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epilepsy

Slamming the Brakes on the Development of Epilepsy

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Two things can happen after someone’s very first seizure.  Nothing (preferable).  Or the beginning of dangerous changes in the brain.

The term that describes the descent from a first seizure into epilepsy is epileptogenesis.  There are some different theories as to what exactly happens that leads a previously healthy brain down the path of recurrent seizures.  Personally, I think that the oxidative stress generated from the seizure begins to destroy the ability of the brain to generate the energy it needs to function.  Essentially the brain cells become “sick.”  Since they were likely compromised in the first place, this makes it difficult for the epileptic patient to recover from without significant changes.

In other words–the lifestyle leading to poor brain health and the first seizure (stress, diet, environmental chemicals, sedentary lifestyles, etc…) is NOT going to be able to stop further degeneration in the brain cells.  It’s going to require an overhaul of lifestyle at this point–an approach only rarely broached by neurologists.

Another theory on epileptogenesis is that changes occur to the DNA as a result of an initial seizure.  As a quick background lesson, epigenetic changes are changes that occur, not to the DNA itself, but rather to the way DNA is accessed.  Consider it much like a program on your computer–the same program can be personalized to have a purple background with orange font or white on black; it just depends on how you decide you want the program to look.  It’s the same program either way.

In this model, after exposure to the initial seizure, the DNA of the brain cells begin to change in ways that make it more likely for future seizures to occur.  Brain cells are known to do this–the firing of one pathway in the brain makes it easier to follow this same pathway again.  Kind of like blazing a pathway or making a path.

This particular article delves into the concept of epigenetic changes leading to epilepsy.  While a little technical, the gist of the study (done on rats) was that the use of adenosine was able to stop the process of epileptogenesis for at least 90 days.  Adenosine is a molecule that helps to make up our DNA, but it also is a part of the all-important energy currency of our cells, ATP, produced in the mitochondria.

Overall, researchers were able to prove that providing adenosine directly to the region of the brain affected by that first seizure was able to halt the progression to epilepsy.  They believe this occurred by blocking the process called methylation involved in epigenetic modification of the DNA.  While powerful information, it is as of yet not applicable to humans, but opens up some powerful directions for researchers to take.

Interestingly, falling back onto MY personal theory, adenosine is an integral part of ATP (aka adenosine triphosphate) and levels of ATP are a major player in the proper functioning of brain cells.  It is possible that the adenosine used in this study is working by a different mechanism that affecting DNA methylation.  If this turns out to be the case, then lifestyle changes geared towards improving the health of the brian cells and increasing the amount of ATP in the brain cells may also play a role in derailing the progression to epilepsy.

Natural Remedies for Seizures: Is Epilepsy an Inflammatory Condition?

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The superficial understanding of epilepsy is that you have a region of brain cells that fire excessively, causing problems. If we can lock down the action of these cells, everything’s all good.

This is an incredibly simplistic view of seizures, but this is usually as far as most neurologists will get.  The entire effort of an epileptic patient is focused on controlling the seizures.  If this is successful (and, on the first shot, this happens only about 30% of the time) then everyone high-fives each other and pats each other on the back.

All of the anti-epileptic medications attempt to prevent a cell from firing in one way or another.  But, as I’ve certainly mentioned before, this does nothing to address what created the problem in the first place.  Why was this brain cell or region of brain cells “sick” to begin with?  To me, this should be the most critical question asked, yet rarely is.

My book, Migraines and Epilepsy, delves into the “why” question quite heavily.  Of critical importance is how effectively our brain cells can generate energy in the form of ATP (a process that occurs in the mitochondria—the powerhouse of the cell).  Anything that begins to disrupt the ability of the brain cell to generate the massive amount of energy that it requires to function normally is going to create a problem.

Inflammation can do just that.  It is a drag on the system, shifting needed resources to prepare to fight off some invader or other stressor.  In this particular study, the researchers looked for links between epilepsy and inflammation.

Specifically, they looked at several compounds produced by the body that are associated with inflammation, including:

  • Several interleukins (IL-6, IL6-sR, IL-1, IL-1RA and TNF-α,

In addition, since iron plays such a large role in inflammation (iron, when not attached to a hemoglobin molecule and carrying oxygen around, is a strong oxidizing agent—think rust), they looked as several markers of iron status and metabolism:

  • Hemoglobin concentration (Hgb), mean corpuscular volume (MCV), hematocrit (Hct) red blood cell (RBC) count, serum iron and copper concentrations as well as several other markers looking at iron metabolism,

While all this sounds a little technical, the bottom line is that they were looking for whether or not inflammation was related to seizure severity and whether or not iron status was also related to seizure activity.

