Posts Tagged seizures

[WEB SITE] Driving and Epilepsy: Issues to Discuss With Your Patients

epilepsy, driving

Dr Sanchez is Assistant Professor and Dr Krumholz is Professor Emeritus, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD.

Worldwide there are more than 65 million individuals with epilepsy.1In the US because driving an automobile is such an important aspect of our culture, driving restriction is an enormous problem for many of these individuals and their families. Indeed, surveys find individuals with epilepsy report driving as a major concern.2 Physicians and other medical providers play an important role educating and counseling people with seizures and their families regarding driving. Here, we provide some background and guidance regarding this issue.

Individuals with seizures are restricted from driving because of concerns that a seizure while driving might result in loss of control of the vehicle and a crash, potentially injuring the driver or others, and damaging property. Tragically, such crashes cause fatalities.3 Therefore every state in the US restricts some individuals with epilepsy from driving. Driving restrictions vary by state and are ultimately determined by the Department of Motor Vehicles (DMV).4 Physicians and other medical providers are involved to varying degrees throughout this process of driving regulation and restriction. They serve as advisers to patients, with a duty to inform patients regarding rules and regulations as well as consultants to state regulatory authorities.

To properly counsel patents, it is important that physicians and other medical providers are familiar with the rules governing driving for patients with seizure disorders. Our recommended approach to counseling patients with seizures and epilepsy regarding driving is illustrated in some of the following examples and discussion.

Case example
A 23-year-old woman presents to your office with new-onset seizures. She generally feels well, has no other relevant history, and her examination is normal. Brain MRI with and without contrast and EEG were performed and were normal.

Question: As the medical provider, how would you counsel this patient regarding driving after her first unprovoked seizure (a seizure not related to an acute precipitating cause)?

Answer: She should be informed that a seizure while driving could be dangerous and result in a motor vehicle crash. Since she has had a seizure, she is at risk for further seizures. Regulations exist in an effort to prevent injury, death, or property damage that might result if a seizure were to occur while driving. She should be informed to stop driving and that patients are required by law to report their seizures to the DMV in their state. In some states, physicians and other medical providers are also required to report (Table 1) that a patient has had a seizure.4 The DMV will determine when she may resume driving.

A seizure-free interval is typically necessary for the DMV to approve a person to drive after a first seizure, this too varies by state. The typically required seizure-free interval may be as short as three months to as long as one year.4 There may be positive or negative modifiers that shorten or lengthen the seizure-free interval (Table 2).5 Antiseizure medication (ASM) is not always prescribed after a first seizure; this is a variable that may be considered on a case by case basis.6

After reporting her seizures to the DMV, the patient and the medical provider are required to complete paperwork regarding the condition. A medical advisory board or similar type of state review will consider the case and make recommendations. Then a final decision regarding any driving restrictions will be made by the DMV. Decisions may be appealed by the patient.


via Driving and Epilepsy: Issues to Discuss With Your Patients | Neurology Times

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[BOOK] Seizures – Open access peer-reviewed Edited volume


Humberto Foyaca Sibat

Edited by Humberto Foyaca Sibat

Walter Sisulu University, Nelson Mandela Academic hospital

This book contains selected peer-reviewed articles that cover novel information on epileptic seizure and psychogenic non-epileptic seizures written by international researchers. In this book, we discuss self-reporting technologies for supporting epilepsy treatment. We also discuss about the diagnostic testing in epilepsy genetic clinical practice. Clinical aspects related to diagnosis in patients presenting psychogenic non-epileptic seizures vs. epileptic seizures and neurocysticercosis are discussed as well. We delivered novel aspects about the treatment for pseudoseizures. In another chapter, the authors estimated the prevalence of ischemic stroke in epileptic patients presenting subarachnoid neurocysticercosis and ischemic stroke frequency among HIV-positive patients, and finally other authors discuss autoimmune epilepsy, its new development, and its future directions. We are looking forward with confidence and pride to the remarkable role that this book will play for a new vision and mission.



