March 21, 2012

Quick Treatment for Prolonged Seizures

Cynthia Harden, MD

Faster, more effective relief of prolonged seizures (which last more than five minutes) may be available with medicine delivered into a muscle via an autoinjector, according to a study recently published by the New England Journal of Medicine. An autoinjector is similar to the EpiPen used to treat serious allergic reactions.

This study represents a major step toward addressing the serious neurologic and medical risk of prolonged seizures. In the study, investigators compared two medicines, midazolam and lorazepam, known to be effective in controlling seizures. The researchers found that an intramuscular injection of midazolam, which quickly delivers anticonvulsant medicine, ultimately worked as effectively and quickly as intravenous lorazepam. So autoinjector technology bypasses the difficulty of rapidly delivering a life-saving intravenous treatment in the field during an emergency with a patient who is actively having a seizure. The device has great value in a clinical setting when used by paramedics. However, the safety of its use by nonmedical persons such as family members remains to be clarified.

The researchers involved in the study, which was sponsored by the National Institute of Neurological Disorders and Stroke, should be praised for this important research, which is readily translatable to helping patients.

For more information on seizures and epilepsy, please visit the Comprehensive Epilepsy Care Center at Cushing Neuroscience Institute.

Visit our main Web site to find a hospital in New York close to you or visit our Find a Physican tool to find a doctor best suited to your needs.

 

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March 21, 2012

Epilepsy Surgery Improves Seizure Control and Quality of Life

Cynthia Harden, MD

A 26-year follow-up study published in the journal Epilepsia revealed that after epilepsy surgery, nearly half of participants were free of disabling seizures and 80 percent reported better quality of life than before surgery.

Spanning over three decades, the study is the longest follow-up of epilepsy surgery patients. However, nothing has changed in that time in that it is still widely accepted that epilepsy surgery is the most effective treatment to halt debilitating seizures.  

In the study, researchers analyzed seizure data and quality-of-life outcomes of 361 patients who underwent epilepsy surgery between 1967 and 1990. Patients were then surveyed to assess seizure control and quality of life. Of the 361 patients, 117 completed follow-up interviews for the study and 48 percent were determined to be free of disabling seizures. On a survey assessing quality of life for those with epilepsy, 80 percent of patients reported their overall quality of life was better than before the surgery, when seizures were frequent and not responding to anti-seizure medication. 

For more information on seizures and epilepsy, please visit the Comprehensive Epilepsy Care Center at Cushing Neuroscience Institute.

Visit our main Web site to find a hospital in New York close to you or visit our Find a Physican tool to find a doctor best suited to your needs.

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October 18, 2011

In the News: Surgery for Epilepsy Patient, Discrimination & Illness, and Esophageal Cancer Risks

Terry Lynam

About half of surgically treated adults with epilepsy remain seizure-free a decade later, a large follow-up study of epilepsy surgery shows. Dr. Ashesh Mehta discusses the study stating, "These days if a patient has failed two or three medications we might consider surgery because it has become much safer and more effective over the last few decades."

A new study suggests that stress associated with racial discrimination may take a heavy toll on the body, which North Shore-LIJ cardiologist and chief diversity officer Dr. Jennifer Mieres says could help explain why certain racial groups tend to have more heart disease, diabetes and other age-related conditions.

North Shore-LIJ gastroenterologist Dr. David Bernstein responds to a new Danish study suggesting that the risk of developing deadly esophageal cancer for patients with a condition known as Barrett's esophagus is significant, but not as dire as once reported. Full Post - to Detail View

July 29, 2011

Innovative Study Looks at How the Brain Communicates with Itself

Ashesh Mehta, MD

In today’s world, networks operate in diverse situations, from communication networks that permit a cell phone conversation to social networks that link friends on Facebook. These networks have properties (e.g., each computer in your home with a wireless network) and hubs, where multiple separate sub-networks come together (e.g., a person who bridges multiple social networks). 

It is increasingly being recognized that these properties operate in our brain too – in both normal functioning and as a mechanism for disorders of the nervous system, like the spread of seizures across the brain. Functional magnetic resonance imaging (fMRI) is a non-invasive method that can be used to measure the tiny metabolic changes that take place in an active part of the brain. To date, fMRI has been typically used to study what parts of the brain become active when subjects respond to stimuli (e.g., being shown pictures) or perform tasks (e.g., rotating objects in their mind’s eye). Recently, there has been interest in looking at how the brain works at rest, by measuring the fMRI signals in different brain regions and seeing how they activate and deactivate together. By measuring the relationship of activity between different brain areas, it is possible to describe an individual’s brain network, including sub-networks where brain areas with higher correlation are more closely connected (much like friends in a social network). While this has been studied extensively with fMRI, results have been difficult to interpret, because of the unclear relationship between fMRI signals and brain electrical activity. 
 
Validation of this fMRI methodology has recently taken a major step forward, with the findings published in a recent issue of Full Post - to Detail View

June 01, 2011

Breastfeeding Linked to Fewer Seizures in Kids

Cynthia Harden, MD

A recent article from Medline Plus commented on a study published in the Journal of Pediatrics, where researchers from the School of Public Health at the University of Aarhus in Denmark found that those babies who were breastfed may have fewer seizures after they’re a year old. Moreover, the longer they were breastfed, the better. This finding that breast feeding reduces the risk of onset of early childhood epilepsy is intriguing.

In the study, kids who had breastfed for at least three months had about a one in 135 chance of developing epilepsy after they were a year old. If they were breastfed for at least six months , this chance dropped to about one in 150. Babies on breast milk for at least nine months had about a one in 200 chance of getting the seizure disorder later.

However, the data from the study is somewhat limited in that almost every infant in the study was breastfed for at least one month and only 2 percent of the sample was not breast-fed at all. Given that about 25 percent of US mothers do not breastfeed their infants, a bigger sample size of those in the study who were not breastfed would have been informative. However, for researchers in epilepsy such as myself, the data from the study is remarkable and very thought-provoking.

For more information about epilepsy, diagnosis and treatment, please go here. 

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