The Known Causes of Seizures

Epilepsy and canines: what to look for

2011-01-01T23:07:00.001-06:00

Here is a great article about Epilepsy and canines! It is a MUST read!

Unfortunately for dogs, epilepsy can either be inherited or it may even be caused by the preservatives in the food that they eat. There are certain breeds that are more likely to experience this condition than others. There are three different types that may possibly present in a canine. Most animals affected by canine epilepsy can be treated by a change in their diet and with proper medication and monitoring.

Beagles, Dachshunds, German Shepherds, Keeshonds and Belgian Tervurens are all breeds with a proven genetic predisposition for seizures. The English Springer Spaniel has also been included in the group frequently. The condition is actually very common for dogs even when it is not a genetically inherited trait and it may just develop over the course of their life. The condition has also been linked to problems related to the thyroid gland and should be considered at initial onset.

A change in diet may be the first course of treatment for many dogs because the preservatives in the food can be the main cause of many seizures.

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For particular breeds that are at high risk, it is wise to feed with only food that has no preservatives from the beginning and eliminate the possible chance of the problem developing. Be sure to read the labels carefully and preservative information will be indicated on the packaging.

The three various type of epilepsy that may occur with canines are reactive, secondary and primary. Seizures labeled as reactive involve the metabolic system. These are always related to either low blood sugar, kidney failure or liver failure.

Secondary refers to symptomatic and is labeled this way because the cause is actually known. The problem is most likely related to stroke or tumors located within the brain. Many times these types of seizures will occur after a particular trauma.

Primary or idiopathic seizures are labeled as such due to having no known cause. This diagnosis is reached when all other probable conditions have been completely eliminated. These are likely to begin in dogs that are in the age group of one and three.

There are different types of seizures as well and they last for different periods of times and have different intensity. The petit mal is mild and may result in brief periods of staring. A grand mal is considered moderate and can last for up to three minutes with a possible loss of consciousness. Status epilepticus or cluster seizures may be hard to distinguish from one another and can last for long periods of time and repeat with the animal losing consciousness; they can be life threatening.

Many medications are available for the treatment of seizures including Phenobarbital, potassium bromide and Valium. When Phenobarbital is being used as the medication of choice, it is necessary to monitor the liver functions closely to avoid liver damage. Should the liver become damaged, the pet will be changed to a medication of potassium bromide for continued treatment. Valium is usually reserved for status epilepticus and cluster seizures and is given either by injection, rectally or orally. Over the counter medications can be used to comfort the animal after seizures to assist with faster recover time; consult a veterinarian about which types are best to use for treatment of canine epilepsy for a particular pet.

Article Source: http://lifestyle.ezinemark.com/things-to-be-aware-of-about-canine-epilepsy-31d606d4cca.html

What to do when someone has seizures?

2010-06-27T14:18:00.001-05:00

Witnessing a seizure can be scary and it is important that you know what to do in case of the event. First, a seizure is normally caused by abnormal electrical discharges in the brain or by fainting (decrease in blood flow to the brain). The symptoms vary depending on the part of the brain involved, but often include unusual sensations, uncontrollable muscle spasms and loss of consciousness. Most people experience a blackout and wake up on the ground with no recollection of the occurrence.

Often times a seizure has a warning sign called an aura. Aura symptoms include blurriness or vision loss, racing thoughts, weird stomach sensations, tingling, fear or panic, dizziness, headache, lightheadedness, nausea and numbness. But other times seizures come without warning and it happens suddenly. The seizure itself is a series of convulsions usually seen as sudden movements and blacking out. A seizure has physical symptoms and sensory feelings: blackout, sensory loss, confusion, out of body experience, fear/panic, difficulty talking, drooling, foot stomping, flailing body limbs, falling down, making sounds, shaking, stuttering and tremors. After the seizure, the person may appear to be waking from a trance and have memory loss of what has happened. They may be on the floor and people will often be looking to see if he or she is okay. The person often feels embarrassed, shameful, depressed, weak and scared. If the person is not known to have epilepsy, the episode is very scary.

In general, seizures may be caused by many conditions, diseases, injuries and other factors. These could include abnormalities in the blood vessels of the brain, atherosclerosis, bleeding into the brain, brain tumors, chromosomal abnormalities, pregnancy or problems with pregnancy, high blood pressure, stroke or transient ischemic attack (mini-stroke). Diseases such as advanced liver disease, Alzheimer’s disease, epilepsy, diseases of the nervous system, meningitis, kidney failure and infections involving the brain are other factors that could cause a seizure. Further, injuries such as choking, head injuries from a motor vehicle accident or a sports injury, electrical injuries and poisonous insect bites or stings may cause seizures. Finally, alcohol withdrawal, craniotomy, very high fever, illegal drugs (i.e. cocaine), lead poisoning and withdrawal from medications are other known causes for seizures.

There are do’s and don’ts when it comes to caring for someone who is having a seizure, and knowing what they are can make a difference in the outcome. First and foremost, stay calm. Though there are many different types of seizures, in the worst-case scenario you may watch as the person shakes violently and turns blue. You may see saliva foam around his/her mouth, and witness the eyes rolling back. How you react may very well determine how well the person fares once the seizure is over.

Next, it is important to ensure their safety. If the person is in a sitting or standing position when the seizure begins, you need to lower them to the floor. Placing a pillow or some type of small, soft object under the head can help prevent a head injury from occurring. You also need to loosen any tight clothing from around the neck, and roll the person onto the side if they begin to vomit (to prevent choking). If the person is unconscious, you’ll want to check the nose and outer area of the mouth to ensure nothing is blocking the airway. However, you NEVER want to place anything in the mouth, and just allow the person to have the seizure.

It is also important that you do not try to restrain the patient, as this can cause injury. You need to stay with the person until the seizure has passed. Make note of the length of time, what body parts were affected, what type of seizure it was and how many seizures were had consecutively. Be sure to talk to them – once the seizure is over, the person will regain consciousness slowly and will normally be disoriented for a few minutes. You need to be reassuring the person and asking simple questions such as his/her name and address, what year it is and who is the current President. These questions will help the person come around a bit quicker.

Lastly, call for medical help. This is not always necessary, but there are certain situations when it is warranted. If it is the first seizure or the person was injured during the seizure, they will need to be examined. If it is a woman and she is pregnant, the seizure occurred in water or the seizure lasted longer than five minutes, the patient will require medical attention. Also, if the person had multiple seizures without regaining consciousness in between, they need to be seen by a doctor.

Any age group can have seizures, even children. A seizure can be treated with daily medication. An exam is usually taken to see if the person has epilepsy or a brain disorder marked by seizures or convulsions. People who may have epilepsy have an EEG test, an electroencephalograph that reads electrical signals coming from the brain. Blood tests are taken to rule out other causes of the seizures. Finally, an MRI or Spinal Tap may be taken to test for other causes, especially if the seizure may have been caused by another condition. Epilepsy can limit activities for people with the brain disorder.

If the seizures happen more often, the person should not drive, drink, or do drugs. If the person has a seizure while driving, or operating heavy machinery, then the effects could be devastating. If the seizures are less common or rare, then the person can live a less-affected life. People with epilepsy should wear a medical alert bracelet or carry ID in their wallet in case they have a seizure suddenly in a public place and will need assistance. Very rarely do serious conditions occur with epilepsy, but if the person experiences a series of close seizures, the lack of oxygen to the brain and organs may cause failure or damage that worsens the condition.

Diet drink could cause seizures or worse

2010-03-07T14:25:00.000-06:00

Hello Folks,

I am here once again with lots of uplifting good news! Your diet-cola maybe killing you!

You heard that right. If you are drinking any kind of diet cola or drink, any sugar free gum, or any sugar substitute like Equal, Nutrasweet or Spoonful, I got news for you.

This article can save you or your loved ones from serious illnesses like brain tumors, leukemia, Alzheimer’s, multiple sclerosis, diabetes, epilepsy, birth defects, chronic fatigue syndrome, Parkinson’s and many more! So I suggest you start paying attention and share it with as many people as you can.

Ok, here is the background:

The substance that is used to sweeten your diet drink and sugar free foods (including Diet Coke, Diet Pepsi, Kool Aid, Listerine Strips, different sugar free gums etc) is called Aspartame. Aspartame is also the technical name for brand names like NutraSweet, Equal, Spoonful and other sugar alternatives. Aspartame was discovered by accident in 1965 by a chemist of G.D Searle Company. G.D Searle tried to get approval from the FDA in United States in 1974 but failed due to objections from a neuroscience researcher named Dr John Olney and a consumer attorney named James Turner. For the time being, the FDA put the approval on hold to carry out further investigation. However, aspartame was allowed on 1981 for dry goods and 1983 for carbonated beverages.

Aspartame is, by far, the most dangerous substance on the market that is added to foods. It is responsible for headaches/migraines, heart palpitations, fatigue, irritability, tachycardia, insomnia, vision problems, breathing difficulties, anxiety attacks, slurred speech, seizures, nausea, numbness, muscle spasms, weight gain, depression, vertigo, memory loss, and joint pain.

According to recent studies it is also responsible for triggering or worsening brain tumors, multiple sclerosis, birth defects, epilepsy, chronic fatigue syndrome, Parkinson’s disease, Alzheimer’s, mental retardation, and diabetes.

So why was aspartame approved by the FDA? Well, for many years FDA not only refused to approve it, but took G. D. Searle to court indicting them under Title 18, Section 1001 for “their willful and knowing failure to make reports to the FDA required… and for concealing material facts and making false statements in reports of animal studies conducted to establish the safety of aspartame.”

You know why? Because in 1969, Searle conducted a study with Dr Harry Waisman on the effects of aspartame on primates. Seven baby monkeys were given Aspartame in milk. One died after 300 days; five others had grand mal seizures. Searle eliminated these findings when they submitted this study to the FDA!

So that’s pretty huge right? And Searle should have been stopped from producing this dangerous chemical forever right? Unfortunately there was a famous man in this story who had very high stakes in Aspartame.

The CEO of G D Searle at the time was Donald Rumsfeld (retired defense secretary for the Bush administration who de facto led the Iraq war)! Mr Rumsfeld said he would ensure that aspartame gets approved even though the FDA said no. He was also on President Reagan’s transition team at the time.

The story of how Rumsfeld accomplished this was told by the attorney James Turner in a documentary on aspartame called “Sweet Misery: A Poisoned World” you can visit the site here http://www.soundandfury.tv/pages/sweet%20misery.html And here is a clip www.soundandfury.tv/pages/Rumsfeld2.html where you can see Mr Turner narrate the story of how greed kills millions of people for years to come!

In 1985, the G.D Searle Company was bought over by Monsanto. The first thing Monsanto did was make the Searle Pharmaceuticals and NutraSweet Company separate subsidiaries.

Now Monsanto is also one of the world’s biggest companies that produce genetically modified foods and other chemicals that go into foods and food production. Monsanto is also known for producing pesticides.

Now we are talking about a multi billion dollar industry called the diet drink industry. Just like CFC (which almost destroyed the earths climate because of its long term destructive properties yet was popularized for more than 40 years as the magic chemical that makes money yet is environment friendly, until we had the Ozone Hole) and Trans-fats (that clog your arteries and makes you obese and responsible for numerous other diseases yet millions of people around the world are eating KFC), Aspartame also is very preciously protected because its HIGHLY PROFITABLE!

In 1992 the Flying Safety Magazine published articles about the dangers of Aspartame and mentioned that some people could be immediately affected by Aspartame with as small doses as a chewing gum. And here is the most interesting piece of information:

Major airline pilots are not allowed drink or consume Aspartame containing goods! You know why? Because it increases the risk of headaches, seizures, heart palpitations, depression, slurred speech, loss of memory, loss of sensation in lower legs, loss of equilibrium, vertigo, anxiety attacks, chronic fatigue, vision loss, etc. How nice is that? Now you can stop worrying because even if you might be killing yourself with Aspartame poisoning, you should be happy knowing that at least you are going to reach your destination in one piece.

Now I know, in your mind you might be thinking well, diet drinks at least keep your weight in check! Right? Well, does it really?

Aspartame has actually been known to contribute to weight problem and obesity even though it is used in diet drinks. Of course it doesn’t cause over weight issues the same way that sugar does, but it causes obesity by creating some very harmful toxic materials in the body. It also makes you crave carbohydrates which makes you gain weight. These toxins are often stored by the body in fat particularly on the hips and thighs. Not surprising that millions of overweight people around the world are drinking diet Coke, Pepsi and other drinks for years and still not loosing any weight!

In the famous book Excitotoxins: The Taste that Kills, Russell Blaylock, a neurosurgeon, says aspartame may trigger clinical diabetes! He says that excitotoxins such as NutraSweet literally stimulate neurons to death, causing brain damage of varying degrees. “What really concerns me about aspartame,” he says, “is its association with brain tumors as well as pancreatic, uterine and ovarian tumors. … and that so many develop an Alzheimers-like syndrome with prolonged exposure.”

Dr Blaylock also commented: “The new study released in the European Journal of oncology by Morando Soffritti and co-workers should terrify mothers and all those consuming aspartame sweetened productsŔ

“This study confirmed the previous study by Dr. Trocho and co-workers, which also found the formaldehyde breakdown product of aspartame to be damaging to cellular DNA and that this damage was accumulative. The type of damage was a duplicate of that associated with cancers. Along with this most recent study, this means that drinking a single diet cola sweetened with aspartame every day could increase one’s risk of developing a lymphoma or leukemia…”

Unfortunately, even as I write this today, millions of people around the world are sipping on their “sugar free” and “zero calorie” poison. Every year millions of dollars are spent on marketing and advertising diet drinks with slim and attractive women in on the billboards and TV. Little do the ignorant consumers realize that they are paying with their health, their children’s health, and their grandchildren’s health everyday to make people like Rumsfeld and companies like Searle and NutraSweet richer and richer.

On the other hand people like me, Dr Betty Martini (who is the world leader in exposing the ill effects of chemical sweeteners) and hundreds of others are trying their best to reach as many people as possible around the world. But we are up against billions of dollars worth combined advertising and marketing budget of the diet drink companies, processed food companies etc.

How much chance do we have to break through the noise of these mega budget campaigns? I don’t know. But I would like to believe that we are making a difference… That you would read this letter today and never touch any aspartame related product ever again. That you would take the initiative to tell as many people as you can in person, on the phone, via email, in the next office meeting or whatever else you can think of. If you do that, we take a step forward and we shall win. If you don’t, then all of this effort is worthless.

Think about it.

Would you like to help the movement and help thousands, if not millions, of people around the world? If so, read on and follow the 3 steps given here to help the world today.

Step 1: Forward this email to at least 5 of your friends, family or loved ones.

Step 2: Let me know that you have forwarded it at bittertruth@aweber.com Just send me just an empty email. Don’t write anything as it is an auto responder. If you have questions or comments follow the email link below.

Step 3: As a thank you gift I’ll send you two motivational ebooks for free. One on a true story of how to bounce back at life when you got nothing more to loose and the other an excellent 49 page special report on motivation. This applies to all readers of this email.

Spread the word and let more and more people live a life of health, abundance and happiness!

Shafin de Zane

What can you do if your dog has seizures?

2010-03-07T13:56:00.000-06:00

By Ruthie Bently

I began doing research into seizures after I knew Skye was coming to live with me. I looked into homeopathy, acupuncture, Reiki and other alternative therapies. I even contacted an animal communicator so I could ‘speak’ to Skye. I did everything I could think of to prepare for living with a “seizure” dog. I thought I was equipped to handle it if Skye had a seizure. But when it happened, even though her seizure was minor (compared to what I expected), it was still an emotional event because I felt powerless to help her.

As I explained in my article on canine epilepsy, when the electrical synapses of a brain misfire, it causes erratic un-coordinated nerve transmissions to the body’s muscles, which results in a seizure. A dog can have a seizure without having epilepsy though, and there are many things in our environment that can cause a seizure. While we understand the mechanics of a seizure, the brain is a complex organism which we do not fully understand. No matter how much information you read on the subject, remember every dog is different and so are their seizures. There are four kinds of seizures (petite mal, grand mal, status epilepticus, clusters) and their severity ranges from mild to life threatening. Seizures are categorized as either partial or generalized. The impulses of a partial seizure begin in a specific area of the brain, while the generalized seizure takes place all over at once.

The symptoms of a seizure are varied and many depending on the seizure. Some seizures begin with a loss of consciousness and all the dog’s muscles contracting. Your dog may begin drooling excessively. A dog’s facial muscles may begin twitching or they may begin vocalizing. There may be opening and closing of the jaws and a dog may look like they are running in place. During certain seizures some dogs are even conscious and aware of their surroundings. After the seizure, a dog may lie still for a short period. They will eventually get up but may show signs of post seizure behavior. These can include bumping into things, being disoriented, temporary blindness or loss of focus, and running or pacing around the house. They can be confused, may not recognize their owner and may even be afraid of them.

When your dog experiences a seizure, electrical and chemical changes occur in their brain; these result in behavioral changes in your dog. These are only temporary conditions and will go away with time. Every seizure affects a dog’s behavior and the more severe the seizure is, the more behavioral changes you will notice. Some are slight and go away quickly and some may take longer to recede. You need to have understanding and patience to help your dog get through this bewildering time. Stay calm while your dog is having the seizure, and don’t get in their way. Try to keep the area around them as clear as possible, so they don’t bump into something and injure themselves. Keep your hands away from their face and body; you may be injured due to their involuntary movements. After the seizure talk to your dog in a comforting voice and try to keep them calm.

If your dog has never had a seizure before, take them to the vet for an overall checkup. Having a blood panel done may be suggested. Contact your breeder to see if any littermates had or developed seizures issues. If your dog came from a shelter, ask if they noticed anything or can tell you about your dog’s background, as some breeds are predisposed to having seizure problems. Check out your home and your dog’s living environment (don’t rule out any changes you may have made) to find a reason for the seizure if the vet doesn’t have an answer. We use many products today, some of which can be seizure triggers for a dog. There are several good sources for seizure triggers on the internet; look them up and compare them to your situation.

It’s always a good idea to keep a medical journal for your dog, and can be especially helpful if your dog has seizures. You can record any seizures your dog has, the duration, symptoms and post recovery. Daily medications, including time of day and dosages given to your dog should be entered. You can also record vaccination records, preparations used for flea and tick removal, and details of all vet visits. If your dog has another seizure or continues to have seizures, you’ll have the information at your fingertips for the next time.

Read more articles by Ruthie Bently

Mosquitos vs. seizures

2010-03-07T13:51:00.000-06:00

Mosquitoes are common flying insects that are closely related to the flies; that is they belong to the family Culicidae. They are mostly known for transmitting malaria but they also transmit a variety of other diseases too.

Malaria
This is a vector borne disease that is infectious, it is caused by the parasites, and the parasites are the protozoan and are of the species of plasmodium. There are four species of the plasmodium that are responsible for the malaria in human, Plasmodium vivax, plasmodium malariae, plasmodium ovale and there is the plasmodium falciparum which causes cerebral malaria.

Symptoms- chills, sweating and high fever, fatigue, muscle and joint pains, headache, vomiting and back ache. In the case of cerebral malaria, death is likely to occur within 24 hours.

Dengue Fever/Breakbone/Dandy Fever
This is a disease that is caused by viruses that are transmitted. This disease usually attacks people that have low levels of immunity, since this disease is caused by one of the for serotype virus, it is possible that one can contract the disease multiple times. However after a dengue fever (pronounced deng-gay) attack it has been known that if you are infected with the virus, your system can develop an immunity that lasts a lifetime.

Symptoms- Head aches, fever, rash, bleeding gums or nose, black stools, joint and muscle pains. In severe cases that result from dengue hemorrhagic fever, there is evidence of hemorrhage in the body.

West Nile Fever.

This is an infection of the brain caused by a virus known as the West Nile Virus and was first detected in Uganda in 1937. This disease is also known as West Nile Encephalitis. Encephalitis means inflammation of the brain.
Another cause of this fever is bacterial infections. This virus is closely related to the Japanese encephalitis virus or the Saint Louis encephalitis. This virus is mainly transmitted to human by mosquitoes that have been infected as they bite other infected people or animals.

Symptoms- fever, head aches, skin rash. In severe cases very high fever, stiffness of the neck, sleepiness, paralysis, coma, convulsions and rarely death (3%-15%).

Yellow Fever

It also is referred to as American plague, black vomit or yellow jack. This disease is an acute viral infection. The reason why it was branded yellow fever is because of the jaundice in its symptoms, simply that means that a person affected turn yellowish. This disease is a source of several epidemics in the past. In 1700, France, England and Spain had over 300,000 people killed. Over half the Army died during the Haitian Revolution as a result of this disease.

Symptoms- arrhythmias (heart dysfunction), bleeding which may result in hemorrhage, headache, jaundice, muscles ache, red eyes face or tongue, vomiting or even vomiting blood, seizures, decreased urination. A person that has advanced yellow fever will show signs of shock, renal failure and even liver failure.

The above mentioned diseases cannot be transmitted if the person was bitten by a mosquito that was not itself infected. The only mode of preventing mosquito bites is getting rid of source that they are breeding at, for instance stagnant water and even long grass.

Low blood sugar caused a fatal accident!

2010-01-22T20:56:00.003-06:00

Betty Diaz, 39, of Lake Forest, is accused of failing to take proper care of her blood sugar level, triggering an episode of hypoglycemia in which she lost control of the Suburban.

Kyung "Connie" Chung was killed in a head-on collision July 3, 2007.

