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Epilepsy

Stigma and Treatment in Epilepsy- When Surgery is Actually the Best Option

By: Stephanie Tuminello 

              Patients and doctors alike oftentimes consider surgery the last resort in epilepsy treatment. This is because of how radical a method of treatment this is considered compared to medication. But the fact of the matter is that all cases of epilepsy are different and that sometimes medication alone is not effective, and, moreover, that sometimes even if medication is working to suppress seizures surgery may work better or even be curative. In actuality surgery should, in some cases, be considered the first option, not the last.

            The method of treatment a doctors and his/her patient chooses is ultimately based upon the patient’s specific illness. If seizures occur in one specific area of the brain that can be easily removed this patient is a prime candidate for surgery. Also, if epilepsy is being caused by growth, tumor, lesion, or cyst in the brain that is not responsive to medication surgery to remove it might be the best option. As with any surgery age, general health, and severity of illness are important factors to take into consideration. 

            There are different types of surgery for epileptics. Focal resection is the act of removing the part of the brain where the seizures originate. This type of surgery is only effective when seizures originate in only one part of the brain, usually the temporal lobe.  A hemispherectomy is more invasive and requires removing almost the entire side of the brain. This form of surgery is used less often but for those patinets to need it in order to eliminate the area of the brain causing seizures. Lastly, a corpus callostomy is when brain surgery is performed to stop the pathways in which seizures spread, confining the seizure to a smaller part of the brain. Each form of epilepsy surgery, like any surgery, have their own risks associated with it, but for many people surgery is the way in which they can eliminate or control their illness in order to live their lives seizure free.

 

References

 

John Hopkins Univeristy (n.d.). Surgery for Seizures & Epilepsy. Retrieved 3/8/14

            from http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/epilepsy/treatment/surgery/

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Epilepsy

Noise of the Neurons

By Priyal Sakhuja

Imagine sitting in a classroom at school or with your friends at lunch, trying to go about your normal day-to-day activities, but you can’t seem to focus. Your mind doesn’t let you. You start to zone out and you wind up staring into the distance. This could happen numerous times a day and you might not even realize it. Externally, it may seem like nothing happened, but if only you could hear your brain, the noise of the neurons might tell you something quite different.

The abnormal electrical discharges would actually tell you that the person is having a seizure.  But how is it possible to hear the sound of a neuron? Josef Parvizi, a Stanford neuroscientist and epilepsy specialist, collaborated with his colleague Chris Chafe, a music researcher at Stanford, to develop the brain stethoscope. This device could could convert brain waves and their electrical discharges into an audio recording of what’s going on inside the brain. Unlike grand mal seizures, which cause convulsions, this type of petit mal seizure is more subtle, and thus, the brain stethoscope allows one to gain a deeper insight into the activities of the brain (Slack, 2014).

So how does it work? The stethoscope detects brain wave activity using a pair of wearable electrodes that sense electrical emissions from the neurons beneath them. The signals chosen by Chafe are then converted to sounds that are similar to the tone of a human voice. The “singing” of neurons that is heard allows one to identify the presence and intensity of seizure activity. A more intensified and disoriented noise is often identifiable during a seizure, while the end of a seizure is characterized by slower and deeper noises, depicting a “tired” brain.  

It’s truly amazing to see the advancements being made by medical science today and the leaps scientists are taking to achieve the unimaginable. It is, in fact, inventions such as these that will allow medical knowledge to spread to even the rural areas of India, where seizures are often undetected. Until now, the only reliable way to learn whether one was having a seizure was to administer an electroencephalogram (EEG), which converts electrical activity to waveforms that are then interpreted by doctors. But for many people in India, this is not a viable option. However, the brain stethoscope will soon become a popular alternative for even the most untrained people to listen to brain activity and determine whether a seizure is occurring. These noises of the neurons may actually bring us another step further to unraveling the mystery of seizures.

References:

Slack, Gordy. (2014, March 28). “Hearing a Seizure’s Song.” Discover. Available:

           http://discovermagazine.com/2014/may/6-symphony-for-a-seizure

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Epilepsy

A Brighter Picture

By Stephanie Tuminello

 

            Conventionally, epilepsy has been treated with a variety of drug alternatives. These drugs are aimed at controlling seizures, and while most are very effective they all have unfortunate side effects including tiredness, nausea, blurred vision, weight loss, weight gain, rashes, and insomnia. Because of this, health care providers seek alternative therapies. Art therapy is one promising example. By reducing the stress of epilepsy patients, art therapy has been shown to indirectly lower seizure frequency independent of any medication.