They looked at the interictal period (ictal = the time during a seizure, so “inter” ictal would be the period of time when a seizure was not occurring).  Seizures themselves create a great deal of inflammation to the brain during the ictal period, but by checking the interictal period, it is a much better reflection on what is going on in the epileptic’s physiology.

Overall, here’s what they found:

  1. There was an increase of IL-6 and a decrease of TNF-α in the epileptic patients.
  2. There were also changes in iron metabolism consistent with acute inflammation.
  3. Higher seizure frequencies were seen with higher eCp (a sign that inflammation levels were higher)
  4. Seizure frequency was also higher with lower Hgb and Hct (since these two compounds help deliver oxygen to the brain, lower levels would essentially starve the brain of oxygen and reduce the amount of energy brain cells could make),
  5. Those patients who had longer durations of epilepsy had lower levels of TNF-α.

Overall, while the results of this study are pretty detailed, the bottom line is that inflammation has a clear role to play in epilepsy.  Whether it is directly related or whether it is indirectly related by lowering the ability of red blood cells to deliver enough oxygen to the brain has yet to be seen.

What we can determine, however, is that anti-inflammatory lifestyles high in omega-3 and lower in omega-6, lower stress, unprocessed foods and contains exercise is going to have a strong benefit.  There have been studies on all these aspects, demonstrating that the better you take care of yourself, the less likely you are to have seizures.

Can Epilepsy be Prevented?

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Regardless of the condition, prevention is a world easier than a cure, although incredibly less dramatic.  But can seizures be prevented?

Many would think this is a pointless question.  The general consensus is that we know so little about what causes a seizure that we couldn’t possibly know enough to prevent to onset of epilepsy.  It is well established that things like a family history of seizures or prior head trauma can contribute to the onset of epilepsy, but these hardly fall under the category of deliberately preventable.

For myself, however, I firmly believe that we have a good grasp on what happens to the brain cells to produce seizures, enough so that I’ve written a book on the topic that focuses heavily on things that you can do to protect and heal your brain (which you can take a look at by clicking here).

Since exercise is so strongly protective to the brain, it would seem a good question to ask if exercise and cardiovascular fitness could play a role in preventing the development of epilepsy.  Which, ironically, is the topic of this particular article.  In it, researchers looked at over 1 million Swedish conscripts and followed them over the course of 40 years to look at this relationship.  Here’s what they found:

  1. Compared to those with the best cardiovascular fitness levels, those who had low cardiovascular fitness had a 79% higher risk of developing epilepsy.
  2. By the same comparison, medium cardiovascular fitness led to a 36% higher risk.

To put this in reverse terms, having a high level of cardiovascular fitness was strongly protective against the development of epilepsy.  This may seem like a stretch based on the average understanding of seizures, but when you look at how much good cardiovascular health plays a role in the optimal function of the brain, it doesn’t seem quite so far-fetched.

Either way, there was a clear association, which adds further weight to the concept that we are strongly in control of what happens to our brains, from dementia to Alzheimer’s to migraines and seizures. For the migraineur or epileptic who has already crossed that line, the addition of exercise to your treatment regimen is not optional—it is an absolute requirement.

Chronic Migraines Headaches and Seizures Linked Again

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This is not the first time I’ve pointed out the links between migraines and seizures (as if my book, Migraines and Epilepsy wasn’t hint enough…) and it won’t be the last.

The reason I need to keep pointing it out is that mainstream medicine (neurologists included) don’t seem to see the association and consider them “comorbidities.”  Comorbidities mean that they are occurring simultaneously and not necessarily related.  Usually, comorbidities are medicated separately (because that’s how we “treat” everything in this country).  Take diabetes and high blood pressure.  Medicated separately.  Heart disease and colon cancer.  Separately.

In so many cases, these are not really separate conditions, but rather two conditions created by the same upstream event.  The prediabetic state increases blood pressure and high cholesterol.  The smart approach would be to make changes to address the prediabetes rather than medicating each of them.

Back to the migraine and epilepsy association.

There is strong evidence that both of these conditions are caused or greatly contributed to by a fundamental problem with the way the cells of the brain generate energy at the mitochondrial level.  You can read more about this in a previous article by clicking here.

This particular study looked at 304 epileptic patients to see just how many have headaches associated with the condition.  Here’s what they found:

  1. Those with more frequent seizures were 60% more likely to also experience headaches.
  2. Headaches were present in 66.1% of these epileptics.
  3. Chronic migraine headaches  were experienced by 32.9% of the patients,
  4. Tension-type headaches were  present in 9.2%.
  5. 6.6% had migraines that led into seizures.
  6. 10.2% had seizures that ended with migraines.

