epilepsy

Obstructive Sleep Apnea: Can Sleep Disturbance Cause Seizures?

October 21, 2012 by James Bogash

Recent studies have linked sleep apnea and chronic headaches. Since migraines and seizures have similarities, can obstructive sleep apnea cause seizures?

Sleep is absolutely vital to the health of your brain. During sleep, while our conscious mind may not be alert, this does not mean that our brain is inactive during this time. Far from it.

But sleep is not important because it allows your brain to relax, but rather because processing and healing occurs during sleep that we do not yet fully understand. It is clear that lack of sleep is a strong trigger for those suffering from migraines and seizures. For this reason, getting a good night’s sleep is essential for good brain health.

This task is not always as easy as it sounds for several reasons:

In today’s stressed out world, chronic stress throws off normal cortisol rhythms, leading to higher cortisol levels at night, making sleep nearly impossible.
Sleep apnea, both obstructive and central, make restorative sleep impossible.
Our use of medications to help us sleep disrupts normal sleep patterns, potentially being linked to over half of a MILLION deaths per year.

As mentioned earlier, sleep problems have already been linked to chronic headaches and this particular study follows along these same lines as it relates to seizures. Researchers looked at an epilepsy center and evaluated those patients with seizures for the presence of obstructive sleep apnea and found:

Patients with epilepsy had a much higher incidence of OSA compared to the general population (15.2% vs. 4.41%)
If patient’s seizures were well controlled, then older men with a higher seizure frequency were even more likely to suffer from obstructive sleep apnea.
In those who did not have good seizure control (medically refractory), those with diabetes and snoring had a higher risk of obstructive sleep apnea.
Treatment of obstructive sleep apnea with a CPAP machine in refractory epilepsy patients improved their seizure control.

Clearly there is a link between sleep problems and seizure control. I would not be surprised at all if the hormone melatonin plays a pivotal role here. Numerous studies over the years have linked melatonin with protecting the brain and helping with seizure control. Sleep disturbances can be caused by a problem with melatonin production (or the timing of melatonin production) and, conversely, sleep problems can lead to altered production of melatonin in the brain.

The bottom line is that sleep is critical for normal brain health. Whether you suffer from chronic headaches or uncontrolled seizures, sleeping has to be brought under control naturally.

The long term solution to sleep problems is stress management and exercise. Few things will restore a healthy sleep pattern as well as these two. In the short term, natural compounds like valerian root may be effective on an individual basis to calm the brain enough to allow sleep to occur naturally.

Melatonin, the hormone mentioned earlier, may also help to restore normal sleep patterns. Typical starting dosages are .5 mg an hour or so before the desired bedtime.

If you have had sleep disturbances in the past, how did you manage them?

Sudden Unexplained Death in Epilepsy: Lower Your Risk

September 18, 2012 by James Bogash

While just dealing with seizures is bad enough, the mind of every epileptic there looms the fear of sudden unexplained death in epilepsy, also known as SUDEP.

The exact cause of SUDEP has not been identified, although cardiac problems are very high on the list of likely suspects.

This should not come as a surprise since, at the cellular level, the way our heart cell develops the rhythm of our heartbeat is similar to the way our brain cells fire. It all has to do with boring topics like cellular membrane potential and voltage gated channels. (I usually save these topics for blogs focusing on insomnia…)

There are risk factors for sudden unexplained death in epilepsy that we already know and understand. Some risk factors, such as living alone will increase the risk of SUDEP. Some studies have suggested that the anti-epileptic drugs themselves affect heart rhythm and increase the risk of SUDEP.

Obviously, doing everything you can to improve brain health in epilepsy should be the most important factor in management of seizures. Without appropriate lifestyle changes targeted towards brain health, even seizures successfully controlled with medication are missing the real problem.

Chronic epilepsy and seizures are the result of something being wrong in the brain. Most evidence points to the mitochondria and the ability of brain cells to generate the energy they need to function properly as causative in seizures.

Overall, because of this, SUDEP is a valid concern, but the incidence still remains low. The progression of damage to the brain, however, is occurring in every epileptic. This is why the concern should be on brain health rather than concern over sudden unexplained death.

Should you STILL be worried, this particular study provides some additional help.

Get a pet.

Yup. It can be that simple. Researchers looked at the rate of SUDEP in a group of 1092 epileptics and looked at those who had succumbed to SUDEP. 1% (11) were classified as SUDEP. Not a single one of these were pet owners.

On the other hand, in the remaining epileptics, 61% were-pet owners.