            Developed in the 1940s, art therapy is not used to treat epilepsy alone. It operates on the idea that creative expression helps to resolve internal conflicts, increase self-esteem and increase self-awareness, and in doing so relieves some of the stress of the patient. Art therapists receive training in both art and psychotherapy so as to be better able to help their patients. Oftentimes, art therapists can be part of a team of health care providers including physicians, psychologists, nurses, and mental health practitioners.

            For epilepsy patients, art therapy will usually take place over a number of sessions. The form of creative expression can vary and can be either drawing, painting, or sculpting. Art therapy can help people with epilepsy communicate their feelings, which they otherwise would not have been able to put into words. It may also help them learn how to better relate to other people, something that the stigma surrounding their condition might otherwise prevent. The art itself evolves over numerous sessions becoming something that opens the lines of communication between the artist and the therapist. Art therapy has been seen to be especially beneficial to young people with epilepsy in helping them make the transition from living a more dependent lifestyle with their parents to a more autonomous one.

          Epileptic artists have created a multitude of awe-inspiring art, both associated with and independent of their medical condition.<span>&nbsp; </span>Below is a link to an online gallery of some of this artwork.

http://www.flickr.com/photos/epilepsysociety/collections/72157629700291003/

            In this way art can be both liberating and healthy for people living with epilepsy, with amazing results. Equally importantly, it can help epilepsy patients by reducing the stigma associated with condition as viewers of their artwork can relate on the most basic, primal levels to the emotions and themes being expressed, so that all and all art therapy is an alternative treatment method of great value.

 

References

(2014). Epilepsy Drugs to Treat Seizures. WebMD. Retrieved March 3, 2014 from http://www.webmd.com/epilepsy/medications-treat-seizures

 

(2014). Art Therapy. Epilepsy.com. Retrieved March 3. 2104 from  https://www.epilepsy.com/epilepsy/treat_art_therapy

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Epilepsy

Mind Over Matter

By Priyal Sakhuja

Take a deep breath in, raise your hands overhead, arms straight, and reach toward the sky with your fingertips. Find your center and feel the essence of your body. That’s yoga, the practice of uniting the mind, body, and spirit. It’s the art of creating balance through developing strength and flexibility. Yoga has recently become an increasingly popular form of exercise for many in the Western world, but its origins lie in ancient Indian philosophies and texts such as the Rig-Veda.  The word yoga itself comes from the Sanskrit word, “yuj,” which means yoking, or a team of oxen (Ann, 2014). Thus, yoga can be interpreted as a union of sorts. So how can this ancient practice, which has recently become an increasingly modern form of therapy and fitness, be beneficial for epileptics?

Epileptologist, Dr. Nandan Yardi, head of the Yardi Epilepsy Clinic in Kothrud, Pune, India explains that seizures are caused by imbalances in the physical and psychological systems or the union of these systems in the body. This is where yoga and its various forms come in, which could become a key step in restoring the balance between the mind and body (“Yoga for Epileptic Seizure Control”).

Pranayama or Deep Diaphragmatic Breathing

It is important for people who are having a seizure to catch and hold their breath to cause changes in metabolism, blood flow, and oxygen levels in the brain. Pranayama, or deep breathing, helps bring about normal respiration and reduce the chances of going into a seizure or can even stop seizures before they are in full effect.

Asanas or Postures 

Postures, or “asanas” are integral to restoring balance to the body and metabolic systems. This is because postures increase physical stamina which helps develop improved strength and flexibility. They are also known to calm the nervous system, which contributes to increased mental strength. Using asanas as physical exercise allows for improved circulation, respiration, and concentration, thus decreasing the chances of having a seizure.

Dhyana or Meditation

Since stress is a major trigger, meditating, or calming the mind is an important method for controlling seizures. Dhyana improves blood flow to the brain and decreases production of stress hormones while increasing production of essential neurotransmitters. Increased levels of neurotransmitters such as serotonin substantially calm the nervous system. Meditation is the key to restoring the balance between the mind and the body.

In 1996, The Indian Journal of Medical Research published the effects of “Sahaja Yoga” on seizure control. While the study was not very conclusive, its results were still quite promising. In the study, a group of patients with epilepsy who practiced “Sahaja Yoga” witnessed an 86 percent decrease in their frequency of seizures. While yoga might not be a cure to seizures, it is certainly an encouraging form of alternative medicine that could only benefit the body in various ways. Although yoga is certainly becoming more popular in recent years, it has proved to be the master of unifying our mind, body, and soul for centuries in ancient India. Yoga is a healthy lifestyle that allows one to get away from the chaos that work, family, relationships, or health issues may bring about. It teaches you how to focus on you. So give it a try. Do it with your loved ones. And remember, mind over matter.

