here are a couple peoples experiences with driving:

“When I was 16 I got my license, I started having bad seizures again. 2 years ago I decided to have surgery.  A month ago I was able to get my license and it’s been  7 years since I have been able to drive, it’s like a whole new life for me”

“I was originally diagnosed with JME the doctor said because I was only having “jerks”  it was safe to drive. My seizures got worse and I still was able to drive, I knew better then to drive when I was having a bad day. I started having staring spells and a got a new doc, she said no driving.  Where I live it’s up to you to turn in your license it’s not the doctors.”

A lot of people want to know…

Will I be able to get my driver’s license?

Yes, if you are not having any seizures that make you black out or lose control of what you’re doing. How long you have to be seizure-free before you can drive depends on which state you are living in. The time ranges from three months to a year. You also have to make a real commitment to take your meds every day, on time, so you don’t risk having a seizure on the road.

I’ve had a couple of seizures but I don’t want to tell my doctor because I’m afraid I’ll lose my license.

If you don’t tell the doctor, you’re missing a chance to adjust your meds so you won’t have more seizures. The bigger risk is that you’ll have a seizure while driving. While it’s tough not being able to drive for a while, you don’t want to risk having a bad accident that hurts you or someone else.

If I lose my license because of seizures, can I ever get it back?

Yes. Once you have been seizure – free (really seizure – free) for however long your state requires, you can re-apply and get your license back.

Every State has Different Laws for more information on your state laws Click HERE

Source:

Today is was a very HOT day, and of course I decided to take advantage of it! The thing is I was putting myself at risk, for not only seizures, but risk of getting sun-burned, and heat stroke. Was it to big of a risk?

I have always had problems with heat. And with fair skin and red hair I am a perfect candidate for getting burnt as well.  AEDs all come with risks, and of course you hear about the common side-effects that come with some medications: sleepiness, upset stomach, and headahces.   The things most doctors don’t tell you is to watch for sun exposure (more prone to sun-burn), heat stroke, and highten risk of seizures.

Now I would like to point out that usually your pharmacy gives you a paper with your medication information, if your pharmacy does not give you that information it is your right to ask for it. There is a lot of good information about your medication that paper. Don’t just throw it in the Trash!

Moving on…

Continuous weather changes cause headaches (for me). Headaches can often lead to migraines which can often lead to seizures. Air pressure changes have been known to cause migraines so when a storm comes the air pressure changes and the possibility of seizures is more likely (I have never personally experienced this) however my migraines have gotten worse with the presence of storms.

As far as cold weather and seizures I can’t say I have ever really had a problem. Has anyone else experienced any problems?

There has been no reasearch in this area, hopefully in the future we will find out more about this. But people with epilepsy report a connection and for me thats good enough.

~S.C.

If you find that getting overheated or physically tired triggers seizures, then you may want to avoid exercising when it’s very hot. Take breaks when you feel you need them.

But if you are like most people with seizures, you will find that exercise is good for you in a number of ways.

• It makes you feel good and fights depression.
• It keeps your weight at reasonable levels so you look your best
• Builds self-confidence and self-esteem.

Many people with epilepsy avoid exercise because they are afraid they will have a seizure during the exercise activity. Then again, it is extremely rare for a person to have a seizure while exercising. Bet you didn’t know that!  Rather than triggering seizures, physical activity can actually reduce the risk. Research has found that most people with epilepsy experience improved during and after exercise. The reasons for this are unknown, but theories include:

• The heavy breathing associated with exercise stops the build-up of carbon dioxide in the blood.
• Stress is a known seizure trigger, and regular exercise is a highly recommended way to manage stress.
• The release of ‘feel good’ brain chemicals (neurotransmitters) during exercise may calm the brain.
• The degree of concentration needed during sport may focus the brain so that seizures are less likely.
• The benefits of regular exercise, such as improved fitness, health and happiness, may contribute to having fewer seizures.