While this is not conclusive by any means, it fits with what we’ve seen in other studies on the heart protection that occurs with pet owners who have chronic conditions.

As an avid dog lover, it would seem a simple tool to add to the toolbox of improving your brain health and improving your chances of a long and healthy life.

What have you done to help heal your brain today?

Ketogenic Diet Plan for Seizures in Children and Adults

August 18, 2012 by James Bogash

Medicine thinks in terms of drugs. Thoughts on diet & supplements are rare & incomplete. A ketogenic diet plan for seizures in children & adults is powerful.

The ketogenic diet is similar to the Atkins’ diet, in that it is very high in proteins and fat. The argument against the ketogenic diet is that it is hard to remain compliant with, because apparently having your brain damaged by aberrant firing of neurons is not as important as that slice of bread.

When it comes to seizure control, the ketogenic diet is amazingly powerful. Consistently across studies, 1/3 of those on a ketogenic diet have >90% seizure reduction and another 1/3 have >50% reduction. This is an amazing response rate. Far, far more effective than any anti-seizure medication available, and yet it is considered as a last line of approach to seizure control (especially in children) instead of the first line.

The question of compliance has already been worked out. In a long term follow up study of the ketogenic diet in children over 20 years, 65% of the patients remained on the diet. I can tell you that, in terms of medication, to get 64% of patients to be compliant with taking a medication for TWENTY years is practically unheard of.

I’ve recently had an opportunity to talk to a mother of a 6 year old epileptic child. Her epileptologists (neurologists that specialize in seizures) have told her that the ketogenic diet would not work for her daughter because she has a rare form of epilepsy. Of course, the medications are not working either, but that doesn’t seem to phase the physicians.

Here’s the rub that many would not agree with. Regardless of how rare or common or distinct a form of epilepsy may be, the brain cells all still work the same. Sure, there may be an enzyme system running slow or not working at all. The number of mitochondria may be reduced. There may be more activity in one area of the brain than another. But I would think that even epileptologists would find it hard to disagree that the overall physiology of the neurons in every form of epilepsy is different.

Although we do not fully understand how the ketogenic diet plan works yet (there are some suggestions that gluten avoidance may be important) you can be sure the benefits are non-specific. Rather, it’s benefits probably lie in the way it improves the overall functioning of the brain cell, rather than blocking receptor X or stimulating receptor Z. So it makes absolutely no sense to suggest that the ketogenic diet plan may not be successful for this child. It clearly does not work in everyone, but when it does, it works well.

To demonstrate just how important the ketogenic diet plan is to seizure control, I am not providing a link to a particular article as I normally do.

Rather, the entire July 2012 issue of the journal Epilepsy Research is dedicated to diet in the control of epilepsy and certain other neurological disorders. By now, if you suffer from epileptic seizures and your doctor has not discussed the ketogenic diet with you, you can be sure he or she has not cracked a medical journal in some time now.

I would like to share with you 3 stories in this journal written by the parents of children with seizures who tried the ketogenic diet plan:

Carson, who with infantile spasms, was able to access the diet as her first line treatment without any medication being taken. Carson is the inspiration behind the Carson Harris Foundation and her family promote dietary awareness in USA.
Matthew, with Dravet Syndrome, was refused for the diet for years, suffered brain damage and was put on a whole host of unsuitable medications before finally managing to get the diet. The diet proved his saving but what could have been the outcome if the family had got the diet when it was first asked for? Matthew is the inspiration behind the Matthew’s Friends – Dietary Treatments for Epilepsy organization
Charlie, suffered with intractable epilepsy, was put on a whole host of medications that did not work and underwent brain surgery before finally getting to the diet that cured him of his epilepsy. He is the inspiration behind The Charlie Foundation in the USA and his father, Jim Abrahams made the film ‘First Do No Harm’ which told the true story of a child who was cured of his epilepsy using the Ketogenic Diet, just like Charlie and thousands upon thousands of other children around the world.

So, I would ask the neurologists of the child I have recently come across, if the ketogenic diet plan can work for Dravet Syndrome (1 in 30,000 births), then why on Earth would we not recommend it as a trial for all children with seizures, especially intractable ones.

If your child has seizures, have you tried the ketogenic diet plan?

SEASONALITY OF BIRTH: EPILEPSY RISK EFFECTED BY VITAMIN D EXPOSURE – (03-06-06)

June 30, 2012 by James Bogash

Seasonality of birth in Epilepsy: A Southern Hemisphere study

Would anyone like to place a bet that vitamin D exposure during the 3rd trimester is the reason people born during the spring and fall have lower rates of epilepsy? Talk about far reaching effects in time.

