.”

The EEE outbreak remained contained on the South Shore, and no horses were affected in other areas. Horses here that have received the initial dose will be given the second dose. In the spring he’ll proceed cautiously with an immunization program, he added.

These cases are the first confirmed EEE in Nova Scotia, but MacHattie says he’s treated horses with similar illnesses over the past 10 years. These cases are rare and were never confirmed as EEE. This is the first time veterinarians have been to confirm the diagnosis through tests.

MacHattie estimates that about two horses each year are typically affected with similar symptoms. However given such a high incidence rate this year, something has changed and should be monitored closely next season.

The outbreaks of EEE are typically sporadic and unpredictable in the normal course of nature. The disease is believed to be spread between nonmigratory birds by a species of mosquito that generally doesn’t bite horses, or humans, he said. No one knows what causes these mosquitoes to begin biting horses, but every now and then it happens and causes an EEE outbreak.

While EEE is carried by birds and transmitted by mosquitoes, affected birds don't show signs of infection. Unlike infections of West Nile Virus, EEE won't give horse owners a warning by killing birds first.

Infected horses will begin showing signs of being ill about five to seven days after being bitten by an affected mosquito. Symptoms of EEE include sleepiness, or depression; affected horses can have difficulty walking and seem unsteady or wobbly on their feet; seizures, muscle twitches, and pressing their heads against solid objects are also possible signs of infection.

This virus is not contagious between horses. Some stables have required that horses undertake a quarantine period after travelling to an affected area, but this is not a necessary measure, Dr MacHattie added.

A seizure disorder can stop a toddler's heart

A couple have spoken about a medical condition which can stop their toddler daughter's heart every time she cries.

Tianne Lewis, two, from Wrexham, suffers from reflex anoxic seizures (RAS), which start when she is shocked by something, or bursts into tears.

Andy McHugh and his fiancée Ceri Lewis feared they might lose their daughter after one terrifying episode.

Mr McHugh said: "Anything that causes her to cry - falling down to bath water being too hot - can stop her heart."

The condition was discovered when Tianna was about 18 months old.

Although the family have been told there are no known fatalities, Mr McHugh said doctors were once concerned Tianna might not survive.

As soon as she starts to cry we head for the shower or the tap, and it goes straight to her face... I know it sounds awful, but we have to act quickly and it shocks her into taking a breath Andy McHugh, Tianna's father

He said: "She had a seizure and this led to her fitting, and it went on for about two hours.

"The doctors told us that if she didn't come around within 10 or 15 minutes, she might not make it."

Mr McHugh, a car salesman, added: "When she cries, she suffers seizures.

"Whereas a normal baby will cry and take a breath, she cries and her heart stops.

"We basically have to shock her out of it before it happens.

"As soon as she starts to cry we head for the shower or the tap, and it goes straight to her face.

"I know it sounds awful, but we have to act quickly and it shocks her into taking a breath."

Mother Ceri, a hotel receptionist, remembers the moment her daughter first had a seizure.

'Deathly grey'

She said: "I picked her up out of her high chair and put her on the floor and she cried for seconds and then she looked like she had died.

"She went a deathly grey, her lips and around her eyes were blue and her eyes rolled back in her head.

"When she has the fits she stops breathing and looks dead because she stiffens up and her back arches.

"I thought she was dead and I was hysterical."

On that occasion, Mr McHugh rushed home from work and gave his daughter mouth-to-mouth resuscitation - after which she took a "massive breath".

The couple are slowly getting used to their daughter's condition, which they hope she will grow out of.

The pair have been supported by the Syncope Trust And Reflex Anoxic Seizures charity (Stars).

Mr McHugh now hopes to raise awareness of the condition and to raise money for the charity with friends by cycling around Wales next year.

Stars founder and chief executive Trudie Lobban said the condition could be as common as epilepsy, but it is thought it is being misdiagnosed.

She added: "Stars is working to support to increase awareness of RAS and to ensure children are correctly diagnosed.

"Unfortunately, statistics have shown that up to 39% of children diagnosed with epilepsy are actually misdiagnosed and many of them will be suffering with RAS."