Exercise safety suggestions

• Before starting any new exercise program, consult with your doctor or specialist. A trainer is always helpful to have to help you create a program that’s right for your body.  A trainer will also make sure you are doing the exercises correctly, so you receive the maximum benefits and so you don’t hurt yourself by doing the exercises incorrectly.
• Avoid known seizure triggers.
• Always take your medication as prescribed.
• Keep an adequate supply of medication on you at all times.
• Make sure your sporting companions are aware of your condition, and know what to do if you have a seizure.
• Wear protective gear appropriate to your sport, such as helmet or knee pads.
• Let family/friends know your walking/jogging/exercise route before you leave and how long you will be out

Water safety

Water safety is particularly crucial, because a person who experiences a seizure while alone in water will almost certainly drown. Suggestions include:

• Be alert to hidden dangers. Did you know, you are more likely to drown in the bath than in the sea?

• Swim with companions who know you have epilepsy, and who are physically strong enough and know what to do if you have a seizure.
• Swim in supervised areas, such as in a public pool with an attendant, trainer, or at the beach between the flags where lifeguards are on patrol.
• Tell the pool attendant, trainer or lifeguard that you have epilepsy. You may need to brief them on how best to help you, if they don’t already know.

Exercise-related epilepsy triggers

It is important to exercise wisely. You could trigger a seizure minutes or hours after exercise if you strain your body. Make sure you are not suffering from these factors before exercising:

• Extreme fatigue
• Lack of sleep
• Dehydration
• Electrolyte loss (due to severe dehydration)
• Hyperthermia (elevated body temperature)
• Hypoglycemia (low blood sugar levels).

• In a study that was performed it showed that those who exercise at least three times a week for a minimum of twenty minutes reported fewer problems with seizures, depression and stress.

• In this study, fifteen Norwegian women with drug-resistant epilepsy spent fifteen weeks taking exercise classes twice a week for an hour. They combined aerobic dancing with strength training and stretching. The median number of seizures decreased from 2.9 to 1.7 during the experimental exercise phase. The women also had fewer health complaints, such as muscle pains, sleep problems and fatigue.

Find out more on our physical fitness and exercise, including details about precautions for specific physical activities. Click HERE

Today we are taking a look at how Alcohol affects your seizures.

There are two questions that have to be considered when the question of alcohol use and epilepsy comes up.

1. Is the effect that alcohol could have on the medicines used to control seizures?
2. Will alcohol itself cause seizures?

To answer the first question lets talk about the medications we all are on.  AEDS and Alcohol can be dangerous when mixed together. Sedative drugs, such as phenobarbital and ativan can be especially dangerous and cause coma, or even death.

To answer the second question-  Large amounts of alcohol are thought to raise the risk of seizures and may even cause them.

We find it interesting that:

When you drink alcohol, it temporarily reduces seizures for a few hours, but then increases the chances of having seizures as the alcohol leaves your body. Thus, people who drink heavily, even though they may not have epilepsy, may experience seizures after periods of binge drinking.

So is it okay to drink socially??

Having one or two drinks during an evening — there seems to be a lot of individual variation. Some people with epilepsy are not affected, and some are. A drink as part of a large meal is less likely to cause a seizure than a drink on an empty stomach.

*Check with your doctor before deciding on your own alcohol use. Be sure to ask about the kind of medicine you are taking and how it might react with beer, wine, or hard liquor. There is roughly the same amount of alcohol in a glass of wine, a bottle of beer and a shot of liquor.*

*E Fact A Day does not condone or discourage the use of alcohol*

What the Diet Does

Normally, our bodies run on energy from glucose, which we get from food. We can’t store large amounts of glucose, however. We only have about a 24-hour supply. When a child has no food for 24 hours — which is the way the diet begins, usually in a hospital — he or she uses up all the stored glucose. With no more glucose to provide energy, the child’s body begins to burn stored fat.

The ketogenic diet keeps this process going. It forces the child’s body to burn fat round the clock by keeping calories low and making fat products the primary food that the child is getting. In fact, the diet gets most (80 percent) of its calories from fat. The rest comes from carbohydrates and protein. Each meal has about four times as much fat as protein or carbohydrate. The amounts of food and liquid at each meal have to be carefully worked out and weighed for each person.

Doctors don’t know precisely why a diet that mimics starvation by burning fat for energy should prevent seizures, although this is being studied. Nor do they know why the same diet works for some children and not for others.

