Epilepsy 
 
Epilepsy is caused by surges of electrical activity

Epilepsy is a common neurological disorder which causes seizures. 

One in 133 people in the UK has epilepsy, and at any one time 300,000 have an active form of the condition. 

What causes epilepsy? 

An epileptic seizure is caused by over-activity of the brain cells, which produces a surge of electricity. 

This may be due to a variety of factors, such as brain damage from birth injuries, head injury, stroke, brain tumours and alcoholism. 

There is some evidence to suggest the condition sometimes has a genetic basis - although it is rare for it to run in families. 

In many instances, the cause of the condition is a mystery. 

Are there different types of seizure? 

Yes. Essentially, there are two types. 

A partial seizure begins in one specific part of the brain, and may spread to other areas. 

A generalised seizure can start in both sides of the brain at once. 

Partial seizures: 

Simple partial seizure - Confined to one particular area of the brain. The person retains consciousness, but may be fearful, and experience a strong sense of deja vu. Symptoms include jerking of an arm and an unpleasant taste in the mouth. 

Complex partial seizure - The electrical disturbance spreads, disrupting consciousness. The person may interact with the surroundings, but be unaware of what they are doing and have no recollection of the event. 

Symptoms may include repeatedly chewing, swallowing or scratching. Afterwards the person is likely to be confused for some minutes.

Generalised seizures: 

Tonic clonic seizure - This leads to 'grand mal' convulsions in which the person loses consciousness, falls to the ground, becomes stiff and shakes. 

In some instances a tonic clonic seizure may occur after an initial partial seizure - in which case the person may have some warning of what is about to occur. 

Absence attack - A blank spell lasting a matter of seconds from which recovery is almost immediate. 

Myoclonic seizures - Jerks caused by a sudden contraction of the muscles. Can affect the whole body usually restricted to one or both arms and sometimes the head. 

Tonic seizures - All the muscles contract. The body stiffens and the person will fall over if unsupported. 

Atonic seizures - All muscle tone is lost and the person simply drops to the ground.

How is epilepsy treated? 

There are a wide range of anti-epileptic drugs to prevent seizures. 

Which drug is prescribed will depend on the individual patient, and their particular form of epilepsy. 

The drugs are effective, but can have side effects, including drowsiness and dizziness. 

Some drugs may produce longer term side effects, such as acne and weight gain. 

Anti-epileptic drugs should not be taken in tandem with some other medications. They may also slightly increase the risk of malformations if taken during pregnancy. 

Is surgery an option? 

Yes, for people who do not respond to drug treatment. 

The most common form of surgical treatment is to remove the hippocampus - a part of the brain involved in memory which is particularly vulnerable to damage. 

Other forms of surgery which may be considered include: 
Temporal lobectomy - a larger part of the temporal lobe is removed. 
Sub-pial resection - fine cuts are made in the motor areas of the brain. 
Hemispherectomy - the removal of the whole of one side of the brain 
Corpus callosotomy - cutting the fibres that connect the two halves of the brain.

An alternative to neurosurgery is a treatment called vagal nerve stimulation in which a pacemaker device is placed under the skin to stimulate the vagus nerve in the neck. 

This form of treatment does not usually cure the epilepsy, but can reduce seizure frequency and severity. 

 
'Drink link' to premature birth 

Doctors say women who drink heavily early in a pregnancy - possibly before they know they are pregnant - may be raising the risk of premature delivery. 

A study of 4,719 Australian women found almost an 80% higher risk for women who drank heavily in the first third of pregnancy, then stopped. 

However, experts warned it was possible the results were a "statistical quirk". 

The BJOG journal study found no evidence of problems for women who drank low levels throughout pregnancy. 

The subject of alcohol and pregnancy has been controversial, with some guidelines advocating no alcohol intake, while other specialists believe that drinking small amounts is unlikely to harm the developing child. 

The latest study suggests that the period during which binge or heavy drinking can have the greatest effect is during the first trimester. 

With as many as 40% of pregnancies unplanned, this may include several weeks in which the woman is unaware she is carrying a child. 

Unusually, the strongest link between alcohol use and early birth was for women who drank moderately or heavily - several units of alcohol or more a week - during the first trimester, but then stopped completely for the rest of the pregnancy. 

