Rapper Lil Wayne suffers seizure

STORY HIGHLIGHTS

• NEW: Fellow rapper Drake and other friends set up vigil outside his room
• "I'm good everybody," Lil Wayne writes on Twitter
• Lil Wayne suffers a seizure and "is recovering," his record label's publicist says
• Lil Wayne is a Grammy-winning and multiplatinum selling artist

Los Angeles (CNN) -- Grammy-winning and multiplatinum-selling rapper Lil Wayne suffered a seizure and "is recovering," his record label's publicist said Friday.

The New Orleans artist arguably occupies the highest rungs of the hip-hop world, but he shares them with fellow rapper Drake, who hails from Toronto.

Drake appeared at the Los Angeles hospital, where Lil Wayne is being treated, with an entourage of Wayne's friends. They pulled up chairs in the hallway near his room and set up a vigil.

Twitter has lit up with rumors, spreading fears of the worst for Wayne's outcome, but a Tweet in his name attempted to calm the tempest.

"I'm good everybody," read a message from Lil Wayne's Twitter account. "Thnx for the prayers and love."

While acknowledging a medical issue, members of the New Orleans' artist's camp have shot down reports that he was near death.

"Dont believe the nonsense about comas and tubes to breathe ... that's false!!" tweeted Mack Maine, the president of Lil Wayne's Young Money label, around 5:20 p.m. (8:20 p.m. ET) Friday.

Sarah Cunningham, a publicist with the Young Money record label, acknowledged that Lil Wayne had a seizure.

The public relations department at Cedars-Sinai Medical Center, the Los Angeles hospital where the rapper is reportedly being treated, did not confirm or deny that Lil Wayne is there, per its policy.

Maine didn't offer much detail, though he did say that he and Lil Wayne had been watching the Syracuse University Orange play Georgetown in the Big East men's basketball tournament.

"Wayne is alive and well!" the record label president wrote on Twitter.

Read more here

Detecting Epilepsy in Newborns

This article discusses signs that may detect epilepsy in newborns other than seizures.

Newborns twitching or rolling up their eyes or making frequent jerky body movements could mean they are having epileptic attacks and need immediate medical attention. Epilepsy may be the most common neurological disorder in the country. According to an ICMR-supported study published in the June issue of the Indian Journal of Neurology, one in 100 suffers from it, though not many are aware of its early warning signs.

While convulsions are an obvious sign of epilepsy, doctors specially warn parents to not to ignore subtle signs such as unexplained blank episodes or those of confusion and fainting and constant shaking of hands and legs as they could indicate the onset of epilepsy. One needs to be especially careful if there is a history of seizures or epilepsy in the family, which can be picked up as early as within 28 days of a child being born.

"In newborns, it is not really a disease as the symptoms are usually minor and result in not-so-serious issues, such as low sugar or calcium levels. However, in teenagers and adults, the cause of attacks could be serious, such as a brain infection, bleeding, legion or cyst that would need proper treatment in the form of medicines," said Dr Nitin Verma, senior consultant, department of paediatrics, Max Super Specialty Hospital, Saket.

Anvesha Mittal (name changed on request), 42, thought her 15-year-old son was having nightmares when he would shiver in his sleep.

"I thought he was having a bad dream. Gradually, the episodes increased and he started shivering during his afternoon naps as well. That's when we took him to a doctor," she said.

Her son was diagnosed with epilepsy after an MRI scan showed a small legion on the left side of the brain. "I have kept his teachers in the loop. They are careful with him now," she added.

The serious form of epilepsy mostly affects people when they are most productive, that is when they are aged between 14 and 45 years. Depending on the condition, treatment can last up to three years to a lifetime.

"A person with epilepsy needs to take medicines for long. Though the medicines are not very expensive, they still can burn holes in the pockets of many. A large number never receive treatment, and 75% of those who do, leave it mid-way," said Dr Manjari Tripathi, additional professor, department of neurology, All India Institute of Medical Sciences (AIIMS), who was part of the ICMR-supported study.

Almost four-fifth of those affected do not receive treatment despite it being fairly inexpensive and effective in 95% of the cases.

Surgery can also treat epilepsy. But not every patient can be operated because of high chances of irreversible brain damage.

Looking at the large numbers, the Government of India is considering an epilepsy control programme to spread awareness about the disease and distribute free medicines.

"The national programme will help by reaching out to people at the periphery, like it happened with the national mental health programme," said Dr P Sathish Chandra, director and vice-chancellor, National Institute of Mental Health and Neuro Sciences, Bangalore.

It is estimated that there are more than 10 million people with epilepsy in our country. "One million new cases get added to the figure every year," said Dr Satish Jain, who runs the Indian Epilepsy Centre in Delhi.