SeizuresEdited by Humberto Foyaca Sibat
Published: May 2nd 2018

DOI: 10.5772/65137

ISBN: 978-1-78923-005-5

Print ISBN: 978-1-78923-004-8

Chapters Downloads

Open access peer-reviewed

1. Introductory Chapter: Seizures and Its Historical Background

By Humberto Foyaca-Sibat and Lourdes de Fátima Ibañez-Valdés


Open access peer-reviewed

2. Autoimmune Epilepsy: New Development and Future Directions

By Sandra Orozco-Suarez, Angélica Vega-Garcia, Iris Feria-Romero, Lourdes Arriaga-Pizano, Emmanuel Rodriguez-Chavez and Israel Grijalva


Open access peer-reviewed

3. Diagnostic Testing in Epilepsy Genetics Clinical Practice

By Birute Tumiene, Algirdas Utkus, Vaidutis Kučinskas, Aleš Maver and Borut Peterlin


Open access peer-reviewed

4. Self-Reporting Technologies for Supporting Epilepsy Treatment

By Jonathan Bidwell, Eliana Kovich, Cam Escoffery, Cherise Frazier and Elizabeth D. Mynatt


Open access peer-reviewed

5. Psychogenic Nonepileptic Seizures in Patients Living with Neurocysticercosis

By Lourdes de Fátima Ibañez-Valdés and Humberto Foyaca-Sibat


Open access peer-reviewed

6. Treatment and Diagnosis of Psychogenic Nonepileptic Seizures

By Cicek Hocaoglu


Open access peer-reviewed

7. Subarachnoid Cysticercosis and Ischaemic Stroke in Epileptic Patients

By Humberto Foyaca-Sibat and Lourdes de Fátima Ibañez-Valdés

via Seizures | IntechOpen

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[WEB SITE] List of Seizures (Convulsions) Medications (60 Compared) –

Medications for Seizures (Convulsions)

Other names: Absence Seizure; Complex Partial Seizure; Fits

About Seizures:  A seizure or convulsion can be a sudden, violent, uncontrollable contraction of a group of muscles. A seizure can also be more subtle, consisting of only a brief “loss of contact” or a few moments of what appears to be daydreaming.


Drugs Used to Treat Seizures

The following list of medications are in some way related to, or used in the treatment of this condition.[…]

For the list of medications, Visit Site —> List of Seizures (Convulsions) Medications (60 Compared) –

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[WEB SITE] This incredible smart band can help detect seizures when worn by people with epilepsy

Syndicate Post image

A seizure-detecting smart band could help people with epilepsy notify their caregivers in the event of an emergency.

Embrace, a smart band created by Empatica, uses advanced machine learning (AI) to monitor seizures, collecting physiological data from users to try to detect unusual events such as convulsive seizures.

The Embrace band is paired to a smartphone or iPod via Bluetooth connection and works in tandem with the Alert app, which sends SMS and phone call alerts to selected caregivers when a seizure is detected.

Embrace will send a command to the Alert app when it detects a seizure (Empatica)

Empatica CEO Matteo Lai said: “Embrace is a Medical Grade device in Europe and the only FDA-cleared seizure monitoring smart watch, which uses AI to monitor for the most dangerous kinds of seizures, known as ‘grand mal’ or ‘generalized tonic-clonic’ seizures, and send an alert to summon caregivers’ help.

“Embrace stands apart from any seizure detection system in that it measures multiple indicators of a seizure.

“Its unique property is its use of Electrodermal Activity, a signal used by stress researchers to quantify physiological changes related to sympathetic nervous system activity, also known as the ‘fight or flight’ response.”

When Embrace detects a seizure, it will send a command to the Alert app, which then sends an alert to the designated caregiver.

“Users can add caregivers who are notified in real time with a phone call and an SMS containing the wearer’s GPS location.

Lai said: “There is also another product that works with Embrace, a diary app called Mate, where the caregiver can monitor sleep and physical activity for patients wearing Embrace.

“The Mate app displays the seizures automatically detected by the Embrace and patients can also insert other, non-convulsive seizures that aren’t automatically detected.”

Embrace costs £177 (Empatica)

Morgan, a user of Embrace, said: “I purchased the Embrace mostly because my seizures have all happened during my sleep.

“I also purchased it so that I could regain a lot of the confidence that I lost once I was diagnosed with epilepsy.

“On November 6th 2016, I had a seizure(s) that lasted over 40 minutes. The Embrace detected the seizures and my emergency contacts were notified… I believe the Embrace saved my life. It helps give peace of mind to me, as well as my friends and family.

“Having the Embrace has also helped me regain the confidence to start being active again.”

Embrace costs 249 US dollars (£177), and is available from the Empatica website.


via This incredible smart band can help detect seizures when worn by people with epilepsy – Evening Express

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[Abstract] The management of epilepsy in children and adults.

