Thursday, October 6, 2011
Wednesday, October 5, 2011
Stopping seizures…: by Phylis Feiner Johnson
Who wouldn’t want to stop — or even alleviate — a seizure? Well, you may be surprised at how many options there are. (I was surprised myself!)
There are some methods that stop a seizure in it’s tracks. Some shorten seizures. And some relieve you of the dreaded after-effects. So, even though some may not be effective or attractive to you, you do have choices.
The Natural Route
The easiest way to stop your seizures — recommended by eforum members — is by placing your pointer finger on the dent above your upper lip (below your nose). This pressure point seems to immediately stop the seizure.
How does it work? The pressure point under your nose is the end to many nerve endings…including certain cranial nerves. Probably the same proximity that makes the area vulnerable is what makes it an effective location for seizure disruption. (Note: Afterwards, you might try taking an Advil or Tylenol with a big glass of water, before you go to sleep to prevent the possibility of a headache.)
Of course there’s behavior modification. Reports indicate that some people have learned to interrupt their seizure process by replacing the aura-induced perception with another pleasant thought. Focus on an enjoyable experience and transport your mind there. Although you may not prevent the seizure, it can be much easier to deal with just by easing the tension. Plus, you can possibly make your seizures shorter in duration and frequency.
Mental imagery can go a long way in arresting a seizure – if you catch your aura in time…
But first you have to get to know your triggers and the auras that usually follow them. Try keeping a daily diary to track the events that lead up to your seizures. Once you know your triggers, you can make the move to take control of your fear…distract yourself…or even change your emotional state.
(I think of riding through Hayden Valley in Wyoming and do deep breathing exercises. Sometimes the Hayden Valley part doesn’t work, but the deep breathing never fails!)
Medications
Then there are the emergency medications. Again, some work better for people than others.
Traditionally, the first line of fire in rescue meds for extreme cases has been Diastat (generically known as diazepam.) It’s available in a gel form that’s inserted into the patient’s rectum to stop a cluster of repeated seizures. (It’s absorbed quickly that way.) However, both children, adults and caretakers aren’t too keen about it, and you can understand why. But recently, it’s been made available in a liquid oral form that comes in a syringe and goes right into the cheek of your mouth. Ask your neuro or pharmacist about it, because it’s relatively new.
But now Diastat has competition! In a recent study, the nasal spray Versed or Midazolam (generically known as benzodiazepine), a short-acting drug that is used for acute seizures was preferred to the rectal solution of Diastat by 16 of 21 caregivers and patients. The results were as equal in effectiveness, side-effects (usually drowsiness) and in suppressing prolonged seizures.
Other people have found liquid Klonopin or Clonazepam, (members of the generic benzodiazepinesto family) successful in preventing seizures. However, it’s important to determine the correct dose.
In short, you have these options plus a whole lot more AEDs which might help control seizure activity. Find out more about these (your pharmacist could be a terrific source because he/she’s worked with all of them before and knows the upsides and the downsides.) Because once you know your options, you can be less fearful and more in control when a seizure strikes.
*Phylis Feiner Johnson has been a professional copywriter for 30 years. She also spent 20 years with epilepsy. She writes from the heart to increase education, awareness and funding for epilepsy research. For further information, contact The Epilepsy Foundation of Eastern Pennsylvania at http://www.efepa.org/ and please make a contribution to become an advocate, too.
Weird epilepsy triggers…:by Phylis Feiner Johnson
Here’s a list of uncommon epilepsy triggers you may have experienced or know about. Feel free to add to this list of the weird and the unknown…
Atmospheric Conditions
Changes in air pressure or any sudden action, (like arising from a prone position too quickly), can act as an instant stressor. Like taking off or landing in an airplane…going up or down on a fast elevator or escalator…
Barometric Pressure
Weather differences such as sudden changes in temperature, dark skies, thunder, or bright, hot sunlight and humidity may be a definite trigger for some.
