In Part 11 What is discussed is Idiopathic Epilepsy (Unknown Cause) and the Rx of all causes!
Than their is the epilepsy that is diagnosed with a IDIOPATHIC cause – meaning unknown cause and the patient could grow out of it in childhood depending on the type of seizure disorder or not–in where the condition becomes chronic (for life).
Although heredity has been known since antiquity to cause epilepsy, the progress to date in identifying the genetic basis of epilepsy has been limited primarily to the discovery of single gene mutations that cause epilepsy in relatively rare families. For the more common types of epilepsy, heredity plays a subtler role, and it is thought that a combination of mutations in multiple genes likely determine an individual’s susceptibility to seizures, as well as the responsiveness to antiepileptic medications.
Epilepsy can be caused by genetic factors (inherited) or acquired (a etiology—cause) , although in most cases it arises in part from both. The neurology and neurological sciences of Stanford Epilepsy Center Dr. Robert S. Fischer Ph D. presents in the article Genetic Causes of Epilepsy.
He also presents in this article our genes are the instruction set for building the human body. Genes reside on chromosomes.
Going to the basics is every person has 46 chromosomes, carrying a total of about 30,000 genes. We get half our chromosomes from our mother and half from our father. While genes determine the structure of our body, they also control the excitability of our brain cells. Defective genes can make hyperexcitable brain cells, which are prone to seizures.
In recent years, several epilepsy conditions have been linked to mutations in genes, but the matter is complicated by the fact that different genes may be involved in different circumstances.
In general, the most common epilepsy conditions, including partial seizures, seem to be more acquired than genetic.
Gene testing will soon be able to identify predispositions to epilepsy, allowing doctors to help a patient get treatment and to assist with family counseling. One day, doctors may simply be able to swap a patient’s cheek, test his or her genes, and predict response to various epilepsy medicines, eliminating much of the trial and error in medication choice that goes on today. Eventually, we may even be able to repair or replace defective genes that predispose a person to epilepsy, a process called gene therapy.
Lastly, Dr. Robert Fischer Ph D presented in his article, that I found very interesting, the general population has about a 1% risk of developing epilepsy. Meanwhile, children of mothers with epilepsy have a 3 to 9% risk of inheriting this disease, while children of fathers have a 1.5 to 3% risk of inheritence. Still, the actual risk is upon the specific type of epilepsy. For example, partial seizures are less likely to run in families than are generalized seizures. In any event, with the usual forms of epilepsy, even if a parent does have the condition, there is more than a 90% chance that their child will not. So most epilepsies are acquired than inherited.
Clearly, genes determine a great deal of who we are, including our possible risk for epilepsy but slim versus a actual cause.
But what happens to us in life and what we do is still the larger part of the risk for epilepsy.
A person given this diagnosis in the 1970’s, or before and even up to the early 1990’s was quiet about ever letting people know about this since in the 1970’s and back with lack of knowledge, information to the public and definitely technology than versus now. Epilepsy is much more an accepted disease in the overall community compared to 20-25 years ago and back. Heck in the 1970’s and back these patients when having a seizure episode were characterized as “Freaks”. This was due to ignorance and lack of information but due to the past 20 to 25 years with the computer used more as a must in our lives with media, television and even our government they all have made it possible for society everywhere in the world to learn and understand diseases with acceptance in wanting to help those, particularly the US, but we still need a healthier America. It will take time to get there with the many multicultural lives that all live in the U.S. which practice differently on how important or where a healthy diet with exercise balanced with rest and stress well controlled is on their priority list in living.
Treatment
Doctors generally begin by treating epilepsy with medication. If medications don’t treat the condition, doctors may propose surgery or another type of treatment.
Medication
Most people with epilepsy can become seizure-free by taking one anti-seizure medication, which is also called anti-epileptic medication. Others may be able to decrease the frequency and intensity of their seizures by taking a combination of medications.
Many children with epilepsy who aren’t experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life. Many adults can discontinue medications after two or more years without seizures. Your doctor will advise you about the appropriate time to stop taking medications.
Finding the right medication and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won’t interact with them.
Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well-controlled.
For a person diagnosed with or without a cause of epilepsy these steps in learning about the disease with higher technology and continuous research with medications over the years has allowed them to be able to live a completely healthy life doing the same things other people do without the disease but only if the patient is UNDER COMPLETE CONTROL which includes being COMPLIANT; this does exist in America.
Compliant meaning taking their medications everyday as ordered by their neurologist with yearly or sooner follow-up visits with blood levels of the anti-seizure medications there on. This is the only way one with chronic epilepsy is guaranteed that living this way MAY stop the seizures from occurring (inactive epilepsy you can call it — meaning you’ll always have the disease but can put the seizure activity in a remission or under control by medications preventing the seizure.)
Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start:
- Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin.
- Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring.
- Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset.
Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment.
When medications fail to provide adequate control over seizures, surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that’s causing seizures.
Doctors usually perform surgery when tests show that:
- Your seizures originate in a small, well-defined area of your brain
- The area in your brain to be operated on doesn’t interfere with vital functions such as speech, language, motor function, vision or hearing
Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages.
In a small number of cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about his or her experience, success rates, and complication rates with the procedure you’re considering.
Therapies
Apart from medications and surgery, these potential therapies offer an alternative for treating epilepsy:
- Vagus nerve stimulation. In vagus nerve stimulation, doctors implant a device called a vagus nerve stimulator underneath the skin of your chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in your neck.The battery-powered device sends bursts of electrical energy through the vagus nerve and to your brain. It’s not clear how this inhibits seizures, but the device can usually reduce seizures by 20 to 40 percent.Most people still need to take anti-epileptic medication, although some people may be able to lower their medication dose. You may experience side effects from vagus nerve stimulation, such as throat pain, hoarse voice, shortness of breath or coughing.
- Ketogenic diet. Some children with epilepsy have been able to reduce their seizures by following a strict diet that’s high in fats and low in carbohydrates.In this diet, called a ketogenic diet, the body breaks down fats instead of carbohydrates for energy. After a few years, some children may be able to stop the ketogenic diet — under close supervision of their doctors — and remain seizure-free.Consult a doctor if you or your child is considering a ketogenic diet. It’s important to make sure that your child doesn’t become malnourished when following the diet.Side effects of a ketogenic diet may include dehydration, constipation, slowed growth because of nutritional deficiencies and a buildup of uric acid in the blood, which can cause kidney stones. These side effects are uncommon if the diet is properly and medically supervised.
Following a ketogenic diet can be a challenge. Low-glycemic index and modified Atkins diets offer less restrictive alternatives that may still provide some benefit for seizure control.
- Deep brain stimulation. In deep brain stimulation, surgeons implant electrodes into a specific part of your brain, typically your thalamus. The electrodes are connected to a generator implanted in your chest or your skull that sends electrical pulses to your brain and may reduce your seizures.
Potential future treatments
Researchers are studying many potential new treatments for epilepsy, including:
- Responsive neurostimulation. Implantable, pacemaker-like devices that help prevent seizures are under investigation. These responsive stimulation or closed loop devices analyze brain activity patterns to detect seizures before they happen and deliver an electrical charge or drug to stop the seizure.
- Continuous stimulation of the seizure onset zone (subthreshold stimulation). Subthreshold stimulation — continuous stimulation to an area of your brain below a level that’s physically noticeable — appears to improve seizure outcomes and quality of life for some people with seizures. This treatment approach may work in people who have seizures that start in an area of the brain that can’t be removed because it would affect speech and motor functions (eloquent area). Or it might benefit people whose seizure characteristics mean their chances of successful treatment with responsive neurostimulation are low.
- Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided laser ablation, show promise at reducing seizures with fewer risks than traditional open-brain surgery for epilepsy.
- Stereotactic laser ablation or stereotactic radiosurgery. For some types of epilepsy, stereotactic laser ablation or stereotactic radiosurgery may provide effective treatment when an open procedure may be too risky. In these procedures, doctors direct radiation at the specific area in the brain causing seizures to destroy that tissue in an effort to better control the seizures.
- External nerve stimulation device. Similar to vagus nerve stimulation, this device would stimulate specific nerves to reduce frequency of seizures. But unlike vagus nerve stimulation, this device would be worn externally so that no surgery to implant the device is needed.
In treatment FOLLOW UP VISITS are part of it, go to the neurologist not a general practitioner and that is a must!!!
The purpose for F/U (follow up) visits is for the neurologist to see how good of a therapeutic drug level your anti-seizure med is in (you get the blood test before the F/U visit). Possible do a EEG (electroencephalogram); the only test to decipher if you have spikes in your brain waves indicating you had a seizure (a 26 lead to wires on the brain, which is painless). Go to the expert for keeping you on the right track. Its just like based on the principle why a person gets a check up on there car by seeing the mechanic (the car’s doctor).
Types of seizures whether with a etiology or unknown:
I-Partial seizures (seizures beginning local)
1-simple partial seizures-(the person is conscious and not impaired). With motor symptoms, autonomic symptoms and even psychic symptoms.
2.)-Complex partial seizures-(the person is with impairment of consciousness)
II-Generalized seizures-(bilaterally symmetrical and without local onset).
3.) Tonic clonic seizures – Grand Mal
For those with epilepsy make your life one without seizures occurring putting your life on HOLD you need to TAKE CARE OF YOURSELF and take the meds including see your neurologist yearly or sooner! That is all up to you the patient diagnosed with it.