The International League Against Epilepsy has recently published a new classification of epileptic seizures and epilepsies to reflect the major scientific advances in our understanding of the epilepsies since the last formal classification 28 years ago. The classification emphasises the importance of aetiology, which allows the optimisation of management. Antiepileptic drugs (AEDs) are the main approach to epilepsy treatment and achieve seizure freedom in about two-thirds of patients. More than 15 second generation AEDs have been introduced since the 1990s, expanding opportunities to tailor treatment for each patient. However, they have not substantially altered the overall seizure-free outcomes. Epilepsy surgery is the most effective treatment for drug-resistant focal epilepsy and should be considered as soon as appropriate trials of two AEDs have failed. The success of epilepsy surgery is influenced by different factors, including epilepsy syndrome, presence and type of epileptogenic lesion, and duration of post-operative follow-up. For patients who are not eligible for epilepsy surgery or for whom surgery has failed, trials of alternative AEDs or other non-pharmacological therapies, such as the ketogenic diet and neurostimulation, may improve seizure control. Ongoing research into novel antiepileptic agents, improved techniques to optimise epilepsy surgery, and other non-pharmacological therapies fuel hope to reduce the proportion of individuals with uncontrolled seizures. With the plethora of gene discoveries in the epilepsies, “precision therapies” specifically targeting the molecular underpinnings are beginning to emerge and hold great promise for future therapeutic approaches.


via The management of epilepsy in children and adults. – Abstract – Europe PMC

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[WEB SITE] You have epilepsy… so what!

By Adeela Akmal


Epilepsy is not a disease, it is a disorder. People who have epilepsy are fully capable of leading a normal life. Read on to find out more…


Epilepsy is not a disease, it is a disorder. People who have epilepsy are fully capable of leading a normal life. Read on to find out more…

Epilepsy is a neurological condition that is estimated to occur in 0.5% to 1% of the population of any country. According to the Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi, one in every hundred Pakistani has epilepsy and at least 5 family members are affected in some way or the other due to it. The condition is also twice as common in rural areas as compared to the urban. Epilepsy is a sudden surge of electrical activity in the brain that causes a temporary disturbance in the messaging systems between the brain cells.

Unfortunately, the condition has been stigmatised in the country due to misinformation. Recently, a press conference was held in a bid to create awareness regarding epilepsy at Najumuddin Auditorium at Jinnah Postgraduate Medical Centre (JPMC) to squash the certain stereotypes of the disorder. According to Prof Dr Hasan Aziz, “It is a common misconception among unaware people that an epilepsy attack is a work of some ‘evil spirit’ or ‘supernatural beings’, or that person can be cured by sniffing a shoe. It is not contagious and is rarely hereditary; and it does not affect your intellectual capabilities. A person can live their life normally if they take their prescribed medicines on time, take care of their diet and sleep.”

There have been many famed personalities like Newton, Tolstoy, Socrates, Da Vinci, to our very own Abdul Sattar Edhi, Nadia Jamil and Suhaee Abro, who are epileptic.

Nadia Jamil, actress and mother of two young boys, was diagnosed with epilepsy in 2011, and has not let that get in the way of her work, “As an actress I need my body to work and as a mother I always have to be energetic. Initially, there was a sense of panic and the limitations of my body hit me, like it would for a person with asthma or diabetes. But, medications have helped me. I cook, clean, shop for groceries, ride a bicycle, work and run after my boys without fear. Epilepsy can be handled with medications and a little care in terms of lifestyle – getting proper rest and full sleep. To anyone who has epilepsy, you are not sick, there isn’t anything that you can’t accomplish. It’s not a disease, it is a condition which can be controlled if taken care,” stated Nadia Jamil while talking to this scribe.


According to National Epilepsy Centre (NEC) at JPMC, in about 70 per cent of the cases, there seems to be no obvious cause of the condition. However, for the remaining cases, strokes, brain tumours, head trauma (such as occurring during a car crash), infectious diseases (for example: AIDS), congenital abnormalities (prenatal injury, or brain damage that occurred before birth), or development disorders (such as autism or neurofibromatosis) are some of the factors that increase the risk of epilepsy.


The key symptom of epilepsy is repeated seizures. One should immediately consult a doctor if it is a recurring matter. A person may experience convulsions with no fever, short spells of blackout, fainting spells during which bowel and bladder isn’t in control. The person may do unexplainable things such as suddenly become stiff, have bouts of blinking or chewing, or do repetitive or jerking movements.


For diagnosis, a person goes through a complete physical and neurological exam, and their clinical history is taken along with a detailed account of their seizure that occurred. Additional testing may include EEG (Electroencephalogram) that detects the brain’s electrical activity.

The epileptic seizures can be controlled with antiepileptic drug (AED) therapy. The doctor will prescribe the dosage according to several factors for a particular individual like age, gender, overall health and the severity of the seizures. So, it is mandatory to take the prescribed dosage with punctuality.

