Posts Tagged seizure

[NEWS] Novela Neurotech to Present nEureka® for Epilepsy Platform at CapCon 2020 Venture Conference – EIN Presswire

NEWS PROVIDED BY Novela Neurotech September 23, 2020, 19:30 GMT

nEureka® for Epilepsy: an all-in-one platform for remote epilepsy monitoring.
nEureka® for Epilepsy: an all-in-one platform for remote epilepsy monitoring. Click to zoom

nEureka® is a telehealth Data-as-a-Service platform transforming costly episodic care to personalized, efficient, and accessible remote care for epilepsy.

ALAMEDA, CALIFORNIA, UNITED STATES, September 23, 2020 /EINPresswire.com/ — Novela Neurotech, a Data-as-a-Service company developing personalized remote epilepsy care using connected consumer data, will showcase its nEureka® for Epilepsy platform at the virtual CapCon 2020 Venture Conference, Sep 29 to Oct 1, 2020.

Over 3 million people in the U.S. are diagnosed with epilepsy, which is characterized by unpredictable seizures. Although a chronic neurological condition, the current status quo for epilepsy healthcare relies on punctuated clinical visits—often three months apart—which delays critical healthcare decisions for epilepsy management. Roughly 70% of epilepsy cases can be controlled with medication, and medication adherence is a key factor for keeping seizures at bay. Epileptologists often adjust their prescriptions using the patient’s self-reported experience of their seizure counts and side-effects. Therefore, precise seizure counts and side-effect data are critical to inform healthcare decisions.

However, current options for tracking seizures and medication are antiquated & inaccurate, fractured, lacking and episodic.

1) Antiquated & inaccurate: Patients often rely on pen-and-paper journals, or single-function seizure tracking apps, to log their seizures, which easily leads to forgetting and inaccuracies.
2) Fractured: Separate alarms and apps are needed for medication reminders, activity and mood tracking, promoting frustration and confusion.
3) Lacking: Patients who are aware of an impending seizure cannot easily notify family for help. During sleep, 1 in every 150 patients with uncontrolled seizures may experience SUDEP (Sudden Unexpected Death in Epilepsy), a devastating condition that is preventable — if provided with adequate monitoring or intervention methods, which are currently lacking.
4) Episodic: with a 3+ month gap between physician visits, patients experience a lag in critical healthcare to keep their seizures under optimal control.

The nEureka® for Epilepsy system combines everyday consumer devices, a cloud data platform and real-time alerts into a powerful all-in-one Epilepsy Remote Care Solution that resolves current pain points. Wearables embedded with seizure-related biomarker sensors will allow continuous recording of biomarkers, and simplified one-button tracking of seizure events to increase the accuracy of seizure counts. Built under the guidance of epileptologists and people with epilepsy, nEureka® also includes SOS alerts to caregivers—day and night—providing patients with independence, and caregivers with peace-of-mind. All data are seamlessly transferred to the patients’ physician portal, and organized as a dashboard into clean and informative charts for easy 24/7 review and follow-ups.

As certified by Impactable, nEureka® delivers significant healthcare impact including $2B+ reduction in cost to reach optimal treatment in the next 5 years in the US alone, with a 40% improvement in medication adherence.

“Altogether, nEureka® for Epilepsy transforms antiquated Epilepsy Care from single snapshots in time to a continuous, data-rich movie. Long gone are the days of intermittent, guess-based healthcare. nEureka® paves the way for patients to launch remote visits with their physicians—anytime, anywhere,” says Ray Iskander, CEO of Novela Neurotech.


About nEureka®
nEureka® by Novela Neurotech is a telehealth Data-as-a-Service platform transforming current costly episodic care to personalized, efficient, and accessible remote care for epilepsy & other chronic neurological conditions. nEureka® leverages everyday consumer technology and wearables to connect patients with their clinicians and caregivers resulting in continuous care and significantly reducing risk of premature death and care costs. For more information, contact shelly.fan@novelaneuro.com.

About CapCon
The CapCon mission is to change the world by promoting forward-thinking life science companies through finance and media. Lack of efficiencies in healthcare need to be addressed to save people and their families, and CapCon aspires to make a dent in the current state of medical problems. Companies that register for CapCon receive exposure to the exact investors they want to meet — including those who have a fundamental interest in the growth of their company. Companies will also receive educational content in finance, legal affairs, regulatory affairs, and business. More at CapCon 2020.

Source: https://www.einnews.com/pr_news/526886922/novela-neurotech-to-present-neureka-for-epilepsy-platform-at-capcon-2020-venture-conference

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[Abstract + References] Evaluation of an Activity Tracker to Detect Seizures Using Machine Learning

Abstract

Currently, the tracking of seizures is highly subjective, dependent on qualitative information provided by the patient and family instead of quantifiable seizure data. Usage of a seizure detection device to potentially detect seizure events in a population of epilepsy patients has been previously done. Therefore, we chose the Fitbit Charge 2 smart watch to determine if it could detect seizure events in patients when compared to continuous electroencephalographic (EEG) monitoring for those admitted to an epilepsy monitoring unit. A total of 40 patients were enrolled in the study that met the criteria between 2015 and 2016. All seizure types were recorded. Twelve patients had a total of 53 epileptic seizures. The patient-aggregated receiver operating characteristic curve had an area under the curve of 0.58 [0.56, 0.60], indicating that the neural network models were generally able to detect seizure events at an above-chance level. However, the overall low specificity implied a false alarm rate that would likely make the model unsuitable in practice. Overall, the use of the Fitbit Charge 2 activity tracker does not appear well suited in its current form to detect epileptic seizures in patients with seizure activity when compared to data recorded from the continuous EEG.

