National Epilepsy Day: All you want to know about managing epilepsy

National Epilepsy Day: Epilepsy is a neurological disorder in which brain activity becomes abnormal and leads to seizures. If you notice anyone who suddenly feels disoriented, lose focus for a few minutes and then feel tired post that, it could be an epileptic attack and urgent medical attention is needed for that person.

While 50 million people worldwide are affected by epilepsy, India accounts for nearly 10-20 percent (5-10 million) of the global burden of epilepsy.

On the occasion of National Epilepsy Day (November 17), Dr Rima Chaudhari, Consultant-Neurology, Fortis Hospital, Mulund, shares facts about this noncommunicable disease of the brain and ways to manage it.

"In an epileptic condition, the abnormal and excessive electrical activity of the brain causes seizures, unusual behavior, sensations, and sometimes loss of awareness. Some people simply stare blankly for a few seconds during a seizure, while some get repeated twitching of arms or legs. Having a single seizure doesn't necessarily mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis, says Dr Chaudhari.

During a seizure, awareness and responsiveness are impaired and people who have them usually don't realize what's happening to them. There is no warning before a seizure, and the person is completely alert immediately afterward, according to Dr Chaudhari.

A common condition in children

Epilepsy is commonly diagnosed in children and can be confused with other conditions. An accurate diagnosis is essential. Seizures usually respond well to medication and most children with epilepsy will enjoy a normal and active childhood.

"Get proper sleep, avoid triggers and take medicines on time to avoid seizures. The impact of epilepsy will vary for every person. Remember to keep a balance between protecting your loved one and encouraging their independence," says Dr Chaudhari.

Difference between focal and generalized seizures

Epileptic seizures can be either be focal or generalized depending on where the abormal brain activity begins. When the seizure occurs only in one area of your brain, it is called focal seizure. Focal seizures without loss of consciousness may alter emotions or sensations transiently, lead to involuntary jerking or tingling in a body part, dizziness, or flashing lights. In another type of focal seizures there is impaired awareness and the affected person may stare into space or not respond normally or perform repetitive movements such as hand rubbing, chewing, swallowing, or walking in circles

Generalized seizures on the other hand involve all areas of the brain.

* Absence seizures are characterized by transient staring into space or subtle body movements such as eye blinking or lip-smacking while tonic seizures cause stiffening of muscles and may cause fall to the ground

* Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause a fall.

* Clonic seizures are associated with repeated or rhythmic, jerking muscle movements of the neck, face, and arms.

* Myoclonic seizures usually appear as sudden brief jerks or twitches of arms and legs.

* Tonic-Clonic seizures are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening, shaking, and sometimes loss of bladder control or biting of the tongue

Epilepsy management: Things to remember

* Epilepsy is a controllable condition

* Epilepsy is not a mental illness

* If you witness an attack, note the details as an accurate description prevents the wrong diagnosis.

* Early treatment is key

* The drugs prescribed have to be taken regularly. Do not miss any dose.

* The duration of treatment generally is 2 to 5 years after the last attack

* Restrictions for a person with epilepsy are very few. Make sure to sleep adequately. Patients can study, work and enjoy life

* Women with epilepsy can marry and bear children

* Treat epilepsy as you would treat asthma, headaches. Do not overprotect nor ostracise.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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Abnormal calcium levels in mitochondria may cause neuronal cell death in Alzheimer's disease

For the first time, using a mouse model of Alzheimer's disease, scientists have documented a link between raised levels of calcium in mitochondria and neuronal death in the living brain.

This relationship was previously documented in cell culture, but seeing this phenomenon in living mice makes it more likely that this occurs in people also and could point to a new target for Alzheimer's disease.

We were able to show mitochondrial calcium dysregulation in the neurons of living mice with Alzheimer's-like symptoms using cutting edge live imaging techniques."

Maria Calvo-Rodriguez, PhD, Study Lead Author, Department of Neurology at Massachusetts General Hospital.

One of the defining hallmarks of Alzheimer's disease is the deposition of amyloid beta plaques and loss of neurons. The accumulation of amyloid beta has long been thought to be a trigger of the disease, but the exact means by which neurons die in Alzheimer's remain a mystery, and the amyloid beta theory has become controversial because so many drug candidates targeting amyloid beta have failed in clinical trials.

One of the effects of amyloid beta plaques is that they cause high calcium ion (Ca2+) levels in the brain cells. There is also evidence that, at least in cell culture, exposure to amyloid beta can raise Ca2+ levels within mitochondria and lead to neuronal death.

Mitochondria influence Ca2+ signaling inside neurons through the "mitochondrial calcium uniporter" that takes up Ca2+ into mitochondria. The investigation of this mechanism in living mice has been hampered by the lack of technologies sensitive enough to directly assess Ca2+ levels in mitochondria in the living brain.

