Category: Conditions

Epilepsy – A Growing Condition

brain electricty

Epilepsy is a broad-term neurological condition that causes seizures. It affects people of all ages, genders, races, and status.

  • Epilepsy affects 65 million people globally — 3.4 million are in the US.
  • 1 in 26 people will develop epilepsy during their lifetime in the US.
  • There are 150,000 new cases of epilepsy in the US every year.
  • More people now live with epilepsy than ever before.

Types of Epilepsy

There are several types of epilepsy that a person can suffer from and the type of epilepsy can change over time. It’s important to remember that all forms of epilepsy are seizures but not all seizures are epileptic. In 2017, the International League Against Epilepsy (ILAE) changed the name and categorization of seizures so you may see the same seizure as different names. Epilepsy can be divided into two categories- generalized and focal – and each has their own breakdowns.  

Generalized –

This type of seizure affects both of the left and right sides of the brain at the same time.

Tonic-Clonic: Once called “grand mal” these are what are often depicted in Hollywood. This may cause you to lose control of your body. You may cry out, seize up, spasm, and lose consciousness. If the seizure lasts for more than three minutes, call 911, as this can lead to breathing problems and increase the risk of biting the tongue or cheek.

Tonic: These seizures that cause the arms, legs, and body to tense are often less than 20 seconds long. They usually occur during sleep but can cause a person to fall if they are standing. This is common in Lennox-Gastaut, a syndrome of epilepsy.

Clonic: These can last several minutes and are when the muscles spasms causing the face, neck, and arms to jerk rhythmically.

Myoclonic: Almost as if receiving a shock, the muscles will jerk suddenly during this type of seizure.  

Atonic: Instead of tensing up, the muscles go limp in this type of seizure. You may drop things or fall during these episodes. Though these are often short – 15 seconds – a person may have multiple in a row. This is often seen in people with Lennox-Gastaut and Dravet syndromes.

Absence seizures: Sometimes referred to as “petit mal”. During this type of seizure, you may stare blankly and become disconnected from the world around you. These last only moments and it’s common to not remember having one. This is found often in children younger than 14 years old.

This is a fascinating article about a young boy who suffers from epilepsy and his family’s journey of managing it through diet after medications failed to work. He has had epilepsy since a young age and it has changed through his time with it. His twin sister also suffers from epilepsy but with more success with conventional methods, showing that each person’s condition and needs are very unique

Focal –

This was called partial seizures and is localized in just one area of one hemisphere.

Simple focal seizures: This can affect your senses. You may smell or taste things and you may have twitching in your limbs. You may feel hot, cold, dizzy, or other sensations but you are typically aware and likely to remain conscious.

Complex focal seizures: You might lose consciousness but seem awake. This focuses more on the emotion and memory parts of your brain and can cause you to cry, laugh, or simple physical motions like lip smacking. It can take several minutes to come out of an episode.

Secondary generalized seizures: This seizure starts in one part of the brain and then spreads to both sides.

Epilepsy goes beyond just the types, different groups of factors that play a role in the condition can be specified even more as a syndrome as part of the diagnosis.

When to call 911

Not every seizure is an emergency so it’s important to distinguish when to call for help especially since they are not so uncommon. 1 in 10 people have seizures so one day you may be in a position help someone during theirs.

Call 911 if:

  • The seizure lasts more than 5 minutes
  • It is their first seizure
  • There is a second seizure in close succession to the first
  • They have trouble breathing or waking when the seizure is over
  • The person gets hurt during the seizure or it happens in water
  • They are pregnant or has a medical condition like diabetes or heart disease

For most seizures, it is helpful to:

  • Check for a medical bracelet or other information
  • Keep the environment and others around them calm
  • Comfort and speak to them in a normal calming voice
  • Stay with them until the seizure is over and they are fully conscious. Keep them in a safe place to sit and tell them what happened.
  • Offer to call for a taxi or a person to see them home safely

Tonic-Clonic seizures may need a little extra care because of the nature of the seizure. They may cry out, jerk, or fall. Because of this, it is best to ease them to the floor and turn them to one side. Place something soft and flat under their head like a folded sweater and remove anything dangerous away. Remove any glasses and jewelry that may restrict breathing. Remember to time the seizure and if it lasts longer than 5 minutes to call 911. It is unnecessary to hold a person down during their seizure, just make sure the area around them is clear, and do not put anything into their mouth. CPR is usually unnecessary as the person will breathe normally again once the seizure is over. Food and water is not recommended until they are fully awake and conscious.

The Red Cross has an app that offers step-by-step first aid and advice including information about epilepsy and seizures. You can find more information about it and their other apps here.