Diaz is accused of taking insulin on an empty stomach, dropping her blood sugar to a dangerously low level.

On July 3, 2007 around 2:15 p.m., Diaz was driving with 8- and 9-year-old children in the SUV when she lost control, veering across a center divider and into oncoming traffic on the northbound side of Irvine Center Drive.

The Suburban crashed straight into the Camry, fatally injuring its driver, 70-year-old Kyung "Connie" Chung. Chung died at a nearby hospital.

Diaz and the two children had to be treated for lesser injuries.

According to a medical evaluation in court records, Diaz has had Type 1 diabetes for 22 years.

Diabetics who are prescribed insulin are told to take it before meals to keep blood sugar from spiking. On an empty stomach, insulin can cause blood sugar to drop to dangerous lows, triggering hypoglycemia.

Hypoglycemia causes dizziness, shaking, sweating, and confusion, and in serious cases, even seizures and fainting.

Diaz told the doctor that she took insulin on an empty stomach that morning. Her last meal before the accident was between 7 and 8 p.m. the day before, according to the evaluation.

She told the doctor that she had tested at dangerously high blood sugar levels -- four times the normal -- the night before the accident. If that's so, then in trying to bring her blood sugar down, Diaz apparently overdid it

The evaluation found that she had likely suffered an episode of severe hypoglycemia.

Diaz has been charged with one felony count of vehicular manslaughter with gross negligence and two felony counts of child endangerment.

The pre-trial hearing at Harbor Justice Center in Newport Beach is her eighteenth since she was charged 15 months ago.

Epilepsy: Causes and Symptoms

2010-01-22T20:24:00.002-06:00

Epilepsy is a grouping of related disorders characterized by a tendency for recurrent seizures. There are different types of epilepsy and seizures. Epilepsy does drugs are dictated to control seizures, and rarely operation is essential if medicines are ineffective.

Causes of Epilepsy

Head trauma is an important reason of seizures and epilepsy.

Although it's generally accepted that a remote injury (i.e., one which happened at once in the past) can cause epilepsy, there's no agreement on how extensive or of what type that injury must be. It's known that the danger for epilepsy increases substantially if there are open or penetrating lesions, however.

Tonic-clonic seizures (grand mal)

The biggest of whole types of seizures, these are characterized by a loss of consciousness, body stiffening and shivering, and some of the times tongue biting or loss of bladder control.

If all areas of the mind are affected by the abnormal electric action, a generalized seizure may result. This means that consciousness is lost or impaired. Often complete the individual arms and legs stiffen and then jerk rhythmically.

Symptoms of Epilepsy

Simple partial seizures are further divided into 4 classes according to the nature of their symptoms: motor, autonomic, sensory or psychological. Motor symptoms include movements such jerking and stiffening.

Generalized seizures

This is the type of seize each time, so the symptoms will be much related from episode to episode.

But some people have several different types of seizures, with different symptoms each time.

Treatments of Epilepsy

Surgical therapy

New advancements in diagnostic technology and surgical methods have led to a raising use of surgical treatment of epilepsy.

Pharmacotherapy

It's newly been shown that early on effectual treatment with anti epileptic drugs will control seizures in up to 70% of newly-diagnosed grownups and kids.

Alternate Treatments

Many alternate treatments are widely encouraged for epilepsy, including bio feedback and vitamins. But their effectiveness is largely unproven.

Medications

More than a 12 medicines are presently sanctioned to treat epilepsy. To each one medicine has does well and side effects, and another medicines are suitable for a different types of epilepsy. No one medicine is examined to be the better treatment for epilepsy.

First of all, let me tell that I'm NOT a fan of the Atkins diet (as a few suggest for epilepsy) and many of its characteristics run counter to what other people recommend for a diet that helps with epilepsy most important of which is the avoidance of animal protein. Beyond that, it's my feeling (shared by a great several other people) that Atkins got a good deal correct but his diet was ultimately fatally flawed once the marketing became centered around the easy and unhealthful formula of basically eliminating crabs and eating just about anything else you needed including junk food and extravagant unhealthful fats. A few carbohydrates are essential for good wellness and I'm one of the ones who trust it was saying when the autopsy conducted on Atkins (and later covered up) revealed important problems and major deterioration of virtually every his major organs and systems. Strict adherence to his diet will indeed result in weight loss, but it may come with the cost of development chronic problems that can eventually be life shortening if not life threatening.

Dietary recommendations:

Eat sour milk products like organic yogurt and kefir.

Include beet greens, chard, eggs, green leafy vegetables, raw cheese, raw milk, raw nuts, and seeds and fermented soy products such miso, tempeh and natto.

Drink fresh juices made from beets, carrots, green beans, green leafy vegetables, peas, red grapes, and seaweed for concentrated nutrients.

Eat little meals, don't drink large measures of liquids at a time, and take two tablespoons of olive oil every day.

Avoid alcoholic beverages, animal protein, fried foods, and artificial sweetening's such as Aspartame, caffeine, and nicotine. Avoid refined foods and sugar.

SOME OF THE most important VITAMINS AND MINERALS FOR EPILEPSY:

Vitamin B Complex

Niacin HERBS FOR EPILEPSY INCLUDE:

DMG
L- Carnitine
L- Tyrosine
Magnesium
Oxygen enhancing products (Such as OxyGen)
Selenium
Taurine
Vitamin B Complex
Extra Vitamin B3 Niacin
Folic Acid
Pantothenic Acid
Calcium
Zinc

IMPORTAN HERBS FOR EPILEPSY INCLUDE:

Alfalfa
Black cohosh, hyssop and lobelia (for best results use on a rotating basis)

Sex doesn't cause seizures!

2010-01-22T20:19:00.001-06:00

During the summer before her senior year at Northwestern, Christine Haselhorst spent three weeks studying eight hours a day for the Medical College Admissions Test. After finishing the exhausting exam, Christine returned home, finally able to relax and release her stressful preoccupation with science jargon and practice tests. Her celebratory dinner with friends, however, was cut short. That evening, Christine, a Weinberg senior, had five seizures in a row, the most she has ever had in a single day. While one episode per week had become normal for her, this extensive sequence of seizures shocked Christine, sent her to the hospital and reminded her—yet again— of the tight grip epilepsy had on her life.

Christine had her first seizure at 12 years old. Electric impulses shot through the left temporal lobe of her brain causing her to lose consciousness. For nearly one minute, her facial muscles twitched and her entire body stiffened and jerked. After eight years with no seizures, Christine began experiencing them again the summer before her junior year. Now, two years and more than 20 seizures later, Christine is still hoping for an effective treatment option. Despite medication, her episodes now occur weekly and, paired with her prescription side effects, they have started to drain Christine emotionally. As her team of neurologists searches for the perfect drug combination, Christine avoids behaviors the medical community has identified as potential triggers, such as sleep deprivation, stress and alcohol use. “Medication is the only solution they have, so I’m trying to do everything else I can,” she says. “Sometimes, though, you don’t want to be that person in the corner. But I guess I’m just not a normal college student.”

Like Christine, many people experience the practical challenges, emotional strain and stigma of epilepsy, a neurological disorder affecting approximately 3 million Americans. For the 150,000 college students with epilepsy, however, life can be especially frustrating. These young adults must establish a new network of support and learn how to manage their condition, while juggling their social life and academic responsibilities. Besides giving up activities that characterize the college experience, epileptics must consider their seizure and health risks when facing typical dilemmas, like sharing a dorm room, making new friends, choosing a major and partying. “College isn’t an obstacle, but people with seizures need to be aware and mature enough to take good care of themselves,” says Eileen Whelihan, a licensed clinical social worker at the Indiana Comprehensive Epilepsy Center. “Personal responsibility goes a long way, but I know it’s frustrating for that age group because they just want to be like their peers."

Epilepsy is a group of disorders characterized by recurrent and spontaneous seizures. These episodes of disturbed brain function cause strange sensations, emotions and behavior, and sometimes convulsions, muscle spasms and loss of consciousness. Although one in 100 people will have a seizure in their lifetime, epilepsy is only diagnosed when a person has had more than one seizure unprovoked by a fever, metabolic disorder or severe head injury. Many people associate epilepsy with convulsive fits, but the disorder can manifest itself in different ways. People can experience absence seizures, characterized by brief staring spells, myoclonic seizures, massive muscle jerks, or the more recognizable tonic-clonic or grand mal seizures, which cause the body to convulse.

While there is no cure, more than a dozen types of antiepileptic drugs available. Treatment is highly individualized though and similar medications can produce different results and side effects. For patients whose seizures cannot be controlled by medications, neurologists may propose brain surgery, vagus nerve stimulation (where a device similar to a pacemaker is implanted in the brain) or investigational therapies, like the ketogenic program, a high-fat, low-carb diet. Although most cases of epilepsy can be controlled with just a few pills each morning, more than 30 percent of patients will continue to experience seizures despite aggressive drug treatment or other interventions. “At least half the time, the first medication works pretty well,” said Dr. Douglas Nordli, neurologist and director of the Comprehensive Epilepsy Center at Children’s Memorial in Chicago. “But for others, it’s a process of trial and error.”

The highest incidence of epilepsy occurs in the first year of life and older than 65 years old. However, there is a slight blip that can account for the forms of epilepsy that emerge in teenage and young adult years. Although treated with similar measures, epilepsy among this age group may have different causes, manifestations and outcomes.

“The fundamental difference is that it is epilepsy in the context of a developing brain,” said Dr. Nordli. “So we have great concerns about brain function and how the patient is doing from a cognitive, developmental, behavioral and psychiatric standpoint.” Repeated seizures can increase the likelihood of social and learning disabilities, brain damage—and even death. According to the National Institute of Neurological Diseases and Strokes, the center primarily responsible for funding epilepsy research, sudden unexplained death from epilepsy is a research priority. Recent studies suggest the risk of death in epileptics may be 25 times higher for those in their 20s to 40s–an especially frightening find for young adults.

Although the underlying causes of epilepsy are often unclear, medical professionals have found that sleep deprivation, heavy alcohol or drug use and stress are common and potent triggers for seizures. Neurologists advise patients to avoid these behaviors and to identify their personal triggers, which can include caffeine, flashing lights and hyperventilation. Fortunately, it’s a myth that sex can cause a seizure. “If you learn that you drink more of anything caffeinated and you start to have seizures, then maybe that’s a trigger for you,” says Eileen Whelihan, a licensed clinical social worker. “It’s a way of learning. The important thing we tell them is that if you find something is true for you then you need to pay attention to it.”

Dorm life, frat parties and classes packed with hundreds of new faces can overwhelm any undergrad. A study the Journal of Adolescent Health revealed that stresses from the daily routine of school and life keep 68 percent of college students awake at night. “So many kids just fall apart in college with the incredible suddenness of freedom,” says Maureen Tillman, licensed clinical social worker and creator of College with Confidence, a counseling service for parents and young adults. “There are so many different kinds of stresses, and it is not a very stable environment.” Free from nagging parents and the daily routine of high school, the university setting requires epileptics to adapt to a life where weekends start on Thursdays and study sessions can last until sunrise. “At home, I never would pull an all-nighter,” says Samantha Gassell, 20, a junior at Emerson College who began having myoclonic seizures in middle school. “But at college, everyone does their homework all night rather than right after school, and I just couldn’t do that.”

Gassell joined a sorority at Emerson College but quickly realized how hard it was to maintain a healthy sleep schedule. After being encouraged to attend late-night activities, she had to explain to her new sorority sisters that she couldn’t participate. “People don’t always understand how the severity of things like stress, drinking and sleep can really affect me,” Gassel says.

Christine has also had to learn how to reduce her exposure to seizure triggers. She tries to stay relaxed by using her free time during the day and writing down everything she needs to get done. (She carries a pocket calendar, keeps a Google Calendar and regularly scribbles “to do” lists on Post-Its.) Christine is also active in the University Chapel Choir, which allows her to pursue her love of singing and, as she declares, keep her sanity. But Christine knows her limits and her sleep requirement: eight hours. “I’ve always been a student first and foremost, so to have to change that is really weird for me,” she says. “Now I have to sacrifice school work for actual sleeping.” Driving can also be a challenge to independence since each state has different laws regarding epileptics. Christine, who is required by Illinois law to be seizure-free for six months before she can legally drive, plans to live in a city or near public transportation when she graduates. “Unless I have driver or maybe a limousine,” she adds with a smile.

Unlike other triggers, doctors understand how consuming alcohol can induce a seizure. Alcohol affects an inhibitory transmitter that reduces neural activity and sedates the brain. After a person has stopped drinking, however, the nervous system becomes irritable and excited, which can trigger a seizure. Since alcohol can also affect the stress hormone system and be dangerous to mix with medications, epileptics are instructed not to drink or to have no more than two drinks.

While most college students could make wiser choices about alcohol, many young adults with epilepsy feel that they miss out by abstaining. Previously, Christine drank in moderation but after she had three seizures following a night of drinking while studying abroad in South Africa, she stopped completely. The risk wasn’t worth the fun.

“I still go out with my friends but I sort of stay on the sidelines and watch. Inside, it’s still hard not to be able to participate fully,” says Christine. “I’m 21 years old and it sucks that I can’t go out and just have fun with my friends.”

In addition to managing a chronic illness, people living with a seizure disorder must develop a deep awareness and familiarity with their body. This can help them realize if they are pushing their limits or if they are experiencing an “aura,” the often indescribable feeling or strange sensation that can precede a seizure. For many, this requires making it routine to be hypersensitive to how they feel.

“If I’ve been out with friends, I’ll wake up the next day and just be super anxious and aware the entire day,” said Hannah Niequist, a dance teacher who has been seizure-free for several years. “It’s like I’m tricking myself into feeling that aura. I’m so just aware if I drink or am stressed or didn’t get enough sleep that it makes me feel uncomfortable and unsettled.”

People with seizure disorders also have to make decisions about telling others about their condition. Although no one can be legally forced to share their condition with a university, roommate, professor or employer, preparing others can make the situation less frightening and easier to manage. Tracy Schultz, community education coordinator for the Epilepsy Foundation, often reminds her clients their safety and academic success could be at risk. Depending on the severity and frequency of seizures, some people with epilepsy will tell friends not to call 911 since that can be expensive and unnecessary. For example, Christine, who wears a medical alert bracelet, tells friends to make sure she doesn’t hurt herself while seizing and wait for her to come out of it.

Still, it can be difficult to talk about epilepsy or to explain a seizure to a group of friends. While Christine has never had a seizure during class, students who have had seizures in a public place often feel embarrassed. (Some did not even want their name or story included in this article). “They may be hesitant to disclose for fear of sticking out or being different from their peers,” says Michelle Grace, health services director at the College of Lake County in Illinois. Nicole Roman, 23, who hasn’t had a full seizure for almost three years, still worries people will treat her differently. “I don’t want my friends to think they can’t come out with me or that they have to watch over me like a mom,” says Roman, who won’t always tell prospective bosses initially. “I just get afraid that there are some employers who don’t understand epilepsy and will disregard me for the job. But I don’t want anyone else choosing my path for me.” Other epileptics feel comfortable telling people about their seizures and view it as a way of educating others and sharing a significant aspect of their life. Most recently, disclosure has become even more important as the central theme of the Epilepsy Foundation’s “Talk About It” public education campaign. By collaborating with celebrities like Gregory Grunberg from the television series “Heroes,” this nationwide initiative hopes to raise awareness about epilepsy and increase funding for research. In 2005, NIH funding per patient with epilepsy was $39, while other conditions like multiple sclerosis, Parkinson’s and Alzheimer’s disease received more than $100 per patient. “When you look at research dollars, it seems markedly disproportional compared to other diseases that are far less common,” says Dr. Douglas Nordli. “Epilepsy is still in the shadows and there need to be more public awareness about how common it is.”

In college, disclosure can be especially important if students want academic assistance. The Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act protect persons with disabilities from discrimination and ensure accommodations are available. But in the college setting, students must self-advocate.

“Once they graduate high school, they kind of fall through the cracks when it comes to assistance,” says Schultz. “Before college, they have a case manager or school psychologist helping them to navigate the system for specialized education. But when they graduate, they’re on their own.”

Many students seek help from university disability services. These offices can help draft letters to professors, provide assistive technology, like a note-taker or laptop, grant extra time or a separate space to complete assignments, and allow early course registration. While these offices can be a great resource, students who miss classes because of seizures must take the lead in getting the help they need.

“Some schools have great programs for students with disabilities but there are some schools where the disability office is one staff member,” says Schultz. “Sometimes they won’t even know what they’re dealing with since many people don’t understand epilepsy as much as they understand other disabilities.”

With auras, academics, stress, sleep and other issues to juggle, it’s not surprising that depression is the most frequent comorbid psychiatric disorder in people with epilepsy, affecting between 20 and 50 percent of patients. When Christine began experiencing weekly seizures, during what she calls the worst summer of her life, her condition began to affect her emotionally. “She has a different life,” says Christine’s mother, Maria Defilippis, who thinks the seizures and medications have changed her daughter’s personality. “Before she was always in control, nothing and no one could stand in her way. But now epilepsy has got her under control.” Christine faces additional frustrations because her epilepsy is not yet controlled. Despite taking medication and changing her lifestyle, she has not been able to fix her brain, and doctors haven’t either. For a week in July, she stayed in the hospital for a series of tests and scans. The findings, however, only confirmed neurologists’ predictions that she was ineligible for brain surgery since her seizures are not localized. Christine is also dealing with the debilitating side effects of her antiepileptic drugs, which cause blurred vision, vertigo and nausea. Since it is harder for her to read, test and write papers, she is stuck between wanting to up her dosage and living with the side effects. But Christine has not given up. At the end of the summer, she began a three-month clinical trial conducted by researchers at Johns Hopkins University to examine the impact of a modified Atkins diet on seizure frequency. While she thinks it may be working, Christine, who now eats pecans portioned out in small plastic baggies, is not sure how much longer she can go without carbohydrates. With the support of her parents and three younger sisters, Christine tries to assure herself that the weekly seizures will end and that she won’t be like this forever. In December, Christine visited MayoClinic, a prestigious medical center in Minnesota, for a second opinion and new treatment options. “We went through all the stages, like death. You’re shocked, then you’re in denial, and then you cry. And now I’m just mad as hell,” says Christine’s mother, who has found it hard to watch her daughter struggle to manage things she once handled with ease. It has been especially disheartening to see Christine consider giving up her life-long dream of becoming a doctor out of fear she won’t be able to handle the stress. Juggling college, a potential medical career and her search for a cure, Christine faces responsibilities and pressures beyond the average young adult. Besides learning the nuances of telling formal dates she’ll pass on the mixed drink, Christine has realized that the small things are not worth stressing about and life is not something she can plan. “The hardest part for me is trying to be a normal college student and still having to deal with this,” says Christine. “You want to be able to go out with your friends and have a good time but this is always in the back of your head — literally and figuratively.”

A young boy suffering from a rare seizure disorder brings joy to other sick children

2010-01-02T18:01:00.001-06:00

Jordan Corvin has seen his share of hospitals.

Jordan suffers from Ehlers-Danlos Syndrome, a disorder affecting connective tissues that causes acid reflux and seizures. He goes to Philadelphia’s Children’s Hospital every four months for potassium treatments. And it was during one of his stays there where, in his own words, “I saw kids being lonely in beds and some were crying.”

Nine-year-old Jordan felt he had to do something. Putting his own illness aside three years ago, Jordan and mom and dad April and Matthew Corvin started a program called Jordan’s Wish – put together with their own funds and the donations of time, gifts, and money from local families.

Essentially, Jordan fills a satchel of small presents that would make Santa proud. Then during the Christmas and New Year’s holidays, he takes them around to hospitals to give to kids and adults. And their response is rewarding for Jordan.
“It’s good. It’s nice. It gives me a happy smile,” said this generous young man.

His benefactors over the years have been Westchester Medical, Kingston and Benedictine hospitals, North Dutchess, and now Columbia Memorial where he recently off-loaded a ton of small gifts before Christmas. In fact, he had so many gifts that he left an additional goody bag to be distributed at the hospital during the New Year’s week.

Dressed in a holiday green Mickey Mouse sweater, Jordan walked the halls of Columbia Memorial with his snowflake decorated blue bag dispensing cheer and goodies that brightened a lot of faces.

Two-year-old Nathan Fulton, dressed in yellow pajamas and sucking on a bright red pacifier wasn’t sure what to make of the Santa-hatted youngster walking into his room. But his mother understood and let the young Jordan give a small Santa bag to her son. Nathan tugged at the bag as Jordan looked on approvingly, his arm warmly draped around the little boy’s shoulders.

“It’s good to give,” said Jordan.

“And it makes my heart feel good.”

Some fertilizers contain toxins that can trigger seizures

2010-01-02T17:36:00.000-06:00

The practice of adding hazardous materials to fertilizers had been a serious issue since 1997. Industries have found a way to get rid of toxic wastes, including industrial wastes and pesticides by putting them in fertilizers.

According to Sen. Miriam Defensor Santiago, some tests done on fertilizers show the presence of numerous heavy metals and other contaminants.

She said these toxic fertilizers have been shown to have caused the contamination and loss of agricultural lands, death of livestock, contamination of groundwater or drinking water and potentially allowed toxic substances to end up in food supplies.

She said some of the toxins which have been found in commercial fertilizers include lead which causes seizures, mental retardation and behavioral disorders, cadmium which is known to cause cancer, kidney disease, neurological dysfunction, immune system changes and birth defects, and arsenic which is a known carcinogen.

