Definition
A brain disorder involving recurrent seizures.
Causes, incidence, and risk factors
A seizure disorder includes any condition in which there are repeated episodes of seizures of any type. Epilepsy (idiopathic seizure disorder) is a term used when the seizure disorder has no identifiable cause such as brain disease. A seizure disorder affects about 0.5% of the population. It can affect people of any age.
Transmission of information from nerve cell to nerve cell occurs by an electrochemical process. This process can be detected as electrical activity by an electroencephalograph (EEG). Abnormal patterns of electrical activity are associated with seizures.
The cause of the seizure correlates to some extent with the age of onset. In some people, seizures may be triggered by hormone changes such as pregnancy or menstruation. They may also be triggered by illness or by sensory stimuli such as lights, sounds, and touch. In many cases, no trigger is found for the seizures. Given sufficient circumstances, any person will have a seizure. The amount of stimulation required to cause a seizure is called the seizure threshold. Many people with epilepsy are considered to have a low seizure threshold.
Some of the more common causes of seizures include:
* Idiopathic (no identifiable cause)
* usually begin between ages 5 to 20
* can occur at any age
* no other neurologic abnormalities present
* often a family history of epilepsy or seizures
* Congenital defects and perinatal (near the time of birth) injuries– seizures usually begin in infancy or early childhood
* Metabolic abnormalities
* may affect any age
* diabetes mellitus complications
* electrolyte imbalances
* kidney failure, uremia (toxic accumulation of wastes)
* nutritional deficiencies
* phenylketonuria (PKU)–can rarely cause seizures in infants
* use of or intoxication from alcohol or drugs
* withdrawal from alcohol
* withdrawal from drugs
* Brain injury
* may affect any age, highest incidence in young adults
* most likely if the brain membranes are damaged
* seizures usually begin within 2 years after the injury
* early seizures (within 2 weeks of injury)–do not necessarily indicate that chronic seizures (epilepsy) will develop
* Tumors and brain lesions that occupy space (such as hematomas)
* may affect any age, more common after age 30
* partial (focal) seizures most common initially
* may progress to generalized tonic-clonic seizures
* Disorders affecting the blood vessels (stroke, TIA, and so on)
* most common cause of seizures after age 60
* Degenerative disorders (senile dementia Alzheimer type, or similar organic brain syndromes)
* mostly affect older people
* Infections
* may affect all ages
* may be a reversible cause of seizures
* brain infections (meningitis, encephalitis)
* brain abscess
* acute severe infections of any part of the body
* chronic infections (such as neurosyphilis)
complications of AIDS or other immune disorders
There may be changes in mental status (such as alertness and awareness) and/or focal neurologic symptoms (localized symptoms of changes in brain function) associated with the seizures. The type of seizure that occurs varies depending on the location and type of the problem causing the seizure and with individual response to the problem.
Seizures may occur in a generalized form (affecting all or most of the brain) or in a partial form (affecting only a portion of the brain). Epilepsy is typically generalized (except in some cases that develop in childhood and have a specific focus). Generalized seizures include variations of generalized tonic-clonic seizures and petit mal seizures. Partial seizures include focal seizures (during which the person remains alert but there are abnormal movements or sensations) and partial complex seizures (during which the abnormal movement or sensation is accompanied by changes in consciousness).
Ketogenic Diet
The ketogenic diet is a high-fat, very low-carbohydrate diet used in children who have epilepsy. The diet should be considered when the frequency of seizures, despite medications, interferes with the child’s functioning or when the medications themselves cause substantial adverse reactions. This diet is not often being used in adults.
No one is certain how the diet works. Fasting (no eating) produces ketosis, because the body is unable to completely burn the fat it is using for energy. The ketones are the byproducts of the incompletely burned fat. The ketogenic diet simulates the biochemical changes of starvation. In the virtual absence of glucose (or other carbohydrates) the body, and more especially the brain, is able to burn these ketone bodies for energy. How the burning of these ketones controls seizures is unknown.
Ketosis is produced by eating foods that are ketogenic (fats) and avoiding foods that are anti-ketogenic (carbohydrates). The dietitian will calculate how many calories a child needs for energy and for growth. This amount is about 75 percent of the usually recommended daily allowance (RDA) for the child’s age. The diet is usually started in a 4:1 ratio (4 parts fat to 1 part protein and carbohydrate) or in a 3:1 ratio. The dietitian creates meal plans. Each meal is precisely calculated to create a ketogenic formula.