"It is an eminently treatable disorder and it is high-time the government takes it up on a priority basis to benefit the poor," said Dr Chandra.

Read more here

Kleefstra Syndrome - Meetup In October in 2012

What is Kleefstra Syndrome

Last Updated on Thursday, 31 May 2012 12:44

Kleefstra syndrome is a rare genetic condition in which a tiny piece is missing from near the end of one of the body’s 46 chromosomes. The missing piece includes a gene called EHMT1. Its absence is believed to cause the major symptoms of the syndrome. The syndrome was officially recognised as Kleefstra syndrome in April 2010 but you may still see it referred to as any of the following:

• 9q34.3 deletion

This was the most common name before Kleefstra Syndrome was recognised, and in fact our original website address was www.9q34.org In April 2010 OMIMrecognised the term "Kleefstra syndrome" and in May 2010 our website adopted the new name.  

• 9qSTDS

Short for 9q Subtelomere Deletion Syndrome - It was suggested by a specialist in the field that this become the uniformed name. Some parents disliked this however, due to other meanings of the term STD.

• CHOMS

Short for Craniofacial characteristics, Hypotonia, Obesity, Microcephaly, Speech problems.  It was suggested to be the uniformed name by one of the specialists looking at the condition.

Other variations are:    

• 9q34.3 microdeletion

• 9q34.3 terminal deletion syndrome
• 
  

Diagnosis

What are the first signs that a baby or child has the disorder?

The first signs can be incredibly diverse. Out of a group of 14 babies, five seemed fine at birth but concern grew later about their development: they failed to track visually, to watch their mother while feeding or their rate of development was slow. One baby seemed to progress as expected until developing a type of seizure at three months; another repeatedly failed hearing tests.

In nine babies there were signs immediately after birth of something wrong, varying from a weak cry, feeding difficulties and unusual facial features (twice thought to suggest Down’s syndrome) to a small head, hernias in the groin and at the navel, a floppy larynx, heart problems, cataracts and seizures. Although a low muscle tone (floppiness) is usually characteristic of newborn babies with Kleefstra syndrome, this may not be obvious: in four babies, no floppiness was observed.

Diagnosis

Last Updated on Tuesday, 01 May 2012 12:56

What are the first signs that a baby or child has the disorder?

The first signs can be incredibly diverse. Out of a group of 14 babies, five seemed fine at birth but concern grew later about their development: they failed to track visually, to watch their mother while feeding or their rate of development was slow. One baby seemed to progress as expected until developing a type of seizure at three months; another repeatedly failed hearing tests.

In nine babies there were signs immediately after birth of something wrong, varying from a weak cry, feeding difficulties and unusual facial features (twice thought to suggest Down’s syndrome) to a small head, hernias in the groin and at the navel, a floppy larynx, heart problems, cataracts and seizures. Although a low muscle tone (floppiness) is usually characteristic of newborn babies with Kleefstra syndrome, this may not be obvious: in four babies, no floppiness was observed.

New Scan May Cause A ‘Paradigm Shift’ in Epilepsy Research

A new non-invasive scan taken directly after a seizure may change the way epilepsy is researched.

An innovative new study merges engineering and clinical expertise to develop a revolutionary method to diagnose and treat epilepsy patients.

Researchers from the University of Minnesota and the Mayo Clinic believe a new type of non-invasive brain scan — taken immediately after a seizure — will provide advanced insight into possible causes and treatments for epilepsy patients.

The new findings could benefit millions of people who are unable to control their epilepsy with medication.

The research is published online in the journal Brain.

Researchers say the study resulted in several significant findings:

• Important data about brain function can be gathered through non-invasive methods, not only during a seizure, but immediately after a seizure;
• The frontal lobe of the brain is most involved in severe seizures;
• Seizures in the temporal lobe are most common among adults. The new technique used in the study will help determine the side of the brain where the seizures originate.

“This is the first-ever study where new non-invasive methods were used to study patients after a seizure instead of during a seizure,” said Dr. Bin He, a biomedical engineering professor in the University of Minnesota’s College of Science and Engineering and senior author of the study. “It’s really a paradigm shift for research in epilepsy.”

Epilepsy affects nearly 3 million Americans and 50 million people worldwide. Although medications and other treatments help many people of all ages who live with epilepsy, about 1 million people in the U.S. and 17 million people worldwide continue to have seizures that can severely limit their lives.

Medical researchers have always faced the challenge of determining the part of the brain responsible for the seizures. Learning the specific site of the seizure helps physicians determine the best possible treatment.

In the past, most research has focused on studying patients while they were having a seizure, or what is technically known as the “ictal” phase of a seizure. Some of these studies involved invasive methods such as surgery to collect data.