In some cases, if there is an underlying brain condition that is causing these seizures, surgeries can be recommended. And, if the AEDs don’t work, the next step could be surgery.


While one is still trying to control their condition, it is imperative to take certain precautions. An epileptic person should avoid all activities that can potentially put their lives at risk like riding or driving a vehicle, working in factories (like having to operate heavy or open machinery) or heights. Anything that involves swimming, working near an open flame should be done under supervision.

There are also certain triggers that can provoke seizures in people with epilepsy like missing medications, consuming recreational drugs and alcoholic beverages, lack of sleep and other drugs that may interfere with the prescribed medicines.

What to do when someone is having a seizure?

Do not panic: If you witness someone having seizures, it’s important for you to stay calm in order to help someone.

Protect the person from potential injuries: Help keeping them from falling and gently guide them to the floor. Remove any objects or furniture that may injure the person.

Place a pillow under their head: If they are already on the ground, turn them to one side and loosen the clothing around their neck. Place something soft under their head.

Don’t force anything: Do not forcibly open or put anything in mouth (water, spoon, cloth). You may end up hurting them and yourself.

Record everything: Record the event on your device to show it to the doctor. Pay close attention to the body movement during seizure, how long it lasted, how the person reacted after and possible injuries.


via You have epilepsy… so what!

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[NEWS] Effective epilepsy medication without the side effects? | Epilepsy Research UK

Posted Mar 9 2018 in Anti-epileptic drugs


Approximately 60-70% of people with epilepsy will have their seizures controlled with medication. But even when epileptic seizures are controlled with medication the drugs used may have unpleasant, unwanted side effects. Ideally what patients and clinicians are looking for is a drug which works effectively and has no down side. Now new research from the Australian National University aims to look at the molecular level to find a way of reducing negative side effects without reducing the drug’s efficacy.  If you would like to read more about this study please click on the link here:


via Effective epilepsy medication without the side effects? | Epilepsy Research UK

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[REVIEW] Care delivery and self-management strategies for children with epilepsy – Abstract



In response to criticism that epilepsy care for children has little impact, healthcare professionals and administrators have developed various service models and strategies to address perceived inadequacies.


To assess the effects of any specialised or dedicated intervention for epilepsy versus usual care in children with epilepsy and in their families.

Search methods

We searched the Cochrane Epilepsy Group Specialized Register (27 September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 9) in the Cochrane Library, MEDLINE (1946 to 27 September 2016), Embase (1974 to 27 September 2016), PsycINFO (1887 to 27 September 2016) and CINAHL Plus (1937 to 27 September 2016). In addition, we also searched clinical trials registries for ongoing or recently completed trials, contacted experts in the field to seek information on unpublished and ongoing studies, checked the websites of epilepsy organisations and checked the reference lists of included studies.

Selection criteria

We included randomised controlled trials (RCTs), cohort studies or other prospective studies with a (matched or unmatched) control group (controlled before-and-after studies), or time series studies.

Data collection and analysis

We used standard methodological procedures expected by Cochrane.

Main results

Our review included six interventions reported through seven studies (of which five studies were designed as RCTs). They reported on different education and counselling programmes for children and parents; teenagers and parents; or children, adolescents and their parents. Each programme showed some benefits for the well-being of children with epilepsy, but all had methodological flaws (e.g. in one of the studies designed as an RCT, randomisation failed), no single programme was independently evaluated with different study samples and no interventions were sufficiently homogeneous enough to be included in a meta-analysis,.

Authors’ conclusions

While each of the programmes in this review showed some benefit to children with epilepsy, their impacts were extremely variable. No programme showed benefits across the full range of outcomes, and all studies had major methodological problems. At present there is insufficient evidence in favour of any single programme.

Plain language summary

Care delivery and self-management strategies for children with epilepsy


Epilepsy is spectrum of disorders in which a person may have seizures (fits) that are unpredictable in frequency. Most seizures are well controlled with medicines and other types of treatments, but epilepsy can cause problems in social, school and work situations, making independent living difficult. People with seizures tend to have physical problems (e.g. fractures, bruising and a slightly increased risk of sudden death) as well as social problems because of the stigma attached to the illness. People with epilepsy and their families may lack social support or experience social isolation, embarrassment, fear and discrimination, and some parents may also feel guilty. Self-management of epilepsy refers to a wide range of health behaviours and activities that a person can learn and adapt to control their seizures and improve their well-being. This approach needs a partnership between the person and the providers of services (e.g. specialist epilepsy outpatient clinics, nurse-based liaison services between family doctors and specialist hospital doctors, specialist epilepsy community teams), as well as targeted services for specific groups (e.g. children, teenagers and families).