References

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2.Jory, C, Shankar, R, Coker, D, McLean, B, Hanna, J, Newman, C. Safe and sound? A systematic literature review of seizure detection methods for personal use. Seizure. 2016;36:4–15.
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3.Beniczky, S, Jeppesen, J. Non-electroencephalography-based seizure detection. Curr Opin Neurol. 2019;32(2):198–204.
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4.Ryvlin, P, Ciumas, C, Wisniewski, I, Beniczky, S. Wearable devices for sudden unexpected death in epilepsy prevention. Epilepsia. 2018;59(suppl 1):61–66.
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5.Poh, MZ, Loddenkemper, T, Reinsberger, C, et al. Convulsive seizure detection using a wrist-worn electrodermal activity and accelerometry biosensor. Epilepsia. 2012;53(5):e93–e97.
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6.Feehan, LM, Geldman, J, Sayre, EC, et al. Accuracy of Fitbit devices: systematic review and narrative syntheses of quantitative data. JMIR mHealth uHealth. 2018;6(8):e10527.
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7.Fisher, RS, Cross, JH, French, JA, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):522–530.
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8.Fisher, RS, Cross, JH, D’Souza, C, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia. 2017;58(4):531–542.
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9.Scheffer, IE, Berkovic, S, Capovilla, G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512–521.
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10.Lee, J, Finkelstein, J. Consumer sleep tracking devices: a critical review. Stud Health Technol Inform. 2015;210:458–460.
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11.Montgomery-Downs, HE, Insana, SP, Bond, JA. Movement toward a novel activity monitoring device. Sleep Breath. 2012;16(3):913–917.
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12.Moreno-Pino, F, Porras-Segovia, A, Lopez-Esteban, P, Artes, A, Baca-Garcia, E. Validation of Fitbit charge 2 and Fitbit alta HR against polysomnography for assessing sleep in adults with obstructive sleep apnea. J Clin Sleep Med. 2019;15(11):1645–1653.
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13.Regalia, G, Onorati, F, Lai, M, Caborni, C, Picard, RW. Multimodal wrist-worn devices for seizure detection and advancing research: focus on the Empatica wristbands. Epilepsy Res. 2019;153:79–82.
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14.Van Ness, PC . Are seizure detection devices ready for prime time? Epilepsy Curr. 2019;19(1):36–37.
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15.Halford, JJ, Sperling, MR, Nair, DR, et al. Detection of generalized tonic-clonic seizures using surface electromyographic monitoring. Epilepsia. 2017;58(11):1861–1869.
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16.Patterson, AL, Mudigoudar, B, Fulton, S, et al. SmartWatch by SmartMonitor: assessment of seizure detection efficacy for various seizure types in children, a large prospective single-center study. Pediatr Neurol. 2015;53(4):309–311.
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17.van Andel, J, Leijten, F, van Delden, H, van Thiel, G. What makes a good home-based nocturnal seizure detector? A value sensitive design. PLoS One. 2015;10(4):e0121446.
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18.Bruno, E, Simblett, S, Lang, A, et al. Wearable technology in epilepsy: the views of patients, caregivers, and healthcare professionals. Epilepsy Behav. 2018;85:141–149.
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19.Patel, AD, Moss, R, Rust, SW, et al. Patient-centered design criteria for wearable seizure detection devices. Epilepsy Behav. 2016;64(pt A):116–121.
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20.Kurada, AV, Srinivasan, T, Hammond, S, Ulate-Campos, A, Bidwell, J. Seizure detection devices for use in antiseizure medication clinical trials: a systematic review. Seizure. 2019;66:61–69.
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21.Benedetto, S, Caldato, C, Bazzan, E, Greenwood, DC, Pensabene, V, Actis, P. Assessment of the Fitbit charge 2 for monitoring heart rate. PLoS One. 2018;13(2):e0192691.
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22.Gutierrez, EG, Crone, NE, Kang, JY, Carmenate, YI, Krauss, GL. Strategies for non-EEG seizure detection and timing for alerting and interventions with tonic-clonic seizures. Epilepsia. 2018;59(suppl 1):36–41.
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[NEWS] Funding boost for AI-based epilepsy monitoring

September 8th, 2020

Funding boost for AI-based epilepsy monitoring
Routinely recorded EEG is used to build a personalised model of the brain Credit: monsitj

University spinout company Neuronostics has received funding to develop its BioEP platform, an AI-based system for faster, more accurate diagnosis of epilepsy and to monitor response to treatment with anti-epileptic drugs (AEDs).