In the new study, researchers used a novel approach by studying the brains of 28 patients immediately after seizures, or what is technically know as the “postictal” phase of a seizure.

They used a specialized type of non-invasive EEG with 76 electrodes attached to the scalp for gathering data in contrast to most previous research that used 32 electrodes. The researchers used specialized imaging technology to gather data about the patient.

The findings may lead to innovative means of locating the brain regions responsible for seizures in individual patients using non-invasive strategies.

Read more here

The Best Ways To Integrate Special Needs Students

I found this report on NPR. I hear parents talk about special education issues every day. Accommodations and modifications are a difficult process for all. Children with seizures, autism, cerebral palsy, ADHD and other neurodevelopmental problems are entitled to education. Parents expect a full range of services. In general, schools have motivated and highly professional personnel and accurate services. At the same time, schools have limited budgets for personnel, occupational, physical and speech therapy.  Its a difficult situation.  A physician can help. JR

The Best Ways To Integrate Special Needs Students

May 2, 2012

Budget cuts in many school districts have some parents and teachers questioning whether they have the resources to support their students. NPR education correspondent Claudio Sanchez and Thomas Hehir of Harvard University talk about how to integrate special needs students into mainstream classrooms.

JENNIFER LUDDEN, HOST:

This is TALK OF THE NATION. I'm Jennifer Ludden, in Washington. A troubling new video has reinvigorated the debate over special needs education. A father was told his special needs child was unruly, so he sent him to school wearing a wire. On the recording, his son is harassed and mocked by a teacher and aide in a special needs classroom.

The video is only the latest example of a widespread sense of frustration about special education. What to do? Advocates often want special needs students to get their own classes, but school districts say that's expensive, and certainly in a time of budget cuts, mainstreaming is on the rise.

If you're the parent or teacher of a special needs student, what works? Our number is 800-989-8255. Our email address is talk@npr.org. And you can join the conversation at our website. Go to npr.org and click on TALK OF THE NATION. Later in the program, why some schools are forcing kids off their bikes and into cars.

But first, best practices for mainstreaming special needs students. Joining me now is NPR's education correspondent Claudio Sanchez here in Studio 3A. Hi, Claudio. Welcome.

CLAUDIO SANCHEZ, BYLINE: Good to be here.

LUDDEN: So this is a trend that's been growing in public schools, but mainstreaming may not be a term that everyone's familiar with. Can you just tell us what it means?

SANCHEZ: Mainstreaming means that a child's instruction takes place in a classroom with non-disabled kids, regular kids, a decision based often on the special needs of that child. So, yes, there's an attempt to have this kid feel inclusive, be inclusive, but often it has to be tailor-made. That's where something very crucial here has to happen, and that is that an individual education plan be designed for this child, which calls for special accommodations, certainly special attention if necessary.

And this is all, of course, in the law, the 1975 law that actually was originally called the Education for All Handicapped Children's Act. It later became the Individual Disability Education Act, and that was, for the most part, kind of reauthorized in 1990.

LUDDEN: So, for decades, there's been this effort - so there was a sense beforehand that special needs kids were kind of shunted away and kept out of sight. Parents wanted them in the mainstream. And yet, as I understand it, there have been a lot of bad experiences in these mainstream classes.

SANCHEZ: And remember, they weren't just shunted away. They were literally kept out of school. I mean, for many, many years, these kids were warehoused somewhere else. Schools didn't deal with them. You know, it took several legal cases and challenges to that, most - especially in 1972 in Pennsylvania, which literally led to the creation of the law.

But you're right. The problem has been money, in many ways. You know, there's been an acceptance that these kids can learn, should be mainstreamed, but the money issue is huge. The federal government, when it authorized this law, more recently said we're going to contribute 40 percent - this is Congress talking - 40 percent of the funding for special education.

To this day, it's never been more than 18 percent. So that means that local and state education folks have to come up with the money somewhere, and we're talking about tens of thousands of dollars for every child, every year. So it's a very - it's a very difficult problem for schools because they don't have the money.

LUDDEN: And I guess more so now with - we've seen so many cuts at local school districts.

SANCHEZ: Exactly. And certainly in this time of austere and very limited budgets, I mean, where do you go? The federal government is not coming up with more money, believe me. States are obviously cutting left and right. So, I mean, often, it comes down to litigation on the part of parents. And if you have a good attorney, sometimes they get money out of the district to pay for these services or to put the child in a private program.

LUDDEN: So this terrible, painful video has surfaced of this child's experience. But I take it that's not a surprise to people who look at this field, that there's been a series of studies recently that show this these kinds of instances.

SANCHEZ: Yes, although I would say that the - you know, it's difficult to really document, certainly, every instance of abuse, but they are pretty common. You know, there are cases - there was on in Georgia, a 13-year-old boy committed suicide after being sent to an eight-by-eight, concrete-block time-out room in Gainesville, Georgia, at the public school there.

