What is epilepsy? What causes epilepsy? - Medical News Today
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People with epilepsy tend to have recurrent seizures (fits). The seizures occur because of a sudden surge of electrical activity in the brain - there is an overload of electrical activity in the brain. This causes a temporary disturbance in the messaging systems between brain cells. During a seizure the patient's brain becomes "halted" or "mixed up".
Every function in our bodies is triggered by messaging systems in our brain. What a patient with epilepsy experiences during a seizure will depend on what part of his/her brain that epileptic activity starts, and how widely and quickly it spreads from that area. Consequently, there are several types of seizures and each patient will have epilepsy in his/her own unique way.
The word "epilepsy" comes from the Greek word epi meaning "upon, at, close upon", and the Greek word Leptos meaning "seizure".
From those roots we have the Old French word epilepsie, and Latin word epilepsia and the Greek words epilepsia and epilepsies.
Epilepsy and life expectancy
compared to the rest of the population, researchers from the University of Oxford and University College London reported in The Lancet.
The authors added that the risk is even greater if a person with epilepsy also has a mental illness.
Suicides, accidents and assaults accounted for 15.8% of early deaths. Among these 15.8%, the majority had been diagnosed with a mental disorder.
Head researcher, Seena Fazel said:
"Our results have significant public health implications, as around 70 million people worldwide have epilepsy, and they emphasize that carefully assessing and treating psychiatric disorders as part of standard checks in persons with epilepsy could help reduce the risk of premature death in these patients. Our study also highlights the importance of suicide and non-vehicle accidents as major preventable causes of death in people with epilepsy."
A Swedish study found that .
Epilepsy in developing nations
There are twice as many people with epilepsy in developing nations than industrialized countries. Unfortunately, , researchers from the University of Oxford reported in the journal The Lancet.
The authors added that the burden of epilepsy in developing countries is "under-acknowledged by health agencies", even though treatments for the disorder are very cost-effective.
Lead author, Charles Newton, of the Department of Psychiatry, said:
"Deriving accurate figures on the epidemiology of epilepsy in low- and lower-middle income countries is very difficult - there have been very few surveys to gather the sort of data we need, and such studies tend to be expensive, especially for countries whose health research funding is likely to be very limited.
However, the research we do have shows that the burden of epilepsy in these regions is at least double that found in high-income countries, and sadly, adequate facilities for diagnosis, treatment and ongoing management of epilepsy are virtually non-existent in many of the world's poorest regions. Many people with epilepsy or their families do not even know that they have a disorder that can be controlled with biomedical treatment, so it is vitally important that awareness is raised and medical care improved in these regions."
Types of seizures
There are three types of diagnoses a doctor might make when treating a patient with epilepsy:
Idiopathic - this means there is no apparent cause.
Cryptogenic - this means the doctor thinks there is most probably a cause, but cannot pinpoint it.
Symptomatic - this means that the doctor knows what the cause is.
There are three descriptions of seizures, depending on what part of the brain the epileptic activity started:
Partial seizure - this means the epileptic activity took place in just part of the patient's brain.
There are two types of Partial Seizures:
Simple Partial Seizure - the patient is conscious during the seizure. In most cases the patient is also aware of his/her surroundings, even though the seizure is in progress.
Complex Partial Seizure - the patient's consciousness is impaired. The patient will generally not remember the seizure, and if he/she does, the recollection of it will be vague.
Generalized Seizure - both halves of the brain have epileptic activity. The patient's consciousness is lost while the seizure is in progress.
Secondary Generalized Seizure - the epileptic activity started as a partial seizure, but then it spread to both halves of the brain. As this development happens, the patient loses consciousness.
What are the symptoms of epilepsy?
The main symptoms of epilepsy are repeated seizures. There are some symptoms which may indicate a person has epilepsy. If one or more of these symptoms are present a medical exam is advised, especially if they recur:
A convulsion with no temperature (no ).
Short spells of blackout, or confused memory.
Intermittent fainting spells, during which bowel or bladder control is lost. This is frequently followed by extreme .
For a short period the person is unresponsive to instructions or questions.
The person becomes stiff, suddenly, for no obvious reason
The person suddenly falls for no clear reason
Sudden bouts of blinking without apparent stimuli
Sudden bouts of chewing, without any apparent reason
For a short time the person seems dazed, and unable to communicate
Repetitive movements that seem inappropriate
The person becomes fearful for no apparent reason, he/she may even panic or become angry
Peculiar changes in senses, such as smell, touch and sound
The arms, legs, or body jerk, in babies these will appear as cluster of rapid jerking movements.