Santiago said this is precisely why she is pushing for the passage of a bill, Senate Bill 3556, which calls for an immediate halt to the practice of adding toxic and hazardous materials to fertilizers.

“The Constitution, Article 2, Section 16 which states that the government “shall protect and advance the right of the people to a balanced and healthful ecology in accord with the rhythm and harmony of nature,” Santiago stated in the measure.

“The purpose of this bill is to stop the practice of adding toxic and hazardous materials to fertilizers immediately,” she added.

The measure would be termed as “Fertilizer Content Act” and would primarily ban fertilizers that poses substantial or potential threats to public health and environment and generally exhibits carcinogenic, ignitable, oxidant, corrosive, toxic, radioactive or explosive characteristics.

Under the bill, the Department of Trade and Industry (DTI) is mandated to analyze samples of all commercial fertilizers for the presence of hazardous wastes or hazardous substances.

The Department of Health (DOH) will assist the DTI in conducting these tests. The Secretary of Trade and Industry will publish a list of fertilizer products containing hazardous wastes or substances and will annually report the results of the sampling and analysis to the legislature.

Serotonin Syndrome vs. Seizures in obese patients

2010-01-02T17:29:00.000-06:00

This clinical review feature article is presented in conjunction with the Department of Emergency Medicine Education at the University of Texas Southwestern Medical Center, Dallas.

Learning Objectives

Identify obesity-related health problems and discuss their impact on the health and well-being of obese individuals.
Identify the two clinical approaches to weight loss.
Identify actions, precautions and side effects of adrenergic, serotonergic and alternative weight loss medications.
Identify and differentiate three classifications of bariatric surgery and the common complications of each.
Describe and explain various components of a bariatric response plan.

Key Terms
Adrenergic: Pertaining to the fibers of the sympathetic nervous system that use epinephrine (adrenalin) as a neurotransmitter.

Anastomosis: Surgical joining of two vessels, ducts or bowel segments.

Benzodiazepines: A class of psychotropic drugs used for sedation, anxiety, seizures, muscle spasm and amnesia, and which includes Valium.

Cardiac sphincter: The muscular fibers at the junction of the lower esophagus and stomach that prevent backward movement of food from the stomach into the esophagus.

Deep vein thrombosis: A thrombus (blood clot) in one of the deep veins of the body.

Ephedrine: A stimulant drug used to suppress appetite and enhance weight loss and concentration.

Fentanyl (sublimaze): A synthetic narcotic used to control moderate to severe pain.

Gastroesophageal reflux: A condition in which food travels backward from the stomach to the esophagus, causing irritation of the esophagus.

Innervated: A state in which a body part has been supplied with nerves or nervous stimuli.

Laparoscopic surgery: A minimally invasive surgical procedure performed with only small incisions.

Leptin: A protein hormone that regulates energy intake and usage, including appetite and metabolism.

Methamphetamine: A drug class that stimulates the central nervous system.

Obesogenic: An environment and its components that contribute to obesity.

Phentermine: A stimulant medication used for weight loss that mimics the actions of the sympathetic nervous system.

Pulmonary hypertension: Abnormally high pressure in pulmonary circulation.

Roux-en-Y gastric bypass (RYGB): An invasive procedure used for morbid obesity that decreases stomach size through creation of a pouch. This procedure also separates the small intestine into two arms, rerouting the jejunum to the stomach and the duodenum to the distal ileum.

Stomal stenosis: An abnormal constriction or narrowing of an opening or passageway (stoma).

Thermogenesis: Production of heat, especially at the cellular level.

Ventricular gallop: In adults, an extra heart sound (S3) that indicates the presence of myocardial failure.

The dispatch report was for a "woman passed out." Everyone on the rescue squad knew the address. It was Dorothy, a 38-year-old bariatric patient who weighed about 300 pounds and had a history of deep vein thrombosis.

On scene, Dorothy’s roommate explained that Dorothy was post-op from a Roux-en-Y gastric bypass (RYGB). When asked what happened, the roommate said Dorothy was having a small bowl of chocolate ice cream to celebrate coming home. After Dorothy started to have severe abdominal cramping and suddenly passed out, her roommate called 9-1-1.

As the crew proceeded into the bedroom, they could hear the arrival of the engine company, whose help would be needed if the crew were to safely care for the patient. After ensuring the patient’s airway and breathing were adequate, the EMT obtained a blood sugar reading, which was low. Although Dorothy was awake and able to maintain her airway independently, the paramedic knew that oral glucose might not be the best choice and elected to immediately administer IV glucose. With assistance, Dorothy was able to walk to the stretcher in the living room, and she agreed to be taken to the hospital. Talking to the emergency department attending later, the EMT and paramedic found out that Dorothy was sent to a dietician for education about how to live with her gastric bypass.

Obesity & Complications
It has been estimated that one-third of Americans are obese, and some of those people are morbidly obese, or greater than 100 pounds over their healthy body weight. Although such people are at increased risk for complications related to obesity, many don’t see themselves as being at risk for obesity-related health conditions. In one survey by Shape Up America, a nonprofit organization founded by former Surgeon General C. Everett Koop, MD, seven out of 10 overweight Americans didn’t consider themselves unhealthy or think their weight posed a risk to their health. Further, Malcolm K. Robinson, MD, of Harvard Medical School, suggests that not only will obesity impact the health and well-being of the patient but the patient may also expect to lose up to 20 years of life expectancy.

Although health problems associated with obesity are numerous (see Table 1, p. 44), some people take action to reduce their weight and address these conditions using a variety of methods. If successful, some patients can look forward to a reversal of many of these illnesses and a return to good health. But these weight-loss interventions aren’t without risk, too.

Adrenergic Agents & Side Effects
At its core, obesity is an imbalance between food intake and energy expenditure. Weight loss measures must be taken to correct this. The clinical approaches to weight loss fall into two categories: medical or surgical. It’s important for EMS providers to understand these bariatric therapies and the problems they can cause.

The earliest medical approaches focused on increasing energy expenditure. Adipose tissue, or fat, is a form of energy storage for the body. Lipids within fat are released for energy when needed, in part by the sympathetic nervous system.

Adipose tissue is highly innervated with sympathetic nerves for adrenergic stimulation. Epinephrine (aka, adrenaline) attaches to beta 3 sympathetic receptors in fat and activates lipolysis, the division of fat into fatty acids, fatty acids being used for energy.

Stimulation of beta 3 adrenergic receptors is usually responsible for thermogenesis, an example of which would be heat production from shivering. Bariatric medications seek to stimulate these beta 3 adrenergic receptors to raise the resting metabolic rate and thereby adjust the ratio of intake versus expenditure to create a caloric deficit and ultimately weight loss.

Used since the 1930s, amphetamines are the earliest examples of these stimulants or adrenergic medications for weight loss, but they were frequently abused. Newer agents, such as phentermine, first approved by the FDA as a diet suppression medication in 1959, have less abuse potential and cause less severe central nervous stimulation.

However, this class of drugs is not without risks. As an adrenergic stimulant, these "diet pills" can lead to hypertension, palpitations and tachydysrhythmias. The effect is even more pronounced if the patient is concurrently being treated for depression and has been prescribed a monoamine oxidase inhibitor (MAOI) class antidepressant. Most medical authorities recommend a two-week "wash-out" period between the end of MAOI use and the start of the adrenergic agent. Without that wash-out period, the combination of MAOIs and adrenergic stimulants can lead to potentially life-threatening hypertensive crises and strokes. Similarly, using such illicit drugs as cocaine or methamphetamine in tandem with these adrenergic stimulants can lead to hypertensive crisis.

Because diet pills have potential for abuse, the FDA has classified these medications as controlled substances under the Controlled Substances Act. Table 2 (p. 46) lists some of the drugs in the adrenergic classification by generic name, trade name and schedule.

Another major side effect attributed to this class of bariatric medications is primary pulmonary hypertension. Pulmonary hypertension’s effect on the bariatric patient is twofold. First, pulmonary hypertension decreases the heart’s ability to increase cardiac output, especially during times of exertion, leading to shortness of breath and fatigue. Second, pulmonary hypertension will eventually cause the right ventricle to fail, a condition called cor pulmonale . Coupled with left-sided heart failure secondary to increased systemic vascular resistance caused by obesity, the patient will go into complete heart failure.

Compounding these complications is the fact that many bariatric patients are also diabetic. Adrenergic stimulants may decrease the patient’s insulin need. Without an adjustment of their insulin dose, a patient may inadvertently overdose on insulin, leading to hypoglycemia.

For a variety of reasons, increasing numbers of patients are turning to alternative or complementary medicine for weight loss. Such weight loss supplements include chromium picolinate, ma huang and white willow bark. These substances are thought to be adrenergic—similar to ephedrine or caffeine. When combined with drugs from the adrenergic class of bariatric medications, these substances pose a great risk for hypertension-related medical emergencies.

Selective Serotonin Reuptake Inhibitors
The other class of bariatric medications seeing greater use is serotonergic agents. Like the adrenergic agent epinephrine, serotonin is a central nervous system (CNS) neurotransmitter that impacts mood and appetite. Originally used as antidepressants, serotonin agents are also prescribed as an appetite suppressant, impacting the intake side of the energy imbalance. They work by either increasing the amount of serotonin available or by inhibiting the reuptake and destruction of serotonin in the distal neuron.

This latter action forms the basis for the effect of selective serotonin reuptake inhibitors (SSRI). SSRI medications allow serotonin to remain in the synapse longer, thereby continuing to stimulate the nerves. Examples include fluoxetine (Prozac) and sibutramine (Merida).

Both Prozac and Merida can cause dizziness, nausea, insomnia and significant increases in blood pressure. The latter is cause for concern. Most physicians won’t prescribe these medications if the patient has a history of coronary artery disease (CAD) or congestive heart failure (CHF). Unfortunately, in many cases, one of the long-term outcomes of obesity is CHF and many of the signs of CHF (such as ventricular gallop, peripheral edema, rales or crackles in the base of the lungs, are obscured in the obese patient).

Serotonin syndrome is a potentially life-threatening side effect of SSRI; it occurs when excessive amounts of serotonin build up in the CNS. This stimulation of the CNS also leads to increased adrenergic activity and is causes the signs associated with serotonin syndrome, which include fever (without infection), clonus (shivering without cold), agitation, tremors and sweating. Serotonin syndrome may result from normal therapeutic levels of SSRI and interactions with MAOIs, tricyclic antidepressants, fentanyl, phentermine, methamphetamine and cocaine. These medications combine synergistically with SSRI to cause serotonin syndrome.

Untreated serotonin syndrome can lead to seizures, hypotension and dysrhythmia. Prehospital care is largely supportive. Benzodiazepines are used to control tremors and clonus.

Bariatric Surgery
Bariatric surgery has become an increasingly popular method of permanent weight reduction, especially with the advent of laparoscopic surgery. It’s estimated that more than 140,000 patients had bariatric surgery in 2004 and that greater than 50% of those surgeries were laparoscopic.

Although the mortality associated with this type of surgery is low (0.1% to 2% depending on the procedure), the complications usually necessitate EMS.

There are three classifications of bariatric surgery: restrictive, malabsorptive and combination. All three bariatric surgeries are intended to block the patient’s intake of excess calories, impacting the energy formula on the intake side.

Restrictive bariatric surgery procedures include gastric banding and gastroplasty. The FDA approved gastric banding, also known as lap banding, in 2001. Lap banding is a minimally invasive laparoscopic procedure that places an inflatable ring at the neck of the stomach near the fundus and proximal to the cardiac sphincter. This inflatable ring creates a small pouch and limits the amount of food the patient can eat.

The alternative to gastric banding is vertical banded gastroplasty (VBG), aka, stomach stapling. Like lap banding, gastric banding creates a small pouch but the procedure also includes a double row of staples that isolates the majority of the stomach from the pouch.

Gastric bypass is an example of a malabsorptive procedure. These procedures involve bypassing the stomach entirely and even removing as much as two-thirds of the stomach. Because of a number of nutritional complications, this procedure is discouraged in favor the RYGB combination procedure.

RYGB may be the most common bariatric surgery in the U.S., but it’s quickly being eclipsed by gastric banding (laparoscopic RYGB trials are being conducted). In such a procedure, the bariatric surgeon creates a one-ounce pouch at the stomach’s inlet and then detaches the small intestine at the jejunum and attaches it to the stomach at the pouch. The remaining arm of the duodenum is also attached to the distal ileum, creating a Y-shaped circuit.

RYGB has a proven record of sustained weight loss but is not without complications. Obvious complications include those common to all abdominal surgeries, including dehiscence (a spontaneous opening at the wound with or without evisceration) and hernia.

Other adverse effects include surgical complications at the site of the connections, or anastomosis. Some 20% of RYGB patients experience leakage of stomach contents into the abdominal cavity as a result of force from overeating at the staple line. These spilled stomach contents can lead to peritonitis. The symptom pattern associated with peritonitis includes dyspnea, tachycardia, abdominal pain and general restlessness.

Approximately 20% of patients who undergo RYGB may experience stomal stenosis, a narrowing of the stomach inlet that results in post-prandial epigastric pain, not dissimilar to the pain felt with gastroesophageal reflux after eating. A key sign of stomal stenosis is regurgitation of undigested food.

Dumping Syndrome
Gastric dumping syndrome is a form of rapid gastric emptying that occurs when a concentrated carbohydrate, such as sugar, enters the digestive tract. The higher osmolarity of the carbohydrates in the small intestines causes fluid shifts in the intestine. These fluid shifts are often accompanied by pain and nausea, and patients experiencing them often complain of feeling bloated or experience diarrhea.

The sugar spike also results in hyperglycemia and a subsequent rise in circulating insulin. As the fluid rapidly passes through the digestive system, the patient becomes hypoglycemic. The symptom pattern associated with hypoglycemia includes lightheadedness, weakness and even syncope. The EMS provider must be alert to the possibility of hypoglycemia induced by dumping syndrome even if the patient has just finished eating.

Treatment, Transport & Sensitivity
There’s a stigma surrounding obesity. In studies, even overweight people reported feeling obesity was unattractive. This "weight bias" can translate into subtle and sometimes not so subtle behaviors that patients can detect.

A greater sensitivity toward obesity comes from understanding that it has a complex etiology. Some believe that obesity is biological, a problem created by protein receptors in the lateral hypothalamus. Others believe that the cause of obesity may be genetic and point to research on the leptin gene. Still others believe that Americans live in an "obesogenic society where increased portions, sedentary lifestyles and unhealthy food lead to obesity.

Regardless of the etiology of obesity, the problem isn’t going to be solved in the field. Perhaps more importantly, if the patient has a negative experience with an EMS provider, they may be less inclined to seek help from other health-care providers. The EMS provider would be well served by maintaining a professional demeanor and acknowledging the difficulty of the patient’s situation.

In EMS terms, a patient is obese when they exceed the load-carrying capacity of the equipment or crew. In those cases, special resources should be brought to the scene.

Special response to bariatric patients should be thought of as a risk-control strategy. By utilizing specialized protocols and procedures, the responding department or agency can decrease their worker’s compensation claims and retain workers longer.

Some crews use specialized lift teams, which combine special tools, such as pneumatic lift devices, and training to move large patients with a minimum of effort. Some agencies have outfitted specialized bariatric ambulances. These agencies may stock large-body stretchers that can carry patients who weigh up to 700 pounds and have extra handholds that permit multiple EMS providers a grip point to help with lifting. These ambulances may also come equipped with ramps and winches to pull the patient into the ambulance.

Conclusion
EMS providers are duty-bound to act when called to the scene of a bariatric patient and may have other duties to that patient that dictated by the Americans with Disabilities Act. Therefore, every EMS system should have a bariatric response plan in place.

But more importantly, EMS providers should see bariatric patients not as a burden, but as another special population of patients deserving of our care and compassion. JEMS

Richard Beebe, MS, RN, NREMT-P, is the paramedic program director for Bassett Healthcare’s Center for Rural Emergency Medical Services Education, clinical assistant professor at the State University of New York at Cobleskill and a practicing paramedic in the town of Guilderland, N.Y. He has been an EMT since 1974 and an EMS educator since 1987. Mr. Beebe is the also the co-author of Fundamentals of Basic Emergency Care (third edition) and the Professional Paramedic Series.

References

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Illegal substances are party poopers for party goers as they may cause seizures or worse

2010-01-02T14:48:00.001-06:00

PARTYGOERS are being warned not to spoil their festive celebrations by taking illegal substances.

Some 'legal high' drugs have now been relabelled as illegal. But at least one highly dangerous substance is still within the law.

And police are urging revellers to steer clear.

Just before Christmas, a group of what were termed 'legal highs' were classified as Class B and C drugs - making them illegal.

Force drugs co-ordinator Bryan Dent said: "The government became so concerned about the adverse health effects of a number of substances, they have made them illegal to possess or supply."

Recently, a smoking/ herbal mixture known as SPICE became popular. SPICE has been found to have been treated with a chemical which mimics the effects of THC – the ingredient found in cannabis.

Mr Dent said: "SPICE was legal to sell and possess, usually from Head Shops and the internet. But now anyone found selling or in possession of SPICE which has been treated with certain chemicals is committing an offence for which they can be arrested. SPICE has become a Class B drug."

GBL (Gamma – Butyrolactone ) – although this colourless, oily liquid has a bona fide industrial use as a paint/varnish stripper and stain remover, it has also become popular on the recreational scene.

Mr Dent said: "Possessing or selling GBL for human consumption is now a criminal offence. Its effects when taken can be deadly – especially alongside alcohol."

Other substances now illegal to possess and sell include BZP and certain anabolic steroids.

Mr Dent said: "We want party goers to enjoy themselves, but also stay healthy. We don't get pleasure from informing parents and loved ones that their son or daughter has become seriously ill or died because they have been consuming drugs thought to be harmless. There is no such thing as a harmless drug."

Mephedrone, also known as M Cat or Meow, is also giving police cause for concern.

It is usually a white powder but is in fact plant food. It can be taken orally or snorted, but it is harsh on the nostrils and causes severe nose bleeds. It can cause blurred vision, increased perspiration and increased risks of fits and seizures, breathlessness and high blood pressure.

Mr Dent said: "Although it is not a controlled drug, in other words not illegal to possess, it is dangerous for humans to consume. A number of people have taken it and ended up in hospital."

Dog seizures: Getting help is the owner's responsibility

2009-12-13T18:21:00.000-06:00

Maxine has seizures.

The 2-year-old old King Charles spaniel was diagnosed with epilepsy early on and has been taking medication ever since. Unfortunately, Maxine's seizures are progressing in duration and frequency and her owners, Tanya and Caleb, are worried.

Seizure disorders are some of the more common neurological diseases in canines, and the list of possible causes is quite long. In a young dog such as Maxine, however, epilepsy is by far the most common cause.

A seizure is defined broadly as an uncontrolled discharge of cells within the brain called neurons. The area from which the seizure emanates is called a seizure focus. In some cases, there can be multiple foci.

As veterinarians, we focus on stopping the seizures, as they can be extremely dangerous, and determining their underlying cause.

It is very important for pet owners to keep a detailed history describing the seizures and possible ingestion of abnormal "food" items. Certain foods can trigger seizures -- dark chocolate, snail bait and moldy walnuts being among the more common.

As far as pinpointing a cause, a blood panel can determine if a metabolic disease, especially one that affects the liver, is at play.

Sampling the fluid around the brain and spinal cord, called cerebral spinal fluid, can tell if abnormalities within this fluid are causing seizures. Sometimes an MRI (magnetic resonance imaging) or a CT (computer tomography) scan of the brain can show abnormal areas that might be causing seizures. Tumors within the brain can be demonstrated this way.

Even with all these tests, we do not find a distinct underlying cause. These patients are usually diagnosed with epilepsy, which is arrived at by excluding other causes of seizures.

Epilepsy also is more common in breeds, among them spaniels like Maxine. Patients with epilepsy are commonly treated with Phenobarbital to prevent seizures. It is usually quite effective and well-tolerated by the dogs. In Maxine's case, however, even with her treatment, her seizures are occurring and worsening.

Maxine needs to have her blood checked to measure her Phenobarbital levels. It may be that she simply is not taking an adequate amount. If that is not the case, she may need to have another anti-seizure medication added to her Phenobarbital regimen. This is not uncommon and will likely take care of the seizures. There is, however, a chance that her seizures are not the result of epilepsy and that there is as yet a cause which will require more diagnostics.

A key point to remember is that the seizures need to be controlled. The more they occur, the harder it is to stop them.

I hope for Maxine's case, it will be a simple case of adjusting her medication.

Jeff Kahler is a veterinarian in Modesto. Questions can be submitted to Your Pet in care of LifeStyles, The Modesto Bee, P.O. Box 5256, Modesto 95352.

The legal rights of families dealing with birth defects such as seizures and much more

2009-12-13T18:02:00.000-06:00

Article provided by Barry D. Lang M.D. and Associates
Visit us at www.lawdoctors.com

What is a birth injury?

A birth injury is an injury that happens to a baby during the birthing process. The majority of birth injuries are minor and will heal on their own within the first few weeks after delivery. For example, minor birth injuries include the bruising, swelling and minor nerve damage that may occur as the baby moves through the birth canal.

Other birth injuries, however, are more severe and may cause long-term damage to the child. For example, if the baby is deprived of oxygen for even a short period of time, the child could develop cerebral palsy. Cerebral palsy is a condition that occurs when there has been trauma to the brain, affecting the development of the child's ability to control and coordinate movement. Cerebral palsy can cause seizures, vision and hearing problems and mental retardation. It is estimated that 5% of cerebral palsy cases are linked to birth injuries.

