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OTHER APPROACHES TO EPILEPSY THERAPY: THE KETOGENIC DIET – WHAT ARE THE COMPLICATIONS OF THE KETOGENIC DIET? IS THE DIET ALWAYS A LAST RESORT TO CONTROL SEIZURES?

admin — Mon, 13 Jun 2011 14:30:28 +0000

“What are the complications of the ketogenic diet?”

During the starvation phase of the diet, the child’s blood sugar may drop, with symptoms like weakness, dizziness, paleness, sweating, and sleepiness. If these occur, it is imperative to measure the blood sugar and to give a small amount of glucose before continuing starvation. We have mentioned that supplementary vitamins and calcium are needed to prevent deficiencies. Your child should gain little weight on the diet if it is properly calculated, and growth may be slightly slowed. However, both will catch up when the diet eventually is discontinued. Despite the high fat content, the diet does not appear to cause atherosclerosis. Kidney stones can occur, but may be prevented by appropriate fluid intake.

“Is the diet always a last resort to control seizures?”

This diet has been used mainly as a last resort. However, since it is so effective when nothing else works, perhaps it should be used earlier in the course of epilepsy, if you and your child are willing to try it as an alternative to medication.

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SURGICAL APPROACHES TO EPILEPSY: TUMOR SURGERY AND EPILEPSY SURGERY

admin — Sun, 27 Feb 2011 08:40:18 +0000

There are two different reasons to do brain surgery in a patient with seizures. One we call “tumor” surgery, the other “epilepsy” surgery. A “tumor” in the brain may cause seizures. By tumor we mean not only abnormal growths and cancer but also abnormal blood vessels, areas of prior bleeding, and cysts, which may press on the surrounding brain causing seizures. The surgeon or neurologist may recommend removal of the tumor and the seizures may be controlled as well. Removal of these abnormalities is called “tumor” surgery, and its purpose is different from “epilepsy” surgery.

Epilepsy surgery is primarily intended to eliminate the seizures, whether or not a “tumor” is present.

Abnormalities of the brain causing seizures may also be subtle, just local abnormalities of cells or local scarring, with nothing pressing on the surrounding brain. In these cases, separating normal from abnormal (“epileptic”) tissue may be more difficult. Removal of these abnormal areas to control seizures is defined as “epilepsy surgery.” Sometimes scars, tumors, or blood vessel abnormalities are removed incidentally while removing the abnormal tissue causing the seizures. As we continue our discussion of surgery, we are focusing on epilepsy surgery and not on tumor surgery.

If there is a small, focal area of abnormality in the brain triggering seizures, it would seem far more logical to have that area removed surgically than to take anticonvulsant medication for a lifetime. Thus, surgery should be the treatment of choice for partial (focal) seizures if the focus is in a part of the brain that can be safely removed. While logical, this procedure is rarely undertaken. The brain has always been considered a sacred organ, one which should not be violated, and physicians have been reluctant to operate on the brain unless it is absolutely necessary. Patients were, and still are, afraid to have brain surgery. While elective surgery on most other organs is now considered routine, surgery on the brain is still considered by many to be a high-risk and frightening procedure, to be undertaken only as a last resort.

With amazing technological advances that have made it possible to locate a seizure focus in more people with epilepsy and to distinguish normal from abnormal brains, surgery has become far safer. Recent advances have changed our whole approach to children and adults with difficult-to-control seizures. Still, epilepsy surgery should be considered only when the seizures have not responded to appropriate medications given in appropriate doses and when either the seizures or the medications are significantly interfering with the daily life of the patient.