Trying to put a child on the diet without medical guidance puts a child at risk of serious consequences. Every step of the ketogenic diet process must be managed by an experienced treatment team, usually based at a specialized medical center.

Chances of Success

Often, a period of fine-tuning is needed before it’s clear whether or not a child is going to respond to the ketogenic diet. Doctors often ask parents to try the diet for at least one month, and even as long as two or three, if it’s not working at first.

A child on the diet usually continues taking anti-seizure medicine, but may be able to take less of it later on. If a child does very well, the doctor may slowly taper the medication with the goal of discontinuing it altogether.

About a third of children who try the ketogenic diet become seizure free, or almost seizure free. Another third improve but still have some seizures. The rest either do not respond at all or find it too hard to continue with the diet, either because of side effects or because they can’t tolerate the food.

A side benefit of the diet is that many parents say their children are more alert and make more progress when on the diet, even if seizures continue. If the diet seems to be helping, doctors will usually prescribe it for about two years. Then, they may suggest that parents slowly begin including regular food in the child’s diet to see if the seizures can still be controlled, even with a normal diet.

Sometimes a small amount of seizure medication is started again after the diet is stopped. However, some children may be able to stay seizure free without any further treatment. If the seizures return, the doctors may recommend putting the child back on the diet.

Side Effects

Like all the other treatments for epilepsy, the ketogenic diet has some side effects, which may or may not affect a particular child. Some side effects may go away if caught and managed early on. Knowing what to look for can make a big difference. Reported side effects include dehydration, constipation, and, sometimes, complications from kidney stones or gall stones.

Adult women on the diet may have menstrual irregularities. Pancreatitis (inflammation of the pancreas), decreased bone density and certain eye problems have also been reported. Again, this is why the medical team closely follows children or adults who are on the diet.

The diet lacks several important vitamins which have to be added through supplements. Sometimes high levels of fat build up in the blood, especially if a child has an inborn defect in his ability to process fat. This possibility can lead to serious effects, which is another reason for careful monitoring.

Making the Decision

Most experts say the diet is worth trying when two or more medications have failed to control seizures, or when medications cause side effects that are having a harmful effect on a child’s life. It also helps to have a child who is willing to try foods that he might otherwise not be enthusiastic about, and is tolerant and not fussy about eating.

The diet seems to work for more than one kind of seizure, and for children who have a lot of seizures or few seizures. But most doctors say it shouldn’t be used instead of medications if the drugs are working and the child is not having bad side effects. Parents generally decide to try the diet because they hope it will give their child a better chance for a normal life.

However, the diet can be a barrier to some normal life experiences for children, especially those that revolve around food and holidays. And, like other treatments for epilepsy, it also can have side effects that affect some children more than others. So, as with any kind of treatment, there’s a lot to think about before deciding to try the diet.

Going over all the possibilities with your doctor is the best way to make the decision. It may also be helpful to talk with other parents whose children have been on the diet.

Tips for Parents

• Don’t be too worried about the initial fasting process when starting the diet; most children handle it surprisingly well because of the promise of fewer seizures.
• Getting into a routine when fixing meals should make things easier.
• Involve your child in measuring his food by guiding him while he places food on the gram scale.
• Your child may feel hungry (because the diet restricts calories) and may try to sneak food from the refrigerator, and even from the pet’s dish. Using water with saccharine, and splitting meals in half may help fight hunger pains.
• Use a salad plate to present each meal, because the smaller plate makes it look as if the child is getting more food.
• If your child loves dessert, always keep a stock of homemade cream Popsicles in the freezer. These are then calculated into meal plans.
• Keep a few pre-prepared meals in small plastic containers in the fridge. Label them carefully for your older child’s use if you are not home or your child goes to a friend’s house.
• Steam vegetables for best nutritional value.
• Be creative with meal choices!
• Cut foods into interesting shapes to make them more appealing.
• Ask your child about her favorite keto food and serve it as a treat.
• Praise your child often for being so cooperative and sticking with the diet.
• Because liquids are also restricted by the diet, check with your doctor about how to handle days when it’s hot and your child perspires more than usual.

Getting Started

The diet starts in the hospital.