Body Toxins
Exposure to toxins in our air, water or food, can cause everything from vomiting, diarrhea, liver or renal failure, blood sugar levels, and electrolyte imbalances. Constipation can be added to the list also. When these things happen, all the toxins already in our system build up. It also might be a side-effect of your drugs or it may cause the effectiveness of your medications, but ether way, you are at risk.
Boredom
You always thought you could be “bored to death” but it can also incite a seizure. By being isolated, having no social interactions, diversions, or recreational activities – all that’s left is to think about yourself and anticipate when your next seizure will come.
Casinos
The flashing lights and all the noise and hubbub at a casino — ringing bells, blaring music, — is enough to give anyone a headache, no less a seizure.
Dental Problems
Have your teeth and gums checked regularly. Some of your medications just love the calcium found in teeth and bones, making them fragile and prone to breakages and disease. Dental disease can no longer be considered a minor problem with just your gums and teeth. Your state of health (especially the state of your immune system), whether you still have amalgam fillings, the amount of mercury you’ve been exposed to over time, and the amount still present in your body, directly influence the number and severity of your symptoms. You’ll never achieve optimum health if you have poor oral health.
Diabetes
People with hyperglycemia tend to have focal or local seizures. And those who are hypoglycemic, tend to have tonic-clonic seizures. To keep your blood sugar from fluctuating, eat a good breakfast when you wake up. Complex carbohydrates will help start your day and give you sustained energy throughout. Also, try to eat wholesome snacks often during the day to keep your system balanced.
Grapefruit
It has been proven that grapefruit/juice/rind/skin can negatively affect some medications. You are probably saying “but I thought these grapefruits were good for me and my health?” Grapefruit juice provides many nutrients such as Vitamin C, but chemicals in grapefruit interfere with enzymes that break down certain medications in your digestive system which, in turn, causes a high risk of bringing on seizures. Tegretol in any form is one of the main anti-epilepsy medications that grapefruit affects.
Hyperventilation
Sometimes in a stressful situation, it’s the body’s way of saying there is confusion in the brain and it just doesn’t know where to turn. Oxygen is not getting to your brain and the hyperventilation expends vast amounts of energy. You could be in shock and this is where it is difficult to tell whether it is a response from an over stimulated brain or a true seizure. But you could go on to have an epileptic seizure following the stress and lack of oxygen. (For a long time, hyperventilation has been used as a means to provoke seizures. It’s often used to trigger epileptiform discharges and/or seizures during EEGs.)
Immersion in Hot or Cold Water
Anything done too suddenly (a quick change of any kind) can lead to a seizure. Going from cold to a warm temperature, or going from a warm house to a bitter cold day outdoors can shock your system. When having a bath it is best to have the bath water warm rather than hot as getting into a hot bath, along with the added humidity present in the bathroom also may be enough to trigger a seizure. When immersing yourself in cold water it is best to do this gradually and make sure you have another person with you to ensure your safety.
Migraines
People with epilepsy are more than twice as likely to develop migraine headaches as those without seizures. Research showed that more than 20 percent of people with epilepsy have migraines, compared to 11 percent of the general population. And there’s an overlap in the two conditions. In another epilepsy study, about 16% of those people who had migraines also experienced epileptic seizures before, during or after a migraine.
Odors and Perfumes
Perfume directly affects the brain and has both a physiological and a psychological effect upon our respiration and breathing, as well as upon our moods and thoughts. Although our sense of smell declines with age, you need to be aware that strong or even subtle smells or perfumes can be one of your triggers for seizures. Sometimes a person who has experienced some seizure activity brought about by a particular odor may not discuss it because they think other people, even their doctors, will think they’re crazy. But it’s for real. And then there are other odors, much less enticing, some of which include paint, hairspray, cleaning products, ammonia, kerosene, car exhaust fumes, gasoline and solvents.