For students, this was a place that they put students in for behavioral problems. Then there was - you know, there are these famous screaming rooms that some schools have where teachers put kids when they're acting out, when they're out of control. And, you know, there was that famous case, I forget where, it may have been Kentucky, where a child was - who was misbehaving, a special ed kid, had been found stuffed in a duffel bag.

I mean, you know, you hear about these things, and you say this can't be. This has to be the exception to the rule. But you'd be surprised how often - I mean, some of these things aren't even reported, but it happens.

Transcript and link to story here

Benefits of hypothermia for infants continue through early childhood

NIH study shows increased survival from treatment for oxygen deficiency at birth.  I have set up these protocols.   The data is clear that  The treatment  works  and  and I have seen remarkable outcomes.   The protocols need to involve neurology because of the high risk of  subtle seizures and the need for cervical examinations by expert.  One needs to ask if this is a standard of care in 2012.  JR

Benefits of hypothermia for infants continue through early childhood

A treatment to reduce the body temperatures of infants who experience oxygen deficiency at birth has benefits into early childhood, according to a follow-up study by a National Institutes of Health research network.

Children who received the hypothermia treatment as infants were more likely to have survived to ages 6 and 7, when they were evaluated again, than were children who received routine care, the study found. They were no more likely than the routine care group to experience a physical or cognitive impairment, it said. The report appears in the New England Journal of Medicine.

“The findings show that the use of this cooling technique after birth increases the chances of survival, without increasing the risk of long-term disability,” said senior author Rosemary D. Higgins, M.D., of the Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

The study was conducted by Seetha Shankaran, M.D., of Wayne State University in Detroit, Dr. Higgins, and 25 other researchers in the NICHD Neonatal Research Network. In addition to NICHD, funding was also provided by the NIH's National Center for Research Resources and the National Center for Advancing Translational Sciences.

Infants born at term may fail to get enough oxygen, from blood loss or other birth complications. Oxygen deprivation during the birth process is called hypoxic-ischemic encephalopathy, or HIE. In severe cases of HIE, death rates can reach 50 percent. Survivors often sustain brain damage, which can result in cerebral palsy, cognitive impairment, or hearing and vision loss. Even if they do not experience detectable brain damage, children who experience HIE at birth are at higher risk for learning disabilities, language delays, and memory deficits. Severe oxygen deficiency at birth is also known as birth asphyxia.

The current study was in follow up to an earlier study, conducted when the children were newborns and had received the body cooling treatment shortly after birth. That earlier study found that infants who received the cooling treatment were less likely to die or to develop moderate or severe disability than were the infants who received routine care. The original study assessed children's movement and cognitive abilities, hearing, and vision when they were 18 to 22 months old.

The study authors noted that neonatal intensive care units around the world have adopted this cooling technique to reduce the risk of death and disability among full-term infants who show signs of the brain dysfunction indicating oxygen deficiency.

“Testing at 18 months can identify major delays in a toddler's growth or brain development, but can't identify some of the more subtle cognitive or physical impairments that might become apparent in an older child,” Dr. Higgins said. “This follow-up study confirms the original finding, showing that children who received the cooling treatment were more likely to survive, and that the survivors were no more likely to have a disability than the children in the untreated group.”

The 208 children in the study were diagnosed with HIE within 6 hours of birth and treated in newborn intensive care units in the network. They were given the usual intensive care or treated with the body cooling technique. With this technique, cool water circulates inside a waterproof blanket beneath the infant. The cool water reduces the infant's temperature as low as 91.4 degrees Fahrenheit, and maintains it there 72 hours, after which caregivers allow the infant's body temperature to return to a normal.

To conduct the current study, the researchers analyzed data from follow-up visits conducted when these infants had turned 6 or 7 years old. The researchers compared rates of death and disability among those who got the cooling therapy and those who had received the usual intensive care. Mortality rates reflected the number of children who died between birth and age 7. The study found a 28 percent mortality rate in the hypothermia group, compared with 44 percent rate in the usual care group.

The researchers calculated the number of deaths and cases of severe disability as a single combined outcome. In the cooling group, the combined rate was 41 percent, compared with 60 percent in the usual care group. Severe disability involved motor function, cognitive ability, and vision. Rates of cerebral palsy, blindness, and epilepsy were similar between the two groups.

“Before the advent of this cooling treatment in 2005, doctors couldn't treat HIE

How to get kids' sleep schedules back on track for school

I recommended that families start this to 3 weeks ago.  But, here we are.  see my advice at the end of this post...JR



How to get kids' sleep schedules back on track for school

This article offers great tips for getting kids back on a regular sleep schedule for school. There is also a great slideshow on the site itself.