The child is placed on a 24-hour fast and is closely watched to be sure he or she is handling the very real stress of not getting any food during that time.

Once the child begins burning fat for energy instead of glucose (a state called ketosis), the doctors gradually introduce the foods that are part of the diet in amounts that are right for that child.

When the child goes home, the parents continue to carry out the diet at home, weighing every item and making sure that the balance between fat and other nutritional elements is maintained. Doctors and dietitians follow children closely to make sure they’re getting enough nutrition and are growing.

Parents of children on the diet use special paper strips to check the ketone level in the child’s urine.

Ketones are the chemicals that the body produces when it burns fat. Parents also test urine weekly for blood, which could be an early sign of kidney stones, a possible side effect of the diet.

Need for Medical Monitoring

Important: Don’t Try it Alone

The ketogenic diet has special appeal to families because changing what a child eats seems like a more “natural” way of preventing seizures than taking pills.

But the diet is anything but natural. It is a highly unnatural choice of foods and it reverses the body’s natural way of using food to gain energy. In fact, the ketogenic diet, like taking medications or having surgery, is a serious medical treatment.

It is not a “do it yourself” diet.

Trying to put a child on the diet without medical guidance puts a child at risk of serious consequences. Every step of the ketogenic diet process must be managed by an experienced treatment team, usually based at a specialized medical center.

Working with a Dietitian

When children (or adults) are treated with the ketogenic diet, the dietitian is a very important member of the medical treatment team. The dietitian works out how much of one type of food or another should be served together to make the diet work. He or she helps the family plan the child’s meals, and works out how many calories the child needs for healthy growth.

Meal plans serve small amounts of fruits or vegetables (carbohydrates) and meat, fish or chicken (protein) with lots and lots of fat (such as cream, butter, eggs, or mayonnaise), and no sugar.

The following sample meal plans provide a general idea of the kinds of foods that are part of the diet.

Breakfast

• Scrambled eggs with butter
• Diluted cream
• Orange juice

Lunch

• Spaghetti squash with butter and Parmesan cheese
• Lettuce leaf with mayonnaise
• Orange diet soda mixed with whipped cream

Dinner

• Hot dog slices with sugar-free catsup
• Asparagus with butter
• Chopped lettuce with mayonnaise
• Sugar free vanilla cream Popsicle

These examples don’t show the exact amounts of each food because those have to be worked out for each child by the dietitian. Each portion of food must be prepared very carefully by the parents, who often use a gram scale to weigh items exactly.

That’s because a tiny mistake in weighing and measuring foods (or if a child finds and eats a few cookie crumbs, or puts anything containing sugar — including medicines and toothpaste — in her mouth), can break the diet’s effects — and cause a seizure.

Source:

Brain surgery can be a successful way of treating epilepsy. Surgery is most likely to be considered when someone with epilepsy:

• Has documented epileptic seizures and not pseudoseizures.
• Has already tried the standard medicines without success (or has bad reactions to them).
• Has seizures that always start in just one part of the brain.
• Has seizures in a part of the brain that can be removed without damaging important things like speech, memory or eyesight.

Surgery for epilepsy is a delicate, complicated operation. It must be performed by a skilled, experienced surgical team. It is usually done at special medical centers that treat patients with epilepsy rather than at local hospitals. In addition to operations that remove a small part of the brain where seizures begin, other procedures may be done to interrupt the spread of electrical energy in the brain.

What are the surgery types?

• Lobectomy and Cortical Resection
• Hemispherectomy
• Corpus Callostomy
• Multiple Sub-pail Transection
• Lesionectomy
• Functional Hemispherectomy

Lobectomy and Cortical Resection- The most common form of epilepsy surgery. It is estimated that approximately 30 percent of persons with partial epilepsy have seizures that are not well controlled with medications and could benefit from this surgery. All or part of a left or right lobe may be removed surgically.

Hemispherectomy- The operations described above usually remove a relatively small area of the brain.However, when a child has Rasmussen’s encephalitis, a rare, progressive disease affecting one whole hemisphere of the brain, a hemispherectomy to remove all or almost all of one side of the brain may be performed.