Erb's palsy is another serious condition that can occur as a birth injury. Erb's palsy occurs when the nerves in the neck and shoulder are stretched or torn, resulting in weakness or paralysis in the arm. The nerves can be stretched during a difficult delivery, either through the natural birth process or if the physician has to use force to deliver the baby. In the majority of cases, the effects will be temporary. But in cases where the nerves were torn, the damage can be long-term or even permanent and may require surgical repair.

Other examples of birth injuries include:

Facial paralysis
Fractures
Soft tissue injuries of the scalp (caput succedeneum)
Broken blood vessels in the eyes (subconjunctival hemorrhage)
Hypoxia (lack of oxygen to the baby)
Cuts/scrapes from use of forceps and/or vacuum

What causes birth injuries?

Birth injuries may be caused by a number of factors, such as:

Difficult and/or prolonged labor
Premature birth
Large-baby birth
Breech position or other abnormal birthing position of the baby
The size and shape of the mother's pelvis

Birth injuries often are associated with large babies because of the increased risk of a difficult labor. The physician may have to use extreme measures to deliver the baby, such as using forceps or a vacuum. Using either one of these devices can cause injury to the infant. If these measures do not work, then the physician may have to resort to an emergency cesarean section (C-section) to remove the baby, which poses an increased risk of injury to the mother and child.

Birth injuries and medical malpractice claims

Sometimes birth injuries are caused by the acts (or the failure to act) of the obstetrics team responsible for delivering the child. Like other medical malpractice claims, a successful birth injury case must show that the doctor or other health care provider acted negligently. To prove negligence, the plaintiff must be able to show that the health care provider failed to provide the accepted standard of care during the birth of the child and that this failure was the cause of the child's injury.

A number of circumstances may point to a physician's negligence as the cause of the birth injury. For example, during labor the physician must monitor the heart rate and oxygen levels of the mother and baby. If these levels go too low or too high, it may be an indication that the baby is in distress and that the physician needs to take immediate action. If the physician fails to take the appropriate steps to remedy the situation, the baby could suffer from oxygen deprivation (hypoxia), putting it at risk of developing cerebral palsy or suffering another type of serious brain injury.

Medical organizations like the American College of Obstetricians and Gynecologists (ACOG) have established specific standards for monitoring statistics during delivery. It is important that doctors, nurses and others on the obstetrics team follow these guidelines to protect the safety of the mother and child ? and not merely rely on their "gut" feelings. When medical standards are not followed and an injury to the child results, the physician and other health care providers may be liable for medical malpractice.

Birth injuries vs. birth defects

Birth injuries are different from birth defects, which happen during the pregnancy. Birth defects may be due to a genetic condition, such as Down syndrome. Birth defects also may be caused by external conditions to which the mother is exposed during pregnancy, like harmful toxins. In addition, birth defects can be caused by bacteria or other substances in food, like high concentrations of mercury in certain types of fish or listeria in lunchmeats. Some medications, such as the acne medication Accutane, that mothers have taken during pregnancy have been connected to birth defects.

Depending upon the factual circumstances, a medical malpractice case also may be appropriate in birth defect cases if the health care provider's negligent acts caused the defect.

Getting help with your claim

If you believe your child's birth injury is the result of the negligent acts of your physician, you may be able to bring a medical malpractice claim against him or her for your child's injuries.

Birth injuries can have devastating physical, mental, emotional and financial consequences for the child and parents. An experienced medical malpractice attorney can review your claim and help you determine if pursuing legal action is in the best interests of you and your child. There is a limited amount of time to file a medical malpractice claim for a birth injury in Massachusetts. For more information, speak with an attorney.

Blood Biomarkers, Preeclampsia and seizures

2009-11-19T19:00:00.000-06:00

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

2009-11-19T18:55:00.001-06:00

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

2009-11-19T18:38:00.002-06:00

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

2009-11-15T00:07:00.001-06:00

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

2009-11-14T23:57:00.001-06:00

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

2009-11-14T23:50:00.001-06:00

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

2009-11-14T23:47:00.001-06:00

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

2009-11-14T14:27:00.000-06:00

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

2009-11-14T14:06:00.002-06:00

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

2009-11-14T14:02:00.001-06:00

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

2009-11-07T15:43:00.001-06:00

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

2009-11-07T15:40:00.002-06:00

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

2009-11-07T15:29:00.001-06:00

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

2009-11-07T14:53:00.000-06:00

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

2009-11-07T14:16:00.001-06:00

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).

Gardasil and Swine Flu vaccines are linked to seizures

2009-09-19T23:25:00.001-05:00

The summer of 2009 revealed two inconvenient truths about vaccination. First, the Gardasil vaccine is not as safe as the government, medical organizations and Merck have said it is. Second, the H1N1 influenza pandemic is not as serious as health officials are telling you it is.

One in every 1,855 Gardasil shots is followed by a bad health outcome report to the government’s Vaccine Adverse Events Reporting System. These bad health outcomes reported after Gardasil shots include lots of girls suddenly passing out and having seizures.

There is also a greater than expected rate of reported blood clots. In fact, four girls have died after they developed a blood clot that traveled to their lungs after Gardasil vaccination.

Apparently, the government can let vaccine manufacturers fast track the Gardasil vaccine, but can’t compel the drug company that makes the vaccine, or doctors giving it, to report each and every death and serious injury that follows vaccination. Why believe anything government health officials tell us about the safety of vaccines? Why believe that the experimental swine flu vaccines being fast tracked with only a few weeks of study are going to be safe, and that all vaccine reactions will be reported to the government and then properly followed up?

It is far more likely that, when children get swine flu vaccine in schools and then get really sick or even die like the Gardasil girls, that all those bad health outcomes will be written off as a coincidence by health officials. That is, if any reports are made to the government at all -- few school nurses or other people giving children swine flu vaccines in the schools will be taking medical histories, much less monitoring children for signs of a vaccine reaction and then filing a reaction report to the government.

It is time to demand that government officials and drug companies stop conducting national vaccine experiments on the American people.

Sources:

National Vaccine Information Center August 24, 2009

Seizures suffered by a participant to: The Secret Millionaire

2009-09-19T23:21:00.002-05:00

One of the county's richest women has spoken for the first time about the double blow of her latest terrifying health scare and the "devastating" death of her mum.

Hilary Devey revealed how she was rushed to hospital after suffering two seizures at her villa this summer in Spain, where she was recuperating from an earlier stroke.

The 55-year-old, who single-handedly set up Ellistown haulage company Pall-Ex, said she thought she was dying when the first fit happened as she was getting ready to go out for the day with friends.

She had a third seizure in an ambulance and was told she had to be resuscitated by doctors when her heart stopped during a fourth episode at the hospital.

Ten days after her ordeal, she was back recovering in her villa.

But then she was hit with another blow – a phone call from England to say her 82-year-old mum, Wyn Cross, was critically ill in hospital.

Unable to fly because of her bad health, she was driven by two friends non-stop for 25 hours from her home near Benidorm, in a mammoth 1,400-mile journey to make it to Wyn's bedside at Queen's Hospital, in Burton-on-Trent.

She got there in time to say her final farewell. Her mum, who had been poorly for many months and suffered heart and kidney problems, died two days later.

Ms Devey, who lives outside Burton, said: "I was not in a good way myself, but I knew I had to get there to be with my mum."

Ms Devey's problems began this year after a tummy tuck operation in January. Weeks later, the wound became infected and she ended up in intensive care after a stroke.

After many weeks under observation in hospital, she was released. She was days into her stay in Spain when the seizures happened in July.

She said: "It was terrible. The seizures came completely out of the blue. I thought I was dying.

"I don't really remember the one in the hospital but there were friends there who told me they'd had a team resuscitate me after my heart stopped."

Ms Devey had the phone call about her mum a few weeks later.

She said: "It wasn't safe for me to fly, or to drive because of my health, but I thought I'd just have to take a chance and get on a plane. I had to get to my mum.

"We went non-stop through Spain and France. As soon as she saw me, she perked up. She'd been holding on for me, but it was clear she didn't have long left.

"The last thing she said to me, the day before she died, was that I looked beautiful. I told her I loved her and I didn't want her to leave me."

Wyn died on August 13. Ms Devey, whose father Arthur died of stomach cancer when she was 17, said nobody could be sure if her seizures were directly linked to the stroke she had this year, but doctors told her it could happen again.

She said she was determined to continue in her role with Pall-Ex, which she started in 1996 and now has an annual turnover of more than £100m.

She said: "I'm just glad I got back to see my mum in time – for that I'll be eternally grateful."

Ms Devey gave more than £130,000 to good causes last year on Channel 4 show The Secret Millionaire.

Fighting seizures and Autism

2009-09-19T22:15:00.000-05:00

It's not exactly a political or town hall rally, but there will be plenty of fervor this Sunday from noon to 4 p.m. at a special "Show-Me Coverage Autism Insurance Rally" at T.R. Hughes Ballpark in O'Fallon, Mo.

A special family that will be there in force is Glendale's Eric and Jaime Schmitt and their youngsters. For Missouri Sen. Eric Schmitt, R-Glendale, this rally involves a personal cause, a family cause and a political cause.

"Of the top 10 most common neurological disorders, autism is the only one not covered by health insurance," said Schmitt. "Families all over our state are struggling every day to afford treatment and services for their loved one with autism.

It's a parity issue and an issue of fairness and more," added Schmitt. "For one thing, we have treatments that were experimental 10 years ago, but which are now accepted as effective. For another, we are now learning just how pervasive autism is as a family situation that needs to be addressed - and addressed early."

Schmitt is being joined in the rally and the cause by state Sen. Scott Rupp, R-Wentzville. Rupp, along with former state Sen. Michael Gibbons, R-Kirkwood, and state Sen. Jolie Justus, D-Kansas City, were instrumental in putting together a Missouri Blue Ribbon Panel on Autism.

The panel's study noted that autism is a profound mental and biological disorder linked to specific brain abnormalities. It shows up under many guises and can involve behavioral problems ranging from extreme introversion to disturbing, angry, violent outbursts.

Autism appears now in one of every 150 children, although its incidence specifically in boys is much higher. Some testifying before the state panel called it an epidemic, although they explained that early diagnosis and intervention can make a big difference in the lives of everyone in coping with autism.

"One thing to emphasize about the rally is that this will not be a bunch of politicians giving speeches," said Schmitt. "It's going to be a fun-filled, family-friendly event. The Dave Glover Band will play; face painting and balloon animals will be there for the kids; and celebrity autographs and photo-ops with sports stars such as Ozzie Smith, Darryl Strawberry and Lou Brock will be part of the day."

Nevertheless, there is a political agenda to the event. The rally is meant to kick off the push for a law in the Missouri Legislature that will mandate "Show-Me Coverage" of Autism by insurance companies.





	Jamie Schmitt with her son, Stephen, in their Glendale home. photo by Diana Linsley (click for larger version)

A Family Concern

Eric and Jaime Schmitt have been assisting their 5-year-old son, Stephen, with autism treatment and care since his diagnosis. Fathers sometimes find it especially hard to connect with children with autism, but Eric has obviously overcome that hurdle as he and his son interact together.

"Autism involves such a broad spectrum. Our son has some severe issues," explained Eric Schmitt. "Stephen did not make eye contact. He had life-threatening seizures. He has made amazing progress since his therapy treatments began.

"He is happy and he is loved, and by the grace of God we have been fortunate to cover his treatments out of pocket," added Schmitt. "Not all families are in a position to cover all the needs that autism can bring."

Jaime Schmitt had high praise for the Kirkwood School District and its resources to deal with developmental disorders such as autism. She also noted that schools are pivotal in helping all parents understand what autism is all about.

In 2008, radio shock jock Michael Savage caused a furor when he insisted 99 percent of autism cases are caused by permissive or poor parenting. Savage said in most every case, autism is about a child "who hasn't been told to cut the act out."

Savage competes for listeners with Rush Limbaugh and Sean Hannity, who are the only right-wing radio talk show hosts with larger audiences. On his broadcasts, Savage said autism has no definitive medical diagnosis and usually involves children without fathers to tell them: "Don't act like a moron. You'll get nowhere in life."

Jaime Schmitt said people are becoming more educated and aware of what autism actually is about. She said autism is a disability that must be diagnosed and treated.

"Quite frankly, Stephen's condition has been a critical factor in the way Jaime and I look at things," said Eric Schmitt. "It has given us a perspective that we would not otherwise have. And I think that to educate people about autism has become important to us.

"People need to know that this is not a behavioral issue," Schmitt added. "It's not a matter of discipline and it's not a behavioral issue. It's not the fault of the child or the parents when autistic children seem to act out in different settings."

Passing A Bill In 2010

Schmitt and other supporters of the autism insurance coverage mandate are optimistic. He explained that in 2009, the autism bill was voted out of the Senate by a 29-2 vote. However, it was bottled up in a House committee and never made it onto the floor for a vote.

According to Schmitt, insurance lobbyists can take credit for stopping progress on the bill in 2009. He said that doesn't have to happen in 2010, and he made that point with Gov. Jay Nixon after the 2009 session ended.

"The insurance industry has blocked autism from being covered in the past," said Schmitt. "They are a special interest group that has argued about costs, but I think the insurance industry is starting to take a new look at the reality of autism. Treatment is an investment that saves costs down the road.

"I did not mind standing with Gov. Nixon on this and to make the point that it should have been passed in the last session" added Schmitt. "For me, passing this bill is the right thing to do. And I don't care who gets the credit, whether it's a Democratic governor or a Republican legislature. It is a bill that will be good for all Missourians."

Jaime and Eric Schmitt are aware of the contentious debate over what causes autism, from vaccines to environmental factors to genetics. For now, they are focused on therapies and the wherewithal to cover needed diagnosis and treatment.

"Everybody and anybody should come to the rally on autism care on Sept. 20," said Schmitt. "I promise there will not be a lot of speech making. I promise," the state senator smiled.

For more information and updates go to www.MoAutismBill.com.

Pollution can cause cancer and seizures in marine mammals

2009-07-31T23:34:00.000-05:00

Have you ever wondered if animals get cancer?

Just like people, animals can become sick and die from cancer.

A recent study by scientists at the Wildlife Conservation Society reports that cancer is a leading cause of death in marine animals, and a major cause of cancer in animals is pollution. Just as pollution can cause cancer in humans, pollution also causes cancer in animals.

Sea turtles living in polluted waters have high cancer rates. Endangered green sea turtles are especially prone to tumors on the skin, lung, liver, kidney, and heart.

Bottom-feeding animals such as beluga whales, catfish, and sole are also susceptible to cancer. These animals are continually exposed to seafloor sediments which absorb harmful industrial toxins. Cancer kills beluga whales living in the polluted St. Lawrence River estuary in Canada. Nearly 20 percent of all beluga whale deaths are attributed to cancer, and over 25 percent of adult beluga whales have tumors.

Beluga whales are affected by man-made pollution from factories on the land near the St. Lawrence River. However, animals can also be affected by naturally occurring pollutants and toxins that exist in the environment.

Some algae are toxic when they naturally occur in high amounts. The result is a red tide. Red tides may affect and kill marine animals such as shellfish, fish, birds, and marine mammals.

Some red tides are caused by natural oceanographic events such as El NiÃ±o. Coastal upwelling, where nutrient-rich water is lifted from the ocean depths towards the surface, may also cause red tides. As human-induced climate change raises sea surface temperatures and increases the frequency of major coastal storms, some scientists predict an increase in red tides.

Other types of human activity may cause red tides. Agricultural runoff contains large amounts of algae "food" (nitrates and phosphates) and may cause red tides. The ever-growing human population will only increase demands on agriculture. As a result, the frequency of red tides is likely to increase.

California sea lions have been feeling the effects of red tides over the past decade, according to researchers at the national Oceanic and Atmospheric Administration in Charleston, S.C., and the Marine Mammal Center in Sausalito, Calif.

Domoic acid, a toxin present in some plankton, causes reproductive problems and seizures in otherwise healthy sea lions. Domoic acid works its way up the food chain. First, sardines and anchovy feed on the plankton. Then, sea lions eat the sardines and anchovies. Mothers can even pass on the toxin to their pups.

Closer to home, 14 humpback whales died in December 1987 as a result of eating mackerel which had fed on a toxin in plankton. Most of these whales washed up around Cape Cod.

Pollution is a major problem, on both land and sea, and it will not go away easily or quickly. Only through wide-scale change may sustainable solutions be implemented to clean up our waters, making them healthier for wildlife and humans alike.

Seventy percent of Earth is covered by oceans. As individuals, we can engage in simple, everyday activities to lighten our load on the planet:

Buy organic produce at local farmers markets this summer.

Use reusable water bottles and cloth shopping bags.

Plant a tree.

Recycle.

Pick up litter on the beach.

Cut back on your meat consumption.

Use compact fluorescent bulbs and remember to turn off the lights when you leave a room.

Dry your clothes on a line instead of in the dryer.

Carpool or take public transportation.

Collectively, we can also make a difference in two major ways: policy and education. These topics will be the focus of my upcoming columns.

Dr. Heidi Pearson, PhD, is the assistant director and stranding coordinator for the The Whale Center of New England, based at 24 Harbor Loop in Gloucester. You can contact her and the center via phone at 978-515-5001, via fax at 978-281-5666, or by visiting www.whalecenter.org. The center's stranding hotline is 978-281-6351.

Born with one brain hemisphere, a young girl amazes experts!

2009-07-31T22:59:00.000-05:00

A 10-year-old girl from Germany has had quite a normal life despite the fact that she was born with only half her brain. Even more surprising, she has almost perfect vision in one of her eyes.

Now, scientists have figured out why. The girl's brain rewired itself — likely in the womb — so that it's able to process information from both the right and left fields of vision even though she is missing the right brain hemisphere, which failed to develop while she was in the womb.

The child's case is the only one of its kind known in the world, researchers said.

Usually, a person's left and right visual fields are processed by opposite sides of the brain — the left hemisphere handles the right field of vision and the right hemisphere takes care of the left field of vision.

But functional magnetic resonance imaging (fMRI) scans of the girl's brain showed that the retinal nerve fibers which should have gone to the right side of her brain instead rerouted to the left. Also, the scans revealed that the visual cortex on the left side of her brain, which maps out the right field of vision, contained "islands" to deal with the left visual field.

“The brain has amazing plasticity but we were quite astonished to see just how well the single hemisphere of the brain in this girl has adapted to compensate for the missing half," Dr. Lars Muckli, a researcher from the Center for Cognitive Neuroimaging at the University of Glasgow, said in a statement.

When the girl, a German who has not been named by researchers, was three years old, she underwent an MRI scan after suffering seizures and twitching on her left side, and she was found to have an underdeveloped brain. Her seizures have since been successfully treated, and she has had an almost normal developmental and medical history, attending regular school and taking part in activities such as roller-skating.

"Despite lacking one hemisphere, the girl has normal psychological function and is perfectly capable of living a normal and fulfilling life. She is witty, charming and intelligent," said Muckli.

When patients have half of their brain removed to treat epilepsy, they lose one field of vision in both of their eyes, meaning they see only objects on the left or right side of their vision. But the German girl's case is unique because she can see both left and right visual fields in one eye.

Each of your eyes sends visual information to two parts of your brain through two different nerve fibers. The nerve fiber closest to your nose is called the nasal retina, and the nerve fiber by your temples is called the temporal retina.

Normally, the nerve fibers from the nasal retina cross over in a section of the brain called the optic chiasma, so they are processed by the opposite hemisphere. On the other hand, the nerve fibers form the temporal retina stay in the same hemisphere. This set up causes the left and right visual fields to be processed by opposite sides of the brain. For instance, in your left eye, visual signals from your left field of vision will be sent to the right side of your brain via the nasal retina, while visual signals from your right field of vision will be processed by the left side of your brain via the temporal nerve.

But in the girl's case, the left nasal retina nerve connected to the left brain hemisphere.

The researchers think that the girl's right brain hemisphere stopped developing early in the womb, and that when the optic nerves reached the optic chiasma, the chemical cues that would normally guide the left eye nasal retinal nerve to the right hemisphere were not present, so the nerve was drawn to the left.

If this is indeed the case, it would mean that there are no molecular repressors to prevent the nasal retinal nerve fibers from entering the same hemisphere.

Dr. Muckli led the study and collaborated with colleagues from the Institute of Medical Psychology at Goethe University, Germany. The results were published online in the Proceedings of the National Academy of Sciences on July 20.

Insects, pets and seizures

2009-07-31T22:56:00.001-05:00

As with most things in life, many things affect dogs the same way it does humans. Stinging insects are issues for dogs as well as humans. It usually takes a couple of stinging incidents before a reaction shows and these reactions run from mild to severe.

Mild
Mild reactions include fever, sluggishness and loss of appetite. Mild reactions mimic reactions your dog may get after receiving a vaccination and usually resolve without treatment.

Moderate
Urticaria is a moderate vascular reaction of the skin marked by hives and rapid swelling and reddening of the lips, eyes, and neck. It's usually extremely itchy and can sometimes progress into a life threatening reaction.

Severe
The most severe reaction is anaphylaxis, which causes breathing difficulties, collapse and possible death. Symptoms usually appear within minutes and include sudden vomiting, diarrhea, staggering, drop in blood pressure, swelling of the larynx, seizures, and cardiovascular collapse or death. This is extremely life threatening.

Veterinary Care
There is no diagnostic tests for anaphylaxis or urticaria, but allergic reactions can be diagnosed with a quick physical exam.