After a summer filled with camp, amusement park trips and swim lessons, switching back to that 6 a.m. morning routine is a rude awakening -- literally.

"A lot of kids get out of a regular schedule in the summertime,” Dr. Dennis Rosen, M.D., associate medical director of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital, tells The Huffington Post, “shifting their internal clocks later, to the point that they’re out of sync with the external clock.”

Those later summertime bedtimes lead to later wake up times for school-aged children, too, he explains, especially teens. But sleeping until noon only causesproblems when September rolls around.

“Waking up earlier becomes quite difficult, almost akin to jet lag,” says Rosen. Not only does it feel crummy, he says, but because sleep plays an important roll in processing and consolidating memories, this seasonal version of jet lag can have an effect inside the classroom as well.

Unlike adults, who need around seven to nine hours of sleep a night, children of different ages require a wide range of sleep amounts to be at their best. Preschoolers typically need about 11 to 13 hours of sleep a night, kids up to 12 years old need 10 to 11 hours of sleep a night and teens need about 8.5 to 9.25 hours, according to the National Sleep Foundation.

But the bell rings at most schools in the U.S. at 8 a.m., HuffPost Education reported in May, and 20 percent of kids and teens must report to first period by 7:45 or before, making it difficult to hit the hay early enough to log the recommended winks.

That’s part of the reason a number of sleep advocates have been pushing for later school start times, a move that would not only allow children and teens to get more -- and better -- sleep, but may also aid learning, boost memory and improve grades and overall performance.

So how can you help your children get their sleep on track in time for headingback to school? Many of our favorite sleep rules still apply: Make your child’s bedroom a peaceful environment for sleep only. Take any electronic gadgets out of the bedroom, and keep it cool, dark and quiet. But there are some summer-specific methods the experts suggest, as well.

Read more here

Children  and teenagers get a circadian rhythm disorder at this time of year called to lead sleep phase  syndrome.  In essence, this is jetlag without the fun of travel.  

Their brain clock is set to go to sleep at a certain time.   This time will not change just because a parent so so.  

 Here is what will happen this week. If your child is set to go to sleep at midnight, they will continue to go to sleep at a late hour. Then because of school, they will be  awakened at 6 or 7. The 1st day they will drag. They may be emotional. They may be inattentive. If they are a set up for ADHD, headaches, tics, seizures,  you may see these increase.

If you  tell your child to go to bed at 9 PM but they have been going to sleep at midnight all week, don't expect a miracle. They are jetlagged by 3 hours.

Have some realistic and gradual expectations.  You need to set up your child to be physiologically ready to accept behavioral change.

 Also,  many people are not aware that the tendency to stay up late is the natural state of the young person's brain.  They live in a 25 hour world.  Unfortunately,  schools still function in a 24-hour world.

Like jetlag the principles of treating are the same.   You need to be awake during the day and sleep when the sun goes down.

So,

• Get your child or teen up at his regular school time this weekend.  Keep them up all day and do not allow napping until the regular bedtime.  
• Get them outside early in the day to expose them to natural bright light. 
• Do not allow  any gizmos that make light after sundown.
• Do not allow caffeine.
• Consistency is key.  Don't change schedules on the weekend.
• Please understand that sometimes this is a difficult problem to treat and medical intervention may be required. A  pediatric sleep specialist  can help. 

New Brain Pacemaker that can Detect Epilepsy and Treat Seizures in Rats

A brain pacemaker has been invented that can detect epilepsy in rats and even help treat their seizures.

Scientists have created a "brain pacemaker" that controls epilepsy in rats by responding only to abnormal electrical patterns in the brain associated with seizures.

The skull implant is similar to an implantable defibrillator and is inserted in the brain and reacts only when a seizure starts to occur by terminating the seizure's electrical activity.

Results from the study, published in the journal Science, showed that the self-adjusting device delivered therapeutic electrical impulses to the brain at the beginning of a short but frequent type of seizure in rats, reducing the length of epileptic seizure by 60 percent in rats with a ‘petit mal’ form of epilepsy, and then automatically shuts itself off.

Most electrical stimulation devices, like ones that deliver deep-brain stimulation to treat Parkinson’s disease and depression, continuously deliver electrical impulses regardless of the patient's brain activity and can cause a range of side effects like headaches.

While other newer seizure-responsive types of deep brain stimulation devices don't continuously operate, these devices also use electrodes that are implanted in the brain and can pose certain risks like worsening epilepsy symptoms.

Lead researcher György Buzsáki, a neuroscientist at the New York University School of Medicine, and his colleagues, used a less invasive treatment method that involved transcranial electrical stimulation (TES) of neurons using electrodes implanted in the skull rather than in brain tissue.