Mah-Jong
Apparently, playing this thinking game, which can require intense concentration, can induce seizures. (You heard it first here!)
Music
Musicogenic epilepsy is a form of reflexive epilepsy in which a seizure is triggered by music or specific frequencies. Sensitivity to music varies from person to person. Some people are sensitive to a particular tone from a voice or instrument. Others are sensitive to a particular musical style or rhythm. Still others are sensitive to a range of noises.
Ramadan
During Ramadan, healthy adult Muslims are required to fast between dawn and sunset which can be a challenge, particularly if you have epilepsy and need anti-epilepsy drugs more than once a day. Recent research has found there was an increase in the number of seizures experienced during the holy month which was probably due to changes in the way anti-epilepsy drugs were taken, sleep patterns being disturbed, going for a long time without food, plus any emotional stress and fatigue.
Sleep Apnea
Sleep apnea includes pauses in breathing, indicated by gasping, snoring or difficulty in breathing during the night. It is more common in men than in women, and often occurs in larger people whose throat muscles and fat tissue cause an obstruction while they’re sleeping. These pauses in breathing can easily be confused with seizures. In fact, having apnea can trigger seizures. Having seizures can also trigger apnea; so it can work either way.
Water
Yes, you can have too much of a good thing. Water is good for us, but it can dilute your medications. It’s best to spread your fluid intake over the day. Your body needs a balance of salt and water. And be cautious of drinking water from plastic bottles and leaving them lying around in the heat.
* Phylis Feiner Johnson has been a professional copywriter for 30 years. She also spent 20 years with epilepsy. She writes from the heart to increase education, awareness and funding for epilepsy research. For further information, contact The Epilepsy Foundation of Eastern Pennsylvania at http://www.efepa.org/ and please make a contribution to become an advocate, too.
Common Epilepsy Triggers :by Phylis Feiner Johnson
Epilepsy affects each person differently. Below is a guide to some common seizure triggers. You may not feel or notice anything in particular. Or you may have triggers which are not mentioned here. Keeping a seizure diary is the most effective way of keeping track of what triggers your seizures.
Reflex Epilepsy
Some people notice that their seizures occur in response to very specific stimuli or situations, as if the seizure is an automatic “reflex.” In this type of seizure, it occurs consistently in relation to a specific trigger. For example, one type of reflex epilepsy is photosensitive epilepsy where seizures are triggered specifically by flashing lights. Other types of reflex epilepsies can be seizures triggered by the act of reading or by noises. These reflex epilepsies are not common. However, knowing the type of epilepsy and trigger is important information for a correct diagnosis. You can then work on eliminating these triggers whenever possible or find ways to lessen their effect on you.
Flickering or Flashing Light
If you have photosensitive epilepsy, certain types of flickering or flashing light may incite a seizure. The trigger could be exposure to television screens due to the flicker or rolling images, computer monitors, certain video games or TV broadcasts containing rapid flashes, even alternating patterns of different colors, in addition to intense strobe lights.
And surprisingly, seizures may be triggered by natural light, such as sunlight, especially when shimmering off water, even sun flickering through trees or through the slats of Venetian blinds.
Stress
Stress can trigger hyperventilation which can provoke seizures, especially absence seizures. It can increase cortisol, known as “the stress hormone” because cortisol is secreted in higher levels during the body’s “fight or flight” response to stress. And, as you may imagine, it’s responsible for several stress-related changes in the body which also may influence seizure activity.
Negative emotions related to stress, such as anger, worry or fright, may also cause seizures. This happens because the limbic system, the portion of the brain that regulates emotion, is one of the most common places for seizures to begin. You’ll probably find that you have more seizures during or after periods of anxiety or stress.
Lack of Sleep
Inadequate or fragmented sleep can set off seizures in lots of people. In one study, the lowest risk for seizures was during REM sleep (when dreams occur). The highest risk was during light non-REM stages of sleep.