And consider this in light of the fear we have induced for sunlight exposure. So, if the mechanisms between migraine and seizure are similiar, would the same increase in migraine sufferers be found in those born in the winter and summer?

Read entire article here

5 Reasons Magnesium May Help Seizures and Migraine Headaches

June 26, 2012 by James Bogash

Can magnesium affect serious conditions like seizures and migraines? Because magnesium is required for some 300+ enzymes in the body, and many of these are required for healthy brain function, this just might make sense.

Today’s diets are notoriously deficient in this mineral. Foods like whole grains, nuts and seeds are good sources and can be added to the diet to increase overall intake. Supplementation beyond dietary intake is very inexpensive and safe.

The beauty of oral magnesium supplements is that you cannot take too much. Certain supplements, like magnesium and vitamin C, can only be absorbed in certain amounts from the gut. If we take too much, we can’t absorb any more, so the extra stays in the intestines. When this happens, the magnesium will attract water and create loose stools or diarrhea (not a bad side effect when someone is dealing with chronic constipation). Anyone who has had a colonoscopy is very aware of what very high doses of magnesium will do to the gut.

Before we go further, I need to remind readers that, while medicine today does not recognize that migraines and seizures are in the same category, I strongly promote that the underlying problems in the brain are similar between the two. For this reason, what helps or harms with one condition has a strong probability of helping or harming the other.

This particular article reviews the potential of magnesium to have a positive impact on seizures. The authors base this on several known findings:

Magnesium deficiency in animals increases seizure likelihood
Low magnesium solutions can generate seizure-like activity in rat brain tissues in the lab
Magnesium blocks the N-methyl-d-aspartate receptor, a receptor that can cause seizures
Studies have shown that people with epilepsy have lower magnesium
Children with infantile spasms responded better to hormone therapy when magnesium was used

While none of these items are a slam dunk to assure that magnesium can be an effective treatment tool in seizures, given the low cost and high safety of magnesium, it would make sense to add magnesium supplements to the daily list of supplements that anyone with migraines or seizures should be taking.

Depending on the quality, levels from 400-800 mg would be good to consider.

So what supplements do you use to help manage your migraines or seizures?

Poor Seizure Control? You Need to Add This Supplement

June 7, 2012 by James Bogash

There is no doubt that epilepsy can be an immensely debilitating condition. Working, social events, driving and family life are all greatly disrupted, if even possible. Sadly, less than 30% of the time the first seizure drug used is effective at controlling the seizure. From this point on it just gets more difficult. Anything that can aid in seizure control can be life changing for these patients.

Few neurologists will give any recommendations for natural products to their patients. Maybe it is a belief in the superior power of pharmaceutical drugs where natural compounds can’t possibly compare. Maybe it’s a belief that there is no research to support natural compounds to control such a debilitating condition, at the same time refusing to embrace the frequent failure of pharmaceutical drugs to achieve seizure control. Whatever the reason, it does not serve the patient’s best interests. Many natural compounds have been shown to have significant seizure control abilities:

This list does not include approaches like the ketogenic diet and a gluten free diet, both of which can play a strong role in seizure avoidance.

This particular article adds to the list of supplements that may play a role in your seizure control. Supplementation with vitamin D in a small group of seizure patients in whom drugs were not controlling their seizures led to a 40% reduction in seizure frequency. 40%. That’s a pretty strong response.

Vitamin D has been known to act as an anti-convulsant for some time now. This is important to remember because a lot of the anti-epileptic drugs – the AED’s – actually lower levels of vitamin D in the blood. So, we have a compound that actually helps protect the brain, but the drugs that we use to control seizures actually lower the levels of a substance that can protect the brain. This creates somewhat of a conundrum. This may also be the reason why most AEDs also have a negative effect on bone density, again strongly supporting the use of vitamin D in migraines and epilepsy.

Taking vitamin D as a supplement is very inexpensive and the safety margins on the dosages of Vitamin D are quite wide (toxicity with vitamin D is not noted until the blood levels are over 200 nmol / L, which is a pretty difficult level reach). However, if someone has any concerns about taking higher dosages of Vitamin D, blood levels can easily be checked. Optimal blood levels are between 60 and 100 nmol / L, although most labs will consider 20 and over as normal.

