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Oregon hosts forums on epilepsy treatment

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  Quote seeroseero Quote  Post ReplyReply Direct Link To This Post Topic: Oregon hosts forums on epilepsy treatment
    Posted: 30 November 2005 at 12:33
Using an analogy of learning how to ride a bike — as in once you learn how to ride one, you never forget — neurologist Dr. Mark Yerby described the importance of medication in the treatment of epilepsy.

“If we can diagnose a patient with epilepsy early on and get that person on the proper medication quickly to reduce and hopefully prevent seizures, we can train the brain to ‘forget’ or ‘unlearn’ the process of seizing,” said Dr. Yerby. “The medication suppresses the condition and can send it into a state of remission. But the key is to catch it early.”

As the medical director of the Providence Epilepsy Center, part of the Providence Brain Institute, Dr. Yerby is working to help patients diagnosed with this disease, as well as to educate the community about the condition and available treatment for it.

“Epilepsy is very serious — and it can be scary, as seizures can dramatically affect many aspects of a person’s life,” said Dr. Yerby. “Yet a variety of treatments and therapies exist that can allow most people to live normal, productive lives. What is crucial is getting patients on a program that best meets their needs and can most effectively control their seizures.”

Discussion of the disease took place at two recent community forums led by Dr. Yerby, “Calming the Seizures: New Options for Epilepsy,” at Providence Portland and Providence St. Vincent Medical Centers. Hosted by the Providence Brain Institute as part of its community educational outreach efforts, both events were well attended by people with a vested interest in the condition, either because they or a loved one was diagnosed with epilepsy.

After headaches, epilepsy is the most common neurological condition, outnumbering stroke, Parkinson’s disease and multiple sclerosis, yet for thousands of years, throughout the world, many people have feared the condition and misunderstood seizures.

Epilepsy can be defined as a series of recurrent seizures caused by excessive electrical discharges from the central nervous system. Nearly 70 percent of seizures happen for no apparent reason, while the remaining 30 percent are caused by conditions such as brain tumors, head injuries, infections or lack of oxygen to the brain during childbirth. During a seizure — which can range from a few seconds to several minutes — a person may:

• Lose consciousness

• Have jerking or spasms in part or all of the body

• Be unable to speak

• Stare

• Have déjà vu

• Experience unusual sensations, including numbness, tingling, odd smells or tastes

• Make grunting or strange noises

Before breaking into a question-and-answer session with attendees, Dr. Yerby highlighted current methods of treatment for epilepsy:

Medications — Many people with epilepsy take antiepileptic medications. While they don’t cure the condition, they can help to control seizures.

Vagus Nerve Stimulator — Similar to a cardiac pacemaker, this surgically implanted device has been clinically proven to decrease, and in some cases, eliminate, seizures by conditioning the brain to better react to the interruptions in brain function. Additionally, many VNS patients have been found to benefit from improved cognitive function including increased alertness, concentration and mood. However, this is an adjunct therapy, to be used in concert with medication, not as a substitute.

Surgery — Surgery to remove the area of the brain where seizures begin is an option for some patients.

Much of the discussion revolved around triggers or causes of seizures, with attendees sharing personal stories. Water on the face (in the shower or bath); light reflecting off water; migraine headaches (sometimes initiated by light); stress; sleep deprivation; and colorful, fast-paced television programming — for example, some animated cartoons — can induce seizures. Additionally, alcohol intake can trigger an episode.

“It’s the alcohol ‘withdrawal’ or ‘excitability’ phase, not the actual drinking, that can cause a seizure,” said Dr. Yerby. “Also, when people are drinking, they can forget to take their medication, which obviously increases their risk of a seizure.”

With Dr. Yerby’s encouragement at the Providence St. Vincent forum, one attendee stood up before the crowd and spoke about her recent VNS surgery and change in medication, which together provide her with more seizure control and enable her to live a more “normal,” uneventful life.

Despite that epilepsy has been documented since ancient times, not much in the way of research has been able to correlate a direct connection between control of seizures and diet, exercise or any “natural element” from Mother Nature. There is some data to support that low-to-no carbohydrate diets can be of moderate benefit in seizure control, especially for young children. Components of marijuana have been seen to have medicinal benefits for patients with epilepsy. Also, meditation and biofeedback are tools that can reduce stress, a known contributor to an increase in seizures.

So, what does the future hold in terms of treatment?

“Within our lifetime, I think we’ll see the development of an electrode similar to what we implant in VNS surgery in the chest area, but placed in the brain,” commented Dr. Yerby. “I don’t think that’s out of the question, at all.”

He added that other modes of treatment — some of them in the more distant future — include neuroimaging and magnetoencephalography, a noninvasive tool to study brain function and electrical currents inside neurons of the brain.

“The future is bright for epilepsy patients — while the condition is serious, it is very treatable,” concluded Dr. Yerby. “And if diagnosis is early, there are many options of care available.”

In case of seizures . . .

If someone is having a seizure, you can help by:

• Getting the person to a safe environment

• Easing the person to the floor if he or she is seated or standing

• Providing a cushion for the person’s head

• Removing dangerous objects from the immediate area

Do not:

• Restrain a person having a seizure

• Place anything in the person’s mouth

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