Treatment
Anaphylaxis is an extreme emergency and occurs soon after being stung. Veterinarians will begin immediate emergency life support to establish the airway to administer oxygen and intravenous fluids to increase the blood pressure. Drugs like epinephrine, diphenhydramine, and cortiocosteriods will be administered. Animals that survive the first few minutes usually return to normal health.

If your dog is known to be allergic, your veterinarian may suggest Benadryl in the early stages of an allergic reaction. Unfortunately oral medications may not be sufficient and you will need to take your dog in for an examination and treatment.

Author: Leanne Moore

Leanne Moore is an Examiner from Charlotte. You can see Leanne's articles on Leanne's Home Page.

Details on Jett Travolta's tragic death!

2009-07-31T22:53:00.000-05:00

Intense scrutiny has focused on John Travolta's family after the death of the actor's chronically ill 16-year-old son Jett, who died at the family's vacation home at a Grand Bahama resort on Friday.

Yesterday, an undertaker said the death certificate concluded that the cause of death was a seizure, and that the teen's body showed no sign of head trauma despite earlier police reports that he hit his head on a bathtub.

Mr. Travolta, 54, and wife Kelly Preston, 46, were spending New Year's with their son and eight-year-old daughter Ella Bleu at the luxury Old Bahama Bay resort community.

In a statement issued last Friday, Grand Bahama Police Superintendent Basil Rahming said caregiver Jeff Kathrain found the stocky teen unconscious in the bathroom; he was later pronounced dead at Freeport's Rand Memorial Hospital. According to the statement, Jett was last seen going into the bathroom on Thursday.

Mr. Travolta attempted CPR to revive his son, who may have died in his arms before an emergency medical technician took over, Usmagazine.com reported, citing the actor's lawyers Michael McDermott and Michael Ossi.

“He did mouth-to-mouth until they had to physically remove John to take Jett to the hospital,” Mr. Ossi told People magazine.

The lawyers have vehemently denied that the boy was unsupervised, saying two nannies were with him.

“[Jett] was spectacularly supervised,” Mr. McDermott told the Associated Press.

The media spotlight has also turned to the Travoltas' adherence to the Church of Scientology, the religious philosophy founded in 1954 by American science-fiction writer L. Ron Hubbard.

Scientology does not recognize autism, which causes seizures in one in four cases, according to the National Institute of Health.

The family has denied that Jett was autistic, maintaining instead that at age 2, he was diagnosed with Kawasaki syndrome, a disease that affects young children, inflaming blood vessels and causing high fevers.

Ms. Preston came to believe Kawasaki syndrome – which is not typically associated with seizures – had been caused by the carpet cleaners she was using in the home.

The actress then led a public crusade against chemical-laden cleaning supplies and pesticides, and told People magazine that a detoxification program based on the church's teachings had helped Jett's health.

On Friday, Mr. Ossi told ABCNews.com that Jett “has had seizures in the past, but they were controlled. This one couldn't be.”

The lawyers also told the celebrity website TMZ that the teen was suffering approximately one severe seizure a week.

They said Jett had been on anti-seizure medication for several years but that the family discontinued his prescription after it stopped working. The teen was reportedly taking Depakote.

Authorities did not release the results of the autopsy yesterday, but the Bahamian undertaker viewed the body and the death certificate.

Bahamian Prime Minister Hubert Ingraham sent condolences to the family. He said the autopsy is a formality the Bahamas require to rule out foul play in cases of sudden death.

“We are heartbroken that our time with him was so brief,” Mr. Travolta and Ms. Preston said Sunday in a public statement. “We will cherish the time we had with him for the rest of our lives.”

Mr. Ossi told reporters that the actor is “heartbroken,” adding, “To bury your son is the worst thing you can ever do.”

It was believed that Jett was to be buried in Ocala, Fla., where his parents and sister live, and late yesterday evening, a black hearse travelled from the funeral home to the airport. Two white jets waited as police in dress uniforms blocked the tarmac.

But the hearse was a ploy, funeral home director Keith McSweeney told a news conference later in the evening. He said that Jett's remains were instead being cremated, and that the family would leave the Bahamas with his ashes today.

Mr. McSweeney told reporters he could not explain the reason for the decoy.

The Bahamas has seen its share of celebrity deaths: Both actress Anna Nicole Smith and her 20-year-old son Daniel died on the island and are buried there.

After a seven-week investigation, Ms. Smith's cause of death was deemed a “combined drug intoxication;” her son's cause of death, meanwhile, was “reserved” by a coroner.

Potassium is important for children suffering from Epilepsy

2009-07-31T21:41:00.000-05:00

For children on the high-fat ketogenic diet to control epileptic seizures, a daily supplement of potassium citrate can prevent kidney stones that the diet sometimes causes, according to research from Johns Hopkins Children's Center. The report is published in Pediatrics.

"We can confidently say this is a safe and powerful way to prevent kidney stones, and it should become part of standard therapy in all ketogenic dieters, not just those who already show elevated urine calcium levels," says senior investigator Eric Kossoff, M.D., a pediatric neurologist at Hopkins Children's. "If you wait, it might be too late."

The ketogenic diet, believed to work by initiating biochemical changes that eliminate seizure-triggering short circuits in the brain's signaling system, is advised for many children whose seizures do not respond to medications. But the diet, which consists of high-fat foods with very few carbohydrates, causes a buildup of calcium in the urine and the formation of kidney stones in about 6 percent of patients.

Hopkins Children's adopted the preventive treatment with potassium citrate two years ago, and doctors now believe this side effect of the diet is no longer a problem, allowing children to stay on the diet for more time. Potassium citrate taken twice daily, either as powder sprinkled on food or dissolved in water, is believed to inhibit stone formation.

In their study of 301 children treated for epilepsy with the ketogenic diet at Hopkins Children's the researchers found that those who got potassium citrate twice daily were seven times less likely to develop kidney stones — one of 106 (0.9 percent) developed a kidney stone compared to 13 out of 195 (6.7 percent) who were given potassium citrate only after testing positive for elevated levels of blood calcium. Most children received one 30-milliequivalent packet (about 1, 170 milligrams or 0.04 ounces) of potassium citrate twice daily.

Although rarely serious, kidney stones can cause significant pain, along with kidney and urinary tract infections, and may require surgery.

Source: Johns Hopkins Medical Institutions

Ancient brain surgery technique saved the life of an elderly woman

2009-07-31T20:34:00.000-05:00

Using a technique that dates back to the Stone Age, one of New Bedford's premier neurosurgeons recently saved the life of an elderly but feisty Acushnet woman who suddenly started bleeding deep in the back of her brain.

There is evidence that, 7,000 years ago or more, Neolithic medical practitioners — such as they were — performed the technique, perhaps to release evil spirits from the afflicted. During medieval times, physicians did the job to restore the balance of the body's four humors.

Trepanation, in which a hole is drilled through the skull to expose the brain, was a widespread practice in the ancient world. It has been performed, since prehistoric times, to treat such conditions as mental illness, seizures, migraines and head wounds.

Had trepanation been performed on a patient such as 90-year-old Irene Andre, the ancient medical practitioner would have actually been on the right track, according to Dr. Aubrey Okpaku of SouthCoast Neurosurgery, part of the Southcoast Health System.

Okpaku says he used essentially the same ancient cure (now called a craniotomy), but with the advantage of modern imaging techniques to tell him exactly where the blood on Irene's brain needed to be drained.

Unlike the practice of ancient trepanation, however, Okpaku did not leave behind a large open hole in his patient's skull or keep the removed piece of bone as a charm against evil spirits.

Though nobody would ordinarily think to compare the highly developed 21st-century skills of Okpaku to his ancient predecessors, he himself did in Irene Andre's case.

Okpaku has a distinguished history of high-tech surgeries to his credit. Before coming to the Southcoast , he was part of the surgical team at Montefiore Medical Center in the Bronx, N.Y., which five years ago separated twin boys born joined at the head.

"That was ground-breaking," the neurosurgeon says. "That was extraordinary."

For Irene Andre's family, her treatment was just as extraordinary, but Okpaku refuses to take credit for her recovery, despite the fact that, without his intervention and expertise, she would certainly have died within 48 hours.

"I don't mean to be glib, but someone was looking out for her other than the hospital staff," insists Okpaku. "The factors that led to a good outcome for her were not in the hands of the medical community that took care of her."

The "point of irony" in his intervention with Irene, Okpaku says, is that it entailed "the oldest surgery in the history of mankind. Three thousand years ago they were drilling into the skull to reduce the pressure on the brain. That's basically what I did."

Nevertheless, Irene's family is grateful to him and the entire St. Luke's Hospital team that saved the Acushnet great-grandmother's life while also preserving all of her mental and physical faculties.

Though she remembers nothing of the surgery, Irene clearly recalls the day her brain started to bleed.

On a Tuesday morning last February, Irene was going about her regular household tasks.

"I putter around," she says. "I'm a putterer."

However, as the morning progressed, she became increasingly unable to coordinate her movements or hold up her head. She remembers curling herself onto the closest chair and calling out to house guest Peter Soucy Jr. for help.

Irene knew something was very wrong, but she wasn't in pain.

She recalls, "I wasn't feeling good. I sat sideways and made like a bridge out of my hands to hold my head."

Even while in the ambulance on her way to St. Luke's and during triage in the emergency room, she was able to fight through the disorientation caused by the bleeding, says son Jim Andre. His mother was able to answer correctly when the medical staff asked her standard assessment questions — who is the president, what year is it — despite the increasing pressure of blood pooling in the back of her skull and pressing on her brain stem.

"When I was called in," Okpaku comments, "I thought I was going to find my patient comatose and on her way to a better place. Most people her age would have died before I ever saw them."

Okpaku says that Irene Andre's cerebral hemorrhage was likely due to a simple weakening of a small blood vessel inside her brain that eventually started to leak. Unlike an aneurism, which forms in large vessels on the surface of the brain and, when it bursts, causes blood to pour out quickly, Irene's smaller bleed may have been seeping into her skull for up to two hours before she noticed symptoms.

Her bleeding was in the posterior fossa, which contains two vital structures: the brain stem and the cerebellum.

Okpaku explains that injury to the brain stem affects respiration, wakefulness and nerves to the face that control functions such as eye movement, tongue movement and chewing. The cerebellum controls movement of the arms and legs.

Ironically, the fact that aging brains tend to shrink up to 25 percent may have provided Irene the extra space she needed during the emergency to withstand pressure inside her skull without damage to her brain.

The most common reasons for the brain's vessels to weaken and bleed, Okpaku says, are long-standing hypertension, diabetes or amyloidosis (protein deposits inside vessel walls). Irene had none of these conditions.

Faced with the tremendous responsibility to choose between life and death for his mother, Jim Andre says he didn't hesitate to approve Okpaku's suggestion that a craniotomy could save her life.

"We were told that if we did nothing, she'd die peacefully within 48 hours. They said the surgery was risky, and that there was no way to tell what shape she'd be in if she survived it. But, we figured a small chance was better than none at all," Andre recalls.

Four hours later, Irene came through her surgery with a small hole drilled into the base of her skull where Okpaku found the troubled blood vessel and stopped it from leaking.

He drained off the pooled blood and made another small hole in the top of her head to insert a drain that kept her cranial pressure under control for several days while the nonagenarian healed.

After a week at St. Luke's, Irene went to a nursing home for several weeks of recovery and physical therapy.

Now, she's back home singing, dancing and watching her favorite horror movies once again with her husband, James, to whom she's been married 58 years.

"I feel good. They saved my life," Irene says with a grin.

As for Dr. Aubrey Okpaku, he's still not taking the credit, even though he moved to the SouthCoast precisely because he was looking for a home where he could make a difference in the community.

"Speaking as a neurosurgeon," Okpaku says, "I'm constantly working to understand and heal the most complex structure known to man (the human brain). We don't know what we're dealing with most of the time.

"Most neurosurgeons have a great deal of humility."

Contact Pamela Marean at pamelamarean@pamela

Heat and seizures: A fatal mix!

2009-07-31T20:11:00.000-05:00

Bill Ross, 55, of Gore was discovered just after 2 p.m. Monday in a construction zone near 41st Street and 25th West Avenue.

Ross’ cause of death has not been determined, however it appears he had been suffering from medical problems and the heat may have contributed to his death.

Before his identity was confirmed, authorities were initially investigating whether the man was homeless due to the circumstance surrounding his death.

Ross lives in a nursing home in Gore due to a head injury he suffered that causes him to have seizures. He was in Tulsa visiting his brother, Jim Reese and his wife Carol Reese.

Carol said that Ross left their home in the 3600 block of South Pheonix Avenue Monday morning and never came back.

“We went looking for him, but we could not find him,” Reese said.

She said that her husband learned about the man who was found in the construction site the next morning and called police Tuesday morning. Later that morning, police notified the family that the man was confirmed to be Ross.

Reese said that she spoke to people at the construction site where he was found and they told her that he had been there since that morning. Authorities and witnesses also said that he had been drinking vodka and there was a bottled found next to him, she said.

Ross had been on several medication due to his seizures and Reese believes that a combination

of the heat, alcohol and medical problems may have caused him to have a seizure.

The Swine Flu and seizures?

2009-07-22T22:57:00.002-05:00

A worrisome report was released today indicating that the swine flu virus can cause infection deep in the lungs, much like the flu virus responsible for the 1918 pandemic that killed at least 40 million people. This means it's more likely than typical seasonal flu to cause stubborn cases of pneumonia, which is one of the leading causes of death in flu cases. But another facet of the outbreak isn't getting the attention it ought to.

The British Medical Journal reported that the British government is seeking public feedback on side effects from Tamiflu and other antiviral medications. Britain is currently in the throes of an H1N1 outbreak, one that even affected "Harry Potter" actor Rupert Grint.

Tamiflu, the name brand of oseltamivir phosphate, and Relenza (also known as zanamivir) are currently the go-to drugs for prevention and treatment of H1N1 flu. They're both recommended for use in patients or family members of patients who have underlying health conditions, such as asthma or heart disease, which could lead to serious complications from a flu infection. Tamiflu is recommended for patients as young as 1 year of age, while Relenza is approved for those 5 and older.

Skin rash, nausea, and vomiting are the most commonly reported side effects from these antivirals. However, the Food and Drug Administration warned as early as 2006 that Tamiflu and similar treatments were linked with "self-injury and delirium" in patients in Japan.

The Tamiflu Web site puts it this way: "People with the flu, particularly children and adolescents, may be at an increased risk of self injury and confusion shortly after taking TAMIFLU and should be closely monitored for signs of unusal [sic] behavior. A healthcare professional should be contacted immediately if the patient taking TAMIFLU shows any signs of unusual behavior." The governments are looking for help monitoring these serious side effects.

As if the public didn't have enough to worry about. President Obama warned the public and health-care providers to continue being vigilant about the virus and its potential for resurgence.

These public-feedback databases are nothing new; perhaps the most well known one is the VAERS, or Vaccine Adverse Event Reporting System, which is administered by the Department of Health and Human Services. It receives input from thousands of parents and patients a year, on everything from irritation experienced at injection sites to seizures and other neurological problems experienced soon following a vaccine's being administered.

The 1918 flu outbreak orphaned my grandmother. Personally, the initial knowledge that the antivirals were often effective in reducing the severity of swine flu cases helped made me relax a little. But it's looking more and more like we have another awfully erratic and harmful virus on our hands—one whose main treatment isn't as uncomplicated as we could hope. The creation of these antiviral side-effect reporting systems ought to make the public more wary of the flu season ahead instead of blindly depending on these medications.

For more information, visit the Centers for Disease Control and Information's "Antiviral Drugs and H1N1 Flu" information page, or search for more information about the medications, or the http://www.flu.gov/, the new HHS-created Web site dedicated to news about the outbreak. For more information about the U.S. Adverse Event Reporting System, or AERS, click here.

Gluten allergy and seizures

2009-07-22T22:52:00.001-05:00

Have you noticed the plethora of gluten-free foods on the shelves of your local grocery store — pastas, cereals, baking mixes, and more. For folks suffering from celiac disease, a gluten allergy, these foods are vital to their daily diet, and according to a study by the Mayo Clinic, celiac disease is four times more common today than it was in the 1950s. It's estimated that one in every 133 people has celiac disease.

Allergies to gluten, the protein in wheat, rye, barley, and possibly oats, create a wide variety of symptoms including: painful stomach cramps, bloating, gas, increased appetite (due to malabsorption of nutrients), weight loss, fatigue, constipation, or diarrhea. Not only that but eating these foods causes damage to the villi in the intestines, affecting the body's ability to absorb nutrients properly. It can also be fatal, so it's really important to avoid gluten-filled foods if you're allergic.

So why the increase in prevalence in this disease? To find out read more.

The most likely explanation may be due to our environment. Culturally, we tend to be such germaphobes; all our cleaning and killing germs may be contributing to an overall increase in allergies, asthma, and immune system reactions. This "hygiene hypothesis" may fall short though since celiac disease is a global issue, affecting both developed and developing countries. A competing explanation revolves around the overly processed nature of most gluten products, and many people's diets consist mainly of foods such as bread, pasta, and baked goods. We may be overdoing it. Though scientists have yet to pinpoint the exact cause of this condition, I'm sure they're working on figuring it out since it's become so common. Tell me, do you know anyone with celiac disease?

Grade 7 students set up fundraiser for Epilepsy in honor of classmate

2009-07-22T22:47:00.004-05:00

Greenwood Village - Ethan Widoff, a seventh grade student at Campus Middle School, is organizing the first annual Derek's Dash, a 5k walk/run to raise money to fight childhood epilepsy. The event will be held on August 30, 2009 at Village Greens Park in Greenwood Village. He has asked several of his friends to help make this event a huge success!

The money raised from this race will go to the IDEA (International Dravet Syndrome Epilepsy Action) League, a volunteer-based, nonprofit organization, founded by parents of children with Dravet Syndrome to promote research and education for the early diagnosis, appropriate treatment, and cure of Dravet Syndrome and related epilepsies.

Dravet syndrome, also known as Severe Myoclonic Epilepsy of Infancy (SMEI), is a progressive childhood neurodevelopmental disorder that does not respond well to treatment. Seizures present themselves in the first year of life in an otherwise typically developing child, increasing in frequency and often severity with maturation. Developmental delays often appear during the second year of life. It affects children of all different ethnicities and geographic backgrounds.

The mission of the IDEA League is to promote awareness and research about Dravet Syndrome and related epilepsies and to provide resources and support to improve the quality of life for affected individuals and families. Their IDEAL is to find a cure.

Widoff is known for his volunteer work and support of charitable causes and organizations. This spring he was one of two Colorado students honored with the Prudential Spirit of Community National Award for his volunteer activities.

This year for his mitzvah project in preparation for his bar mitzvah, Widoff decided to organize and host Derek's Dash in honor of his cousin, Derek Rudawsky, who suffers from Dravet Syndrome. Rudawsky is 14 years old and has suffered from epilepsy since he was 6 months old. His parents have tried numerous treatments including medicine, an implanted Vagus Nerve Stimulator, a special ketogenic diet, and other traditional and non traditional treatments. Unfortunately his seizures remain largely uncontrolled. Derek is developmentally delayed and his family struggles daily to help him.

Widoff hopes Derek's Dash will help Rudawsky and other children and families who struggle with Dravet Syndrome.

"Although Derek faces challenges every day, he inspires me because of his positive attitude," said Widoff. "Derek never complains or whines. The only time he is not happy is when he is having seizures and not feeling well. He has taught me what is truly important in life."

Widoff and several friends, who are serving as co-chairs of Derek's Dash, are meeting regularly to plan the event.

"It's fun to share this experience with my friends, and we are learning how to be leaders in our community," said Widoff. "It is great to see that we are making a difference for the next generation. The only way for a better tomorrow is to start doing something today."

The students have already garnered the support of local businesses, including Dance Trax Entertainment, Mix 1 Drinks, Colorado Athletic Club, Colorado Rockies, Brownstein, Hyatt, Farber, and Shrek, Integrative Health, Inc., Perry and Young Dental Laboratory, Deli Tech Restaurant, Chris Andersen - the Birdman, Baskin Robbins, and Smashburger Restaurants.

If you are interested in helping out by contributing to the IDEA League, donating items for the silent auction, donating items or services for the party after the race, or participating in the race/walk please contact Widoff at dereksdash@comcast.net.

For more information about Derek's Dash, visit www.dereksdash.com.

Injuries and seizures

2009-07-11T22:17:00.001-05:00

Emergency room doctors note that as the temperatures rise, so do trips to pediatric emergency rooms. Severe cuts, broken bones and head injuries are the most common causes for ER visits during the summer, says Tony Scalzo, M.D., professor of pediatric emergency medicine at Saint Louis University School of Medicine.”In the summer, we see a much higher incidence of injuries caused by accidents and sports,” says Scalzo, who is a SLUCare pediatrician at SSM Cardinal Glennon Children’s Medical Center.

These are the six most common summer dangers for kids, according to a SLUCare press release:

1. All-Terrain Vehicles: There are two things Scalzo would like to see banned in America - ATVs and trampolines. Sure, kids have fun on these but they also cause a lot of preventable, serious injuries, he says.

While children can get hurt doing anything from climbing trees to playing on the monkey bars, Scalzo says ATVs are more likely to cause serious, life-threatening injuries. ATVs are more dangerous because they are motorized and have a lot of momentum. It’s also easy to lose control of them, which can lead to the heavy ATV falling on the driver. If you choose to let your child drive or ride on an ATV, despite the danger, it’s absolutely necessary to wear a helmet, Scalzo says.