The device is described as a simple, closed-loop system. Additionally, because the device is only activated in response to seizures, researchers said that the risk of causing brain changing side effects is significantly smaller compared to the effects of continuously stimulating devices.

Epilepsy, a brain disorder that triggers repeated seizures over time, affects nearly 3 million people in the U.S., according to the Epilepsy Foundation, making it third most prevalent neurological disorder in the country after Alzheimer's disease and stroke.

Seizures are episodes of disturbed brain activity that leads to changes in attention or behavior. In a seizure, brain cells keep firing instead of acting in an organized way. The brain's faulty electrical system and sudden chaotic neuronal activity triggers an overflow of energy that can cause unconsciousness and involuntary muscle contractions.

Epilepsy patients can suffer from two different kinds of seizures like petit mal seizures and grand mal seizures. Petit mal seizures occur frequently and often last for just a few seconds whereas grand mal seizures are rarer but involve more violent muscle contractions and a loss of consciousness.

Buzsáki and his team tested the new device against petit mal seizures in laboratory rats because this type of seizure can happen hundreds of times a day, allowing the scientists to effectively test the system they designed.

Researchers noted that patients with petit mal seizures are effectively treated with drugs, so the device would not be used to treat that type of seizure and instead by used to treat seizure in drug-resistant patients.

While the device does not prevent seizure, it treats them right away and reduces the length of the seizure by about 60 percent.

Researchers explained that in people, two plates about the size of a pocket watch could be inserted into the skill in a position that targets the affected area of the brain. The electrodes will sit right on top of the brain and be powered by ultra-light electrical circuits implanted in the skull.

Buzsáki and his team hope to replicate their findings on people with complex partial seizures or epileptic seizures that affect both sides of the brain and cause patients to lose consciousness and can occur simultaneously with head injuries, brain infection and stroke.

There is no cure for complex partial seizures, and the cause of the condition is unknown. An estimated 20 percent to 40 percent of people who have complex partial seizures do not respond to medication.

Dr. Orrin Devinsky, director of the epilepsy program at New York University and who was not associated with the study, told HealthDay that the recent findings have great potential for treating epilepsy and other neurological problems like tremors, Parkinson's disease and even serious depression.

"What's unique about this technique is that it's a sophisticated way to identify the rhythmicity of the seizure itself and interrupt the cycle with precision," he said, according to HealthDay. "Existing [deep brain stimulation] devices don't finesse the timing this way."

Read more here

New Classification of Genes May Help Prevent Seizures

Discovery of a new classification of genes have the potential to change medication that can prevent seizures.

IRISH RESEARCHERS HAVE identified a new gene class which they say could potentially provide new treatment that would prevent epileptic seizures.

Researchers at the Royal College of Surgeons in Ireland, clinicians at Beaumount Hospital, and experts from Madrid’s Cajal Institute say that the new class of gene, called MicroRNA, is instrumental in the control of protein production inside cells. They found much higher levels of one particular type of this gene (microRNA-13) in the part of the brain that causes epileptic seizures.

The journal Nature Medicine has published the team’s paper, which outlines how scientists used a new type of drug-like molecule called antagomir which seems to lock onto the microRNA-13 gene and remove it from the brain cell – and, by doing so, prevent epileptic seizures.

“We have been looking to find what goes wrong inside brain cells to trigger epilepsy. Our research has discovered a completely new gene linked to epilepsy and it shows how we can target this gene using drug-like molecules to reduce the brain’s susceptibility to seizures and the frequency in which they occur,” said the senior author of the paper Prof DavidC Henshall,of the Department of Physiology and Medical Physics at the RCSI.

Approximately 37,000 people in Ireland are affected by epilepsy and, of those, one in three continue to experience seizures despite being prescribed medication.

Read more here

Animals can also have sleep disorders

Interesting information about animals and the sleep issues they can face.

Sometimes people ask if animals dream or have sleep disorders like them. The answer is yes! Just watch a sleeping dog for a few minutes and you will see their eyes moving from side to side, just as human's do during REM sleep.

Dogs and cats have many of the same sleep disorders as humans including sleep terrors, nocturnal seizures, narcolepsy, cataplexy and limb movements.¹

Narcolepsy is known to occur more frequently in certain breeds of dogs, including Doberman pinschers, poodles, Labrador retrievers, beagles and dachshunds. Horses can also be affected. This disorder is usually inherited from the parents. Animals with narcolepsy also tend to have cataplexy when they are excited, for example when the feeding bowl arrives. It is treated much as it is in humans, with stimulants and anti-depressants.

It appears that most mammals and birds have REM sleep. It is questionable as to whether reptiles have REM sleep based on one study with turtles.² Brain structures are different than in mammals and birds, so it is difficult to say absolutely.