To explore the relationship between Ca2+, mitochondria and neuronal death, Calvo-Rodriguez and her colleagues combined multiphoton-microscopy with a ratiometric Ca2+ indicator targeted to mitochondria to asses Ca2+ levels. They applied these technologies to examine the neurons of a transgenic mouse model of Alzheimer's disease that develops amyloid plaques similar to those from human patients.

Their studies demonstrate that increased mitochondrial Ca2+ levels are associated with plaque deposition and neuronal death in this model, indicating that abnormal Ca²⁺ levels in mitochondria could play a role in neuronal cell death in Alzheimer's disease.

Additionally, they observed that when soluble Aβ is applied to the healthy mouse brain Ca2+ concentration in mitochondria increases. That process can be prevented by blockage of the mitochondrial calcium uniporter with a drug. Soluble amyloid beta is a type of amyloid beta similar to that in the human Alzheimer's brain.

"High calcium levels in the mitochondria cause oxidative stress, and the death of neurons via apoptosis," says Calvo-Rodriguez. "We propose that by blocking the neuronal mitochondrial calcium uniporter we can prevent cell death and impact disease progression." Their work suggests targeting calcium entry to the mitochondria could be a promising new therapeutic approach in Alzheimer's disease.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Proning' Is a Promising Treatment for Coronavirus—Here's How It Works

Some doctors on the frontlines of the coronavirus pandemic are having success treating COVID-19 patients with a simple technique called 'proning.' The term basically means putting a patient in the prone position, or "flat on their belly with their chest and face down, rather than on their back,” Jack Stewart, MD, a pulmonologist with St. Joseph Hospital in Orange County, California, tells Health.

Proning requires little or no equipment, and the technique may prove to help patients who are critically ill avoid being put on ventilators for breathing assistance.

Why does proning work? Flipping a patient on their stomach helps respiration because “oxygenation (getting more oxygen into the blood) is easier in the prone position," says Dr. Stewart. It's a function of anatomy, as the human body has more lung tissue in the back of the body than in the front. The coronavirus causes abnormal fluids and secretions to pool toward the back, where there's more lung tissue, and leads to greater interference with lung function.

“When a patient is in the prone position, gravity helps the secretions move downward, so more of the ‘good’ lung is on top and therefore less affected,” Harry Peled, MD, a medical director in critical care at St. Jude Medical Center in Fullerton, California, tells Health. 

Proning is also an effective treatment for a condition called acute respiratory distress syndrome (ARDS), a life-threatening complication of coronavirus infection that manifests as shortness of breath and quickly progresses. A study published last month in JAMA Internal Medicine suggests that more than 40% of individuals in the study hospitalized for severe and critical COVID-19 developed ARDS—and over 50% of those diagnosed died from the disease.

ARDS poses a risk to patients who have influenza, pneumonia, and pulmonary edema (fluid in the lungs from heart disease) as well. “Proning has been used to treat ARDS for a number of years,” says Dr. Stewart. A 2013 study by French doctors published in the New England Journal of Medicine found that patients suffering from ARDS had a lower risk of death if prone positioning was used in the hospital early on. 

Further research on how proning affects coronavirus patients is needed, but anecdotal evidence shows the effectiveness of the treatment since the global pandemic began.

In the US, a coronavirus patient at Long Island Jewish Hospital managed to avoid needing life support after being put in the prone position, CNN reported. In the UK, a 50-year-old woman with COVID-19 pneumonia who doctors were convinced only had a “couple of hours” to live made a remarkable recovery after medics turned her onto her belly, according to an article written by the patient’s husband for The Times. 

Proning isn’t just being used for patients in critical condition. In fact, new guidance from the UK’s Intensive Care Society, written by doctors and nurses who specialize in intensive care and respiratory medicine, says the technique can reduce the need for invasive ventilation and the chance of death for conscious COVID-19 patients before they reach intensive care.

“Prone positioning is a simple intervention that can be done in most circumstances, is compatible with all forms of basic respiratory support, and requires little or no equipment in the conscious patient,” states the new guidance. However, the technique is not suitable for all patients, such as morbidly obese people, pregnant women or those with facial injuries.

A team at Rush University Medical Center in Chicago is currently conducting a clinical trial to establish whether the prone position is helpful for COVID-19 patients who are not so sick that they need a ventilator to breathe for them, but sick enough to require supplemental oxygen delivered through a tube in their nose.

Proning does come with some risks, such as pressure sores and dislodging of an endotracheal tube (a flexible plastic tube placed through the mouth and inserted into the windpipe to help a patient breathe), says Dr. Peled. The greatest risk is difficulty performing CPR if a patient goes into cardiac arrest. “It’s crucial to have a highly trained team and organized approach to ensure the procedure is performed safely and efficiently,” he adds.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

 

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
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