2. Trampolines: Every summer children come in the emergency room with broken bones and serious gashes caused by falling off a trampoline or falling on the metal springs. If you decide to decide to let your children jump, though, Scalzo recommends installing the protective netting around the trampoline that will prevent the most serious accidents.

3. Bikes, Inline Skates and Skateboards: Each year, more than 580,000 bicyclists and 100,000 in-line skaters and skateboarders are injured. The majority of these accidents can be prevented with proper use of the proper safety gear. Wearing a properly-fitting helmet prevents 85 percent of head injuries, yet only 11 percent of children ages 11 to 14 wear helmets. Wrist guards, knee pads, elbow pads and shin pads are also a good idea for skaters.

Other bike safety tips include: testing the bike’s brakes, making sure tires are secured tightly and properly inflated, wearing reflective material and using a light when riding at dusk or dawn.

4. Drowning: Drowning is one of the leading causes of accidental death among young children and can occur in the bathtub, swimming pool, while boating or even in small amounts of water, such as in a large cooler. Children should never be left unattended near water and should always wear a life jacket when near a pool or boating.

Home swimming pools should be protected with fencing on all sides and have securely locked entrances. Splash alarms can add an extra level of safety, but nothing can substitute the importance of parental supervision.

5. Car Accidents: Being properly restrained in a car is imperative all year long. However, because families take more road trips during the summer, more injuries caused by children not wearing seat belts are reported during this time of year. Even if your children get antsy during long car trips, Scalzo says it is never safe to allow them out of the appropriate booster or car seat. Instead, make more frequent stops to let them burn off their energy.

6. Heat and Dehydration: Every year children die or become very sick from being left inside a car. Heat and dehydration can be very dangerous for children. Scalzo says children should not be left in the car for even a short period of time because the car can heat up quickly.

Keeping children well hydrated, especially when they are playing outside in the heat is also important. However, parents should avoid giving infants water because it dilutes the salt in their blood and can lead to respiratory problems and seizures. For infants, Scalzo recommends offering an extra bottle on hot days.

Dogs trained to detect seizures!

2009-07-11T22:08:00.002-05:00

Peter DaSilva for The New York Times Dogs like Kobi, a yellow Labrador, have participated in cancer detection studies.

Catching up on my weekend Web reading, I came across an interesting video from National Geographic, about dogs who sniff out cancer and health problems associated with diabetes.

One of the dogs featured, a collie named Tinker, began whining and barking when his owner, who has diabetes, experienced dangerous drops in blood sugar. Although Tinker wasn’t trained at first, his reactions to the hypoglycemic attacks led to further training as a qualified “hypo alert” dog. The video also features the work of the British research center, Cancer and Bio-Detection Dogs.

The center has 17 rescue dogs at various stages of training that will be paired up with diabetic owners, including many children, reports Reuters.

Last year, researchers from Queen’s University in Belfast decided to investigate anecdotal reports from dog owners who said their pets warned them of hypoglycemic attacks. They surveyed 212 dog owners, all of whom had Type 1 diabetes, an autoimmune disorder that prevents the body from producing insulin. A regular concern with Type 1 is that blood sugar will drop precipitously low, causing a person to fall unconscious.

Among the dog owners, 138, or 65 percent, said their dog had shown a behavioral reaction to at least one of their hypoglycemic episodes. About a third of the animals had reacted to 11 or more events, with 31.9 percent of animals reacting to 11 or more events. The dogs got their owners’ attention by barking and whining, (61.5 percent), licking (49.2 percent), nuzzling (40.6 percent), jumping on top of them (30.4 percent), and/or staring intently at their faces (41.3 percent). A small percentage of the dogs reportedly tremble in fear at the time of a hypoglycemic attack.

To learn more, watch the three-minute video or read the transcript on the National Geographic Web site.

And for more on dogs detecting cancer read “Moist Nose Shows Promise in Tracking Down Cancer,” by my colleague Donald G. McNeil, Jr.

By Tara Parker-Pope

Can traditional veterinary medicine treat seizures?

2009-07-11T21:58:00.000-05:00

There are many causes for seizures in animals. The overall incidence of seizures in dogs is estimated at 1 percent, but goes up to 15-20 percent in purebred dogs.

Should your pet have seizures, a minimum evaluation should include a thorough physical exam, blood work, urinalysis, heart worm test, fecal exam and possibly chest and abdominal radiographs, and abdominal ultrasound.

Sometimes CT or MRI Scans, cerebrospinal fluid tap and analysis, or EEG are performed. Many times after a thorough evaluation, no abnormalities are found and this is called idiopathic epilepsy. In idiopathic epilepsy treatment options include Western drugs, Western herbal medicine, acupuncture, and traditional Chinese herbs.

In most cases, idiopathic seizures can be controlled with Western medications, the most common being phenobarbital. Anti-convulsant medication must be given every day, can cause drowsiness and can have side effects on the liver.

Seizures in Chinese medicine are considered internal wind. There are several causes and the treatment is slightly different. Acupuncture points and Chinese herbs are selected according to the pattern that is diagnosed. This case illustrates the use of traditional Chinese veterinary medicine on a case of idiopathic epilepsy.

A 5-year-old female spayed beagle was presented for seizures of unknown cause. She had been having seizures for almost a year.

Initially the seizures were every two months then started being monthly. The last seizure had been almost a month before presentation. The owner and veterinarian were discussing the possibility of putting the dog on seizure medication.

The owner was concerned about having to give phenobarbital on a daily basis and its side effects. The dog was diagnosed with internal wind due to liver and kidney yin deficiency, excess heat and stagnation.

The dog was treated with acupuncture and scheduled for an appointment a week later. The dog had a mild seizure the night before the appointment. A second acupuncture treatment was done, Chinese herbs were prescribed and food therapy was initiated. Several follow-up appointments were scheduled with increasing time in between. The dog has had no seizures for eight months and is doing extremely well.

The dog is still on a Chinese herbal formula but at a reduced dose and if doses are missed there are no adverse problems. Not all seizure problems can resolve as quickly as this case did but traditional Chinese veterinary medicine gives owners another alternative.

In all cases, a thorough Western evaluation is recommended. Chinese practices can be safely used in conjunction with Western medications and can be used in any species.

Dr. Connie Clemons-Chevis has received certification in acupuncture, Tui-na and Chinese herbology through Chi Institute in Reddick, Fla., and China National Society of TCVM. Alternative Medicine for Pets offers TCVM services in Bay St. Louis, Escatawpa and Pascagoula. Appointments are required and can be scheduled by calling 671-6210.

Stagnant water can cause seizures in your pet

2009-07-11T21:47:00.002-05:00

A deadly poisonous algae has been thriving in the heatwave Photo: Reuters

Water plays an important part in human leisure activities. Swimming, surfing, sailing, and canoeing are popular pastimes, with the urban population descending on lakes, rivers and beaches at weekends. Many dogs also enjoy water, with owners using swimming as a regular form of exercise for their pets. Swimming is a useful form of physical exertion. The muscles work hard, but because of the buoyancy of the body in water, the joints are not stressed by the full weight of the animal. Swimming can be especially beneficial for animals recovering from injuries, or for older animals suffering from arthritis. During hot spells, it can be a way of exercising animals that’s less likely to lead to overheating: every year, dogs collapse during walks on sunny days from hyperthermia; swimming in cold water avoids this risk.

Dog owners are being warned today about a dangerous poison that’s become more common in ponds and lakes across the UK after the recent hot spell: blue-green algae. Dogs are at risk when they drink or swim in water where there’s been an algal bloom, typically seen in stagnant pools of water after warm, calm weather. These blooms are often concentrated on the windward side of ponds, lakes or reservoirs, so it’s well worth checking these areas out for visible signs of green or blue slime or scum before allowing a pet access to the water. If there’s a known problem, local authorities often erect warning signs, but you can’t depend on being warned in this way: a new algal growth can appear in a clean body of water at any time.

There’s a range of different types of algal blooms, each producing a different type of poison. There are three main types of toxins: one causes liver failure, and the other two are neurotoxins. Pets are affected after ingesting the algae, either by drinking affected water, or by grooming themselves after being immersed. Signs of poisoning happen very rapidly, within minutes or hours of exposure, and emergency veterinary treatment is needed.

If the liver toxin has been eaten, a dog becomes dull and weak, often with vomiting and diarrhoea. This is followed by collapse, and then death from massive liver failure. If the ingested algae contain neurotoxins, signs include muscle rigidity, tremors and seizures, followed by paralysis, respiratory paralysis and death.

A diagnosis of algae toxicity is presumed if these signs follow exposure to stagnant water, but it can be difficult to confirm the diagnosis. Attempts can be made to detect either the algae or toxin in stomach contents or in samples of bloom material, but it’s not always easy to do this.

As with most cases of poisoning, there’s no antidote for algal toxins. Treatment is symptomatic and supportive, using drugs and intravenous fluids to keep the dog alive while the poison works its way through the system.

Interestingly, some of toxins from blue-green algae are known to have an anti-viral effect, and work has been done on their use as a potential source of antiviral substances against influenza virus.

There’s no need for dog owners to stop their dogs from swimming completely: the incidence of blue-green algae toxicity is still very low. But it makes sense to be cautious: check out the appearance of that water before allowing your enthusiastic dog to take the plunge.

Hypoglycemia and seizures

2009-07-11T21:41:00.001-05:00

Diabetes patients who are hospitalized for non-critical illnesses, and develop hypoglycemia while hospitalized, are likely to remain hospitalized longer and face greater risk of mortality both during and after hospitalization, according to a study published in the July issue of Diabetes Care.

This retrospective cohort study of more than 4,300 admissions, by researchers at Boston's Brigham and Women's Hospital, was the first to examine mortality risks for hospitalized diabetes patients outside a critical care setting. Previous research found an association between hypoglycemia in ICU patients and an increased risk of morality, seizures and coma.

However, the majority of hospitalized diabetes patients are treated on the general ward. This study found that each hospital day in which a person with diabetes had at least one episode of hypoglycemia was associated with an 85.3 percent increased risk of dying as an inpatient and a 65.8 percent increased risk of dying within one year of discharge. The odds of inpatient death also tripled for every 10 mg/dl decrease in the lowest blood glucose during hospitalization. And, a patient's length of stay increased by 2.5 days for each day spent in the hospital with a hypoglycemia episode.

As a result of these findings, the researchers recommend carefully monitoring people with diabetes admitted to the general ward of the hospital for hypoglycemia and suggest interpreting its appearance as "a warning sign of impending clinical deterioration."

"It could serve as a useful indicator for the necessity of increased monitoring, more aggressive treatment of infections, transitioning to a more intensive care setting, and case management," the study concludes.

To reach lead researcher Dr. Alexander Turchin, Division of Endocrinology, Brigham and Women's Hospital, phone 617-732-5661 or email aturchin@partners.org.

Diabetes Care, published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into one of the nation's leading causes of death by disease. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure, and non-traumatic amputations.

The American Diabetes Association is leading the fight against the deadly consequences of diabetes and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, our mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information, please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit www.diabetes.org. Information from both these sources is available in English and Spanish.

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Contact:
Dayle Kern, ADA
(703) 549-1500 ext. 2290

Loving their child is the best gift they can her despite knowing she will never see her teenage years

2009-07-11T21:13:00.008-05:00

Emily Sanda's parents harbor no delusions about their daughter's future. They know their firstborn child, now 6 years old, will never ride a bicycle. They know she'll never go to school, never speak, never grow up.

They'll count themselves lucky if they get to see her turn 12.

Emily, who was born in Merced, has Niemann-Pick Type C, or NP-C, an extremely rare genetic disorder for which there is no cure. The disease prevents the breakdown of cholesterol, causing the body to store it in the brain and other vital organs. The buildup causes severe neurological damage and eventually death.

BEA AHBECK

Merced Sun-Star - PHOTO BY BEA AHBECK

Emily Sanda, 6, sits with her mother, Rachel Sanda, in her grandmother Elizabeth Schultz's home in Atwater. Emily, who was born in Merced, has Niemann-Pick Type C, or NP-C, an extremely rare genetic disorder for which there is no cure.

Hope for Emily dinner
WHAT: A fundraiser to find a cure for Niemann-Pick Type C
WHEN: Saturday, 6 p.m.
WHERE: Merced Senior Community Center,
755 W. 15th St.
TICKETS: $30
CALL: (209) 357-1729 or (209) 777-6322
MORE INFO: www.parseghian.org

"In a lot of ways I've already mourned her loss," said Emily's mother, 28-year-old Rachel Sanda. "I've accepted the fact that she will never become the daughter I imagined."

Emily's father, 30-year-old David Sanda, is equally realistic about what the next five or 10 years will bring. "No matter what we do, we know there probably won't be a cure in time for her," he said.

But that hasn't discouraged the Sandas from trying to save others.

Since Emily's diagnosis four years ago, her family has raised more than $15,000 for medical research aimed at fighting NP-C. Most of it has come from fundraiser dinners they've organized themselves and sales of candles and other crafts that David and Rachel make at home.

All of the money has gone to the Ara Parseghian Medical Research Foundation, an Arizona-based nonprofit that's exclusively dedicated to funding NP-C research. The Sandas are holding another fundraiser dinner Saturday in Merced.

"Every time we send another check into the foundation, it's like I'm punching the enemy," David Sanda said. "The disease makes you feel so helpless, but this is something we can do."

As if the Sandas didn't have enough to do already.

Besides Emily, they have two more children, 3-year-old Elijah and 16-month-old Jacob, and Emily's care alone is a full-time effort.

NP-C's symptoms are wide-ranging and get worse with time. The disease causes a loss of intellectual and motor function, clumsiness and difficulty with swallowing and up-and-down eye movements.

As few as 100 children are thought be living with NP-C in the United States today. As the disease progresses, walking and swallowing become harder. Patients in later stages usually require wheelchairs and intensive care. Most die of pneumonia before adolescence.

For now Emily is still able to walk but she falls a lot. She moves slowly. Her muscles are becoming more and more rigid and her vision has worsened. She still eats some food on her own, but gets most of her nutrition through a feeding tube that doctors permanently inserted into her stomach this spring. She drools and suffers seizures and cataplexy.

She vomits often and the medication she takes to slow her degeneration causes nearly constant diarrhea. She tires easily and sleeps a lot. She goes to physical therapy but not to school.

"We change diapers and clothes all the time, and we always have to be ready for a seizure," Rachel Sanda said. "We can't just hop in the car for a quick trip to the grocery store or the park. Everything kind of becomes an ordeal.

"We spend a lot of time close to home, but we don't mind. We just like being together."

The 15 to 20 words Emily knew when she was 2 are long gone. She doesn't speak and she doesn't understand language anymore.

Even so, she is responsive, affectionate and curious. She doesn't watch television but she likes music and going outside. Her favorite thing to do is wander slowly and pick up things within reach to feel them.

"She likes to explore," David Sanda said.

The Sandas' boys have shown no signs of NP-C. Elijah was a month old when Emily was diagnosed. Doctors told the Sandas there was a 1-in-4 chance he would also have the disease. They opted not to have him tested. Jacob also has not been tested.

"We decided we wouldn't have any more children, because we didn't want to take the risk," Rachel Sanda said. "Jacob was a surprise. ... Now we call him Elijah's blessing, because he'll still have a sibling to grow up with after Emily is gone."

Soon after Emily's diagnosis she began taking a drug called Zavesca, still considered experimental for use by NP-C patients. It slows the effects of her disease, but it won't cure her.

The Sandas went nearly broke paying the drug's $5,000-per-month cost before they figured out that David's mother's health insurance is among the few that will cover experimental uses. In 2006, they legally gave up custody of Emily to her grandmother so they could get the drug for free. (Emily still lives with her parents.)

The family moved to Oklahoma near David's dad about two years ago. David Sanda works for a contractor there and is going to school to become a physical therapist. Rachel Sanda is a stay-at-home mom.

"We're not rich but at least we were able to buy a house there," David Sanda said. "We knew that wouldn't be an option in California."

The Sandas are here for a month-long visit, staying in Atwater with David Sanda's mom, Elizabeth Schultz, who teaches at Crookham Elementary School in Winton.

"It's great to have them here," Schultz said. "I'm just trying to enjoy Emily and not think so much about what the future is going to be like. ... She's my only granddaughter."

Besides spending time with family and friends they left behind when they moved, the Sandas are trying to gather at least a few thousand dollars for NP-C research while they're here. So far, they've sold about 30 tickets for Saturday's fundraiser. They're hoping for a lot more in the next couple of days.

The Ara Parseghian Foundation has paid for most of the studies that have been done on NP-C. It has raised about $33 million since it began in 1994. Right now, the organization is funding 25 research projects across the country. It's named for the well-known Notre Dame football coach who lost three of his grandchildren to NP-C.

Peg Romano, the foundation's assistant director, said efforts like the Sandas' are especially important because NP-C is so rare.

"When so few people are affected by a disease it's really difficult to generate enough funding," Romano said. "We really couldn't do it without families like the Sandas."

Their work toward a cure is even more remarkable in light of their circumstances, she said. "Families with NP-C often live very challenging lives, including financially. And yet, the Sandas take the time to do these fundraisers, and they pass on all the money."

The Sandas don't seem to think their efforts are anything special. "It helps us cope," Rachel Sanda said. "It's something positive we can do. That's all."

And coping they are.

"When Emily was first diagnosed, I thought I'd never smile again," David Sanda said. "But we're really OK now. We're happy.

"We're taking advantage of the time we have with her."

Reporter Corinne Reilly can be reached at (209)385-2477 or creilly@mercedsun-star.com.

Toddler suffering from rare seizure disorder fights for her life!

2009-07-09T23:59:00.001-05:00

Chances are you haven’t heard of Propionic Acidemia but for one local family, their lives have become about battling it, including raising money to end the disease that threatens the life of a little girl.

Gwen Mouat, is the daughter of Jennifer (Buck) and Tom Mouat, formerly of Pomeroy and granddaughter of Bob Buck of Pomeroy. Gwen is one of four PA survivors under the age of four who are being treated for PA at Nationwide Children’s Hospital in Columbus. This Saturday, Gwen’s family is organizing a corn hole tournament to fight the rare disease. Registration begins at 11 a.m. with tournament play beginning at noon at Bun’s Party Barn in Pomeroy.

The tournament will be a double elimination, four bracket setup. The entry fee for a two person team is $20. Prizes will be awarded at the tournament with the first place team winning $200 and second place team receiving $100. Pre-registration is recommended due to the 32 team limit. There will be prize drawings and 100 percent of funds raised will go to the PA Foundation to fund “desperately needed seed research in order to gather data that will help obtain larger National Institute of Health grants,” according to Gwen’s family.

Individuals with PA cannot break down essential parts of protein and some types of fat due to a non-functioning enzyme. Without the enzyme, amino acids are only partially processed, which causes propionic acid to build-up in the bloodstream. This in turn causes build-up of dangerous acids and toxins, which can cause damage to the person’s organs. Even with intense management, PA can damage the brain, heart, liver, cause seizures and delays to normal development. The median survival age is three years.

For Gwen, who is now three years old, her battle with PA began when she was just three days old and has since dealt with an array of health issues caused by the constant stress to the central nervous system and other major organs. Throughout her life, she will be fed a highly specialized and ever-changing formula through the gastrostomy tube in her belly due to special dietary needs and food aversions, which are common in PA patients.

Beating the odds, Gwen has fought through the 50-plus hospitalizations that have followed due to a variety of reasons from a common cold to life-threatening infections. Jennifer says her daughter’s exuberance is a testament to strides that have been made in treatment for PA even since her birth. Her apparent good health, while a blessing, is not taken for granted. Gwen’s parents know that any single virus or trauma could take her life tomorrow, which makes every day she’s still here a “sweet gift.”

Submitted photo - Gwen Mouat (pictured) is fighting Propionic Acidemia, a rare, life-threatening disease which her family is raising money to fight with a corn hole tournament held on Saturday in Pomeroy.

Jennifer says every dollar counts in the fight to fund PA research, adding, thanks to the PAF and local supporters, Ohio fundraisers have produced a total over $130,000, allowing doctors and researchers to make strides in the diagnosis and treatment of this disorder that will hopefully give these children a prognosis for better, longer, healthier lives.

With the infusion of money raised in Ohio, the foundation was able to fund three research grants last year instead of two. This year, however, PAF was forced to turn down a research opportunity due to lack of funding for the project and Gwen’s family hopes to help change that with help from Saturday’s tournament.

For more information about Gwen’s battle, visit www.GwenForACure.com For information about the corn hole tournament, contact event organizer Jackie Buck at 508-0412. For more information about PA visit www.PAFoundation.com.

Demerol and seizures: Was this medication a factor in Michael Jackson's death?

2009-07-09T23:50:00.000-05:00

Michael Jackson’s death continues to consume the news cycle.

There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK’s The Sun, “An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent Demerol similar to morphine . . . Shortly after taking the Demerol he started to experience slow shallow breathing . . . His breathing gradually got slower and slower until it stopped.”

Another report from the Times Online, noted that, “Family members [said] he had received his daily shot of Demerol at 11.30 am, but the dosage was ‘too much’.”

I would not want to be that doctor who administered the drug, and apparently, police are looking for him.

An overdose of Demerol, also known generically as meperidine, is a plausible explanation for what happened. Certainly more likely than coronary artery disease. In fact, he had undergone a 3 to 4 hour physical a few months before for insurance purposes, and was given a clean bill of health. Presumably, that exam would have included thorough cardiac testing.