Man loses son to rare epileptic seizure

ONE HELPING of agony, Mekete Gebrehanna saw coming. The second portion, he wasn’t prepared for. Gebrehanna left his home in Ethiopia to earn a degree in environmental science in Guyana. Afterward, his wife and two sons joined him for their new life in Truro, where he began studying for a master’s degree at the Nova Scotia Agricultural College in Bible Hill. They loved living in Canada. "The people here are so kind, they humble me," Gebrehanna said, reflecting on the generosity his new neighbours showed his family. His family together, his education almost complete, Gebrehanna was happy. But a few months of bliss came to an end with a visit to the doctor, when his wife Senait was diagnosed with breast cancer. Two years ago, at the age of 44 and three years after arriving in Canada, she died. Shattered, Gebrehanna devoted himself to his sons Fikreab, then 10, and Redeat, 17, who had suffered from epilepsy since he was a toddler. "The maximum that he would get a seizure in a year would be four or five," Gebrehanna said of his oldest. "It was controlled by only one kind of medicine, called phenobarbital. When he came here, he continued to have seizures, and more often. I took him to the doctor and he got referred to quite a few specialists, he even got an MRI and EEG. They say the temporal lobe has a lesion, that’s what they expect causes a seizure. "Eventually, on one day he had nine seizures, in a day, and that was so alarming. He was delusional. Also, some of the medicine . . . had to be corrected, he was off balance some times. He was getting good attention, as far as medical attention was concerned." Gebrehanna had completed all the classes for his master’s, and the bulk of the work on his thesis. But he spent the days after Senait’s death working in the woods, unable to concentrate on his studies. He feared that if Redeat’s seizures worsened, his son’s mental capacity could be affected. "But one day I was working in the woods, and when I come out, they told me he had a seizure at school," Gebrehanna said. "I went straight to the hospital, they put him in emergency. That very day, they say he is OK to go home. They usually do that, because when the seizure is over, they send you back. I bring him home, we have dinner together, and he was complaining ‘How long am I going to stay with this kind of disease? Why can’t they figure it out?’ " In keeping with the culture of their homeland, father and sons were sleeping on the floor as part of the grieving process. To help his younger boy go to sleep, Gebrehanna would lie with him every night, rubbing his back and caressing his head. But after Redeat suffered the seizure at school, he claimed the spot next to his father that night. It had been 19 days since Senait died. "Next morning I want to wake him up. He’s not there. Long gone," Gebrehanna said, tears streaming down his cheeks. "When I touch him, it was so stiff, I thought he had a seizure and I flip him over right away. His face was covered with blood, and the pillow was covered with blood. I know how to give CPR, and I try to give him mouth-to-mouth. After I remove my mouth, the foam gets into my mouth, the bloody foam gets into my mouth. "In the meantime, I call the neighbours, also call 911. I knew he was gone. He was 19. I knew my wife was going to die, but I could never have imagined I could lose my son, too." More than 10,000 people in Nova Scotia suffer from epilepsy, but SUDEP (Sudden Unexplained Death in Epilepsy Patients) is rare. "People don’t generally die from epilepsy," said Iris Elliot of the Epilepsy Association of Nova Scotia. "Even the medical fraternity don’t know exactly what causes it. We know what makes the seizures happen, the electricity in the brain goes haywire, but as to why that happens to some people and not others, who knows?" Elliot has come to know Gebrehanna and admire his resilience. "He’s a man with a lot of faith," she said. "Also, he’s got the younger son to think about, and he has to keep going because of him." Unable to cope with going back to the agricultural college, Gebrehanna moved to the outskirts of Halifax, where he hopes to become a taxi driver so he can support Fikreab, now 12, and be home to greet him when he arrives from school. "He’s a great little kid," the father said. "Had it not been for him, I don’t know if . . ." Many people in Gebrehanna’s circumstances wouldn’t be thinking of others, but he began to ponder how he could help make sure other families do not suffer as his has. So, to raise funds to support epileptic people and their families and to raise awareness of SUDEP, Gebrehanna will host For Redeat . . ., an Ethiopian buffet and cultural showcase, in Halifax on Nov. 8. "I have been humbled by the Canadians, and not only me, there are many Ethiopians humbled by Canadians, make Canada their home," Gebrehanna said. "I ask them if they can help me if I plan such a thing. "There are 35 people preparing food for the event, there will be 17 different types of food and a silent auction of many items, all handmade from Ethiopia." And, Gebrehanna vows, he will finish his master’s degree. "I don’t have any excuse, I want to finish my school," he said. "It’s just — I can’t concentrate. I can read and read any other thing, but not my school. My wife, she would love to see me finish my school. "My happiness was my family. I love my family. My happiest place in my life was my family."

A Calcium imbalance can create havoc for your health

Calcium, a mineral component of blood, that assists in heartbeat regulation, nerve transmission, muscles contraction and bone and teeth formation. Calcium must be balanced in order to be healthy. An excess of calcium (hypercalcemia) or too little calcium (hypocalcemia) can cause life-threatening medical problems. An imbalance of calcium affects the membranes of all body cells, muscles, bones, parathyroid glands and parathyroid hormones (these regulate calcium absorption and utilization).

Causes of Calcium Imbalance


The causes of inadequate calcium include: underactive parathyroid glands from disease or damage during neck surgery, decreased intake of calcium and vitamin D, malabsorption from the gastrointestinal tract (usually for unknown reasons), severe burns or infections, pancreatitis, kidney failure, and decreased blood levels of magnesium.
The causes of excessive calcium include: overactive parathyroid glands, multiple fractures, prolonged bed rest, multiple myeloma, and tumors, benign or malignant, that destroy bone.

Signs and Symptoms of Calcium Imbalance


Symptoms of inadequate calcium: muscle spasms, twitching, cramps, numbness, tingling in the arms, legs, hands and feet, seizures, irregular heartbeat, high blood pressure.
Symptoms of excessive calcium: lethargy, appetite loss, vomiting, diarrhea, dehydration, thirst irregular heartbeat, blood , depression, delirium, confusion, seizures and coma (worst cases only).