References:

Langley, Zoe. “Yoga for Epileptic Seizure Control.”  Online. <http://hinduism.about.com/od/meditationyoga/a/Yoga-For-Epileptic-Seizure-Control.htm>

Pizer, Ann. (January 2, 2014). “What is Yoga?” Online. <http://yoga.about.com/od/beginningyoga/a/whatisyoga.htm>

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Epilepsy

Relationships and Epilepsy

By: Stephanie Tuminello

With Valentine’s Day just passed it seemed as though all the world was full of reds and pinks and candy hearts. All this emphasis on love and relationships can be hard enough to deal with as is, but becomes significantly more difficult for those suffering from conditions like epilepsy and the stigma associated with it.

The history of epilepsy in terms of love, sex and marriage in the United States is both shocking and appalling. Up until as late as 1980 there were states which prohibited people with epilepsy from marrying. Worse still, until 1958 there were 18 states that legally allowed for eugenic sterilization of people with epilepsy.

Nowadays, things are better but can still be challenging. This is mostly due to misconceptions and misinformation. Despite overwhelming belief to the contrary, people with epilepsy can enjoy normal relationships and have normal sex lives.There has yet to be any concrete evidence that epileptic episodes are triggered by sex. Even though there is some statistical evidence that impotence and lower libido are more common in epilepsy patients, this is still not the majority of cases.

Men with epilepsy are just as likely as other men to have healthy children. Most epileptic women can have healthy offspring as well, though some antiepileptic drugs have been associated with birth defects. Still, though fertility is decreased in some epileptic men and women, this does not mean that children are not possible, and in fact many with epilepsy go on to have healthy, happy families.In the end, people with epilepsy are just as entitled to love and happiness as anyone else, and stigma alone seems to prevent this. If you find yourself in such a relationship, either as the person with the condition or the partner, the best course of action is an open, honest discussion. Because real, intimate love is patient, selfless, and never judgmental.

References

http://www.epilepsy.com/epilepsy/social_romantic

http://www.who.int/inf-fs/en/fact166.html

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Epilepsy

Reaching the Heart of India

By: Priyal Sakhuja

The great Mahatma Gandhi once said, “The true India is not to be found in its few cities, but in its seven hundred thousand villages. If the villages perish, India will perish too.” Sadly, if Gandhi were to see the current health care scenario in rural India right now, he would not be too pleased. And neither are the seventy percent of India’s population who reside in these rural areas.

Unsurprisingly, the prevalence of epilepsy in these rural areas is higher than that in urban areas due to the lack of resources and under-treatment in the villages of India. However, the underlying issues don’t revolve around the lack of accessible health care. Instead, the integral issues lie within the cultural restrictions that add a burden to already burdened villagers who must deal with the health as well as the social issues associated with epilepsy.

In some rural areas of India, people with epilepsy are thought to have “demons” within them.  Attempts are made to exorcise these evil spirits by tying them to trees, beating them to release the spirits, cutting parts of their hair, or even starving them. One cannot help but stop and ask- Why is there still such a lack of knowledge in areas that need it the most? Why are people who are already struggling faced with even more struggles by the stigma of society? Why isn’t anything being done to change this situation?

Although much change is still needed in these areas, there is hope coming into the villages of India and that is “Hope on Wheels,” which is a mobile health care center that provides diagnosis, treatment, and most importantly, education about epilepsy in rural India. The pilot project focuses on rural Rajasthan, which will introduce a mobile health clinic vehicle equipped with diagnostic and treatment tools. The team of “Hope on Wheels’ includes clinical and technical experts as well as social workers who will collaborate with top city-based neurologists through a video conferencing facility.

Additionally, “Hope on Wheels” will provide patient, family, and community support through social work visits and follow-up consultations to regulate the treatment and identify any adverse effects. This program is moving one step towards altering the perception of epilepsy in rural India through the use of education and social workers. With continuous support and effort, “Hope on Wheels” hopes to reach more than 50, 000 patients and caregivers in Rajasthan.

Gandhi’s words resonate even today. Let’s not forget that the heart of India lies in its villages, and more importantly in its people. “Hope on Wheels” is just one step closer towards reaching the roots of India but it doesn’t end here. 