The following conditions need to be eliminated as they may present similar symptoms, and are sometimes misdiagnosed as epilepsy:
A high fever with epilepsy-like symptoms
(recurring episodes of sleep during the day and often disrupted nocturnal sleep)
Cataplexy (a transient attack of extreme generalized weakness, often precipitated by an emotional response, such as surprise, fear, one component of the narcolepsy quadrad)
Sleep disorders
Nightmares
Fugue states (a rare psychiatric disorder characterized by reversible
for personal identity)
Psychogenic seizures (a clinical episode that looks like an epileptic seizure, but is not due to epilepsy. The EEG is normal during an attack, and the behavior is often related to psychiatric disturbance, such as a conversion disorder)
Breath-holding episodes (when a child responds to anger there may be vigorous crying and subsequent apnea and cyanosis - the child then stops breathing and skin color changes with loss of consciousness).
What are the treatments for epilepsy
When a diagnosis of seizures or epilepsy is made, the doctor will then discuss with the patient or the patient's family what the best treatment options are. If an underlying correctable brain condition was causing the seizures, sometimes surgery may stop them. If epilepsy is diagnosed (ongoing tendency to have seizures), the doctor will prescribe seizure-preventing drugs or anti-epileptic drugs.
If drugs do not work, the next option could be surgery, a special diet or VNS (vagus nerve stimulation). Trigeminal nerve stimulation is also effective, .
The doctor's aim is to prevent further seizures from occurring, while at the same time avoiding side-effects so that the patient may lead a normal, active, and productive life.
Some children not getting treatment fast enough when at school
when they are at school or other community settings as intended by their specialist neurologist, researchers from UCL Institute of Child Health, Great Ormond Street Hospital for Children and Young Epilepsy, England informed in October 2012. They presented the findings of the PERFECT Initiative at the ILAE's 10th European Congress on Epileptology (ECE), in London.
Team leader Prof J. Helen Cross, said:
"The PERFECT Initiative is the first to investigate the discrepancies that often exist in European countries between policy and practice in the treatment of prolonged, acute, convulsive seizures in children.
We found that the differences in clear guidance, awareness and education around the use of rescue medication for treating seizures in children living with epilepsy, ultimately create a shortfall in care that we, as clinicians, intend that they receive, whether in hospital or away from it."
Anti-epileptic drugs (AEDs)
The majority of AEDSs are taken orally. The type of seizure the patient is having will decide which drug the doctor may prescribe. We do not all react in t while some of us may experience side effects from one type of medication, others will not. Some drugs effectively stop further seizures from occurring with one patient who has a certain type of epilepsy, while another patient with the same type will experience no benefit from that same drug. Even when the right drug is found, it could take some time to find the ideal dose.
AEDs are aimed at modifying the structures and processes involved during the deve including neurons, receptors, glia, ion channels and inhibitory or excitatory synapses. Inhibition is triggered to stop or prevent seizure activity.
Famous people who have/had epilepsy:
Agatha Christie (writer)
Alexander the Great (monarch)
Alfred Nobel (scientist)
Alfred the Great (monarch)
Aristotle (philosopher)
Bud Abbot (actor, comedian)
Charles Dickens (writer)
Charles V (Spanish monarch)
Danny Glover (actor)
Edgar Allen-Poe (writer)
George F. Handel (musician)
Hannibal (military commander)
Julius Caesar (emperor)
Leonardo da Vinci (artist)
Lewis Carroll (writer)
Lord Byron (writer)
Louis XIII (monarch)
Martin Luther (theologian)
Michelangelo (artist, sculptor)
Napoleon Bonaparte (Emperor)
Neil Young (musician)
Nicolo Paganini (musician)
Peter Tchaikovsky (musician)
Pythagoras (mathematician)
Richard Burton (actor)
Sir Isaac Newton (scientist)
T. Roosevelt (statesman)
Vincent Van Gogh (artist)
Children take the same AEDs as adults. They may be present as tablets, capsules, syrups or sprinklers. As in the case of treating adults, AEDs are designed to prevent seizures. Some are effective with a limited number of types of seizure, while others may treat a broader range. Doctors will try to control seizures with just one drug, but some children may need to take more than one. The success of childhood AEDs also depends to a great extent on compliance - following instructions carefully (not forgetting to take them).
Here is a list of the most commonly prescribed AEDs.
acetazolamide (brand name Diamox)
acetazolomide modified release (brand name Diamox SR)
carbamazepine (brand name Tegretol)
carbamazepine modified release (brand name Tegretol Retard)
clobazam (brand name Frisium )
clonazepam (brand name Rivotril)
ethosuximide (brand names Emeside - Zarontin)
gabapentin (brand name Neurontin)
lacosamide
(brand name Vimpat)
lamotrigine
(brand name Lamictal )
levetiracetam
(brand name Keppra)
oxcarbazepine
(brand name Trileptal phenobarbital)
(Food and Drug Administration) on Monday 22nd October, 2012. Fycompa is already approved in the European Union (27 sovereign states), Norway and Iceland, and is made and marketed by Eisai.