There are times when vitamin D supplementation may be of concern. One such situation is with the use of thiazide diuretics that raise the level of calcium (due to reduced excretion). Also patients with the auto-immune granulomatous disorder sarcoidosis need to be a little bit more cautious. Other conditions known to increase the levels of calcium in the blood like histoplasmosis or hyperparathyroidism require care with supplementation. If someone has any questions or concerns they should obviously discuss them with their primary care doctor. In addition, there are a lot of great resources on the Internet.

Recommended dosages depend on several factors, such as how much sun exposure you get or what latitude that you live at (higher latitudes get less direct sunlight so our bodies make less vitamin D; near the equator vitamin D production is at is highest). Many mistakenly believe that they get enough sun exposure and that supplementation is not needed. However, there is concern that the sun passing through glass allows only UVA penetration, actually breaking down the production of vitamin D in the skin. So if you drive around all summer with the windows up in your car and the AC cranked, you may actually be lowering your vitamin D levels. Furthermore, it takes at least 8 hours to fully produce and absorb the vitamin D our skin is trying to produce, so showering at night may lower blood vitamin D levels. There is also concern of particulate matter in the atmosphere blocking UVB penetration and also lowering vitamin D levels.

Because of these concerns, I generally start patients anywhere from 2,000 to 4,000 IU per day, although it is sometimes higher depending upon the clinical scenario. Having your bone density checked can further help determine vitamin D need. In our clinic we strongly recommend patients have their first bone density testing in their 20’s and 30’s so they aren’t waiting until they’re 55 or 60 and are now at the crisis stage for treating low bone density.

For supplementation, liquid forms are going to be much cheaper and easier to use. Vitamin D can actually be dosed on a weekly basis. The vitamin D we use in the office has 2,000 IUs per drop; if someone is on 2,000 IUs per day they can actually do seven drops once a week. It is one of the easiest and cheapest supplements to take.

When Wheat Allergies Cause Seizures

June 4, 2012 by James Bogash

There has been much increased awareness of the problems associated with wheat allergies. Celiac disease. Allergy to wheat. Gluten sensitivity. Whatever you call it, it’s here to stay. But exactly how far do the negative health effects run? And can wheat allergy affect the brain?

Let’s start with the basics. Traditionally, celiac disease was a condition where an allergy to the gluten containing grains (most commonly wheat, barley and rye, but also in trace amounts in oats) sets up an autoimmune reaction that destroys the villa of the small intestine. You may have heard that the total surface area of the small intestine is close to that of a tennis court because all of the villi increase the surface area. Consider this shrinking to the size of a ping pong table and you get the idea. Nutrient malabsorption results and all kinds of bad things follow.

That was then…this is now…

Over time, we have come to understand that the scenario described above is the far end of a spectrum that starts with slight sensitivity that can only be picked up via stool sampling at specific labs (like www.enterolab.com). The real problem is that the inflammation set up by exposure to a common allergen such as gluten wreaks subtle havoc that compounds over the course of years and decades. Celiac disease has been linked to:

Before you begin to think this is new news, you need to understand that this was on the radar screen over a decade ago, if not longer. Strong concerns were noted with celiac disease in toddlers.

But can something occurring in the gut actually affect something as far away as the brain?

The answer is a clear yes. Almost 20 years ago researchers where calling for evaluation of gluten sensitivity in any undiagnosed neurological disorder. This particular study demonstrates very strong links between epilepsy and celiac disease. Those with the far spectrum of celiac disease (villus atrophy) had a 40% increased risk of developing epilepsy.

Two very important factors come to mind.

First, this is the far spectrum showing a 40% increase, but what about the entire range of the spectrum? What if we looked in reverse to see how many epileptics had sensitivity to gluten? We may be surprised at what we would find.

Second, the ketogenic diet has been shown to be an incredibly powerful therapy for seizure control for epileptics. Interestingly, researchers are not really sure how the diet works to control seizures, although some have speculated that the fat intake is key. But, on the ketogenic diet most grains are eliminated or cut back on severely. Could gluten really be the key? Based on this study, it may very well be the link researchers have been looking for on the reason why the ketogenic diet works.

Simple Supplement Can Protect Memory in Seizures and Migraines?

April 26, 2012 by James Bogash

While most sufferers consider them separate entities, migraines and seizure share many common characteristics and the underlying problem with the cells of the brain are also similar. What contributes to or triggers a migraine headaches can also trigger seizures, such as lack of sleep, stress and skipping a meal. In the short term, both of these conditions dramatically affect quality of life. Even more concerning is what these conditions due to the brain in the long run.

Read entire article here.