BioEP works by creating mathematical models of the brain using short segments of electroencephalogram (EEG) recordings. Computer simulations rapidly reveal the ease with which seizures can emerge and form the basis of the BioEP seizure risk score.

Neuronostics is developing BioEP in partnership with the University of Birmingham, where mathematician Professor John Terry, co-founder of the company, is Director of Centre for Systems Modelling & Quantitative Biomedicine.

Professor Terry’s research aims to improve diagnosis and treatment for people with epilepsy. He explains: “We build personalised models of the brain using EEG that is routinely collected when seeking to diagnose epilepsy. From these models the risk of epilepsy can be quickly determined. In contrast, multiple EEG recordings are often required to reach a clinical diagnosis at present. This is expensive, time-consuming, and exposes people with suspected epilepsy to risk.”

The funding, from the National Institute for Health Research (NIHR), will enable the research partnership to progress a prototype clinical platform that can provide a risk score showing the individual’s susceptibility to seizures. This measurement can be used in diagnosis, and as an objective assessment of response to treatment with AEDs, resulting in faster seizure control for people with epilepsy.

The clinical utility of the BioEP seizure risk score has already been demonstrated in a cohort of people with idiopathic generalized epilepsy.1 Using just 20 seconds of an EEG recording that would be considered inconclusive in the current clinical pathway, BioEP achieved 72% diagnostic accuracy. This matches the accuracy achieved in the current diagnostic pathway, which typically takes a year, and involves multiple follow-ups.2

The company is interested to hear from commercial partners in EEG hardware manufacturing, digital EEG analysis, and companion diagnostics or prognostics, and research and clinical partners with interests in epilepsy, traumatic brain injury and dementia. For collaboration enquiries please email: info@neuronostics.com.

The NIHR funding was delivered through the AI in Health and Care Award, part of the NHS AI Lab, which was launched by the UK Government earlier this year to accelerate the adoption of Artificial Intelligence in health and care.


More information:
References
1. H Schmidt et al. A computational biomarker of idiopathic generalized epilepsy from resting state EEG Epilepsia 57: e200-e204 (2016).
2. S Smith. EEG in the diagnosis, classification, and management of patients with epilepsy Journal of Neurology, Neurosurgery & Psychiatry 76: ii2-ii7 (2005).

For further media information please contact: Ruth Ashton, Reputation & Communications Development Manager, University of Birmingham Enterprise, email: r.c.ashton@bham.ac.uk.

About Neuronostics

Neuronostics was established in 2018 and is focussed on developing clinical decision support tools and at home monitoring devices for people with suspected neurological conditions. Neuronostics is currently Medilink SW Start up of the Year and has been supported by grant funding in excess of £1M. Neuronostics’ first product—BioEP—is a revolutionary, patented, biomarker of the susceptibility to seizures in the human brain, informed by clinical EEG recordings.

About the University of Birmingham

The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 6,500 international students from over 150 countries.

About NIHR

The National Institute for Health Research (NIHR) is the nation’s largest funder of health and care research. The NIHR:
● Funds, supports and delivers high quality research that benefits the NHS, public health and social care
● Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
● Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
● Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
● Partners with other public funders, charities and industry to maximise the value of research to patients and the economy

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.

Provided by University of Birmingham

Source: https://sciencex.com/wire-news/361008258/funding-boost-for-ai-based-epilepsy-monitoring.html

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[WEB PAGE] Why Did Terms for Seizures Change?

Article written by Mary K. Talbot

In 2017, the International League Against Epilepsy (ILAE) released updated classifications for epilepsy. The new classifications better reflect current scientific understanding of seizures. The classifications were last updated in 1989.

Before this new update, seizures were divided into two broad categories — partial-onset seizures and generalized seizures. Partial-onset seizures originate in one area or side of the brain and generalized seizures start in both sides of the brain.

The new classification considers three main factors when defining seizures:

  1. Point of origin
  2. Awareness level
  3. Behaviors

For example, simple partial seizures have been renamed focal onset aware seizures, and complex partial seizures have been reclassified as focal onset impaired awareness seizures.

Why the changes? Ingrid Scheffer, who led the ILAE effort to reclassify seizures, said the group was focused on creating “transparent language” for seizure types. “We wanted language that patients could understand, not just doctors.”

Current Classification of Types of Seizures

Seizure type is now identified by point of origin, awareness level, and accompanying behaviors.

Point of Origin

The point of origin for each type of seizure is now classified into one of four categories:

  • Focal Onset — Formerly known as a “simple partial seizure,” focal onset seizures originate within networks limited to one hemisphere of the brain. They may be localized to one small area of the brain or more widely distributed.
  • Generalized Onset — These originate within and rapidly engage areas in both sides of the brain at once.
  • Unknown Onset — As the name suggests, the origin of these seizures is unknown.
  • Focal to Bilateral Seizure — These seizures start on one side of the brain and spread to both sides.