References: 

Dutta, Nirmalya. “What ails India’s Healthcare System?” The Health Site. August 18, 2012. Online. <http://health.india.com/diseases-conditions/what-ails-indias-healthcare-system>

Rizvi, Safia. “Epilepsy Care Rolls Into Rural India.” UCB. October 7, 2015. Online. <http://www.ucb.com/magazine/article/Epilepsy-care-rolls-into-rural-India>

 

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Epilepsy

The Keto Diet: Fat is the Cure

Welcome to the Keto Diet. Breakfast, lunch, and dinner consist of mainly fats in a 3:1 ratio of fats to carbohydrates and protein but can be increased to 4:1 or even 5:1 for younger children. That sounds unhealthily delicious doesn’t it? To be able to eat bacon for almost every meal of the day?

This obviously raises some health concerns for parents who are new to this idea. Not only does it mean that your options for food is severely limited, but your child’s diet is reduced down to foods with a high fat content. Not only that, every meal has to be carefully calculated and weighed out down to the last gram. Many families have to go to great lengths to plan out their child’s meals and can never say,” let’s just order some pizza” at the end of a long day. Snacks have to be packed for sleepovers, your child can never partake in some of the birthday cake, and restaurant outings are an almost nonexistent possibility. So, why would you saturate your child’s diet with fats and place such restrictions on his or her life?

Well for one thing, these diets are usually implemented for severe cases, where medications do little to limit the amount of strokes. As a University College London study noted, 38% of patients had reduced frequency of strokes by more than 50% and 7% had the seizure frequency reduced by more than 90%. When there are some children out there who suffer up to 100 seizures per day, this can greatly increase a child’s quality of living. It’s crazy how fat can sometimes be beneficial.

Nutrition Issues in Gastroenterology. Series 39. June 2006. “The Ketogenic and Atkins Diets: Recipes for Seizure Control.” Retrieved November 11, 2013. http://www.medicine.virginia.edu/clinical/departments/medicine/divisions/digestive-health/nutrition-support-team/nutrition-articles/TurnerArticle.pdf

New York Times. November 17, 2010. “Epilepsy’s Big Fat Miracle.” Retrieved November 10, 2013. http://www.nytimes.com/2010/11/21/magazine/21Epilepsy-t.html?pagewanted=all

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Epilepsy

Steps towards Explaining Epilpesy

            BOOM! POW! Nowadays when we read about superheroes, they are beating up the bad guys – the robbers, the criminals, and the evil scientists.  These superheroes have amazing abilities, that range from super speed, to flying, to incredible strength. Children from around the world admire them, and aspire to be just as benevolent and amazing.

            Keeping this in mind, Eisai, a leading organization in the epilepsy community, was proud to announce its new comic book designed to educate children about epilepsy. The comic book tells the story of Jack, a 14 year old child with epilepsy who is trying to get through middle school while living his condition. He’s accompanied by a team of five superheroes who are trying to explain epilepsy to both Jack and his peers.

            The book’s content addresses the diagnosis and treatment of the disease and focuses on the stigma that children with epilepsy must face by spreading awareness and educating. The authors for the book recognize that the lack of awareness of such a prevalent disease is unacceptable and that it is essential to educate the public about the condition.

It’s reported that 36% of students with epilepsy try to keep their condition a secret to avoid discrimination and 23% of parents try to keep the secret to protect their children. The book tries to break down the tough medical concepts so children can really understand the disease and be able to educate their family, friends and peers about it.

Eisai has taken the first step towards educating and eliminating the stigma associated with epilepsy in a creative and fun way, and it’s important we continue to take these steps to prevent discrimination and aim for a happier and more aware society.

Here’s how you can order your book! http://www.eisaiepilepsy.com/

 

References

“Eisai Tackles Stigma Associated With Epilepsy Through Support Of Comic Book Addressing

The Condition KYTX CBS 19 Tyler Longview News Weather Sports.”Eisai Tackles Stigma Associated With Epilepsy Through Support Of Comic Book Addressing The Condition – KYTX CBS 19 Tyler Longview News Weather Sports. N.p., n.d. Web. 5 Dec. 2013. <http://www.cbs19.tv/story/24120934/eisai-tackles-stigma-associated-with-epilepsy-through-support-of-comic-book-addressing-the-condition>.