These are numbers that should make even the most skeptical neurologist sit up and take notice.  Worse, either condition, by themselves, is bad enough.  The amount of strain and oxidative damage to the brain that occurs during either a migraine or seizure is bad enough—the combination of the two is devastating.  And all the more reason to take up the mantle of protecting your brain and begin to make some serious lifestyle changes.

Stress and Seizures. Good or Bad?

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Before we answer that question, we need to understand that stress is supposed to be good for us.

While many may find that hard to believe, the stress response is an adaptive response designed to protect us in times of hardship.  This may be an increased storage of calories for a famine or a heightened immune response to fend off an infection.  In addition, the acute stress response produces a sharpening of the neurological system.  Makes sense—you really wouldn’t want to lose focus when chased by a saber-toothed tiger.

Either way, that was then.  This is now.

Acute stress no longer has a place in the world we live in. Sure, we get cut off in traffic or pissed off on the phone with the cellular phone company, but rarely do the majority of us have to deal with life-threatening situations that require a true acute stress adrenaline surge.

Rather, our lives seem dominated by chronic stress that never seems to have an end.  But what does this do to our brains and does this have an impact on the development and further risk of seizures?

In my book, Migraines and Epilepsy, I point out that acute stress is protective for our brains and against seizures, while chronic stress destroys our brains and promotes seizures.

This particular article goes a long way towards explaining how this may happen.  But first, a primer on adrenal hormones and stress.

The outside part of the adrenals, called the cortex, produces 3 hormones: cortisol, aldosterone and DHEA.  Aldosterone helps to conserve sodium to keep our blood pressure elevated.  Cortisol is the body’s stress hormone.  DHEA, dehyrdoepiandrosterone, is used by our bodies to make other steroid hormones like testosterone, estrogen and progesterone.  When we experience chronic stress, the cortex of the adrenal glands can only make so much end-product and the default choice is cortisol, leading to lower levels of aldosterone and DHEA.  So what happens now?

Researchers looked at what role DHEA played at the synapses of brain cells (the gap between two neurons where messages get passed along).  Specifically, the transfer of the excitatory neurotransmitter glutamate in seizures.  In general, the more glutamate that is present in the synaptic cleft between the brain cells, the more the brain cells fire, potentially perpetuating a seizure and creating a massive amount of damage to the cells.

Giving DHEA to rats who had seizures induced by iron led to an increase in the transporters responsible for getting the glutamate out of the synaptic cleft.  Less glutamate means that those brain cells are going to fire less.   This is a very good thing and goes a long way towards understanding how adrenal health and stress contribute so massively to seizures.

For this reason, stress management HAS to be a major tool for anyone dealing with epilepsy and seizures.

 

Natural Remedies for Seizures: At the Heart of the Problem

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Ahh.  Mitochondria.  Darn near my favorite word.  And the key to natural remedies for seizures and chronic migraines.

This is certainly not the first time I’ve written about my favorite organelle, and to some, it may seem like I attribute mitochondrial dysfunction to just about all that is evil in human physiology.  Lest you think I’ve turned into a broken record, you need to remember what the mitochondria do in each and every one of the cells of your body.

Deep inside every cell, at the electron microscopic level, cells are very busy little things.  Thousands upon thousands of reactions occur every second inside each and every cell.  Some cells have more going on than other cells, like the nervous system, muscle, heart and other organs.  Each and every thing that gets done requires energy in the form of ATP, and that ATP comes from healthy functioning mitochondria.

It’s at the core of what we are, and the breakdown of this process can wreak havoc on every single cell in your body, but likely beginning with the high energy demand cells like those just mentioned.  But for the purpose of this article, we’ll stick with the brain.

Due to the massive energy demand, each brain cell has thousands of mitochondria floating around in the cytosol.  You see, in order for a brain cell to NOT fire, it requires constant energy to keep levels of sodium and potassium on opposite sides of the cell membrane.  Without a constant pumping action shifting leaky sodium back out of the cell, the brain cell would no longer be able to keep an electrical gradient and the cell would fire before it’s supposed to.  Kind of like 10 strong men holding up a heavy boulder—if half of them decide they all have to go to the bathroom at the same time, the remaining five will likely leave the boulder to collapse to the ground suddenly.

With seizures, the same thing happens.  Without enough energy in the form of ATP from the mitochondria, a brain cell may fire before it’s supposed to, triggering a seizure (for a more detailed overview, feel free to purchase my Migraines and Epilepsy eBook by clicking here).