Hormones
For many women, certain hormones seem to trigger seizures at particular times in their menstrual cycle. It can be during ovulation, menstruation, pregnancy or menopause. This is known as “catamenial epilepsy.” If you’re going through menopause, you may find that the hormonal changes at this time make you more likely to have seizures, (although for some women, seizures will not be affected or become less frequent).
Food Allergies
Both food sensitivities and allergies can definitely trigger seizures. Especially foods that are rich in glutamate and aspartame – two very excitatory amino acids. Food allergies may also trigger seizures in children who also have migraine headaches, hyperactive behavior and abdominal pains.
Illness
High fevers in children can commonly incite a seizure. Vomiting, diarrhea, and fever are all triggers. And vomiting may reduce the dosage level of previously ingested anti-seizure medication. As for adults, they usually weather illness fine but it can reduce the seizure threshold, and make you more likely to have a seizure.
Prescription Drugs
Some prescription medications — especially penicillin, anti-depressants and anti-anxiety drugs — can prevent your medication from working. It could be caused by the way your system responds to a certain a drug, a combination of drugs, reaction or withdrawal. Make sure all your doctors know everything you take.
Over-the-Counter-Drugs
Certain over-the-counter medications (Advil and Tylenol are fine but never take aspirin!) can make you more likely to have a seizure, if you have epilepsy or a history of seizures. For example, anti-depressants and antihistamines are possible seizure triggers. Also certain supplements — like evening primrose oil — can also be a trigger.
Alcohol
There are two questions that have to be considered when the question of alcohol use and epilepsy comes up. One is the effect that alcohol could have on the medicines used to control seizures. Alcohol can be dangerous when mixed with sedative drugs and can cause coma, or even death. The other question is whether the alcohol itself will cause seizures.
Large amounts of alcohol are thought to raise the risk of seizures and may even cause them. When you drink alcohol, it may temporarily reduce seizures for a few hours, but then increases the chances of a seizure as the alcohol leaves your body.
Cigarette Smoking
Nicotine is both a stimulant and a depressant to the central nervous system. The nicotine in cigarettes acts on receptors for the excitatory neurotransmitter acetylcholine in the brain, which increases neuronal firing.
But if you want to STOP smoking, here’s a piece of scary information: some nicotine preparations used to help people stop smoking can have a side effect of convulsions. So, if you’re thinking of quitting, check out your smoking cessation program with your doc first.
Caffeine
Much like nicotine, caffeine stimulates the nervous system. Adrenaline is released and the liver begins to emit stored blood sugar. Insulin is then released, and blood sugar drops below normal—a common seizure trigger. And caffeine can be a “stealth” drug, too. It can be found as an ingredient in medications, including some antihistamines and decongestants.
Musicogenic Epilepsy
This is a form of reflexive epilepsy in which a seizure is triggered by music or specific frequencies. Sensitivity to music varies from person to person. Some people are sensitive to a particular tone from a voice or instrument. Others are sensitive to a particular musical style or rhythm. Still others are sensitive to a range of noises.
Individual Triggers
A common trigger is too much heat, internal from extremely excessive exercise or external from an overheated house or apartment. Other triggers include the smell of glue and the color yellow! Many people have their own specific triggers, while others don’t. It’s a combination of possibilities: personal chemistry, biology and genetics.
*Phylis Feiner Johnson has been a professional copywriter for 30 years. She also spent 20 years with epilepsy. She writes from the heart to increase education, awareness and funding for epilepsy research. For further information, contact The Epilepsy Foundation of Eastern Pennsylvania at http://www.efepa.org/ and please make a contribution to become an advocate, too.