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SURGICAL APPROACHES TO EPILEPSY: TUMOR SURGERY AND EPILEPSY SURGERYThere are two different reasons to do brain surgery in a patient with seizures. One we call “tumor” surgery, the other “epilepsy” surgery. A “tumor” in the brain may cause seizures. By tumor we mean not only abnormal growths and cancer but also abnormal blood vessels, areas of prior bleeding, and cysts, which may press on the surrounding brain causing seizures. The surgeon or neurologist may recommend removal of the tumor and the seizures may be controlled as well. Removal of these abnormalities is called “tumor” surgery, and its purpose is different from “epilepsy” surgery.Epilepsy surgery is primarily intended to eliminate the seizures, whether or not a “tumor” is present.Abnormalities of the brain causing seizures may also be subtle, just local abnormalities of cells or local scarring, with nothing pressing on the surrounding brain. In these cases, separating normal from abnormal (“epileptic”) tissue may be more difficult. Removal of these abnormal areas to control seizures is defined as “epilepsy surgery.” Sometimes scars, tumors, or blood vessel abnormalities are removed incidentally while removing the abnormal tissue causing the seizures. As we continue our discussion of surgery, we are focusing on epilepsy surgery and not on tumor surgery.If there is a small, focal area of abnormality in the brain triggering seizures, it would seem far more logical to have that area removed surgically than to take anticonvulsant medication for a lifetime. Thus, surgery should be the treatment of choice for partial (focal) seizures if the focus is in a part of the brain that can be safely removed. While logical, this procedure is rarely undertaken. The brain has always been considered a sacred organ, one which should not be violated, and physicians have been reluctant to operate on the brain unless it is absolutely necessary. Patients were, and still are, afraid to have brain surgery. While elective surgery on most other organs is now considered routine, surgery on the brain is still considered by many to be a high-risk and frightening procedure, to be undertaken only as a last resort.With amazing technological advances that have made it possible to locate a seizure focus in more people with epilepsy and to distinguish normal from abnormal brains, surgery has become far safer. Recent advances have changed our whole approach to children and adults with difficult-to-control seizures. Still, epilepsy surgery should be considered only when the seizures have not responded to appropriate medications given in appropriate doses and when either the seizures or the medications are significantly interfering with the daily life of the patient.*151\208\8*

THE FACTS-THE FIRST SEIZURE AND THE DIAGNOSIS OF EPILEPSY: OTHER CAUSES OF IMPAIRED OXYGEN SUPPLY TO THE BRAIN-TICS, HABITS, AND RITUALISTIC MOVEMENTS, COLIC

admin — Sat, 05 Dec 2009 12:31:56 +0000

Tics in children usually involve the upper part of the face—screwing up the eyes, or rapid blinking. More complex habits such as grunting, and brushing the hair away from the eyes are common in children, and seldom confused with seizures. Sometimes, however, children indulge in strange patterns of movement which they apparently find pleasurable, and which they stop immediately on reprimand. Sometimes infants and toddlers will rock backwards and forwards squeezing their thighs together in a manner which seems to be masturbatory.

Colic-Colic or ‘wind’ is a common symptom in babies and young infants, and is usually easily recognized and diagnosed. However, occasionally infantile spasms (West’s syndrome), may be mistaken for colic or some other type of pain, which can lead to a delay in the diagnosis of this type of epilepsy.

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THE FACTS-THE FIRST SEIZURE AND THE DIAGNOSIS OF EPILEPSY: OTHER CAUSES OF IMPAIRED OXYGEN SUPPLY TO THE BRAIN-VERTIGO

admin — Sat, 05 Dec 2009 12:31:46 +0000

Doctors are careful to distinguish true vertigo—a perception of dysequilibrium of the body in its relation to space—from non-specific feelings in the head such as ‘dizziness, or ‘muzziness’ which are so often associated with anxiety and depression. True vertigo is rarely a symptom of a partial seizure in a temporal lobe. Far more common is vertigo due to a disorder of the balancing organ—the labyrinth—lying within the inner ear. The labyrinth may malfunction in an episodic way in both children and adults. In young children the distinction between paroxysmal vertigo and partial seizures may not be easy, as in both the child is frightened, and may either hold on to his mother or fall. The distinction rests on the absence of amnesia or confusion after the attack of benign paroxysmal vertigo, and the presence of abnormal tests of labyrinthine function.

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THE JOY OF PERFECT HEALTH: POLLUTION OF THE ENVIRONMENT

admin — Sat, 05 Dec 2009 12:31:40 +0000

Many species of birds, marsupials, mammals and other animals on our planet become extinct every year.

The main reason for their extinction is that their organisms cannot cope with the increasing levels of pollution in their food and their environment.