Awareness Level

Awareness levels during seizures have four distinguishing features:

  • Focal Aware — During focal aware seizures, a person is aware, but may be unable to talk or respond during a seizure.
  • Focal Impaired Awareness — Formerly known as a “complex partial seizure,” a focal impaired awareness seizure occurs when a person’s awareness is impacted at some point during a seizure.
  • Awareness Unknown — This classification is used when a seizure takes place with no witness to observe awareness levels.
  • Generalized Seizures — Generalized seizures, which affect both halves of the brain, usually always affect a person’s awareness or level of consciousness in some way.

Behaviors

Behaviors that accompany focal onset seizures also have classifications:

  • Focal Motor Seizure — This term describes a seizure accompanied by movement, such as stiffening, thrashing, jerking, or automatic movements like walking or running.
  • Focal Nonmotor Seizure — This is a seizure with other symptoms that precede it, such as changes in thinking, emotions, or sensation.

These behaviors accompany generalized onset seizures:

  • Generalized Motor Seizure — “Tonic-clonic seizures,” with their characteristic stiffening and jerking motions, is still an accurate term. However, the term “grand mal seizure” that often accompanied that description is no longer relevant.
  • Generalized Nonmotor Seizure — “Absence seizures,” with brief changes in awareness that include staring and some repeated movements, is the new classification. This has replaced “petit mal seizures.”

Read more about types of focal seizures and their symptoms.

Read about treatments for focal seizures.

Scientific Progress in Understanding Epilepsy

Understanding the history of epilepsy research can shed light on how and why terminology has changed, and why the current set of terms is the most accurate so far. The ancient Greeks coined the term epilepsy (meaning “to seize”) and attributed the condition to an attack by a demon or a god. Babylonians documented seizures on clay tablets. Ancient Persians believed the source was mental illness, while Chinese physicians more than 2,500 years ago believed epilepsy was caused by an excess of secretions in the brain.

By the 1860s, British neurologist John Hughlings Jackson had determined that seizures were due to activity in the brain. For the first time, he hypothesized that seizures present differently depending upon the part of the brain from which they originated. In the 1930s, this groundbreaking theory inspired Canadian-American neurosurgeon Wilder Graves Penfield to use electrostimulation to simulate the seizure behavior and locate the area of the brain where the onset occurred.

Henri Jean Pascal Gastaut took that research one step further, working with his wife, Yvette, to define five major human electroencephalogram (EEG) patterns. He also discovered Gastaut syndrome (photosensitive epilepsy) and Lennox-Gastaut syndrome (severe childhood encephalopathy). Diagnostic imaging helped Gestaut better understand seizures.

Significant advances in diagnostic imaging have been made in the last 50 years. New imaging tools include computerized tomography (CT scan), magnetic resonance imaging (MRI), single photon emission computerized tomography (SPECT) and positron-emission tomography (PET), magnetic resonance spectroscopy, and magnetoencephalography (MEG). With each new tool, scientists have become better able to understand brain activity.

Collaboration and Education

As scientists gained a deeper understanding of the brain and epilepsy, formal organizations were established to study epilepsy, share knowledge, and improve care. The International Bureau for Epilepsy (IBE) was established in 1961 to study the medical and nonmedical aspects of epilepsy. In 1966, the surgeon general of the United States created the General Public Health Service Advisory Committee on the Epilepsies.

The International League Against Epilepsy took a leadership role in 1969 when it accepted the first “Clinical and electroencephalographic classification of epileptic seizures” at its General Assembly in New York. The new standards created common terminology for epilepsy. A shared set of terminology facilitated improved communication and information-sharing among researchers. Those original classifications were updated in 1981 and 1989 before the most recent update in 2017.

References

  1. Epilepsy: from the early civilizations to modern days — Hektoen International
  2. Brief History of Epilepsy & Seizures — University Health Network
  3. Highlights in the History of Epilepsy: The Last 200 Years — Hindawi
  4. International Bureau for Epilepsy
  5. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology — International League Against Epilepsy
  6. 2017 Revised Classification of Seizures — Epilepsy Foundation
  7. The ILAE seizure and epilepsy classifications: Critique, response and the way forward — International League Against Epilepsy

via Why Did Terms for Seizures Change? | MyEpilepsyTeam

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[WEB PAGE] International researchers propose new classification system of seizures

Epilepsy is a wide-spread neurological disorder that affects around 50 million people worldwide. It is characterized by recurrent epileptic seizures, which are sudden bursts of electrical activity in the brain. There are many different types of seizures, and a person with epilepsy can experience more than one type.

Clinicians today use EEG measurements, with electrodes either placed on a patient’s scalp or inside the brain, to identify when and where a seizure begins. But these measurements alone do not always provide enough information to understand the type of seizure and make optimal decisions regarding treatment.

Now, an international team of researchers led by Aix-Marseille University in France and the University of Michigan has proposed a new classification system of seizures based on a deep understanding and mathematical modelling of brain oscillations. “It represents the first objective and unbiased taxonomy of its kind”, says one of the lead authors, HBP-scientist Prof. Viktor Jirsa from Aix-Marseille University.

The researchers used “bifurcation theory” – a method commonly used in fields such as physics and engineering – to analyze data from over a hundred patients across the globe. Researchers from the University of Melbourne and Monash University, both in Australia, the University of Freiburg in Germany, and Kyoto University in Japan also contributed to the work. Seizures with similar properties were categorized into groups.