The classic signs of a Demerol overdose include changes in mental status, constricted pupils, and a decreased respiratory rate, among others. However, those signs are not always 100 percent accurate, for instance, as studies have shown some cases of Demerol overdoses in patients having normal sized pupils. Of these symptoms, a respiratory rate below 12 is the best predictor of an overdose. Also of note, Demerol is somewhat unique among the opioids in that it is also associated with seizures at high doses.

As to how a Demerol overdose can lead to cardiac arrest, a slowing in respiration rate decreases the oxygen supply to the heart, causing it to eventually stop beating, or go into a life-threatening arrhythmia.

No different from most emergencies, focus on airway and circulation is critical in suspected Demerol overdose cases. Narcan, also known as naloxone, which is a short-acting drug that counteracts opioid drugs, is then given. Repeatedly, if necessary, until the respiratory rate rises above 12. Restoring adequate breathing is the leading priority. I could not find a report saying if Narcan was administered on the scene, or if so, how soon it was given.

An autopsy is scheduled for today, which may shed more light into the mysterious circumstances surrounding his death.

But I wouldn’t be surprised if a high Demerol dose was a mitigating factor in Michael Jackson’s cardiac arrest.

Family hosts fundraising event to provide son with a seizure alert dog

2009-07-09T23:39:00.000-05:00

12-year-old Lee Balderas can't do what other kids his age enjoy doing.

"When he was 10 he had 2 major seizures, I didn't know what was going on," Lee's Mother, Patricia Torres, said.

Just last month he was diagnosed with epilepsy, which causes him to have unexpected seizures.

"We just have to watch him go through it. It's hard. Sometimes he stiffens up when he has it and makes a crying noise. He shakes and turns blue and sometimes we have to put him on his side," Torres said.

Wtih Lee's condition, he must be supervised at all times, and even that can sometimes become emotional.

"Keep him from choking on his tongue, keep him breathing. It's scary, it's a lot more than it seems. Even if a doctor says it's not all serious; every seizure is serious," Lee's Stepfather, Angel Torres, said.

The Torres family could use extra help when caring for Lee which is why they are putting together a fundraiser barbeque to help afford a seizure alert dog, one that is vital to Lee's condition.

"We want to get him this dog because it's trained to know before or when he's having a seizure, they'll train him on the all the signs," Patricia Torres, said.

It's not just during a seizure when the service dog can help Lee.

"After a seizure he can't walk or stand cause it hurts. The dog will be there to get what he needs," Patricia Torres, said.

Patricia says she hopes others will learn from her son's condition, and lend a helping hand.

"I wish people knew more about epilepsy. I wish there would be some organization. Maybe him and I can do it ourselves and help others who have epilepsy," Patricia said.

The Torres family will be holding the fundraiser BBQ at Moss Lake in Big Spring on July 4th and they hope to raise enough money to purchase the seizure alert dog which costs about $5,000.

Drowning and seizure disorders

2009-07-09T23:37:00.000-05:00

In 2005 alone, there were 3,582 fatal drowning accidents in Los Angeles.

According to studies, about 350 kids aged 5 below die from drowning accidents each year and 2,600 are sent to the hospital for treatment related to drowning injuries.

It was also found out that non fatal droning accidents could lead to some devastating injuries like brain damage and this could lead to loss of memory, learning disabilities and even paralysis.

Drowning accidents are not exclusive to swimming pools; an individual can also drown in bathtubs, Jacuzzis, during boating and in a body of water like lakes and rivers, and others.

The most common cause of Los Angeles drowning accidents are:

• Lack of barrier – Barriers can prevent children from gaining access to a pool without supervision of an adult.

• Lack of supervision – According to studies, most young children who drowned in pools was out of sight for just about 5 minutes. If you are near a swimming pool or any body of water, constant supervision is needed for children because it will only take less than 5 minutes for a child to drown.

• Alcohol use – Alcohol is involved in more than 50% of all adolescent and adult drowning accidents and about one in five boating fatalities.

• Seizures disorders– Drowning is one of the leading cause of death for people with seizure disorders. Most drowning accidents happen in the bathtub during bath.

• Defective pool design - Some pools designs does not mark the change of depth in the pool sections. It can lead to a person miscalculating the depth and end up drowning

• Defective equipments – Defective heaters and sump pumps can cause explosion and electrocution.

• Getting caught in drain covers – A swimmer can get his/her foot caught in a drain cover and get stuck which could lead to drowning.

Preventing Drowning Accidents

Here are some basic guidelines to help prevent drowning accidents:

• Always have adults supervising children during bath or in swimming pools. A supervising adult should not be distracted while watching over children. I would take less than 5 minutes of inattention for a child to drown.

• Swim with a buddy. Do not go into deep depths alone so that if something goes wrong someone will be there to help.

• Select swimming sites with lifeguards.

• Avoid alcohol before or during swimming, boating or any activities near a body of water. Do not drink alcohol while supervising children as well.

• Learn to swim. Although this is not recommended for children below 4 years old.

• Learn cardiopulmonary resuscitation (CPR). This may be extremely vital especially if paramedics or lifeguards are not available immediately.

• Do not use air-filled toys as substitute for life jackets. They are not designed to keep swimmers safe.
For people who own a swimming pool at home:

• Install a 4 sided fence that separates the pool from other areas of the house. The fence should be at least 4 feet high and has latches that cannot be opened by children.

• Remove floating toys and devices from the pool after use. These toys can attract children and cause them to lean over the pool to reach floaters.

If you or your family has been a victim of a drowning accident, consult a Los Angeles drowning accident lawyer to help with your case.

Article Source: ABC Article Directory

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Make-A-Wish Foundation gives boy a service dog

2009-07-09T23:33:00.001-05:00

Thanks to the Make-a-Wish Foundation, the Dainiaks, of Bedford, will have a new addition to their family in January. His name is Buzz and he is a service dog.

He will join the family to help 6-year-old Nicholas, who has Batten Disease, a neurological degenerative disorder that causes vision loss and seizures, and is considered terminal.

“The dog will be great in all stages,” said Heather Dainiak, Nicholas’ mother. “It will be a german shepard or lab, whatever they think is going to work best.”

The dog will be trained to best meet Nicholas’ needs.

Buzz will be trained in Ohio and the whole family will go there in January to work with the service dog for two weeks before he returns to Bedford with them.

“He will help with vision, mobility and seizures,” said Heather. As Nicholas’ condition deteriorates, Heather sees the dog becoming more of a companion to her son.

The cost of a service dog is $12,000-$14,000 and the Dainiaks originally decided that they would save for it. However, they quickly realized that by the time they saved enough, Nicholas’ condition may have deteriorated to a point that he would not benefit from a dog.

“We contacted Make-a-Wish in the attempt to attract a celebrity to our fundraising events,” said Chris Dainiak, Nicholas’ father. “At that point, they suggested that the need for a service dog could be fulfilled through Make-a-Wish, if this was truly Nicholas’ wish.”

When the team came to visit Nicholas and ask him what he wished for, he replied “a dog named Buzz.”

About 100 Manchester Firefighters planned a ride from Manchester to Colebook to raise money for Make-a-Wish to grant Nicholas his wish. They celebrated June 4 at a barbecue, where Nicholas got to meet rescue dogs from the Canine Alert Search Team.

Despite having the need for a service dog filled, the Dainiaks are still fund raising to search for a cure for Batten Disease. Along with other families dealing with the disease they are trying to raise $2.5 million to fund a study at Cornell University.

The local community has come together to help with the effort in big and small ways. Students at Harmony Learning Center, where Nicholas’ brother William attends pre-school, are collecting nickels for Nicholas. Last Sunday, Salon Thairapy in Hooksett offered free kids haircuts and welcomed donations to Nicholas’ fund.

This weekend there are two events planned, the Fore Nicholas Golf Tournament at Candia Woods on Saturday and Drive for a Cure on Sunday in North Andover, Mass.

A Bounce U event and gala dinner are planned for the coming months.

“Every donation is a big donation,” said Heather. “We started at nothing.”

For more information you can visit ourpromisetonicholas.com.

The worst foods for your pets that can cause seizures or worst!

2009-07-09T22:24:00.000-05:00

This is a list of the 10 most toxic people food to not give you kitty and a short description of the toxic ingredients within the food, as well as some signs of adverse reactions.

If your kitty is anything like mine, it may run at the mere hope of snagging a table scrap each time you walk to the kitchen. Although people foods are generally not harmful to us, kitties’ digestive tracts are quite different as well as their nutritional needs.

Besides preventing your cuddly little feline from expanding its sleek waistline, here are my top 10 toxic people foods that should validate solid reasons to refrain feeding your kitty table scraps:

Alcohol – the toxic ingredient is ethanol and a little can do a lot of damage.Adverse reactions include: depression, excitability, poor coordination, slow respiratory rate. Severe cases: cardiac arrest and or death.
Selected Fruits (such as apples, apricots, cherries, peaches and plums) – large amounts of seeds, leaves and stems carry a compound of cyanide. Adverse reactions include: dilated pupils, shock, apprehension, hyperventilation as well as breathing difficulties.
Avocados- toxic ingredient is persin which is a fatty acid derivative. It is unsafe to feed any part or amount of avocado to cats or dogs. Adverse reactions include: abnormal breathing, fluid accumulation in chest abdomen or around the heart as well as breathing difficulties.
Baking Powder/ baking soda or yeast – toxins are related to large amounts ingested and to leavening agents which cause the powders or yeast to expand. Adverse reactions include: low potassium and calcium with high sodium causing abnormal electrolytes. Severe cases: can cause muscle spasms and congestive heart failure.
Chocolate – besides the high fat content it contains caffeine and bromine, which is not just toxic to dogs but to cats as well. Adverse reactions: muscle spasms, increase in water consumption and urination, hyperactivity, excessive panting, restlessness, the heart’s rate and blood pressure my rise. Severe cases: seizures or worse.
Coffee – also contains caffeine which is toxic to pets. Adverse reactions are similar to chocolate. Please keep in mind, only 8 tea spoons is enough to be lethal.
Onions and garlic – any form of onions, powdered, dried, fresh is extremely harmful. Garlic is slightly less harmful than onion. The toxin in these related root veggies is called N-propyl disulphide. Adverse reactions: toxin damages red blood cells which can cause anemia and lethargy. Trace amounts in cat food or treats should be okay but large amounts should be avoided.
Grapes and raisins: the toxicity of these two in regards to pets is unknown, no amount is advisable. Adverse reactions: can cause kidney failure.
Green tomatoes or green potatoes - raw, the stems, leaves etc. are all harmful due to a poisonous alkaloid called glycoalkaloid solanine. Adverse reactions include: causes severe lower gastrointestinal symptoms.
Salt – in large quantities can lead to sodium ion poisoning. Definitely should be limited or removed from diet due to adverse reactions which include: vomiting, diarrhea, excessive water intake and urination, muscle spasms and tremors, fever and in severe cases seizures and or death. (I know my kitty likes chips and other salty snacks, but are too much salt for feline consumption.)

There are many people foods to avoid giving pets. To ensure a healthy and long life for your kitty, its best to save the people food for the people. For more information and to view other toxic foods to avoid please click here.

Widower is protesting the fact that Texas' doctors don't report patients suffering from seizures

2009-07-09T22:15:00.000-05:00

Donald Pugh was in the throes of a seizure when he drove his car into Sally Hoffecker’s stopped sedan at 80 mph last year.

The deadly crash happened just a few hours after law officers, who had no way of knowing about Pugh’s history of seizures, let him drive away from the scene of another crash.

While some states require doctors to report seizure patients to agencies that issue drivers licenses, Texas isn’t one of them. Hoffecker’s husband thinks that should change.

“At this point all I can do is try to keep people like (Pugh) off the streets. It won’t bring my wife back, but maybe it will help others from being killed or maimed and their families from suffering,” said widower Phil Trumbly.

A Harris County jury recently sentenced Pugh, who has a lengthy criminal history, to life in prison for neglecting his medical condition and killing Hoffecker. Testimony at his trial revealed he’d been involved in three other crashes in a six-month period that authorities blamed on his seizures, including one earlier that day. In the earlier wreck, Pugh told authorities he swerved to miss a truck that cut him off, sending Pugh into a hedge and a brick wall, and blowing out two tires.

Texas has a voluntary system for doctors to alert the Department of Public Safety about seizure-prone patients, so police didn’t know about Pugh’s condition.

“Texas law does not require physicians to report, however, they are encouraged to let us know about conditions that could affect a person’s ability to safely operate a motor vehicle,” said DPS spokeswoman Tela Mange. Requiring doctors to report seizure-prone patients would require action from state lawmakers.

Some opponents

That system doesn’t seem to be working, Trumbly said.

“If the doctors didn’t voluntarily flag this guy, who would they flag?” Trumbly said. “Unfortunately, we just can’t rely on a person’s word when they apply for a driver’s license or renewal.”

Advocates for epileptics and seizure-prone people are opposed to the change, arguing that it will cause some patients to lie to their doctors about their conditions.

“We’re opposed to mandatory reporting, because it actually encourages people to not tell their doctors that they’re having seizures,” said Sandy Finucane, a spokeswoman for the National Epilepsy Foundation.

Finucane wasn’t aware of Pugh’s case, but spoke generally about seizure-prone people who drive despite doctor’s warnings.

“The theory is that if you make the rules reasonable, people are more likely to comply. If you have a person who is just not being straightforward with themselves or other people and is breaking the law, then they have to bear all the responsibility for that.”

Seizure disputed

The law in six states — California, Delaware, Nevada, New Jersey, Oregon and Pennsylvania — includes mandatory reporting by doctors and administrative hearings to safeguard against licensing those with an uncontrolled seizure disorder.

Finucane said she’s unaware of any evidence that such laws have resulted in fewer crashes.

Still, Trumbly can’t help but think his wife would still be alive if the officer who worked Pugh’s first crash on Jan. 7, 2008, would have known about his medical condition.

“I truly believe that if there had a been a flag on his license, at the accident that morning, the officer would’ve thought ‘this guy probably had a seizure’ and done something,” Trumbly said.

Pugh’s wife, Linda, argued that another medical condition — a blood problem that causes fainting — which doctors were late to diagnose, caused Pugh to faint, not have a seizure, causing the Katy Freeway frontage road wreck that killed Hoffecker.

“That lady didn’t deserve to die — my husband and I are really stressed that the woman died,” Linda Pugh said. “There was a letter by a doctor (that arrived after the trial) that said it was an involuntary reflex, that my husband fainted.”

She also said it was not a medical condition that forced her husband into a curb earlier that day. Pugh was avoiding a truck in traffic, she said.

Trumbly — and a jury that heard his explanation — disagreed and said he believes Pugh had a seizure.

“Instead of police knowing what was going on, (Pugh) put two new tires on his car, proceeded to go on down the road and kill my wife,” he said.

‘Ignoring doctors’ advice’

A month before, Pugh lost control of his car and crashed into the front of an H-E-B grocery store and witnesses said he appeared to be in the midst of a seizure as his wheels continued spinning after hitting the store, Assistant District Attorney Samantha Peden said. She also said Pugh had another seizure about 6 months before, in July 2007.

Prosecutor Brent Mayr said jurors considered Pugh’s medical condition and the fact that his doctors told him not to drive when they decided his fate.

“That jury ultimately gave him life in prison because they saw him as a person who kept ignoring doctors’ advice not to drive, ignoring his own body’s advice not to drive.”

brian.rogers@chron.com

Hyponatremia and seizures

2009-07-09T21:49:00.001-05:00

Hyponatremia may be the most common electrolyte disturbance seen in hospitalized patients. It is the most likely to lead to permanent or lethal complications if treated incorrectly. Recently, a new class of therapeutic agents called “aquaretics” have become available and will simplify the treatment of hyponatremia. To realize the promise of these new agents, it is important to understand how hyponatremia develops, how the body responds to the disturbance, and how to make therapeutic interventions that improve symptoms caused by hyponatremia without causing iatrogenic injury (Am J Med 2007;S1-21).

Pathogenesis

Hyponatremia is caused by water retention (N Engl J Med. 2000;342:1581-1589). Except for patients with renal failure whose inability to eliminate excess water is independent of hormonal controls, failure to inhibit secretion of the antidiuretic hormone, vasopressin, in response to hypo-osmolality is responsible for almost all cases of hyponatremia in the hospital (Table 1). In hyponatremia caused by hypovolemia, heart failure, or hepatic cirrhosis, nonosmotic release of vasopressin is a response to an inadequate circulation and patients retain both water and salt. In hyponatremia caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH), nonosmotic release of vasopressin occurs without a hemodynamic stimulus and patients retain water while excreting all the salt that is given to them( N Engl J Med. 2007:356:2064-2072).

Two receptor subtypes (V_1Aand V₂) mediate vasopressin's major physiologic effects. V_1A receptors are located on vascular smooth muscle cells and cardiac myocytes, affecting vascular tone and myocardial function (Circulation. 2008;118:410-421). V₂ receptors are located on cells lining the kidney's collecting duct; activation of the V₂ receptor inserts vasopressin-sensitive water channels in the cell membrane, promoting the reabsorption of water and elaboration of a concentrated urine. Physiologic inhibition of vasopressin secretion or pharmacologic blockade of vasopressin V₂receptors causes an “aquaresis,” the excretion of increased volumes of dilute urine without an increase in sodium or potassium excretion (Lancet. 2008;371:1624-1632). The elimination of electrolyte-free water in the urine returns the serum sodium to normal.

Consequences of hyponatremia

Because the blood-brain barrier is much more permeable to water than to salt, a low serum sodium concentration creates an osmotic force that drives water into the brain( Am J Med. 2006;119[7 Suppl 1]: S12-16). Hyponatremia that develops over a few hours (e.g., in patients given hypotonic fluids after surgery or in patients with self-induced water intoxication associated with psychosis, competitive running, or use of the amphetamine ecstasy) causes life-threatening cerebral edema and symptoms of headache, nausea, vomiting, confusion, and obtundation. There often follows an explosive onset of seizures, coma, respiratory arrest and, rarely, death from herniation of the brain.

Given a day or two, the brain adapts to osmotic swelling by shedding cellular solutes so that the osmolality of brain cells and the plasma can be equal without an increase in cell water content. The adaptive loss of organic osmolytes from brain cells minimizes brain swelling in chronic hyponatremia and permits survival despite extremely low serum sodium concentrations. However, the loss of solute from the brain causes reversible neurologic symptoms and makes the brain vulnerable to injury if the serum sodium concentration is normalized too rapidly. Too great a correction of hyponatremia in too short a time shrinks brain cells and initiates a progressive and often permanent neurologic syndrome known as “osmotic demyelination or central pontine and extrapontine myelinolysis”( N Engl J Med. 1986;342:1535-1542).

Hyponatremia is associated with increased hospital mortality, likely reflecting the severity of illnesses that cause hyponatremia (severe heart failure, end-stage liver disease, respiratory failure, malignancies, renal failure, etc.). Fatal cases are rarely associated with evidence of cerebral edema or osmotic demyelination; in other words, patients die with hyponatremia and not from hyponatremia. However, it remains possible that non-neurologic effects of hyponatremia not yet understood are responsible for the poor outcomes that have been recorded.

Acute hyponatremia

Symptomatic acute hyponatremia is a true emergency that demands prompt and definitive intervention. Because minor degrees of cerebral edema can be catastrophic in patients with elevated intracranial pressure caused by underlying neurologic or neurosurgical disease, patients with intracranial hemorrhage, brain tumors, or central nervous system infections who become symptomatically hyponatremic should also be treated urgently. In 2008, an expert panel released guidelines on treating acute hyponatremia in runners (Clin J Sport Med, 18:111-21, 2008 ); the panel's recommended regimen can be applied to all hyponatremic emergencies. ()

An increase in serum sodium concentration of 4-6 mmol/L is enough to stop seizures caused by hyponatremia and to prevent herniation. If life-threatening cerebral edema is suspected, a bolus infusion of 100 mL of 3% saline should be given to acutely reduce brain edema, with up to two additional bolus infusions of 3% saline given at 10-minute intervals if there is no clinical improvement. This regimen translates to a maximum of 6 mL/kg of 3% saline in a 50-kg woman, enough to increase the serum sodium concentration by 5-6 mmol/L. Once the bolus therapy has been completed, further treatment with hypertonic saline may be unnecessary. Because not all patients respond to aquaretics, these agents cannot be recommended as monotherapy for hyponatremic emergencies.

Chronic hyponatremia

Treatment is indicated for all hospitalized patients with hyponatremia. Even hyponatremia that appears to be “asymptomatic” is associated with an increased risk of falls and fractures and can be shown on formal testing to cause gait disturbances and disturbed cognition. Severe chronic hyponatremia usually causes moderate but distressing symptoms (e.g., weakness, confusion, delirium, gait disturbances, muscle cramps, nausea, and vomiting) that improve with treatment. Seizures are uncommon, but they can occur in patients who present with extremely low serum sodium concentrations or who have pre-existing seizure disorders or alcohol withdrawal.

Overcorrection of chronic hyponatremia risks iatrogenic brain damage. Although no therapeutic limit is absolutely safe, observational studies suggest that correction of serum sodium concentrationby more than 10 mmol/L in 24 hours or 18 mmol/L in 48 hours is unnecessary and risky. These are limits that should not be exceeded and not therapeutic goals to be reached. Therapy should be designed to keep patients safe from serious complications of hyponatremia while staying well clear of correction rates that risk iatrogenic injury. Thus, the following targets are appropriate in most cases: increase in serum sodium concentration of 6 to 8 mmol/L in 24 hours; 12 to 14 mmol/L in 48 hours; and 14 to 16 mmol/L in 72 hours. For patients with advanced liver disease or severe malnutrition who are at very high risk for osmotic demyelination, even slower daily rates of correction are indicated.