Nature gives us a fair warning. If we keep polluting our planet, it may soon be our turn.

So far into our “civilised evolution” we continue to develop more and more diseases, allergies etc. and have increasing difficulty maintaining good health.

However, when we understand the reasons for this, we have a choice. Rather than waiting for governments and the industry to do something about it, WE THE CONSUMERS should make a choice first.

No industry will produce articles consumers do not want.

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EPILEPSY: THE FACTS-THE FIRST SEIZURE AND THE DIAGNOSIS OF EPILEPSY: OTHER CAUSES OF IMPAIRED OXYGEN SUPPLY TO THE BRAIN-NARCOLEPSY

admin — Sat, 05 Dec 2009 12:31:31 +0000

Any one of us may feel drowsy in a stuffy lecture theatre, or as a passenger on a long car journey. Those suffering from narcolepsy, however, feel an uncontrollable desire to sleep at other times, and may indeed drop off in socially embarrassing circumstances. This unusual symptom may be associated with ‘cataplexy’—a sudden loss of postural tone causing collapse without loss of consciousness, often precipitated by strong emotions such as anger or amusement. In a way, these phenomena are nearest to epilepsy, as they presumably result from some paroxysmal disorder of cerebral nerve cells. However, such patients have epileptic seizures no more often than the general population, the EEG whilst awake is always normal, and drugs of a completely different type from those used in epilepsy may produce a favourable response.

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EPILEPSY: THE FACTS-THE CAUSES OF EPILEPSY: PRECIPITANTS OF

admin — Sat, 05 Dec 2009 12:31:13 +0000

SEIZURES-MOOD AND OTHER ILLNESSES

Mothers of young children with epilepsy can sometimes tell from their child’s mood and behaviour that they are ‘building up to a fit’. Adults with epilepsy may experience a peculiar feeling of heaviness or depression on the morning of the days of their seizures. Occasionally elation rather than depression is reported. It is impossible to decide whether these emotional changes cause the seizures, whether both the mood and the seizures are caused by some common factor, or whether the change in mood is in some way produced by a limited paroxysmal discharge that finally erupts into an obvious seizure.

Other illnesses-Any one with epilepsy may have a seizure in relation to a severe other illness such as pneumonia. In children with epilepsy, fever may precipitate seizures, but it is important to retain the distinction between these and febrile convulsions.

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THE CAUSES OF EPILEPSY: PRECIPITANTS OF SEIZURES-ALCOHOL

admin — Sat, 05 Dec 2009 12:31:08 +0000

One of the most common reasons for staying up later than usual is to go to a party, where alcohol may be drunk. The social use of alcohol depends largely on its ability to remove inhibiting factors in our personalities and conversation, thereby making us perhaps more interesting and amusing. A similar removal of inhibition of an epileptic focus may allow a seizure to occur. Often, however,’ the seizure occurs during the ‘hangover’, at a time when the blood alcohol is falling, or near zero. It is probable that other changes in body chemistry, particularly in the distribution of water within and outside cells, plays a part in causing such seizures. Over-hydration of experimental animals with epilepsy may precipitate seizures, so there are grounds for believing that large quantities of beer, containing both alcohol and much water, may be more likely to precipitate an attack than moderate use of wine or spirits.

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THE TREATMENT OF EPILEPSY

admin — Sat, 05 Dec 2009 12:26:49 +0000

The treatment of epilepsy begins with making a correct diagnosis—the diagnosis that the events are truly seizures, the diagnosis of the seizure type, and the diagnosis of the epilepsy syndrome. This is particularly important in children in whom other non-epileptic, brief disturbances may be confused with and misdiagnosed as epilepsy. The drugs which are used to prevent or control epileptic seizures (anti-epileptic drugs; anticonvulsant drugs) may have to be used for some years—even for life—and have side-effects which are occasionally serious. It is therefore important that the diagnosis of epilepsy is correct before these are prescribed.

The reason for taking drugs is to prevent further seizures or fits from occurring. The drugs will only do this if they are taken regularly, and as advised by the doctor. One common reason for people with epilepsy having further attacks is because they either do not want to take, or forget to take their medication regularly.

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