What’s worse is that this firing of a brain cell before it is supposed to actually causes connecting cells to fire (monkey see, monkey do).  This depletes the energy in the brain further, leading to a bad situation.  The brain cells affected by this surge of firing become sick, leading to an increased risk of future seizures.

When this process happens after a very first seizure, it can set up the stage for the development of future seizures, a process called epileptogenesis.  This particular article sets up the stage for looking into mitochondrial dysfunction as the root of the progression to epilepsy and using interventions geared towards the mitochondria to slow or stop this progression.

Unfortunately, mainstream medicine has been slow to adopt this mechanism as it relates to seizures.  Maybe slow isn’t the word.  Sloth speed in quicksand may fit better.

Current approaches to seizures and epilepsy take no thought into protecting the brain from further damage.  NONE of the anti-epileptic medications will improve mitochondrial function and some have been shown to worsen it.  Neurologists and epileptologists think their job ends when the seizures are controlled, but all the medications do is completely numb down the neurons so they can’t communicate effectively.  Worse, when the seizures are intractable and don’t response to a single medication (which happens in some 70% of seizures), multiple medications are used to numb the brain further.

Until we take a stand and accept that the mitochondria are THE critical element in seizures, epileptics will not be fully served by the physicians pledged to protect them.

Migraine Headaches and Seizures Linked

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I have stated for years that the causes of chronic migraine headaches and epilepsy are the same. While not generally accepted, it is consistent with current research.

The finding of a genetic link between migraines and epilepsy have been all over the news since this article hit the mainstream media earlier this month.  I have had a standing Google alert for “migraines and epilepsy” for quite some time now.  Nothing was on the radar screen on the Internet until this study hit.

For those of you who know, I have a particularly strong interest in migraines and epilepsy and have spent the past 6-7 years working on my book, “Migraines and Epilepsy: You Are Not Alone.”  During the writing of this book, it has been very common for me to be asked about the combination of the two conditions, because they are not generally thought of in the same sentence.  This includes most specialists dealing with epilepsy and with migraines.

However, the underlying problem with both of these conditions are very, very similar and this particular study lends weight to this concept.

Basically, researchers looked for families that had several epileptics in the family so they could basically single out a family with a strong genetic predisposition to seizures.  Seizures don’t always run strongly in families, so this was the researchers way to kind of “narrow the pool” so to speak.  They then looked at the presence of migraine with aura within these families and found a definite link between the two (Tweet this).

So what does this really mean?  When I think genetics traits, I think of enzymes, because genetic uniquenesses that change the speed of how an enzyme runs is the most common difference or commonality in conditions that run in families (this is called a single nucleotide polymorphism, or SNP for short).  With a genetic link between migraines and epilepsy, I can clearly envision an enzyme that affects how our cells generate energy (the technical term would be SNPs present that affect the mitochondrial energetic pathway).

If several family members have problems generating energy for the brain cells, this can result in different outcomes along the same path.  In one family member it produces a seizure disorder.  In another family member a migraine with aura.

My hope for this study is that we don’t view these as “comorbidites,” meaning that these two conditions just happen to coexist but don’t have much relationship to each other (like high triglyerides and high blood pressure).  Rather, we need to view these two conditions as having the same basic problem, but with a different outcome depending upon the individual.

As an example, (and a bad one, but it’s close to bedtime as I write this) consider stress.  People under extreme levels of stress may experience different outcomes.  Stroke in one, heart attack in another.  And cancer in a third.  All stemming from the same problem, but leading to different outcomes dependent upon uniqueness’s present within the individual’s makeup.

Overall, this post was designed less to educate and more to inform.  If you are a migraine headache sufferer or someone who experiences seizures, pay attention to things that you may learn that help the other condition–it may benefit you as well.

Treatment of Epilepsy in Women – (01-29-04)

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Updates on the Treatment of Epilepsy in Women

The topic of seizures hits close to home for me. My wife had experienced several seizures several years ago. All her contact with mainstream medicine strongly urged anti-epileptic medication. This included a “well-known and respected” neurologist. There was NEVER any consideration that medication was not the answer. A little thought process and recollection strongly tied aspartame to her symptoms. No Nutrisweet – no seizures. To think that the doctors wanted to put her on a medication with potentially devastating side effects for a condition that was related to one initiating factor I would consider at best ignorance and apathy, at worst malpractice.

Arch Intern Med — Abstracts: Tatum et al. 164 (2): 137 –

Read entire article here