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Two common antiseizure medications, lamotrigine, and levetiracetam, are safe to use during pregnancy, according to a Stanford Medicine-led study. The research, which was published online Nov. 25 in JAMA Neurology, is the first to evaluate the drugs’ long-term effects on children born to mothers who took one or both medications for epilepsy while pregnant. The findings confirm that these two drugs offer a safe alternative to older antiseizure medications such as valproate that are known to be harmful to fetuses…..Continue reading….
By: Erin Digitale
Source: Stanford Report
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Critics:
A seizure is a sudden change in behavior, movement, and/or consciousness due to abnormal electrical activity in the brain. Seizures can look different in different people. It can be uncontrolled shaking of the whole body (tonic-clonic seizures) or a person spacing out for a few seconds (absence seizures) Most seizures last less than two minutes. They are then followed by confusion/drowsiness before the person returns to normal.
If a seizure lasts longer than 5 minutes, it is a medical emergency (status epilepticus) and needs immediate treatment. Seizures can be classified as provoked or unprovoked. Provoked seizures have a cause that can be fixed, such as low blood sugar, alcohol withdrawal, high fever, recent stroke, and recent head trauma. Unprovoked seizures have no clear cause or fixable cause. Examples include past strokes, brain tumors, brain vessel malformations, and genetic disorders.
If no cause is found, it is called an idiopathic seizure. After a first unprovoked seizure, the chance of experiencing a second one is about 40% within 2 years. People with repeated unprovoked seizures are diagnosed with epilepsy. Doctors assess a seizure by first ruling out other conditions that look similar to seizures, such as fainting and strokes. This includes taking a detailed history and ordering blood tests. They may also order an electroencephalogram (EEG) and brain imaging (CT and/or MRI).
If it is a person’s first seizure and it was “provoked”, or caused by another condition, treatment of the cause is usually enough to treat the seizure. If the seizure is “unprovoked”, brain imaging is abnormal, and/or EEG is abnormal, start anti-seizure medications is generally recommmended. A seizure can last from a few seconds to 5 minutes. Once it reaches and passes 5 minutes, it is known as status epilepticus. Accidental urination (urinary incontinence), stool leaking (fecal incontinence), tongue biting, foaming of the mouth, and turning blue due to inability to breathe commonly are seen in seizures.
A period of confusion typically follows the seizure that lasts from seconds to hours before a person returns to normal. This period is called a postictal period. Other symptoms during this period include drowsiness, headache, difficulty speaking, psychosis, and weakness. Observable signs and symptoms of seizures vary depending on the type. Seizures can be classified into generalized seizures and focal seizures, depending on what part of the brain is involved.
Focal seizures affect a specific area of the brain, not both sides. It may turn into a generalized seizure if the seizure spreads through the brain. Consciousness may or may not be impaired. The signs and symptoms of these seizures depends on the location of the brain that is affected. Focal seizures usually consist of motor symptoms or sensory symptoms. Sensory symptoms: Auras are subjective sensations that occur before focal seizures. Auras include changes in vision, hearing, or smell (example is smelling rubber).
Feelings of deja-vu or abdominal discomfort are also examples of auras. A person who experiences focal weakness of a limb may also have just experienced a focal seizure. This is known as Todd’s paralysis. Motor symptoms: Head turning and eyes moving to one side, with contraction of limbs on one side is a common presentation. Automatisms are also an indicator that a seizure is focal.
These are repetitive movements. It can be lip smacking, chewing, swallowing, eyelid fluttering, feet shuffling, or picking movements. Jacksonian March is also a motor presentation of a focal seizure, with contractions spreading from one muscle to the next on one side of the body.
Seizures have a number of causes. Seizures can be classified into provoked or unprovoked. Provoked seizures have a cause that is temporary and reversible. They are also known as Acute Symptomatic Seizures as they occur closely after the injury. Unprovoked seizures do not have a known cause or the cause is not reversible. Unprovoked seizures are typically considered epilepsy and treated as epilepsy. Of those who have a seizure, about 25% have epilepsy.
Those with epilepsy may have certain triggers that they know cause seizures to occur, including emotional stress, sleep deprivation, and flickering lights. Dehydration can trigger epileptic seizures by changing electrolyte balances. Low blood sugar, low blood sodium, high blood sugar, high blood sodium, low blood calcium, high blood urea, and low blood magnesium levels may cause seizures. Up to 9% of status epilepticus cases occur due to drug intoxication.
Common drugs involved include antidepressants, stimulants (cocaine), and antihistamines. Withdrawal seizures commonly occur after prolonged alcohol or sedative use. In people who are at risk of developing epileptic seizures, common herbal medicines such as ephedra, ginkgo biloba and wormwood can provoke seizures. Systemic infection with high fever is a common cause of seizures, especially in children. These are called febrile seizures and occur in 2–5% of children between the ages of six months and five years.
Acute infection of the brain, such as encephalitis or meningitis are also causes of seizures.Acute stroke or brain bleed may lead to seizures. Stroke is the most common cause of seizures in the elderly population. Post-stroke seizures occur in 5-7% of those with ischemic strokes. It is higher in those who experienced brain bleeds, with 10-16% risk in those patients.
Recent traumatic brain injury may also lead to seizures. 1 to 5 of every 10 people who have had traumatic brain injury have experienced at least one seizure.Seizures may occur within 7 days of the injury (early posttraumatic seizure) or after 7 days have passed (late posttraumatic seizure).
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