You may be wondering, which mammal has the most REM sleep per day. The platypus ranks number first, getting about eight hours of REM sleep.³ The ferret, armadillo and possum also have high amounts of REM sleep daily. The giraffe and horse have the least at about 0.5 hours.

I hope you've found this information fun and interesting. The next time a patient complains of sleep difficulties, tell them they are not alone. They have only to look around their home to see how sleep affects their pets.

Sharon M. O'Brien, MPAS, PA-C, works at Presbyterian Sleep Health in Charlotte, N.C. Her main interest is helping patients understand the importance of sleep hygiene and the impact of sleep on health.

References

1. Schenck, Carlos. Sleep: A Groundbreaking Guide to the Mysteries, the Problems, and the Solutions. New York: Penguin Group. 2007. pp. 258-263.
2. Zepelin, Harold. Siegel, Jerome. Tobler, Irene. Chapter 8. "Mammalian Sleep". Principles and Practice of Sleep Medicine Fourth Edition Philadelphia: Elsevier Saunders, 2005. pp. 91-100.
3. Siegel, Jerome. Chapter 10. "REM Sleep". Principles and Practice of Sleep Medicine Fourth EditionPhiladelphia: Elsevier Saunders, 2005. pp. 120-135.

Read more here

New Technology: Tiny Microchip that can Detect an Epileptic Seizure

A new microchip is being developed that could result in epileptic patients staying in the hospital less. It would be especially useful for children.


A hi-tech medical patch being developed in Abu Dhabi should soon help epileptics avoid long stays in hospital.

The 50fil adhesive microchip, the work of a researcher at the Masdar Institute, monitors epileptic seizures.

It will allow doctors to keep a close eye on patients for up to two weeks without the need for them to stay in hospital attached to a cumbersome and uncomfortable electroencephalograph (EEG) machine.

It would be applied to the forehead and is expected to be smaller in size than three grains of rice.

Currently, doctors often have to rely on patients' own descriptions of their seizures. But their recollections of events under such circumstances are notoriously unreliable.

The chip, which detects rapid eye movements - the early sign of an epileptic seizure - will give doctors a far more accurate picture of what happened, from the length of an attack to its severity.

The patch is the work of Dr Jerald Yoo, a circuit designer at the Masdar Institute, jointly funded by the Massachusetts Institute of Technology in the United States.

About 50 million people worldwide suffer from epilepsy. While no exact figure exists for the UAE, it is believed to be about 2 to 3 per cent of the population - more than 100,000 people.

Dr Yoo said the patch would be especially useful for children or babies, who cannot express what they have suffered.

The chip can also record seizures while asleep, of which patients might not even be aware.

"Doctors need to see raw information and data with their own eyes so they can make the right decisions, diagnoses and treatments.

"You need to learn the patient's seizure traits as they usually have one or two, which allows a more thorough diagnosis and treatment."

The Taiwan Semiconductor Manufacturing Company and the Abu Dhabi-owned Mubadala - which owns most of the chipmaker, Global Foundries - are looking to start making the chip by the end of this year.

Dr Sarmad Al Shamma, a neurologist at the Neuro Spinal Hospital in Dubai, said home monitoring would be good for doctors and patients alike.

"In addition to the discomfort of being in a hospital for more than 24 hours, there is a reduced possibility of an attack in the hospital because patients are lying in bed the entire time," he said.

"This often means they have to stay in the hospital for an even longer time. By monitoring them outside the hospital, we can learn what is triggering the attacks."

Epileptic seizures can be triggered in different patients by lack of sleep, stress, low blood sugar and flashing lights.

Dr Taoufik Al Sadi, the head of neurology at Sheikh Khalifa Medical City, said the chip could help fill "gaps in knowledge" about the condition.

"If this proves to be scientifically solid it would be an excellent addition to better understand the frequency and severity of the seizures, their duration," he said.

"It will allow better options for treatment based on solid, objective data, rather than relying on a patient's history and recollection."

He added that the chip could help reduce the stigma associated with epilepsy.

"Many sufferers feel deprived from basic privileges, such as driving a car and in some cases, going to school," said Dr Al Sadi.

"They find it difficult to be in social situations because they never know when they're going to have the next attack.

"But what they need to know is that after six months of treatment they can drive and resume their normal life."

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Pen-like tool might effectively stop seizures

New pen, similar to an epi-pen, is being developed to help stop seizures. This could be a huge advancement for emergency medical services when responding to calls about seizures.

Would it come as a surprise to learn that every two minutes someone dies from a neurological emergency? Or that seizures are the most common reason for ambulance calls? Witnessing someone having a seizure can be frightening – especially if you don’t know what to do.