They found sixteen types of seizure dynamics – or ‘dynamotypes’ – with distinct characteristics. “Similar to the periodic table of elements in chemistry, we demonstrated the existence of a clear classification system of seizures”, says Jirsa.

The system could lead clinicians to a better understanding of seizures and how they should be treated. “Seizure types react differently to treatments. For instance, some seizures can be stopped through electric stimulation, others not, dependent on their dynamotype. The systems scientific basis is theory work developed around the Epileptor, a central epilepsy model we developed in the Human Brain Project that is also at the heart of a large clinical trial running now”, the researcher explains.

Classification, however, is not explanation. There is much work ahead of us to better understand epilepsy mechanisms. This is where EBRAINS will play a key role, as it provides the tools connecting cellular, network and brain imaging signals aiding in mechanism discovery. ”

Prof. Viktor Jirsa, HBP-Scientist from Aix-Marseille University

EBRAINS is a new shared digital brain research infrastructure for the European Union that the Human Brain Project (HBP) is building.

Within the HBP, Jirsa and his team had first begun adapting the open network simulator The Virtual Brain towards applications in epilepsy. The work has laid the foundations for project EPINOV (“Improving EPilepsy surgery management and progNOsis using Virtual brain technology”) a multi-year project involving more than a dozen French hospitals that is funded by the French state. EPINOV tests whether the use of the personalized HBP modeling technology for epilepsy networks can improve surgery preparation in drug-resistant patients.

via International researchers propose new classification system of seizures

 

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[BLOG POST] Hiding Epilepsy Symptoms

“I spent the last 2 years hiding at home. I was sitting here wondering if there were any friends from my old life I remembered enough to reach out to? Why is it that I feel so guilty for being upset?” -A member of MyEpilepsyTeam

On MyEpilepsyTeam, the social network and online support group for those living with epilepsy, members talk about a range of personal experiences and struggles. Hiding epilepsy symptoms are one of the top 10 topics most discussed.

Here are a few question-and-answer threads about hiding epilepsy symptoms:

Does or has anyone ever felt embarrassed about telling someone about their seizures?

Are men or women more embarrassed about having epilepsy?

Has anyone had embarrassing things happen when they had a seizure?

Here are some conversations about hiding epilepsy symptoms:

My depression is returning and I’m hiding it.

I feel like I’m living this double life.

Being out with my girlfriend has certainly helped keep me going rather than hiding away.

Have another topic you’d like to discuss or explore? Go to MyEpilepsyTeam today and start the conversation. You’ll be surprised just how many others may share similar stories.

Feel free to ask a question here.

via Hiding Epilepsy Symptoms | MyEpilepsyTeam

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[BLOG POST] Things I Wish Everyone Knew About Epilepsy

Screen Shot 2016-03-21 at 11.33.51 AM

To spread epilepsy awareness, we’ve asked some of our favorite bloggers to share what they’ve learned while living with epilepsy. Our friend Ellis shares what she wishes everyone knew about living with epilepsy. Please share with the friends and family in your life!

I started having seizures at the ripe old age of 24. It took me six years to find a good neurologist and effective treatment, and as it turns out, I’m one of the lucky ones. Here are a few things I didn’t know about epilepsy until I was staring it in the face:

The doctors don’t know.
The brain is still a mystery. The first time you have a seizure, you’re rushed to the hospital and given a CT scan. That scan might show a tumor or brain deformation. Or, as in my case, it might be perfectly normal.

At this point, your doctors throw up their hands. One seizure could be anything. You may not ever have one again. Whoops—but I did! And still my brain looked fine.

You look to your doctor for reassurance and answers—especially when you’ve been healthy your whole life, you’re scared, and you don’t know what is going on. Unfortunately, medical science just hasn’t figured out why most seizure disorders occur. It’s a tough thing to have to accept.

It’s different for everyone.
The problem with nailing down epilepsy and other neurological issues is that no two people suffer identical forms. Abnormal electrical activity can affect many different regions of the brain, to different degrees, leading to all sorts of weird problems.

Some epileptics have the violent, thrashing seizures most people are familiar with, but not all do. Some epileptics just stare off into space. Some lose bowel or bladder control. Some have orgasms. And did you know hiccuping might be a form of seizure? (There’s no consensus on this.)

I’ve been told my seizures look scary, but they sound pretty uneventful as such things go. I tense every muscle in my body, and stop breathing long enough for my lips and hands to turn blue. I’m unaware of it because I’m unconscious at that point. It’s like sleeping in on Saturday, or all those billions of years before I ever existed. I couldn’t care less until I wake up. Then I get treated to a headache, nausea, amnesia—and often, a crushing sense of guilt. Sometimes I’ll cry and apologize to everyone around me.

A person’s epilepsy also may or may not have a trigger.
Strobe light patterns may trigger a seizure in some epileptics, but not others. I’m not photosensitive, but stress does seem to make my seizure activity worse. As does my menstrual cycle—a poorly understood phenomenon called catamenial epilepsy.

Frequency is also variable.
Some people’s brains have epileptic activity all day long. Others may go months or years without a seizure.