Corpus Callostomy- By separating the cerebral hemispheres, the spread of an epileptic discharge can be confined to one cortex, reducing generalized seizures. A corpus callosotomy may be performed when partial seizures secondarily generalize and it is not possible to identify a single epileptic focus or when resection of a localized focus would cause a pronounced neurological deficit. Uncontrolled generalized seizures, especially atonic seizures (drop attacks), may also be treated with this type of surgery.

Multiple Sub-pail Transection-seeks to control seizures by cutting nerve pathways. It is used when the seizure focus is located in a vital area of the brain that cannot be removed, such as the speech area. Instead of taking out the affected tissue, the surgeon severs the parallel connections between cells in the affected area.

Lesionectomy-surgery to remove isolated brain lesions — areas of injury or defect such as a tumor or malformed blood vessel — that are responsible for seizure activity.

Functional Hemispherectomy-his is a variation of a hemispherectomy, a radical procedure in which one entire hemisphere, or one half of the brain, is removed. With a functional hemispherectomy, one hemisphere is disconnected from the rest of the brain, but only a limited area of brain tissue is removed. This surgery generally is limited to children younger than 13 years old who have one hemisphere that is not functioning normally.

What tests tell me I am a candidate for Epilepsy surgery?

Pre-surgical evaluation begins with a complete physical and neurological examination and a thorough seizure history. Most of the tests are to identify the precise location and extent of the seizure focus, the character of the seizures, and the relationship of the seizure focus to other brain functions, such as speech. How many tests have to be done depends on the type of operation being planned and how much information each test produces.

Test Include (but are not limited to):

• Electroencephalography (EEG)
• Simultaneous video-EEG monitoring
• Computerized tomographic (CT) scans
• Magnetic resonance imaging (MRI)
• Neuropsychological tests
• Single photon emission computed tomography (SPECT) scans
• A cerebral angiogram (X-ray)
• WADA (intracarotid sodium amobarbital) test
• Positron emission tomography (PET)
• MEG

If the tests do not provide enough information on the site of the seizure focus, invasive surgical procedures may be required, these include:

• implanting depth electrodes or placing subdural – thin wires placed deep in the brain through narrow rods.
• epidural strips directly on the brain to monitor seizure discharges – small plastic strips or sheets with electrodes embedded in them.

How much does Epilepsy Surgery Cost?

Surgery for epilepsy is complex and must be carefully planned for good results. It is therefore best undertaken in a center that specializes in epilepsy surgery and has a successful track record.

In addition, some surgical cases offer a greater challenge than others and may require more testing and evaluation before an operation takes place.

Because of this variation, the cost of surgery also varies. A range of between $50,000 to more than $200,000 is possible, depending on the kind of procedures that have to be done. Families should review their coverage with their third-party payer (insurance company) and the surgeon.

How long is Recovery?

After the operation, the patient stays up to a week in the hospital and then goes home and continues to recuperate. After about three to eight weeks he or she can usually go back to normal activities.

Doctors usually recommend that surgery patients stay on anti-epileptic medicines for up to two years after the operation. Some people may have to continue with medication indefinitely to retain seizure control.

Planning Ahead – Understanding Risks and Epilepsy Surgery Outcome.

Good communication between the doctor and the patient is important with all epilepsy treatment, but especially when surgery is being considered.

Although surgery for epilepsy is more common, more successful and safer than ever before, it is still a major operation.

The patient and the family should therefore have a realistic picture of the benefits, the risks, and the chances of complete or partial control of seizures afterwards.

After the operation, most patients are monitored in an intensive care unit for 24 to 48 hours. Possible complications of surgery include death, bleeding, stroke and infection. Patients may also experience effects because of the areas of the brain that were removed. These may be transient or permanent. All the possibilities should be discussed beforehand. The patient stays a few additional days in the hospital and then goes home to recuperate. After about three weeks he or she can usually resume normal activities.

There may be some physical after-effects of epilepsy surgery. Sometimes there are emotional changes as well. People may feel disappointed if their seizures do not stop completely, or if they have to go on taking medicine, at least for a while, after the surgery.

When seizures stop altogether or happen very seldom, there is an understandable feeling of relief and celebration. But sometimes people also feel depressed. It may be stressful and difficult to meet the new expectations that others may have, or to adjust to being a person without seizures after having them for so long.