INFLUENCE OF SEIZURE TYPES About Epilepsy & Seizures > Psychiatric and Behavioral Aspects > Influence of seizure types :from Epilepsy.com
Author: JC Holzer and DM Bear
The influence of seizure type and location on psychiatric and behavioral symptoms
Epileptic seizure disorders can be grouped into two large families:
generalized epilepsies, in which the epileptic activity involves the entire brain from the onset
partial epilepsies or epilepsies of focal origin, in which the seizure activity originates from an identifiable cortical region
Psychiatric disorders have been recognized in patients with both generalized and partial epilepsies. Most of the psychiatric disorders have been associated with seizure disorders of focal origin, however, primarily those involving frontal and temporal structures.
Psychopathology in generalized epilepsies
Generalized epilepsies can be subdivided into two groups:
Idiopathic or primary generalized epilepsies, of unknown cause
Secondary generalized epilepsy (or Lennox-Gastaut syndrome), resulting from a severe insult to the brain, such as an infection of the brain or anoxia at birth
Psychopathology has been identified in patients with both types. For a long time, there was a false impression that patients with primary generalized epilepsies (including absence seizures, juvenile myoclonic epilepsy, or generalized tonic-clonic seizures on awakening) did not experience any psychopathology. In fact, these patients can present with problems of impulsive behavior, poor frustration tolerance, and short attention span.
The vast majority of patients with secondary generalized epilepsy suffer from cognitive developmental delay, which may range from mild to profound. The psychopathology identified in these patients is closely associated with these cognitive disturbances. The most frequent problems involve motor hyperactivity, impulsivity, aggression and agitation, and self-mutilation.
Psychopathology in partial (focal) epilepsies
Patients with seizure disorders of focal origin are more likely to present depressive, anxiety, and psychotic disorders, or attention deficit disorder in children.
Timing of symptoms in relation to seizures
Psychiatric symptoms may be classified according to when they occur in relation to seizures:
pre-ictal symptoms, preceding a seizure
ictal symptoms, an expression of the actual seizure
postictal symptoms, following a seizure
interictal symptoms, when patients are not having any seizures
Pre-ictal symptoms usually may be recognized several hours before the seizure, though it is not rare for them to be present 48 or even 72 hours before the occurrence of seizures. As the seizure onset nears, the intensity of these symptoms may increase. They consist typically of irritability, poor frustration tolerance, impulsivity, and a variety of symptoms of depression. Parents often can predict the occurrence of seizures as their child becomes more restless and impulsive.
Ictal psychiatric symptoms consist of symptoms of depression, fear, panic, or pleasurable sensations that are an expression of seizure activity involving certain structures in the temporal lobe (i.e., amygdala) or frontal lobe (i.e., cingulate gyrus). In contrast to pre-ictal symptoms, ictal symptoms are brief, lasting less than 30 seconds.
Postictal psychiatric symptoms can occur anytime within the 120 hours that follow a seizure or cluster of seizures. Frequently, patients are free of symptoms for 24 to 72 hours before any symptoms appear. Patients may experience isolated symptoms or a cluster of symptoms that may mimic depressive, anxiety, or psychotic episodes.
Symptoms of depression and anxiety are most frequently identified during the postictal period, but they have been the least investigated. Psychotic symptoms are more readily recognized and reported because of their negative impact on the patient's ability to function. Since the 1980s many reports of postictal psychosis have been published. Postictal psychosis occurs in approximately 5% to 10% of patients with poorly controlled seizures. Although postictal depressive and anxiety symptoms have been identified in up to 45% of patients with poorly controlled seizures, only a handful of studies have been published to date.
Postictal psychiatric symptoms may last only a few minutes or persist for several days. Often patients experience clusters of psychiatric symptoms that mimic depressive, anxiety, or psychotic disorders lasting several days or weeks. These symptoms often go unreported by patients and unrecognized by physicians, but they account to a significant degree for the negative impact that seizures have on the patient's quality of life.
Interictal psychiatric symptoms are those that occur when patients are not experiencing any seizures. These psychiatric symptoms are recognized more often. They may present as depressive, anxiety, or psychotic disorders, as behavioral disorders, or may mimic attention deficit disorders. Very often they may be indistinguishable from psychiatric disorders identified in people without epilepsy. Interictal symptoms often worsen during the postictal period.