First of all, what is a seizure? Seizures are a symptom of a commonly known condition: Epilepsy. A seizure results from a disturbance in the normal electrical functions of the brain. These intermittent, intense bursts of energy often affect a person’s consciousness, bodily movements or sensations for a short time. Epilepsy affects approximately three million Americans and 50 million people worldwide; it is the third most common neurological disorder in the U.S. after Alzheimer’s disease and stroke. It is estimated that about one in 10 people will experience a seizure at some point in their lives.

Typically, epilepsy patients can decrease the frequency and intensity of their seizures or even become seizure-free by using an anti-epileptic medication. Other treatment options include the removal of the part of the brain that causes the seizure – only if it doesn’t interfere with vital functions, including speech, language or hearing. Another option is vagus nerve stimulation – a therapy involving the implantation of a device under the skin of your chest, which delivers short bursts of energy to your brain through your vagus nerve.

One condition, termed status epilepticus, is of particular concern, as it causes 55,000 deaths each year. This type of seizure is one that lasts more than five minutes. The usual treatment for status epilepticus is the IV delivery of anticonvulsant drugs (e.g. lorazepam). As one might imagine, it can be very difficult to place an IV into someone having a seizure, thus wasting valuable time. Fortunately, new research has developed a pen-like mechanism – similar to an EpiPen for allergic reaction – which delivers anti-seizure medicine directly into the muscle, rather than through an IV.

A new trial, the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART), is the first randomized clinical trial to investigate whether intramuscular delivery of midazolam is as effective as IV-delivered lorazepam, the current standard of care. In this study, paramedics compared how well delivery by each method (IV vs. intramuscular) stopped patients’ seizures by the time the ambulance arrived at the emergency department.

Upon arrival at the hospital, 73 percent of patients were seizure-free (with intramuscular injection) whereas only 63 percent were seizure-free (with IV injection). Patients treated with midazolam (intramuscular injection) were also less likely to require hospitalization than the IV injection group. Among those admitted to the hospital, however, both groups had similarly low rates of recurrent seizures.

This development provides a promising future for those who suffer from seizures or epilepsy. Thus far, IV delivery has only been researched and utilized by paramedics. More research is needed to ascertain the ease of usage among epilepsy patients and their care givers.

In the meantime, if you do witness someone having a seizure, the best actions you can take are to: protect the person from injury by removing any harmful objects, cushion their head and call 911, especially if it lasts more than five minutes. Do NOT try to restrain the person’s movements, move them or put anything in their mouth.

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Epileptic encephalopathies of the Landau-Kleffner and continuous spike and waves during slow-wave sleep types: Genomic dissection makes the link with autism

Epileptic encephalopathies of the Landau-Kleffner

 and continuous spike and waves during slow-wave 

sleep types: 

Genomic dissection makes the link with autism

Summary

Purpose:  The continuous spike and waves during slow-wave sleep syndrome (CSWSS) and the Landau-Kleffner (LKS) syndrome are two rare epileptic encephalopathies sharing common clinical features including seizures and regression. Both CSWSS and LKS can be associated with the electroencephalography pattern of electrical status epilepticus during slow-wave sleep and are part of a clinical continuum that at its benign end also includes rolandic epilepsy (RE) with centrotemporal spikes. The CSWSS and LKS patients can also have behavioral manifestations that overlap the spectrum of autism disorders (ASD). An impairment of brain development and/or maturation with complex interplay between genetic predisposition and nongenetic factors has been suspected. A role for autoimmunity has been proposed but the pathophysiology of CSWSS and of LKS remains uncharacterized.

Methods:  In recent years, the participation of rare genomic alterations in the susceptibility to epileptic and autistic disorders has been demonstrated. The involvement of copy number variations (CNVs) in 61 CSWSS and LKS patients was questioned using comparative genomic hybridization assays coupled with validation by quantitative polymerase chain reaction (PCR).

Key Findings:  Whereas the patients showed highly heterogeneous in genomic architecture, several potentially pathogenic alterations were detected. A large number of these corresponded to genomic regions or genes (ATP13A4, CDH9, CDH13, CNTNAP2, CTNNA3,DIAPH3, GRIN2A, MDGA2, SHANK3) that have been either associated with ASD for most of them, or involved in speech or language impairment, or in RE. Particularly, CNVs encoding cell adhesion proteins (cadherins, protocadherins, contactins, catenins) were detected with high frequency (≈20% of the patients) and significant enrichment (cell adhesion: p = 0.027; cell adhesion molecule binding: p = 9.27 × 10⁻⁷).

Significance:  Overall our data bring the first insights into the possible molecular pathophysiology of CSWSS and LKS. The overrepresentation of cell adhesion genes and the strong overlap with the genetic, genomic and molecular ASD networks, provide an exciting and unifying view on the clinical links among CSWSS, LKS, and ASD.