Don’t Wait To Treat Psoriatic Arthritis

Psoriasis

Psoriasis is a skin condition that forms red patchy scales that are itchy and can be painful. The lifecycle of kin cells is sped up causing them to build up rapidly on the surface. This is a chronic disease with no cure that can come and go. Management through lifestyle habits such as moisturizing, reducing stress, and quitting smoking may help alleviate symptoms. 

Psoriasis affects males and females at equal rates and is likely to first appear sometime between 15-35 years of age. According to the American Academy of Dermatology, 7.5 million people in the United States are affected and by the International Federation of Psoriasis Associations roughly 3% of the world has some type of psoriasis.

Psoriatic Arthritis

A type of psoriasis that affects the joints. Almost 30% of those with psoriasis later develop psoriatic arthritis but joint problems can begin prior to the appearance of surface lesions. It can cause stiffness, swelling, and joint pain anywhere from the fingertips to the spine and range from mild to severe pain. Like psoriasis, this may alternate between periods of flares and remission.

PsA that is considered mild can also be called oligoarticular, which means that no more than four joints are affected. Polyarticular, a more severe form, means that four or more joints are affected. Different classifications are dependent on which joints are affected. The spinal column, which includes the neck, lower back, and sacroiliac joints is called spondylitis and tends to co-exist with other forms of psoriatic arthritis. Enthesitis is the inflammation of where tendons or ligaments insert into the bones. Tissues in these areas can become solid (calcification or ossification) or ropey (fibrosis). Dactylitis, sometimes called “sausage digits”, is the swelling/inflammation of a whole toe or finger. It often affects multiple digits unevenly on the body.

Symptoms:

  • Pain in the back (upper and lower) and neck
  • Tender, swollen joints
  • Stiffness (especially in the morning)
  • Swollen toes and fingers
  • Plaques (red, scaly patches of skin)
  • Pitting or separation from the nail bed
  • Fatigue

Treatment

While there is no cure for PsA, there are treatment options to help manage the symptoms. Each person’s treatment plan is unique to their condition, so speak with your doctor about what your best options are. Treatment for psoriatic arthritis is important as studies have shown that delaying even just six months can cause permanent damage to joints.

There are various drug options to help manage symptoms:

    • NSAIDs (non-steroidal anti-inflammatory drugs) inhibit your body from creating the chemicals that cause inflammation. Over the counter (ibuprofen, aspirin, etc) and prescription options are available but can have undesired side effects.
    • DMARDs and Biologics are for when NSAIDs don’t work well or the condition is more severe. They are stronger and can have a delayed effect but may help stop or slow joint and tissue damage, swelling, and pain. Common DMARDs include Cyclosporine, Methotrexate, Sulfasalazine, Leflunomide. Biologics are a newer type of DMARD that block the protein that sources inflammation. These include Etanercept, Golimumab, and Infliximab to name a few.

Remicade®, an Infliximab biologic medication, has shown in clinical studies that it can help with pain, swelling, and stiffness, stop joint damage, and improve skin conditions. Integrated Neurology Services offer Remicade administration, among other infusion medicines.

  • Enzyme Inhibitors are new and for chronic inflammation. It also works in blocking a specific type of protein.
  • Steroids, specifically corticosteroids, help serious swelling and pain.
  • Surgery is typically the last resort option if nothing else works. Most PsA patients won’t need surgery but it is an option of treatment.

Again, a doctor will help with deciding on the best treatment plan for each individual’s condition.

Integrated Neurology Services’ Infusion Suite offers a comfortable location to receive prescribed infusion medications. Our facility includes cozy leather chairs, refrigerator, microwave, and free WiFi. Let us know how we can help in your infusion treatment options for psoriatic arthritis or any other condition that may need IV therapy.

The Lowdown on Myasthenia Gravis

 

What is Myasthenia Gravis (MG)?

Myasthenia Gravis is a chronic autoimmune neuromuscular disease that causes weakness in skeletal muscles. The name translates from Latin and Greek origins to “grave, or serious, muscle weakness”. This disease targets muscles that are responsible for breathing and moving body parts, like arms and legs, and is worse after active periods but improves with rest. Often, muscles that control talking, chewing, swallowing, facial expressions, the eyes, breathing, limb movement, and the neck are affected.

Over half of MG cases, eye problems were the first sign. These include ptosis, which is the drooping of one or both eyelids, and diplopia, double vision that improves if one eye is shut. Throat and face muscle symptoms are the first sign in about 15% of those who develop myasthenia gravis. These are the most common symptoms seen in myasthenia gravis patients.

Other symptoms include weakness of the neck, arms, and legs. These don’t usually present themselves without the above symptoms. Legs are less often affected than arms but may cause patients to waddle. More seriously, breathing can be affected and can be a critical issue. Continue reading “The Lowdown on Myasthenia Gravis”