It might come with spider-sense.
Some epileptics, like me, have a set of symptoms that proclaim BEND OVER, A SEIZURE IS HERE. This is called an aura, or partial seizure. My symptoms involve feeling spaced out while my thoughts spin out of control, referred to as forced thinking. Then I feel nauseated, sometimes full of dread. Sometimes I get a sense of déjà vu as well, just to change things up. I also stop being able to spell or string words together in a sentence.

I can never control whether I’m with-it enough to lie down somewhere or tell someone what’s going on. In the latter case especially, I often can’t push words out of my mouth. Sometimes I wave my hands in distress. Sometimes I run to the nearest bathroom, convinced I’m about to throw up (I never do). Sometimes a full seizure follows, and sometimes it doesn’t. An aura by itself is not uncommon. Afterward, I might feel anywhere from “Well, that was annoying. Who’s up for coffee?” to “I’m going to bed, wake me up next month.”

No one knows how the medication works, or if it’ll work for you.
That is not an exaggeration. You know what seizure medication is? “Hey, we gave this pill to sufferers of Disease X. The Disease X patients who also have epilepsy stopped having seizures while on this pill. This pill is now an epilepsy drug!”

You probably don’t have Disease X. You probably don’t need treatment for Disease X, or any of the horrible side effects that come with it. Too bad! There is no medication specifically targeted to treat epilepsy. There’s just a huge swath of these “Disease X and also seizures” meds that you get to Russian roulette your way through until you find one—or a combination—that stop your seizures without killing you.

Again, not an exaggeration. The first medicine I tried made me suicidal. The second gave me a serious allergic reaction. I was damn lucky to wind up unscathed on Pill #3, but this one has a reputation for a wee bit of severe liver damage. I have to get my blood tested twice a year to make sure my liver isn’t, you know, disintegrating.

But, no more full seizures. It’s a trade-off I learn to accept.

Some people never find a drug that works for them. Depending on how badly epilepsy affects them, surgery might be the next option. It’s no more complicated than cutting away the part of brain in which the seizures occur. Yay?

Oh- and never miss a dose. That in itself can trigger a seizure.

There are odd things you can’t do anymore.
If you don’t have an aura, you’re often prohibited from driving. You’re not allowed to skydive. You may or may not be able to donate blood anymore—not just because of the medication in your blood, but also because those medicine levels drop when you give blood, which itself can result in a seizure.

Due to the medicine(s) you’re on, you may have other weird prohibitions. I can’t eat grapefruit or starfruit, for instance. Also, alcohol has a completely random effect: either it doesn’t touch me at all, or it puts me right to sleep.

Being on chronic medication means you always have to worry about how much medicine you have on hand, and when to harass your neurologists for prescription refills. A bad neurologist might never return your calls. Then you run out of meds, have a seizure, and back to the ER you go! (Yes, this happened to me. A good neurologist is hard to find, but invaluable.) When you travel, you must remember to pack your pills and a note from your neuro. Yes, Mr. TSA Agent, I’m allowed to have these. Really, who’d be taking this stuff for fun?

You feel like it’s your fault.
Because no one really knows what’s going on inside your head, why it started, or how to make it stop, it’s tempting to look for your own answers. It could be my fault. There might be something I did or am still doing that led to all this. I may never know, which can be really frustrating sometimes.

Google things like neuroplasticity, and it sure seems like it should be possible to rejigger your brain somehow so the seizures vanish without medication or surgery. You begin to feel like there’s something you’re not doing that you should be doing. What could it be? “What if I avoid stress and caffeine from now on? That ought to stop the seizures from triggering!”

So you experiment a little, cross your fingers … then you have another seizure, and you feel like a failure who places an unfair burden on everyone you care about. I feel like I have it easier than my loved ones, who have to watch it happen or be prepared to rush home at a moment’s notice because I feel an aura coming on.

What to do for someone having a seizure:
There are a lot of first-aid sites that cover this better, but here are a few general points:

  • If the sufferer is thrashing, don’t restrain them. Just make sure they don’t bump into anything.
  • Don’t stick anything in their mouth.
  • When the seizure is over, turn them on their side (if you can) to open airways.
  • A seizure does not automatically necessitate a trip to the hospital. If the person has a known seizure condition they’re already being treated for, it may be OK for them to stay home. See if there are family or friends nearby who can confirm. When in doubt, call an ambulance.
  • Check for medical IDs that the EMTs can look at when they arrive. It’s important for them to know what medication(s) they’re currently taking, and if they have any allergies.
  • As they’re coming around, be calm and reassuring. They probably have no idea who they are, or why they’re on the ground feeling like crap. When it hits them, they might be accepting, or they might freak out. Again, let them know they’re OK.

This post was written by Ellis Morning and originally appeared here. Reposted here with permission. Ellis is a writer from Pittsburgh, PA. Check out more of her work at her website, www.ellismorning.com.

via Things I Wish Everyone Knew About Epilepsy | MyEpilepsyTeam

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[WEB PAGE] Mozart may reduce seizure frequency in people with epilepsy

June 10, 2020. Source: University Health Network

Summary

A new clinical research study has found that a Mozart composition may reduce seizure frequency in patients with epilepsy.

