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Entries in Epilepsy (5)

Tuesday
Mar122013

Early Surgery Can Cure Epilepsy in Children, Study Finds

iStockphoto/Thinkstock(CLEVELAND) -- For the youngest epilepsy patients for whom medication doesn't work, frontal lobe surgery can stop seizures -- in many cases forever -- a new study published this week in the Annals of Neurology finds.

Doctors say the brain essentially rewires itself to compensate for the removed lobe or lobes.  Where the seizure originates is essentially damaged and so removing it actually helps the health of the brain.

"We have a chance with this surgery to really give people their life back," said Dr. Lara Jehi, lead study author and director of the Cleveland Clinic Epilepsy Center, where about 100 pediatric surgeries are performed each year.

Researchers reviewed 158 patients who underwent frontal lobe epilepsy surgery from 1995 to 2010.  They found that patients who had a shorter duration of epilepsy were almost twice as likely to be seizure-free after surgery.

Epilepsy is a chronic medical condition marked by recurrent seizures, an altered brain function caused by abnormal, excessive or electrical discharges from brain cells.

It affects an estimated three million Americans, or about 1 percent of the population, according to the Cleveland Clinic Epilepsy.  About 1 in 4 patients do not respond to medication, and for them, a frontal lobectomy can provide a "cure."

Those with the worst form of epilepsy -- with convulsions and big seizures that include stiffening and shaking -- usually have malfunctions in the frontal lobe, according to Jehi.

Those who are resistant to medication are apt to suffer injuries and accidents.  They are also three to 12 times more prone to sudden death.

"They go to sleep and never wake up," she said.

Most epilepsy patients wait decades before being offered surgery and doctors say more might seek this option.

"We found that the mere fact of time -- waiting too long before you do surgery -- is the most harmful thing you can do to a patient's brain," Jehi said.

Patients who have surgery within five years of epilepsy onset have an 80 percent to 90 percent chance of being seizure-free for life, she said.

"If you wait more than five years, it drops to 10 percent," she said.

Surgery may sound daunting, but Jehi said the mortality rate is less than .02 percent.  And the earlier it is done, the better the outcome.

Copyright 2013 ABC News Radio

Wednesday
May232012

Epilepsy: ‘Miracle Diet’ Prevents Seizures; Scientists May Know Why

Hemera/Thinkstock(NEW YORK) -- While neurologists have known that a high-fat and very low-carb diet, known as a ketogenic diet, reduces seizures in epileptic patients who are resistant to medical therapy, the “why” to it all has always been a mystery.

But today, some scientists say they may have found the answer. Researchers at Dana-Farber Cancer Institute and Harvard Medical School said seizures might be linked to a protein that changes metabolism in the brain, which is why patients respond so well to the ketogenic diet.

Epilepsy is a brain disorder in which a person has repeated seizures, or convulsions, over time. The seizures represent episodes of disturbed brain activity and cause changes in attention and behavior, according to the National Institutes of Health. The condition affects about 3 million Americans and 50 million people worldwide, according to the Epilepsy Foundation.

The ketogenic diet mimics aspects of starvation by forcing the body to burn fats instead of carbohydrates. The diet produces ketones in the body, organic compounds that form when the body uses fat, instead of glucose, as a source of energy. An elevated level of ketone bodies in the blood reduces the frequency of epileptic seizures.

The study, published in the journal Neuron and conducted in genetically-altered mice, found that the effect of the ketogenic diet on epilepsy can be mimicked using a much more specific and non-dietary approach by manipulating a particular protein in mice, said Gary Yellen, a professor of neurobiology at Harvard Medical School and co-author of the study.

“This points toward potential new ways of treating epilepsy in patients for whom current drugs are not effective,” said Yellen.

Yellen said that while the connection between epilepsy and diet has remained unclear for nearly 100 years, he has seen children’s lives change drastically after changes in their food intake. In the past, some patients have also seen improvement when they cut nearly all sugar from their diets.

Experimenting in mice, the researchers found they could mimic the effects of the diet by altering a specific protein, known as BAD. Seizures decreased in the mice.

While the research must first be replicated in humans, Yellen said, in the long run, scientists should be able to target this pathway pharmacologically.

“Because the ketogenic diet can be so broadly effective against many types of epilepsy that are not well-treated by existing medications, tapping into its mechanism may be valuable for treating many epilepsy patients,” he said.

Copyright 2012 ABC News Radio

Wednesday
Feb152012

EpiPen to Stop Epileptic Seizures?

Getty Images/Photo Researchers RM(ANN ARBOR, Mich.) -- The longer an epileptic seizure lasts, the more likely it is to turn deadly.

Besides administering an oral or anal gel suppository -- which can be difficult to give successfully in the midst of a seizure -- caregivers are at a race against time, with little to do but wait for paramedics to arrive.

But researchers at the University of Michigan and the University of Cincinnati say creating an insertible pen to stop seizures -- much like the popular EpiPen used widely for treating acute allergic reactions -- may prove to be a lifesaver.