Anatomic structures involved in the development of psychiatric symptoms
As already mentioned, psychiatric symptoms can be identified in patients suffering from both generalized epilepsies and epilepsies of focal origin. It is generally accepted that structures that are part of the limbic system mediate the development of these psychiatric symptoms, at least in part. Symptoms of depression and anxiety have been associated with seizures originating in the temporal lobe, frontal lobe, or both. Psychotic symptoms also have been identified in patients with seizures of focal origin, but are more likely when bilateral seizure foci are identified.
A localized seizure focus does not necessarily preclude other brain dysfunction at a distance from the seizure focus. For example, it is well known that patients with temporal lobe epilepsy may have dysfunction of the frontal lobes, evidenced by neuropsychological studies. Patients with temporal lobe epilepsy who have proven frontal lobe dysfunction are more likely to experience depressive episodes.
Impulsivity, poor frustration tolerance, and problems with attention-the most frequent symptoms of primary or idiopathic generalized epilepsies-suggest frontal lobe dysfunction. Up to one-third of children with partial epilepsy also may display oppositional and aggressive behavior, impulsivity, and poor frustration tolerance. While these behavioral problems are more common among children with seizures of frontal or temporal lobe origin, they also may be identified in children with seizures arising in the occipital or parietal lobes. Propagation of epileptic activity to frontal lobe structures may ultimately result in frontal lobe dysfunction facilitating the occurrence of these symptoms.
Adapted from: Holzer JC and Bear DM. Psychiatric considerations in patients with epilepsy. In: Schachter SC, Schomer DL, eds. The comprehensive evaluation and treatment of epilepsy. San Diego, CA: Academic Press; 1997. p. 131-148.
With permission from Elsevier (www.elsevier.com)
Reviewed and revised April 2004 by Andres M. Kanner, M.D., epilepsy.com Editorial Board
Epilepsy Stats and Facts: By Phylis @ Epilepsy.com
I call epilepsy a “stealth” disease, but it’s difficult to imagine how so few people can know about a disease that affects so many.
For example, few people know:
* Epilepsy affects over 3 million Americans of all ages – more than Multiple Sclerosis, Cerebral Palsy, Muscular Dystrophy, and Parkinson’s Disease combined.
* In America, Epilepsy is as common as Breast Cancer, and takes as many lives.
*Almost 500 new cases of Epilepsy are diagnosed every day in the United States.
* Epilepsy affects 50,000,000 people worldwide.
* One in 100 people will develop Epilepsy.
* One in 10 people will suffer a seizure in their lifetime.
* This year another 200,000 people in the U.S. will be diagnosed with Epilepsy.
* Each year over 125,000 to 150,000 are newly diagnosed with Epilepsy.
* 30% of those diagnosed are children.
* Epilepsy can develop at any age and can be a result of genetics, stroke, head injury, and many other factors.
* For many soldiers suffering traumatic brain injury on the battlefield, Epilepsy will be a long-term consequence.
* In two-thirds of patients diagnosed with Epilepsy, the cause is unknown.
* In over 30% of patients, seizures cannot be controlled with treatment.
* Uncontrolled seizures may lead to brain damage and death.
* Up to 50,000 Americans die each year from seizures and related causes.
* The mortality rate among people with Epilepsy is two to three times higher than the general population.
* Risk of sudden death among those with Epilepsy is twenty-four times greater.
* Epilepsy results in an estimated annual cost of $15.5 billion in medical costs and lost or reduced earnings and production.
* Historically, epilepsy research has been under-funded. Each year NIH spends $30 billion of medical research, but just ½ of 1% is spent on epilepsy.
* The Federal government spends much less on Epilepsy research compared to other diseases, many which affect fewer people.
* St Valentine is the patron saint of people with epilepsy!
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