In most cases, these reactions are temporary. Like other issues that may arise in connection with epilepsy surgery, they can be handled better if both the patient and the family know what to expect and have talked about them with the multidisciplinary medical team (which may include neurologists, surgeons, nurses, and psychologists) before any operation takes place.

After Surgery- Surgical Outcome.

Most surgery patients stay on antiepileptic medications for one to two years after the operation. Some will have to continue with medication indefinitely for the best outcome.

According to the National Institutes of Health, the success rate of lobectomies or cortical resections (no seizures with loss of consciousness) is between 30 and 70 percent, depending on the area removed. Some centers report higher rates. Brief sensory changes (auras) may continue for some years afterwards. The risk of death to lobectomy patients is less than 2 in 100. Complications occur in about 4 of every 100. These may include partial loss of vision, motor ability or speech. Infection or temporary swelling of the brain may also occur.

Among corpus callosotomy patients the risk of major or minor complications following surgery is around 20 percent. Atonic seizures (drop attacks) generally improve. Other generalized seizures may stop or happen less often. Partial seizures are likely to continue and may even get worse. Centers which perform hemispherectomies report good outcomes. However, there are more risks with this operation than with any other types of epilepsy surgery, and there will be permanent weakness on the side opposite the surgical site. Multiple sub-pial transection has limited data on outcomes.

After Surgery- Social Outcome.

Although seizures may be greatly reduced or totally controlled following surgery, a number of patients report periods of depression during the adjustment period and it appears that the greatest benefit accrues to those whose seizures are completely controlled. Postsurgical studies of patients’ employment and quality of life show the greatest gains among those who had some employment history prior to the operation and among those whose seizures were completely controlled.

Sources: and  WebMD Medical Reference

What is a Simple Partial?

• They are remarkably different from person to person, depending on the part of the brain where they begin. The one thing they all have in common is that the person remains alert and can remember what happens

Here are a couple of experiences:

• “I almost enjoy them. The feeling of déja vu, as if I’ve lived through this moment and I even know what’s going to be said next. Everything seems brighter and more alive.”
• “It is a pressure that starts in my stomach, then rises to my chest and throat. When it reaches my chest, I smell an unpleasant odor of something burnt. At the same time I feel anxious.”

Sometimes the seizure activity spreads to other parts of the brain, so another type of seizure follows the simple partial seizure. This can be a complex partial seizure or a secondarily generalized seizure.

How long do they last?

Only a short time, usually less than 2 minutes.

Tell me more!

Doctors often divide simple partial seizures into categories depending on the type of symptoms the person experiences:

Motor seizures:

These cause a change in muscle activity. For example, a person may have abnormal movements such as jerking of a finger or stiffening of part of the body. These movements may spread, either staying on one side of the body (opposite the affected area of the brain) or extending to both sides. Other examples are weakness, which can even affect speech, and coordinated actions such as laughter or automatic hand movements. The person may or may not be aware of these movements.

Sensory seizures:

These cause changes in any one of the senses. People with sensory seizures may smell or taste things that aren’t there; hear clicking, ringing, or a person’s voice when there is no actual sound; or feel a sensation of “pins and needles” or numbness. Seizures may even be painful for some patients. They may feel as if they are floating or spinning in space. They may have visual hallucinations, seeing things that aren’t there (a spot of light, a scene with people). They also may experience illusions—distortions of true sensations. For instance, they may believe that a parked car is moving farther away, or that a person’s voice is muffled when it’s actually clear.

Autonomic seizures:

These cause changes in the part of the nervous system that automatically controls bodily functions. These common seizures may include strange or unpleasant sensations in the stomach, chest, or head; changes in the heart rate or breathing; sweating; or goose bumps

Psychic seizures:

These seizures change how people think, feel, or experience things. They may have problems with memory, garbled speech, an inability to find the right word, or trouble understanding spoken or written language. They may suddenly feel emotions like fear, depression, or happiness with no outside reason. Some may feel as though they are outside their body or may have feelings of déja vu (“I’ve been through this before”) or jamais vu (“This is new to me”— even though the setting is really familiar).

Who gets them?

