Link found between epilepsy and obstructive sleep apnea

Doctors find key link between epilepsy and obstructive sleep apnea

By medical reporter Sophie Scott

Updated Sun Jun 2, 2013 11:01pm AEST

PHOTO: In the general population, the prevalence of sleep-disordered breathing is 3 to 7 per cent. ()

Australian doctors have found a new link between epilepsy and obstructive sleep apnoea, a condition where patients stop breathing at night.

Professor Terry O'Brien from the Royal Melbourne Hospital says there has been some evidence from other studies that patients with epilepsy may have an increased incidence of sleep-disordered breathing.

Professor O'Brien says there are similar symptoms of daytime sleepiness and fatigue between the two conditions.

He says patients with epilepsy can gain weight as a result of their medications, something that increases their risk of sleep-disordered breathing.

"We put two and two together and thought we should look into this," he said.

Doctors recruited 87 patients with epilepsy and monitored them in a sleep unit.

They found 25 per cent had significant sleep-disordered breathing that was severe enough to require treatment.

In the general population, the prevalence of sleep-disordered breathing is 3 to 7 per cent.

Awake for up to three days straight

Thirty-six-year-old Daniel Goldstein had always had strange sleeping habits, which included rocking back and forth during the night while he slept.

Eventually, he was diagnosed with epilepsy but it was hard to stop seizures.

To identify the issue, Mr Goldstein undertook a sleep study at the Royal Melbourne Hospital and was found to have severe sleep apnoea.

He said at times he would be awake for up to three days straight.

Since being treated for sleep apnoea, Mr Goldstein has also been able to reduce his epilepsy medications.

Mr Goldstein was also given a CPAP machine which he says helps him soundly throughout the night.

"Now I've got energy in a way I didn't have before. It's like learning to walk again," he said. "I feel just phenomenal."

Well-established treatment for sleep-disordered breathing

Professor O'Brien says the beauty of this recent research is that there is a well-established treatment for sleep-disordered breathing.

He says when epilepsy patients were given a CPAP machine, there was a significant improvement.

http://www.abc.net.au/news/2013-06-02/link-between-epilepsy-and-obstructive-sleep-apnoea/4728076

Ketogenic Diet May Help Children with Epilepsy

This article discusses a ketogenic diet and why it helps children with epilepsy.

A ketogenic diet is sometimes used as a treatment in children with persistent epilepsy that has failed to respond to medical treatment. The diet can be challenging and have adverse side effects, however, so scientists are researching other dietary measures that may help reduce seizures. Researchers with Johns Hopkins Children’s Center have found that periodic fasting may help either in tandem or as an alternative to the ketogenic diet plan.

Epilepsy is a brain disorder in which a person has repeated seizures over time. About 65 million people worldwide (including about 2 million Americans) have the condition. In most cases, there may not be any known cause for the seizures. However some cases of epilepsy may be due to stroke, traumatic brain injury, infections, brain defects present at birth, a brain tumor, or metabolism disorders. Symptoms vary from person to person but could include staring spells or violent shaking and loss of alertness that can last from a few seconds to a few minutes.

As many as 20 to 40 percent of patients with epilepsy have what is known as refractory epilepsy, meaning that it is resistant to antiepileptic drugs. In these cases, children may be treated with a high-fat, low-carbohydrate diet known as the ketogenic diet which causes the body to adopt a “fasting” type state in which it produces ketones, a by-product of fat metabolism. The diet is believed to work by triggering biochemical changes that eliminate seizure-causing short circuits in the brain's signaling system. The diet must be strictly followed and requires a significant commitment to work effectively.

Because the body mimics a fasting state during the ketogenic diet, doctors at Johns Hopkins studied the effect of actual fasting to see if there may be an added benefit or if the treatment could replace the ketogenic diet as a therapy option.

Six children, aged 2 to 7, who were already following the ketogenic diet were asked to fast on alternate days. All six of the kids had seizure disorders that had not completely resolved using the diet alone. After fasting was added to the dietary regimen, four of the six children experienced between 50 and 99 percent fewer seizures.

Based on previous studies in mice, the doctors believe that fasting works on the brain differently than the ketogenic diet, so it could potentially be used as a stand-alone therapy as well. "Our findings suggest that fasting does not merely intensify the therapeutic effects of the ketogenic diet but may actually represent an entirely new way to change the metabolism of children with epilepsy," says lead investigator Adam Hartman, MD, a pediatric neurologist.

"We don't fully understand the reasons for these marked differences,” says Eric Kossoff MD, the director of the ketogenic diet clinic at the Johns Hopkins Children’s Center, “but unraveling the mechanisms behind them will help pave the way toward new therapies for epilepsy, and is the focus of our ongoing work."

Of course, the study is very small and results are preliminary. The researchers caution that larger studies are needed to further evaluate the benefits – and potential consequences - of periodic fasting in children. Parents should discuss all epilepsy treatment with their child’s neurologist before attempting any such therapies.

Read more here

Dr. Rotenberg to speak at Houston Epilepsy Foundation Conference

  

2012 Family Conference

November 10, 2012

Toyota Center

Houston, Texas

Registration

2:00 p.m.

Session I

3:00 p.m.

Parent Track: Dr. Rotenberg- Seizures and Sleep

Adult Track: Maria Palacios- Living Well with Epilepsy

Session II

4:00 p.m.

Parent Track: Mary Jane Williams- IEP and ARD Overview

Adult Track: Dr. Hartshorn- Medical Management

Session III

5:00 p.m.

Parent Track: Dr. Wilfong- New Treatment & Surgery Options

 

Adult Track: Dr. Kalamagalam- 

New Treatment & Surgery Options

Dinner

6:00 p.m.

Houston Rockets vs. Detroit Pistons

7:00 p.m.

Activities will be provided for children 

ages 6-13 years during the conference

**Parking is not included in the ticket price. 

Participants are responsible for their own parking 

at the Toyota Center**

Contact Heather at hpena@eftx.org

buy tickets here 

or 888-548-9716 or 713-789-6295 with any questions. 

 link to full flyer here