The diet should only be done under careful medical supervision and is usually started in the hospital by fasting the child for 48 hours. Throughout the fasting stage it is important to monitor the child carefully. Most children tolerate this period well. Once the child has large amounts of ketones in the urine, the diet is gradually introduced. Throughout the hospitalization the parents are instructed about the diet, including how to weigh and measure foods and avoid products or medications that contain carbohydrates.
The diet is very restrictive, but the restrictions are usually worthwhile if seizures stop or are significantly reduced. Only the foods and the quantities calculated into the diet can be consumed. Medications that are not sugar-free must be avoided. Even small amounts of carbohydrates such as a cookie, several nuts or carbohydrate-containing toothpaste or antibiotics may eliminate the ketosis and nullify the effects of the diet. Fluid intake is also moderately restricted. While the effects of the diet on blood cholesterol and other lipids are under investigation, there is currently no evidence that the diet causes early heart disease or strokes.
Pre-Disposing Factors:
a. Metal body burdens (aluminum, mercury, lead, cadmium and copper are the most common).
b. Intestinal parasites.
c. Food sensitivity (dairy products, gluten containing grains and night shades are the most common).
d. If seizures occur only at night or when the patient has not eaten for over four hours, reactive hypoglycemia should be ruled out.
e. Manganese, magnesium, or vitamin B6 deficiency.
Dietary Suggestions:
a. Eliminate all refined carbohydrates, alcohol, processed foods and foods containing caffeine such as coffee, tea, cola and chocolate. If the patient has a significant craving for chocolate, magnesium deficiency is probable.
b. Eliminate all hydrogenated fats and oils. Eat only extra virgin olive oil, fish oils and coconut oil as your only sources of dietary oil.
c. Eliminate all artificially sweetened foods.
d. Eliminate all dairy products and gluten containing grains.
e. Sip a mouthful (about 2 ounces) of water (distilled or filtered) every 30 minutes while awake, every 15 minutes if exercising or perspiring.
NOTE:
The human body needs – 16 Vitamins,30 Minerals (at least), 3 Essential Fatty Acids and 8 Essential Amino Acids (Protein) every day for optimum health. In addition to a ?good & well chosen? diet the following supplement program containing the first 5 items below is designed to satisfy those ABOVE-NOTED nutritional needs:
NUTRITIONAL SUPPLEMENTS (For Adolescents or Adults)
Primary Nutrients:
1. BIO-GLYCOZYME FORTE ?- 3 tablets, 3 times daily after meals.
2. BIO-C PLUS 1000 — 1 tablet 2 to 3 times daily after each meal
3. M S M POWDER — 1/2 teaspoonful 2 to 4 times daily depending on the severity of symptoms. NOTE: Try to take MSM with your Vitamin C.
NOTE: Take M S M 2 to 4 times daily until all symptoms resolve, then decrease dosage to once or twice daily or whatever you feel your optimum dose is.
4. BIOMEGA-3 – 4 – 5 capsules, twice daily after meals for 1 month, then 4 – 5 capsules once daily thereafter M – F of the week.
Specific Nutrients (Use for 1 month, then re-evaluate)
5. B6 PHOSPHATE ?- 1 tablet, 3 times daily after meals.
6. B12 2000 LOZENGES – Chew 1 tablet, 3 times daily after meals.
7. MG-ZYME ?- 1 tablet, 3 times daily after meals. Increase by one tablet daily until bowel tolerance (loose stool) is reached.
8. MN-ZYME FORTE – 1 tablet, 3 times daily after meals.
Specific Nutrients: When symptoms or condition begins to subside, gradually, as needed, wean yourself from the Specific Nutrients & stay on the Primary Nutrients. If any symptoms re-occur resume taking Specific Nutrients.
ADDFENDUM
Links:
American Academy of Neurology (AAN)
1080 Montreal Avenue
St. Paul, MN 55116
Phone: (651) 695-1940
Fax: (651)695-2791
E-Mail: foundation@aan.com
www.aan.com
Epilepsy Foundation of America (EFA)
4351 Garden City Drive
Landover, MD 20785
Phone: (301) 459-3700
Toll-free (800) EFA-1000
Fax: (301) 577-4941
E-Mail: info@efa.org
www.efa.org
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Office of Communications and Public Liaison
PO Box 5801
Bethesda, MD 20824
Phone: (301) 496-5751
www.ninds.nih.gov