Anybody can get them. They may be more likely in people who have had a head injury, brain infection, stroke, or brain tumor but most of the time the cause is unknown.

Whats the outlook?

These seizures often can be controlled by seizure medicines.

What else could it be?

Medical disorders such as, stomach disorders or a pinched nerve can cause some similar symptoms. Hallucinations can accompany psychiatric illness or the use of certain drugs. And some symptoms (such as déja vu) are experienced by almost everyone at some time. Whether the symptoms represent simple partial seizures depends on how often they occur and whether they are associated with other episodic changes or other seizure types.

How is the diagnosis made?

A complete medical history and physical examination can help to rule out other possible causes of the symptoms and assess the likelihood of epilepsy.

Source: Epilepy.com  Topic Editor: Steven C. Schachter, M.D.

So lets get down to the facts about PNES:

• -A nonepileptic seizure is the result of subconscious mental activity or distress. It is NOT the result of abnormal brain electrical activity.
• -Doctors consider most of these episodes psychological in nature, but not purposely produced. Therefore, the older term “pseudoseizures” has fallen out of favor.
• -The person is usually unaware that the seizures are not epileptic. Nonepileptic seizures most often resemble complex partial or tonic-clonic seizures.
• -The degree of resemblance varies considerably, often making diagnosis difficult.

So how common is PNES?

• -Nonepileptic seizures are most common in adolescents and adults but also can occur in children and the elderly.
• -They are three times more likely in females.
• -These episodes have been more widely recognized during the past several decades. In comprehensive epilepsy centers, where video-electroencephalogram (video-EEG) monitoring is performed, approximately 20% of referred patients are found to have nonepileptic seizures.

How is PNES diagnosed?

• The diagnosis of nonepileptic seizures is most often made with video-EEG monitoring. Doctors often try to have a family member or friend observe the recorded event to ensure that it is identical or nearly identical to the usual episodes. Certain tests may be safely used to help provoke a seizure of this kind.

How is PNES treated?

• The treatment of nonepileptic seizures varies. In some cases the episodes subside when the patient learns that they are not epileptic seizures and are not due to a serious neurological disorder.
• Nonepileptic seizures are not necessarily an indication of a serious psychiatric disorder, but the underlying problem needs to be addressed and, in most cases, treated.
• There may be coexisting depression or anxiety that can be helped with medication. The prognosis for control of these episodes and for the patient’s psychological well-being varies.
• Counseling with a psychologist, psychiatrist, or clinical social worker for some period of time after the diagnosis is a mainstay to successful treatment.
• Accepting the diagnosis, at least as a real possibility, and following through with therapy are essential for a successful outcome.

Is it dangerous to treat PNES as if they were epileptic seizures?

• Absolutely! It is very important to diagnose whether seizures are epileptic or nonepileptic, as the treatments vary widely. Why expose a patient with nonepileptic seizures to antiepileptic medications with their associated risks and side effects?
• As importantly, repetitive non-epileptic seizures in a patient may mimic a very serious and dangerous condition, status epilepticus, for which doctors would administer sedating intravenous medications, often requiring intubation (putting a tube in the patient’s throat to help with breathing), thus exposing the patient to unnecessary invasive procedures.

Can patients with PNES also have Epileptic seizures?

• Patients with nonepileptic seizures may also have epileptic seizures.
• Epilepsy centers have shown that anywhere from 10-40% of patients with nonepileptic seizures also have epileptic seizures. This makes diagnosis of the different spells very important, as treatment for each type is so different.

Source: NYU Medical Center | 530 First Avenue, New York, NY 10016 | (212) 263-7300

Now the difference is back home, I live in a small suburb out of the city. Where bus and cab service is limited. To even get to the bus-stop from my house it’s about 5+ miles (at the least) – and in the below degree weather I am not sure I would be into walking that.  However, there is plus to living in a small town- you can walk to the grocery store (if that’s what you need)

What I find helpful is I have heard some people get free public transportation if they have Epilepsy! How awesome is that? So what are your thoughts on this?

What is your experience with public transportation? Do you get free public transportation because you have epilepsy?  Do you have good public transportation in your city? If so, where do you live?

~S.C.

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