A new clinical research study by Dr. Marjan Rafiee and Dr. Taufik Valiante of the Krembil Brain Institute at Toronto Western Hospital, part of University Health Network, has found that a Mozart composition may reduce seizure frequency in patients with epilepsy.

The results of the research study, “The Rhyme and Rhythm of Music in Epilepsy,” was recently published in the international journal Epilepsia Open. It looks at the effects of the Mozart melody, “Sonata for Two Pianos in D Major, K. 448” on reducing seizures, as compared to another auditory stimulus — a scrambled version of the original Mozart composition, with similar mathematical features, but shuffled randomly and lacking any rhythmicity.

“In the past 15 to 20 years, we have learned a lot about how listening to one of Mozart’s compositions in individuals with epilepsy appears to demonstrate a reduction in seizure frequency,” says Dr. Marjan Rafiee, lead author on the study. “But, one of the questions that still needed to be answered was whether individuals would show a similar reduction in seizure frequency by listening to another auditory stimulus — a control piece — as compared to Mozart.”

The researchers recruited 13 patients to participate in the novel, year-long study. After three months of a baseline period, half of the patients listened to Mozart’s Sonata once daily for three months, then switched to the scrambled version for three months. The others started the intervention by listening to the scrambled version for three months, then switched to daily listening of Mozart.

Patients kept “seizure diaries” to document their seizure frequency during the intervention. Their medications were kept unchanged during the course of the study.

“Our results showed daily listening to the first movement of Mozart K.448 was associated with reducing seizure frequency in adult individuals with epilepsy,” says Dr. Rafiee. “This suggests that daily Mozart listening may be considered as a supplemental therapeutic option to reduce seizures in individuals with epilepsy.”

Epilepsy is the most common serious neurological disorder in the world, affecting approximately 300,000 Canadians and 50 million people worldwide.

Many experience debilitating seizures. The treatment is often one or more anti-seizure medications. But for 30 per cent of patients, the medications are not effective in controlling their seizures.

“As a surgeon, I have the pleasure of seeing individuals benefit from surgery, however I also know well those individuals for whom surgery is not an option, or those who have not benefitted from surgery, so, we are always looking for ways to improve symptom control, and improve quality of life for those with epilepsy,” says Dr. Taufik Valiante, senior author of the study and the Director of the Surgical Epilepsy Program at Krembil Brain Institute at UHN and co-Director of CRANIA.

“Like all research, ours raises a lot of questions that we are excited to continue to answer with further research and support from the epilepsy community.”

While these results are promising, the next step is to conduct larger studies with more patients, over a longer period of time.


Story Source:

Materials provided by University Health NetworkNote: Content may be edited for style and length.


Journal Reference:

  1. Marjan Rafiee, Kramay Patel, David M. Groppe, Danielle M. Andrade, Eduard Bercovici, Esther Bui, Peter L. Carlen, Aylin Reid, Peter Tai, Donald Weaver, Richard Wennberg, Taufik A. Valiante. Daily listening to Mozart reduces seizures in individuals with epilepsy: A randomized control studyEpilepsia Open, 2020; 5 (2): 285 DOI: 10.1002/epi4.12400

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[Abstract] Epilepsy after severe traumatic brain injury: frequency and injury severity

ABSTRACT

Objective

To estimate national frequency of posttraumatic epilepsy (PTE) after severe traumatic brain injury (TBI) and assess injury severity (Glasgow Coma Scale (GCS) and posttraumatic amnesia (PTA)) as prognostic factors for PTE.

Methods

Data on patients ≥18 years surviving severe TBI 2004–2016 were retrieved from the Danish Head Trauma Database (n = 1010). The cumulative incidence proportion (CIP) was estimated using death as competing event. The association between injury severity and PTE was assessed using multivariable competing risk regressions.

Results

CIP of PTE 28 days and one year post-TBI was 6.8% (95% confidence interval (CI) 5.4–8.5) and 18.5% (95% CI 16.1–21.1%), respectively. Injury severity was not associated with PTE within 28 days post-TBI but indicated higher PTE-rates in less severely injured patients. PTA-duration >70 days was associated with PTE 29–365 days post-TBI (Adjusted sub-hazard ratio 4.23 (95% CI 1.79–9.99)). GCS was not associated with PTE 29–365 days post-TBI.

Conclusion

The PTE frequency was higher compared to previous estimates. Increasing injury severity was associated with PTE 29–365 days post-TBI when measured with PTA, but not with GCS. Though nonsignificant, the increased PTE-risk within 28 days in lower severity suggests an underdiagnosing of PTE.

Source: https://www.tandfonline.com/doi/abs/10.1080/02699052.2020.1763467

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[WEB SITE] Epilepsy – The Path to Diagnosis – MyEpilepsyTeam

Article written by Kelly Crumrin

Epilepsy can be difficult to diagnose, in part because doctors rarely witness seizures firsthand. Epilepsy can also be challenging to distinguish from other conditions, including meningitis, schizophrenia, migraines, sleep disorders, heart problems, multiple sclerosis (MS), attention deficit hyperactivity disorder (ADHD), and transient ischemic attacks – temporary low blood flow to part of the brain, sometimes called a “mini-stroke.” It is possible to have one or more of these conditions in addition to epilepsy, further complicating diagnosis.