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Epilepsy

The Stem of the Stigma

We’ve talked a lot about the stigma of epilepsy in all parts of our life: in school, at work, at home, and in general. We’ve mentioned why these stigmas are wrong, and how we can change them. But where did these stigmas come from? Where did they originate? Research has shown that epilepsy has been feared, and stigmatized for years, in many different parts of the world. Every culture had their own explanation, and their own beliefs on what it was, and how to get rid of it. Although there are slight variations, most lie along the same lines, and the misunderstandings have a lot of common ground. Here are some flashbacks of the stigma:

                The Hammurabi code, dating back to 1750 B.C. once said that a person with epilepsy could not marry or testify in court. They believed that they were not good enough to reproduce, or even be slaves. In fact, the Hammurabi code stated that if a slave was sold, and then found to have epilepsy, he could be returned.

                The myth that epilepsy is contagious is still prevalent today. It started in the early Christian church, clergy and synods segregated the “possessed” from the “faithful”. Christians were afraid that people with epilepsy would taint holy objects with their “evil” breath and their “unclean and deaf spirit”! Up until the 18th century, epilepsy was still believed to be contagious. A professor from the 18th century once wrote: “Therefore, neither talk nor bathe with him, since by their mere breath they infect people”

                In the late 19th century, it was commonly believed that people with epilepsy were frequently violent, anxious, and were prone to terrible hallucinations. They believed this was also related to religious ecstasy.  In fact, the Arab-Persian manuscripts in 600 A.C. also referred to epilepsy as a disease caused by demons. It’s these beliefs that cause the fear, the misunderstandings, the rejection and the stigmatism.

                Although we have made progress in terms of understanding epilepsy and educating ourselves and others, the stigma still exists. While “demons” may not be the center of the stigma today, people with epilepsy still face discrimination in school, at work, and in their social life. It’s important to continue to educate and advocate for people with epilepsy so that they too may live healthy and happy lives.  

References

“EpilepsiaVolume 44, Issue Supplement s6, Article first published online: 18 AUG 2003.” The History and Stigma of Epilepsy. N.p., n.d. Web. 21 Nov. 2013. <http://onlinelibrary.wiley.com/doi/10.1046/j.1528-1157.44.s.6.2.x/pdf>.

“Epilepsy Stigma.” ibe-epilepsy.org. N.p., n.d. Web. 21 Jan. 2013. <http://www.ibe-epilepsy.org/wp-content/uploads/2013/07/1-Burden-Stigma-of-Epilepsy-Hanneke-de-Boer.pdf>.

 

 

Categories
Epilepsy

Suspect 6: Tonic-Clonic. (A.K.A. the grand mal)

By: Neha Kinariwalla

Before cueing any James Bond music, let’s take a look at the grand mal (equally big and bad)!

Because we often tend to unfairly stigmatize epilepsy it’s worthwhile to explain what the grand mal seizure actually is, as well as the physiology behind it. Let’s start by defining what the term literally means. The grand mal seizure consists of the following two phases; the first being tonic, and the last being clonic.

During the tonic phase, since breathing decreases, a person’s lips, nail beds, and face can turn blue—this usually lasts for a minute or so.

During the clonic phase, there are jerking movements that usually alternate.

Tonic: Commonly thought of as some form of medicine taken to bring feel good, in physiological terms it means “muscular contraction” [2]. When a person has a tonic seizure, their muscles stiffen, their eyes roll to the back of their head, and they lose consciousness. This could be rapidly occurring at first, but will subside gradually. People often think that a person having such a seizure will “swallow their tongue”. Thankfully, that’s physically impossible! Though one should never, under any circumstances attempt to open their tightly clenched jaw as that can be tremendously harmful to the patient experiencing the seizure.

Clonic: I can’t say clonic is commonly used in day-to-day language, but in medical terms it is just simple alternation of contraction and relaxation [2]. So naturally, a clonic seizure is when the individual’s muscles begin to spasm and jerk. Towards the end of this phase, one should look for a deep sigh after which normal breathing will resume.

It’s rare for these two types of seizures to be separate from one another. And when both are experienced at the same time, it’s known as the tonic-clonic seizure. Makes sense, right?

So what should you do? Prevent injury by placing something soft under their head. Loosen tight clothing. Turn a person on their side. Stay with that person and be there for them—physically and emotionally. If lasts longer than 5 minutes, call the doctor.

References:

[1] “Tonic and Clonic Seizures” Johns Hopkins Medicine. Web. 30 Oct. 2013.

[2] Tonic Clonic Seizures. Epilepsy Foundation. Web. 30 Oct 2013.

[3]  www.dictionary.com

 Reviewed by Dr. Miller-Horn