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In a new study, published Wednesday in the New England Journal of Medicine, researchers found that injecting emergency anti-seizure medication into the muscle can stop prolonged seizures -- seizures that last for five minutes or longer -- faster than if it were administered through an IV line administered by a paramedic.

Nearly 900 patients with epilepsy who experienced seizures lasting longer than five minutes either were given a shot in the muscle with the anticonvulsant midazolam by paramedics or the standard IV line of the anticonvulsant drug lorazepam.

On average, the seizures were shorter for those patients who were administered a shot of midazolam directly into the muscle, lasting just 1 1/2 minutes after the medication was injected. Patients who received anticonvulsant drugs by IV drip, by contrast, suffered longer seizures, which continued on average for as long as five minutes before the treatment took effect.

Nearly 55,000 people die each year from prolonged seizures, according to Dr. Robert Silbergleit, emergency physician at the University of Michigan Health System, and lead author of the study.

"It's difficult to start an IV in somebody who's having convulsions, who's shaking, and that difficulty can cause a delay in getting the IV started, which can cause a delay in stopping the seizure," said Silbergleit. "And it can also be a safety hazard for the paramedic who's got a sharp object and a shaking patient," he said.

Although paramedics administered the shot to patients in the study, the findings could pave the way for a shot that can be administered by caregivers before paramedics even arrive, according to Dr. Jason McMullan, assistant professor of clinical emergency medicine at the University of Cincinnati and co-author of the study.

"The earlier they are treated, the sooner the seizure will stop, the easier it will be to control and the better the outcome," said McMullan.

The study enrolled adults and children as young as 2 years old.

"Most seizures stop on their own without any type of medication," said McMullan, adding that the findings only apply to those who have prolonged seizures, known as status epilepticus.

Midazolam, one drug in a class of medications called benzodiazepines, can be used to stop seizures. Other benzodiazepines, diazapem and lorazepem are anticonvulsants currently used anally and in IV form, respectively.

"I am very excited that this is another tool in the arsenal for present lifesaving treatments for prolonged seizures," said McMullan.

Although midazolam currently is used off-label to stop seizures, syringes with a standard dose of the medication -- such as those used in the study -- are not currently approved by the U.S. Food and Drug Administration.

While it might take a while until an auto-injector "epi-pen" of the medication is approved for caregivers, McMullan said paramedics can use the technique now.

"They can draw it up in a syringe and use it as a shot, just like how medications are given," said McMullan.

Copyright 2012 ABC News Radio

Monday
Jan232012

Autism Plus Mental Illness Affects Disorder's Course, Study Says

iStockphoto/Thinkstock(BALTIMORE) -- Additional mental disorders, such as learning disabilities, speech problems and epilepsy, could help predict which children might grow out of their autism diagnosis as they age, according to a new study.

Researchers at the Johns Hopkins Bloomberg School of Public Health studied more than 1,300 children who had been diagnosed with autism. The researchers found that certain disorders distinguished children who had a current autism diagnosis from those who had fallen out of the autism category as they aged.

The disorders varied for autistic children of different ages.  In children ages 3 to 5, those with autism were 11 times as likely to have a learning disability and nine times as likely to have a developmental delay as those children who had grown out of an official autism diagnosis.

Autistic children ages 6 to 11 were nearly four times as likely to have past speech problems and 3.5 times as likely to have moderate to severe anxiety.

Autistic teenagers were 10 times as likely to have seizures or epilepsy as children who were no longer classified as autistic.

The symptoms of these different disorders greatly overlap with the symptoms of autism, which is defined by a broad spectrum of behavioral, social and communication deficits.  But the researchers say the study suggests that separate diagnoses of learning disabilities or speech problems appeared to predict which kids would continue to be autistic and which ones might grow out of the diagnosis.

"This doesn't mean that a child who has a co-illness is definitely going to change their diagnosis status," said Heather Close, one of the study's authors. "But we were able to establish some associations with different disorders."

Lori Warner, director of the HOPE Center for Autism at the Beaumont Children's Hospital Center in Royal Oak, Mich., said that kind of information could prove valuable to therapists studying and treating autistic children.

"We're always looking for anything that helps us potentially predict who's going to continue to have a diagnosis and who won't," she said.

Copyright 2012 ABC News Radio

Friday
Mar042011

FDA: Topamax Increases Risk of Babies Being Born with Oral Clefts

BananaStock/Thinkstock(SILVER SPRING, Md.) -- On Friday, The Food & Drug Administration (FDA) issued a warning that using the drug Topamax (topiramate) can increase the risk of babies being born with cleft lip and cleft palate.

The drug is used for the treatment of seizures in people who have epilepsy and also to prevent migraine headaches from occurring.

The FDA warning, which also extends to the generic versions of the drug, says that the increased risk applies to women who use the drug during pregnancy. The FDA is urging health care professionals to warn their patients who are of childbearing age about the potential hazard topiramate poses to the fetus if women use the drug while pregnant. Health professionals are also being urged to use alternative drugs that have a lower risk of birth defects.

According to a release by the FDA, oral clefts are birth defects that occur when parts of the lip or palate don't completely fuse together in the first trimester of pregnancy.

Copyright 2011 ABC News Radio







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