Therapeutic options

Fluid restriction. Unless the patient is excreting a maximally dilute urine, fluid restriction (typically less than one liter daily) is a needed adjunct to therapy. However, if the cause for water retention persists, fluid restriction alone will increase the serum sodium concentration by little more than 1-2 mmol/L per 24 hours.The urinary cation concentration (sodium plus potassium) divided by the plasma sodium concentration can help predict the response to fluid restriction. If the ratio is less than 0.5 (meaning that electrolyte-free water clearance is positive), correction of hyponatremia is likely to be prompt (and often faster than intended), and fluid restriction need not be stringent. If the ratio is equal to 1.0 or higher (meaning no electrolyte-free water clearance), hyponatremia is likely to be recalcitrant to water restriction alone.

Potassium. If the patient is hypokalemic, administration of potassium will help increase the serum sodium concentration. Hourly IV “runs” of potassium chloride 10 mmol in 100 mL of normal saline, which has a cation concentration of 254 mmol/L (almost always higher than the urine cation concentration), will reliably correct hyponatremia and hypokalemia in potassium-depleted patients.

Isotonic saline. Elimination of a volume stimulus for vasopressin secretion results in an aquaresis. However, if vasopressin is secreted for a reason other than volume depletion (e.g., SIADH caused by nausea, pain, surgical stress, respiratory infections, tumors, neurologic conditions, or medications), isotonic saline is ineffective. If the urine cation concentration exceeds 154 mmol/L, infusion of isotonic saline may actually lower the serum sodium concentration( Ann Intern Med. 1997;126:20-25). Isotonic saline will not improve hyponatremia caused by hepatic cirrhosis or heart failure, and it will worsen edema. Therefore, isotonic saline should be reserved for hyponatremic patients who require volume resuscitation for hypotension or patients with mild hyponatremia who will not be harmed if the serum sodium concentration fails to improve with this therapy.

Hypertonic saline. Many hospitalized patients present with multiple potential causes for hyponatremia. Therefore, it is often prudent to begin therapy with hypertonic saline or a vasopressin antagonist. Hypertonic saline will reliably increase the serum sodium concentration regardless of etiology. A slow infusion of 3% saline at 15-30 mL/hr can be used for chronically hyponatremic patients with mild-to-moderate symptoms( Clin J Am Soc Nephrol. 2007;2:1110-1117). Chemistries should be obtained at 4- to 6-hour intervals during the infusion, and the urine output should be carefully monitored. Hypertonic saline should be discontinued after the serum sodium has increased by 4-6 mmol/L or if an aquaresisemerges.

Loop diuretics. Loop diuretics interfere with the kidney's concentrating ability and therefore are indicated in patients with hyponatremia caused by heart failure. Thiazide diuretics, on the other hand, are contraindicated in hyponatremic patients. Loop diuretics can be combined with hypertonic saline or oral salt tablets (9 g of sodium chloride daily is equivalent to 300 mL of 3% saline); potassium replacement or administration of a potassium-sparing diuretic, such as amiloride, may be necessary to avoid hypokalemia from this maneuver.

Aquaretics. Conivaptan, which blocks both V₂and V_1A receptors, is currently the only vasopressin antagonist available for use in the United States. At least two orally active selective V₂-receptor antagonists are currently seeking approval from the FDA. Because conivaptan interacts with many medications, the drug is approved only for the short-term management of hyponatremia in hospitalized patients. Conivaptan is contraindicated in volume depletion because antagonism of the V_1Areceptor could cause hypotension. Moreover, this agent cannot be recommended in patients with cirrhosis and ascites because hepatorenal syndrome is improved by agonists of the V_1A receptor and administration of a V_1A antagonist could cause this complication. Conversely, antagonism of the hemodynamic effects of the V_1Areceptormay be desirable in patients with heart disease; therefore, the drug is approved for the treatment of hyponatremia associated with heart failure as well as for the treatment of euvolemic hyponatremia caused by SIADH.

Vasopressin antagonists are likely to be effective in most patients with hospital- acquired hyponatremia. These agents are an especially attractive alternative for patients with heart disease who require treatment of hyponatremia but are intolerant of a salt load (the drug is not indicated for the treatment of congestive heart failure).

Inadvertent overcorrection

Many causes of hyponatremia in hospitalized patients are reversible (e.g., hypovolemia; beer potomania; drug-induced hyponatremia; cortisol deficiency; or self-limited causes of SIADH, such as pain, nausea, hypoxia, alcohol withdrawal, or recent surgery). Once the reason for vasopressin secretion resolves, excretion of dilute urine increases the serum sodium concentration very rapidly (by 2 mmol/L or more per hour) and much more than would be predicted by calculations that ignore urine output. To avoid injury from inadvertent overcorrection of hyponatremia, urine output should be carefully monitored in all cases of severe hyponatremia. If an aquaresis emerges, urinary water losses must be replaced or, alternatively, the aquaresis can be terminated by administering the synthetic vasopressin anaolog, desmopressin( Clin J Am Soc Nephrol. 2008;3:331-336, 2008).

Desmopressin has been used clinically as a therapeutic agent to avoid overcorrection of hyponatremia and to return the plasma sodium concentration to lower levels after inadvertent overcorrection.The drug can be given as soon as the targeted initial increase in serum sodium concentration (approximately 6-8 mmol/L) has been achieved or as soon as an aquaresis is recognized. A dosing interval of 6 or 8 hours, rather than the twice-daily dosing schedule used in patients with diabetes insipidus, is recommended initially. Less frequent dosing can be used later to allow water losses to further increase the serum sodium. Alternatively, desmopressin can be continued, maintaining an antidiuresis until the serum sodium has been increased to the mildly hyponatremic range with the concurrent administration of hypertonic saline.

Administration of high-dose desmopressin to terminate an aquaresis induced by vasopressin antagonists is a theoretically attractive, but as yet, untested strategy that would allow more therapeutic precision than is currently possible. While awaiting more data, clinicians using vasopressin antagonists to treat hyponatremia are advised to closely monitor urine output and be prepared to match urinary water losses to avoid inadvertent overcorrection.

Dr. Sterns is Professor of Medicine at the University of Rochester School of Medicine and Dentistry and Chief of Medicine at Rochester General Hospital, both in Rochester, N.Y. More in-depth information on this important topic is provided in a paper recently coauthored by Dr. Sterns and two colleagues and scheduled to appear later this year in Seminars in Nephrology.

From the June 2009 Issue of Renal And Urology News

Gardasil is linked to fainting spells and seizures!

2009-07-09T21:35:00.000-05:00

Due to the high volume of reports of young girls fainting and having 'non epileptic' seizures after the Gardasil vaccine, Merck have conceded to include these side effects to their packaging and labelling as from 9th June 2009.

Information Pertaining to Labelling Revision for Gardasil

"On June 9, 2009, the Food and Drug Administration (FDA) approved a revised label for Gardasil, a vaccine to protect against cervical, vulvar and vaginal cancers caused by Human Papillomavirus (HPV) types 16 and 18 and genital warts caused by HPV types 6 and 11. In the new label, information pertaining to syncope (fainting) is now also included in the Warnings and Precautions section, and this section has new information noting that individuals who faint sometimes have tonic-clonic (jerking) movements and seizure-like activity. The addition of syncope to the Warnings and Precautions section emphasizes that healthcare providers and consumers should be alert that fainting may occur following vaccination with Gardasil, sometimes resulting in falling and injuries. To prevent falls and injuries all vaccine recipients should remain seated or lying down and be closely observed for 15 minutes following vaccination."

This minor change has taken the drug giants three whole years to put into place, although fainting was included in the small print in 2007. Merck have stated that these seizures are not epileptic in nature, however, even they have to admit that a faint followed by tonic-clonic movement and seizure like activity, which ever way they dress it up, is really saying in the broad sense, a child could have a 'Grand Mal Seizure' after having a Gardasil vaccination. Many girls have gone on to be diagnosed as epileptic after having Gardasil vaccines. Girls like Katherine Kimzey, a 14-year-old girl who experienced headaches, fainting, and stiff joints after receiving the second shot of her three-dose Gardasil vaccine battery. A few weeks later, Katherine had a seizure and was eventually diagnosed with epilepsy. Katherine is one girl of many who has encourntered a serious adverse reaction after receiving Gardasil. I believe that Merck are becoming very worried indeed if they have suddenly decided to take the unusual step of altering labels and packaging. Are they running scared perhaps?

The Epilepsy Foundation seem to describe a Grand Mal Seizure, in the same way as Merck are now describing on their new labelling. So what causes a seizure, epileptic or otherwise? Many people are confused and do not understand the difference between the terms "seizure" and "epilepsy". A person can have a single seizure without going on to develop Epilepsy. A seizure is simply caused by an abnormal electrical discharge in the brain. So what is causing seizures in the girls receiving the Gardasil vaccination?

Dr Andrew Moulden feels he knows and gives a very comprehensive explanation in his three DVD's as Sandra Chevalier-Batik explains in her article Can Dr Andrew Moulden Change CDC Childhood Immunisation Policy She explains that Dr. Moulden says the shots cause our body´s own immune systems to hyper-react as large white blood cells naturally rush to attack the foreign particles injected into our bloodstream. Well that does make sense as vaccines have been linked to seizures as far back as 1950.

Vaccines and adverse reactions to vaccines have been linked to seizures for years. One of the earliest professionals to spot a connection was a Prof Gordon Stewart. Professor Stewart first spoke of his concerns in 1950 His main work was surrounding the Whooping Cough and DPT vaccine. Over the years he has written letter after letter raising concerns to the Department of Health and the Government. Most of his concerns were ignored but they were discussed at meetings involving the Joint Sub Committee on Adverse Reactions to Vaccination and Immunisation. Professor Gordon Stewart's views make him unconventional among medical men but his opinions and advice are of great importance to the parents of children who are candidates for whooping cough vaccine. Vaccination to Professor Stewart spells one word and that is 'danger'.Many doctors and professionals agree with him and have been writing letters expressing their concerns about vaccines and patients having seizures for many years as this letter from 1979 shows.

Here are just a few of the long list of professionals raising concerns:-

Harris L. Coulter, Ph.D - S.I.D.S and Seizures

Baraff LJ et al (1988). Infants and children with convulsions and hypotonic-hyporesponsive episodes following diphtheria-tetanus-pertussis immunization: follow-up evaluation. Pediatrics 81(6):789-94 1988. Department of Pediatrics, University of California, Los Angeles, School of Medicine.

Cizewska S, Huber Z, Sluzewski W, "[Prophylactic inoculations and seizure activity in the EEG]," Neurol Neurochir Pol 1981 Sep-Dec;15(5-6):553-557. [Article in Polish]

Coplan J, "Seizures following immunizations," J Pediatr 1983 Sep;103(3):496

Jacobson V et al (1988). Relationship of pertussis immunization to the onset of epilepsy, febrile convulsions and central nervous system infections: a retrospective epidemiologic study. Tokai J Exp Clin Med 13 Suppl:137-42 1988. Department of Neurology, UCLA School of Medicine.

To read these and many many more the informative website Whale to on Vaccines has details of them all.

With all this evidence pointing to the fact that vaccines do indeed induce seizures, in some children, is it any wonder that Merck have become worried? They are not the only ones.

Dr. Andrew Moulden returns to KRFC FM on June 15 to Discuss Vaccination-Induced Brain Damage.

This will be Dr. Moulden´s second interview on KRFC FM. During the first on June 1, he explained how and why all vaccines cause neurological damage. Thousands of people listened to the interview since news of the program spread throughout the Autism and Gardasil communities. One of the most stunning comments that Dr. Moulden issued is that everyone has been "vaccine damaged" in one form or another. He believes that the high incidences of cancers, elderly neurological problems, immune disorders and other diseases are due to processes that have already been put into place after an inoculation. Repeated vaccinations only speed along the processes by which vaccine induced damage – which, according to Dr. Moulden are "cumulative, summative and additive," leading to a myriad of pathological problems that are now pervasive to society.

Based on Dr. Moulden´s theory the burden of responsibility to prove vaccine damage will be taken out of the hands of the so-called "isolated pockets" of children and their parent´s into a larger realm of brain injury and disease that has affected millions of vaccinated people worldwide. This is an important point since the U.S. and other countries including the U.K., are currently considering mandating compulsory vaccination laws to be enforced by the end of this year.

On Monday, July 6, Toni Blake J.D., M.A., who jointly owns and operates SBS Defenese.com with 2nd Chair Services will be interviewed on behalf parents who have been falsely accused of Shaken Baby Syndrome due to pre-existing neurological conditions that may have occurred post-vaccination.This is another aspect of vaccine injury involving the innocent families of brain-damaged infants that is rarely explored, although professionals have tried in the past to raise their concerns and have been ignored.

Lisa Blakemore-Brown, Charles Pragnell, Clifford Miller, Harold Buttram, Michael Innis, Viera Scheibner PhD are just a few of the professionals that have become increasingly concerned about the rising number of parents falsely accused of child abuse when their child becomes vaccine damaged.

Ms. Blake is a Juris Doctorate, has a Masters in Cognitive Social Psychology and is an Associate Professor of Psychology with an extensive research background in jury decision-making and cognitivepsychology in the courtroom. She is the author of and has published numerous books and articles. The Chicago Union Tribune, DISCOVER Magazine, Washington University Law Review, and American Association of Physicians and Surgeons have covered Ms. Blake´s research. She has been a guest lecturer for law schools, bar associations and medical conventions. Some of Ms. Blake´s high profile cases have appeared on Court TV, Dateline, 20/20, as well as in other international media outlets and television shows.

With all this going on is it any wonder the drug companies are beginning to get a little nervous? I.C.A.P is another organisation that has also been working very hard behind the scenes, raising awareness to the problems associated with both Gardasil and the Cervarix vaccine. I.C.A.P or the International Coalition of Advocates for the People, began as a group of seven women in four countries who decided to join forces to promote change.

Cynthia Janak and Leslie Botha wrote

Serious Concerns regarding the safety and efficacy of the HPV Vaccines

Dear friends, associates and all other esteemed individuals,

I am part of an international group from the United States, United Kingdom and the Netherlands. The documents which are attached represent our three countries. These documents have gone to 13 scientists from the Robert Koch Institute, Health Minister of Germany, as well as to the Commissioners of STIKO. We felt it was important to highlight the serious problems which are occurring all over the world (Australia, New Zealand also have problems) and to bring to the attention of the fact, that in the United States and Europe, there have been deaths and in all these cases the girls had been given their vaccinations. The United Kingdom has been fortunate so far, to the best of our knowledge, not to have any deaths reported but there have been several cases of paralysis which are identified in the UK Report.

We intend to prove that the serious health concerns that are becoming evident due to Gardasil and Cervarix around the world are valid.You will see that the studies themselves will prove the lack of efficacy and the increased risks to the health of our young people Also entered into this report are communications with the lead researcher for both Gardasil and Cervarix. Included are reports of young girls and women who have had serious adverse effects and deaths with unknown etiology from the United States and Europe. Attached is a video of Karen Maynor who lost her daughter after receiving the Gardasil vaccination.This mother is trying to come to terms with the fact that the post mortem determination is unknown.

We also want you to know that an inquiry was done by the researchers in the United States as to the overall health and activity level of the affected young people pre-vaccination. The results of the inquiry and investigation that ensued are startling. It has been determined that the young people most likely to be affected are very active, athletic and high achievers or have a serious weight problem. A subset of the affected received the vaccination when they were at the pre-menstrual time of their cycle. What these three groups have in common is that estrogen, which we know protects the brain from stroke, is decreased leaving the brain more susceptible to damage of the capillaries and the neurotoxin Aluminum.

Thousands of young girls and women are experiencing severe adverse events and their quality of life is vastly diminished around the world from Gardasil and Cervarix HPV vaccines.

We do so hope you will read our submission and if you wish to ask any questions of the authors, email addresses have been provided.

Sincerely,

Cynthia Janak

Research Journalist

Founder & President

International Coalition of Advocates for the People

ICAP

cjanak@i-c-a-p.org

Leslie Botha

Researcher and Broadcast Journalist

Vice-President

International Coalition of Advocates for the People

lbotha@i-c-a-p.org

First Father's Day shadowed by son's condition

2009-07-04T16:58:00.002-05:00

Greg and Laurel Beth Lamendola had a pleasant Mother’s Day. They went out to brunch with his parents and made light-hearted conversation. So they will try to have an equally pleasant Father’s Day today.Not that it won’t be difficult. After trying for three years to have children, and suffering three miscarriages, Laurel Beth finally gave birth to the couple’s first children in September: a pair of fraternal twin boys, Drew and Parker.

Unfortunately, in March, Parker began having seizures. He has since been diagnosed with “infantile spasms,” a potentially fatal form of epilepsy that causes brain damage in most of its survivors.

So the couple, as they did on Laurel Beth’s first Mother’s Day, finds themselves wearing brave smiles on Greg’s first Father’s Day.

“Father’s Day represents the joy of our two boys,” Greg said. “It will also bring some sadness because we’re not all healthy here.”

Greg, 35, and Laurel Beth, 40, are Tallahassee natives. They began dating seven years ago and have been married four years. Greg, a soccer star at Maclay School and University of North Carolina-Wilmington, is a physician’s assistant. Laurel Beth, a Leon High grad, spent 17 years as a dental hygienist before becoming a stay-at-home mother.

The couple wanted to publicize their story in hopes of helping other parents. After Parker began having seizures, it took more than a month for doctors to diagnose his condition. Local physicians diagnosed Parker’s seizures as a continuation of a form of acid reflux both twins had as newborns and predicted they would go away on their own. Doctors at Shands Hospital in Gainesville seconded that diagnosis -- until the Lamendolas “begged” for more intensive tests that revealed Parker’s condition.

“In our hearts, we knew (the condition was more serious),” Greg said. “We wanted to encourage other parents, who feel something is not right with their child, to keep pursuing an answer.”

Statistically, infantile spasms occurs once in every 3,500 births and five out of every 100 babies born with the condition die by age 5. Among survivors, 90 percent suffer “some degree of intellectual impairment,” and about a third incur behavioral difficulties, such as autism, said physician David Dunn.

“Unfortunately, it’s one of the most serious forms of epilepsy,” said Dunn, a professor of children’s neurology at Indiana University and a member of the national Epilepsy Foundation Professional Advisory Board. “Some of the kids go on to normal lives. But the majority will always struggle with schoolwork and continue to have problems with seizures.”

The condition is not uncommon in twins, as multiple births increase the risk for many conditions, or with older mothers, such as Laurel Beth, who had a difficult pregnancy. Impregnated through in-vitro fertilization, Laurel Beth spent eight weeks on bed rest in Tallahassee Memorial Hospital before giving birth to her sons, who spent two weeks in the TMH neo-natal unit with acid reflux.

But the cause of infantile spasms, which are a result of organic malfunctions in the brain, are still unknown.

“It’s absolutely nothing the parent has done during pregnancy or since the child was born,” Dunn said. “It’s frightening. Parents are expecting good healthy babies and then there are problems.”

Parker began having seizures when he was six months old. Since his condition was diagnosed by Shands’ Dr. Paul Carney, a pediatric neurologist, Parker has been treated with steroids and three kinds of drugs. The drugs have lessened the severity of the seizures -- he has 15 to 20 a day -- but cause an irritability that leads to his constantly moaning when awake. His cries are heart-wrenching to his parents.

“I haven’t seen him smile since this nightmare started,” Greg said. “We saw his ‘fun’ personality before this started. Now, it’s all hidden.”

Understandably, Parker’s condition has “turned our world upside down,” said Laurel Beth. Once an active couple who exercised together and went out with friends, the couple is “now secluded,” she said.

Their parents, Edward and Patricia Lamendola, Thomas and Grace Lawhorn and Laurel Beth’s mother, Nancy Dell Lawhorn, have been invaluable supporters. One or more parents visit almost daily to help with the boys. Nancy Dell Lawhorn, a former Tallahassee Chamber of Commerce executive who now lives in Atlanta, has spent weeks at the couple’s home. She encourages everyone she meets to pray for her daughter, son-in-law and grandson.

“It’s been awful (for Greg and Laurel Beth). Their emotions fluctuate up and down,” said Lawhorn, who sleeps in the room with Parker to attend to his near-hourly wake-ups. “At their age, it’s hard to have faith and trust that things will get any better.”

The help from parents has allowed the couple to spend time with healthy twin Drew, “giving him the attention he needs,” said Laurel Beth. The situation also has brought the couple closer.

Greg is the worrier; Laurel Beth is the cheerleader. Greg goes online nightly to look for more information; Laurel Beth eschews further bad news and concentrates on taking care of her sons and husband.

“I’ve seen strengths I didn’t know my wife had,” Greg said. “Her compassion, her caring, her encouragement.”

Laurel Beth does daily physical therapy with Parker. The couple networks with other parents of children with infantile spasms. They make twice-monthly visits to Shands for tests and consultations: In September, Parker will undergo an MRI of his brain on his first birthday that will provide important indications of his condition’s future.

And while today is not exactly the cheerful Father’s Day he might have imagined, Greg tries to stay upbeat.

“This has tested our faith; we hope eventually we’ll see some light,” he said. “But it’s brought out the love and support of family. It’s connected us in ways we would not have been connected.”