It is also important to note that not all seizures are caused by epilepsy. Epilepsy is defined as a neurological disorder that involves recurrent seizures caused by abnormal electrical activity in the brain. Nonepileptic seizures do not originate from abnormal electrical activity and may require different treatment than epileptic seizures.

Typically, a neurologist diagnoses epilepsy, but it may also be diagnosed by a pediatrician, emergency room physician, or general practitioner.

How is epilepsy diagnosed?

There is no single test to diagnose epilepsy. Instead, the doctor will consider your medical history and may perform a variety of diagnostic tests.

Medical history

The doctor will take a thorough history, asking detailed questions about what happens during seizures, how long they last, and how often they occur. The physician may ask about a history of head injuries, infections, or other neurological symptoms. The doctor will likely ask about family history of seizures. A clear picture may emerge from the medical history to help the doctor assess risk factors that strengthen the suspicion of epilepsy or rule out other conditions.

Electroencephalography (EEG)

EEG is a test that visualizes brainwaves to monitor seizure activity. For an EEG, the technologist will place electrodes on your scalp. The electrodes pick up the tiny electrical charges resulting from brain activity. Most EEGs take one to one-and-a-half hours to set up and complete the test. Receiving an EEG is painless and cannot harm you.

About half of EEGs performed on people who have seizures produce normal results. Even if you have frequent seizures, your EEG may be normal if you are not having a seizure during the test. You may be asked to rapidly blink your eyes, stare at blinking lights, or breathe deeply for several minutes to provoke seizure activity.

Ambulatory EEGs record brainwaves for a longer period of time, usually 24 hours or three days, to increase the chances of recording seizure activity. Ambulatory EEGs may be performed at home, at an outpatient clinic, or as an inpatient at a hospital.

During a video EEG, video and audio of your movement, behavior, and sounds are recorded along with brainwave patterns. Video EEGs allow the neurologist to see what is happening in your brain during specific seizure behavior. Video EEGs can be done on an inpatient or outpatient basis.

When EEGs do capture seizure activity, they are very valuable tools. Some brainwave patterns are distinctive indicators of certain types of epilepsytypes of seizures, or other neurological disorders. Sometimes, EEG results can even indicate where in the brain the seizures originate.

If your EEG results are normal, it is not conclusive whether or not you have epilepsy. Further tests will be performed.

Brain imaging

Imaging tests are performed to evaluate brain function and structure. The most common neuroimaging procedures are magnetic resonance imaging (MRI) and computed tomography (CT or sometimes CAT) scans. Neuroimaging scans can detect potential causes of seizures including tumors, scar tissue, abnormal blood vessel formations, or hydrocephalus (an excess of spinal fluid).

Other tests

Blood or saliva tests may be ordered to check for genetic causes of epilepsy.

Some people with epilepsy may have speech or auditory processing problems, so tests may be performed to measure processing ability. Assessment tests may be performed by audiologists (hearing specialists) or speech and language pathologists.

The doctor may order a test to quantify cognitive (related to thinking, memory, and reasoning) abilities in relation to normal or abnormal brain structures. Cognitive assessments may be performed by doctors, psychologists, educators, or other specialists.

What is the prognosis for epilepsy?

Roughly 60 percent of people diagnosed with epilepsy who receive appropriate treatment will become seizure-free within a few years. Some people never have another seizure, while others have sporadic seizures or uncontrolled seizures despite being on anti-epileptic drugs (AEDs).

What is remission?

Some doctors define remission from epilepsy as 10 years without having a seizure, and being off of AEDs for the past five years. Other doctors consider someone in remission after two years without seizures (the last year off AEDS), or five years without seizures (the last two off AEDs). The chances for remission are higher if the cause of epilepsy is unknown, seizures are few and far between, seizures are responsive to AEDs, and there are no underlying neurological problems.

Age at diagnosis

The age at which a person receives an epilepsy diagnosis varies widely and is often correlated to the cause of epilepsy. Some forms of epilepsy, especially those that are caused by birth trauma or a genetic mutation, are diagnosed in infancy or early childhood. Other types of epilepsy don’t develop until adolescence or adulthood.

Resources

External resources

MyEpilepsyTeam resources

FAQ

Is it possible to have seizures without having epilepsy?

Yes, it is possible to have seizures that are not caused by epilepsy. Nonepileptic seizures can look and feel like epileptic seizures, but they do not involve abnormal electrical activity in the brain. Nonepileptic seizures can have several different causes. Febrile seizures, caused by high fever, are very common in children. Another type of nonepileptic seizure is the psychogenic seizure. Psychogenic seizures are caused by psychological stress, sometimes related to an anxiety disorder. Nonepileptic seizures can also be caused by heart problems and metabolic conditions such as diabetes. Women are at a higher risk for nonepileptic seizures. It is possible for someone who has epilepsy to experience one or more nonepileptic seizures.

Kelly leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here.

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