The researchers suggested that it was possible that the sudden cessation of alcohol drinking might provoke inflammation which could harm the developing foetus in some way, although this idea was not tested during the study. 

Caution urged 

Dr Colleen O'Leary, from the University of Western Australia, who led the study, said: "The risk of pre-term birth is highest for women who drink heavily or at binge levels. 

"Women should be advised that during pregnancy, drinking alcohol above low levels increases the risk to the baby and that the safest choice is not to drink alcohol during pregnancy." 

The editor of the British Journal of Obstetrics and Gynaecology, Professor Phillip Steer, said the study represented a warning to women. 

He said: "When you consider the number of pregnancies which are not planned, it is quite possible that by the time a woman realises she is pregnant, it is too late and the damage has been done." 

However, Professor Andrew Shennan, representing baby charity Tommy's, said that the results needed to be interpreted cautiously. 

"It is still possible that, given the relatively small number of women involved, this finding could be a statistical quirk. 

"More research needs to be done to ascertain the true extent of the risk posed by drinking alcohol during pregnancy. 

"This is a controversial area with many conflicting results and recommendations about what is deemed a 'safe' level of alcohol consumption." 

However, he said that a precautionary approach was still sensible for women who might fall pregnant. 

"Now that you can buy kits which can tell you whether you are pregnant before you have even missed a period, perhaps women who binge drink should take advantage of these." 
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7839671.stm

Published: 2009/01/21 00:11:43 GMT

© BBC MMIX

Autistic traits 'spread widely' 
 
Autism is more often diagnosed in boys


Many children have mild autistic "symptoms" without ever having enough problems to attract specialist attention, say UK researchers. 

The Institute of Child Health team says diagnosed children have severe versions of character traits probably shared by millions of others. 

The 8,000 child study found even these mild traits could impair development. 

Boys - who make up the bulk of autism diagnoses - were most likely to be affected, the US journal study found. 
  Clinicians and those involved in education need to aware that there are children who do not have autism but who nevertheless have somewhat elevated levels of autistic traits 
Professor David Skuse
Institute for Child Health


Scientists have understood for some time that the "autistic spectrum" covers a wide range of children with differing levels of problems, from relatively mild cases to severely disabling problems. 

However, a relatively small number of children - approximately 116 per 10,000 - are said to have an autistic disorder. 

The UK research, published in the Journal of the American Academy of Child and Adolescent Psychiatry provides further evidence that the same traits do not begin and end there, but continue at into the whole population of children, just at a level which does not lead parents to seek medical help. 

Seeing autism as a "distinct illness" was probably wrong, they said. 

Even at this mild level, however, these characteristics - particularly problems communicating with peers and teachers - can be a disadvantage. 

The findings confirmed that IQ was not an issue - the traits could be present regardless of levels of intelligence. 

However, it cast some light on the differential in the numbers of boys and girls diagnosed with autism. 

Girls with autistic traits appeared to be able to compensate for social communication problems if they had sufficient "verbal IQ" - a natural ability to use language well. 

However, even boys with high "verbal IQ" seemed less able to overcome their communication problems. 

Education awareness 

Professor David Skuse, one of the researchers involved, said the results did not downplay the genuine impact of more severe autism. 

However, he added: "What this does suggest is that drawing a dividing line between those with autism and the rest of the population involves taking an arbitrary decision." 

"Clinicians and those involved in education need to aware that there are children who do not have autism but who nevertheless have somewhat elevated levels of autistic traits - our research suggests that these children are at slightly greater risk of developing behavioural and emotional problems." 

In an accompanying editorial, Professor John Constantino, from Washington University, said that the idea that autism represented the "severe end" of a natural distribution of abilities could help scientists looking for the genetics underlying the condition, or for ways to treat it. 

It could also help the development of children who were affected, but not to the level of an autism diagnosis. 

He wrote: "The approach of teachers and family members to such children can vary dramatically on the basis of the perceived origins of the behaviour, and recognition of the contribution of subthreshold autistic impairments can result in far more appropriate and supportive responses than typically occur when antisocial motives are presumed."