(brand name Epanutin)
pregabalin
(brand name Lyrica)
(brand name Mysoline)
rufinamide
(brand name Inovelon)
sodium valproate (brand names Epilim - Episenta)
sodium valproate modified release
(brand name Epilim Chrono)
(brand name Gabitril )
topiramate
(brand name Topamax)
valproic acid (brand name Convulex)
vigabatrin
(brand name Sabril)
zonisamide
(brand name Zonegran)
Recent developments on epilepsy treatment
from MNT news
In 2013, the Food and Drug Administration approved an implantable medical device to treat epilepsy. Now, doctors from the Rush Epilepsy Center in Illinois are the first to couple it with a novel electrode placement planning system, which is enabling the device to better reduce seizures.
The device, called the NeuroPace RNS System, works by using "on-demand" direct stimulation in order to find abnormal electrical activity in the brain and send small bits of electrical stimulation. The doctors from Rush Epilepsy Center explain, by doing this, the device suppresses seizures before they begin.
Within a decade, people with drug-resistant epilepsy may be able to take a pill to suppress seizures as required, in a similar way to how we take painkillers to relieve a .
Researchers from University College London (UCL) in the UK believe that the new "on demand" seizure suppressant pill they have developed may offer help to this 30% of epilepsy patients who do not respond successfully to AEDs.
A new study claims epilepsy patients could reduce seizure frequency by consuming low doses of
fish oil every day. The research team at the University of California-Los Angeles (UCLA) School of Medicine, says their findings may be particularly useful to epilepsy patients who no longer respond to medication.
They publish their findings in the Journal of Neurology, Neurosurgery & Psychiatry.
Researchers are increasingly reporting the therapeutic potential of music. Now, a new study suggests it could be useful for treating epilepsy.
Fatty acids for new epilepsy medications
, scientists in London reported in Neuropharmacology. They explained that fatty-acid based drugs might provide similar symptom control as Ketogenic diets do.
They hope to identify the specific fatty acids in the Ketogenic diet that are effective in controlling seizures. The scientists, from University College London and the Royal Holloway Hospital expect their research will pave the way for new anti-epileptic therapies which have the same beneficial effects as the diet without having to make the patient suffer the severe side-effects.
Professor Matthew Walker said:
"Epilepsy affects over 50 million people worldwide and approximately a third of these people have epilepsy that is not adequately controlled by our present treatments. This discovery offers a whole new approach to the treatment of drug-resistant epilepsies in children and adults."
The ketogenic diet is commonly prescribed for children with severe drug-resistant epilepsy. It is a high fat low-carb diet which stimulates starvation by forcing the body to burn fats instead of carbs. However, it can lead to , growth retardation,
(low blood sugar) and .
What is the prognosis? What is the outlook?
Experts say that about 60% of people who are untreated have no further seizures during the 24 months following their first seizure. The outlook (prognosis) for most people with epilepsy is good. Approximately 70% go into remission for 5 years on or off treatment (no seizures for five years). About 20% to 30% develop chronic epilepsy (long term epilepsy) - these people are generally treated with AEDs.
How common is epilepsy?
Approximately 50 out of every 100,000 people develop epilepsy each year in industrialized nations.
UK - According to Epilepsy Action 460,000 people in the United Kingdom have epilepsy.
USA - According to The Epilepsy Foundation over 3 million Americans are affected by epilepsy and seizures. About 200,000 new cases of seizures and epilepsy occur in the USA each year. 10% of all Americans will experience a seizure some time during their lifetime.
According to The National Society for Epilepsy (UK) about 50 million people have epilepsy globally.
News on Epilepsy
For the latest news and research on Epilepsy, and to sign up to newsletters or news alerts, please visit our
Written by Christian Nordqvist
Copyright: Medical News Today
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This article originally appeared on Medical News Today on Tuesday 19 May 2009, and was last updated on Monday 10 August 2015.Visit our
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Sources: National Health Service, Centers for Disease Control and Prevention, University of Oxford, Wikipedia, Medical News Today archives
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What is Auto Layout - what does it do, and is it an iOS 5 feature?
Since the new iPhone 5 has a bigger screen, all the options on how to optimize your applications for it come down to Auto Layout.
Can you point me to some article about Auto Layout, and how I can adapt it with my project?
21.1k84079
I recommend watching the WWDC 2012 session .
is a new way to define dynamic GUIs. Before, we had autoresizing masks, that described how a subview will resize or move when its superview is resized. With Auto Layout you can do the same and also a lot more complicated GUIs quite easily.
27.7k55791
You can also check 2 nice beginners tutorials:
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The underlying engine used by Cocoa Touch is Cassowary, and it's also used in other toolkits, such as enaml. I recently wrote a brief overview of Cassowary, with a comparison between Cocoa Touch and enaml wherein I port a Cocoa Auto Layout example to Python and enaml."
And the WWDC Session:
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best tutorial link for autolayout:
"Autolayout" is
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For further understanding you can visit:
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