Study characteristics

We searched scientific databases for studies in children and adolescents with epilepsy that looked at the effects of self-management of epilepsy. The results are current to September 2016. We wanted to look at several outcomes to see how well people and their families generally cope with epilepsy.

Key results

This review compared six education- or counselling-based self-management interventions for children with epilepsy. Four interventions were aimed at children and their parents; one was aimed at teenagers and their parents; and one was aimed at children, adolescents and their parents. Each of the interventions appeared to improve some of the outcomes studied, but no intervention improved all of the outcomes that were measured. The studies also had problems with their methods, which makes their results less reliable. While none of the interventions caused any harm, their impact was limited, and we cannot recommend any single intervention as being the best one for children with epilepsy.

Evidence for the best ways to care for children with epilepsy is still unclear.

Quality of the evidence

The quality of the evidence is poor because all of the studies had major problems in how they were run.


via Care delivery and self-management strategies for children with epilepsy – Fleeman – 2018 – The Cochrane Library – Wiley Online Library

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[WEB SITE] Epilepsy Drug With Marijuana-Based Ingredient Could Be Available In The US This Year

 By Allan Adamson Tech Times

A new class of epilepsy drugs based on a marijuana ingredient could be become available in the United States as early as the second half of 2018 pending approval from the Food and Drug Administration.


GW Pharmaceuticals, the maker of the drug called Epidiolex, announced on Wednesday the promising results of a clinical study of the drug.

A group of 171 individuals were randomly assigned to either receive Epidiolex treatment or placebo. The participants were between 2 and 55 years old with a condition called Lennox-Gastaut syndrome. They were also suffering from seizures existing drugs cannot efficiently control.

The participants on average had tried and discontinued use of six anti-seizure treatments and were experiencing 74 “drop” seizures per month. This particular seizure involves the entire body, head and trunk, and often leads to fall and other injuries.

LGS Patients Taking Epidiolex Sees Significant Reduction Seizures

Results of the study, which was reported in the journal Lancet,  showed that over a period of 14 weeks, 44 percent of the patients taking the drug saw significant reduction in seizures. The rate is significantly higher compared with the 22 percent in the placebo group. More of those who were given the experimental drug also experienced a 50 percent or greater reduction in drop seizures.

“LGS is one of the most difficult types of epilepsy to treat and the majority of patients do not have an adequate response to existing therapies,” said Elizabeth Thiele, from Harvard Medical School. “These results show that Epidiolex may provide clinically meaningful benefits for patients with LGS.”

Epidiolex is based on pure marijuana-derived cannabidiol or CBD. The cannabis compound has been known for its medical benefits sans making people feeling “stoned.”

Adverse Events Linked To Use Of Epidiolex

Adverse events associated with use of the drug include diarrhea, decreased appetite, sleepiness, vomiting, and fever. Once given the go-signal to be marketed in the United States, the drug is intended to be used as a prescription drug to be dispensed by doctors.

“Add-on cannabidiol is efficacious for the treatment of patients with drop seizures associated with Lennox-Gastaut syndrome and is generally well tolerated. The long-term efficacy and safety of cannabidiol is currently being assessed in the open-label extension of this trial,” investigators wrote in their report.

GW Pharmaceuticals has not yet disclosed the pricing of the drug, but Justin Gover, GW’s chief executive officer, said that the company is already in talks with health insurers about coverage.

via Epilepsy Drug With Marijuana-Based Ingredient Could Be Available In The US This Year : Health : Tech Times

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[WEB SITE] Stress Reduction May Help Reduce Epileptic Seizures

Last Updated: February 14, 2018.

Both focused attention and progressive muscle relaxation result in reductions in seizure frequency in patients with epilepsy, according to a study published online Feb. 14 in Neurology.

Sheryl R. Haut, M.D., from the Montefiore Medical Center in Bronx, N.Y., and colleagues randomized 66 adults with medication-resistant focal epilepsy to 12 weeks of either PMR with diaphragmatic breathing or control focused-attention activity with extremity movements.

The researchers found that seizure frequency was reduced from baseline in both treatment groups (PMR: 29 percent; P < 0.05; focused attention: 25 percent; P < 0.05). There was no difference between the two interventions in seizure reduction (P = 0.38), although PMR was associated with greater stress reduction compared to focused attention (P < 0.05). Daily stress was not found to predict seizures.

“These findings highlight the need for larger, individually targeted behavioral therapy trials to control seizures and improve quality of life in patients with epilepsy,” the authors write.

Abstract/Full Text (subscription or payment may be required)

via Stress Reduction May Help Reduce Epileptic Seizures –Doctors Lounge

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