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A 6 year old girl with Case History A seizure results from an abnormal discharge of electrical activity from the brain. A person is said to have epilepsy when a seizure is more than an isolated event having a tendency to recur. Until the mid-nineteenth century, there was much misconception and prejudice that surrounded those who had epilepsy. In the nineteenth century it became apparent that there were physical changes in the brains of many patients who had epilepsy that could scientifically explain this condition. There is a variety of criteria used to classify seizures. One method is to describe what the seizure looks like. The following is a list of different types of seizures: Generalized: Is also known as a grandmal seizure and is the type of seizure most people visualize when they think of epilepsy. In these seizure there is abrupt loss of consciousness, followed by violent alternation of muscle contraction and relaxation. After the violent spasm, the patient enters a deep coma which may last about 20 minutes. The patient has no recollection of the seizure and is postictal (feelings of confusion, lethargy and fear after the seizure). Absence or petitmal: During these seizure the patient is unresponsive and staring. Often repetitive actions such as chewing, lip-smacking or eye fluttering may be observed while the person is having a seizure. They start and end suddenly, lasting only seconds. The patient usually will not fall and there is no postictal state. This type of seizure disorder almost always starts during childhood. Partial complex seizures : These seizures begin like petitmal with a vacant stare but, they last much longer on the order of minutes rather than seconds. Also like patitmal, there may be automatism such as chewing and lip smacking. In addition to this, there are also a variety of hallucinatory and psychological phenomena associated with these seizures. The patient may report seeing or hearing things that are not there. Patients may also experience a range of emotions such as fear, rage, pleasure, or eroticism. The most common is fear. Partial simple: With this seizure disorder there is no loss of consciousness and no postictal state. It is characterized by muscle twitches, numbness and tingling sensations or other abnormalities in sensation. They may occasionally be accompanied by emotional symptoms. The patient has complete recall of the seizure. Psychogenic: Also known as hysterical, thought disorder, psuedoseizure or anxiety attack. This disorder is characterized by bizarre actions and behaviors. There is usually complete recall of the event and it can often be terminated with strong stimuli such as a shout or clap. Syncopal seizure: This is a brief seizure that last only a few seconds. After loss of consciousness there is a spasmodic contraction and relaxation of muscles. Like grandmal, there is no recall of the seizure and there is a postictal state. In addition to the above descriptions of the various seizure disorders the EEG (measurements of the electrical activity of the brain) provide information on determining the type of seizure disorder present. Because of the wide and varied ways that epilepsy can present classification of these disorders is complex and confusing. In addition to the above system of classifying epilepsy by the seizure type other systems of classification take into account epileptic syndromes. These classifications take into account not only the seizure type but age of onset, causative factors and severity as well as other characteristic signs and symptoms. Examples of epileptic syndromes include infantile spasms, frontal lobe epilepsy, benign childhood epilepsy and epilepsy with myoclonic absence are a few examples of the many syndromes that have been defined. The value of being able to diagnose a syndrome in addition to the seizure type is that knowing the syndrome allows for better and more specific treatment and also give more information on how the disease may progress over time. There are many different factors that are known to cause epilepsy. The actual seizure type give very limited information as to what is causing the seizure. This again is one of the values in using syndrome complexes to describe epileptic disorders since this takes into account the causative factors. Genetics seems to be one factor in determining if somebody will get seizures. Studies have shown that relatives of patients with epilepsy are more likely to have abnormal EEGs and seizures than the general population. Also with identical twins it is common that both siblings will have the disorder. It is also know that events surrounding the development of the fetus and birth can cause seizure disorders. These include viruses, substance abuse during pregnancy, exposure to radiation early in the pregnancy, and lack of oxygen. Various toxins such as psychoactive drugs, carbon monoxide, lead and mercury exposure may also cause seizure activity. In adults, infections such as syphilis, tuberculosis, parasites and bacterial meningitis may also cause seizures. Patients who have coronary artery disease and suffer from strokes may also develop a seizure disorder. The sudden onset of a seizure in an adult always raises concern of a brain tumor. Disturbances in metabolic function are also known to cause seizures. It is known that a high sodium or low calcium or magnesium level may produce seizure activity. This has been substantiated by Dr. Emanuel Revici who determined that to much anabolic activity or to little catabolic activity may set up metabolic conditions that are conducive to seizure activity. The patient, L.I., is a 6 year old girl who has seizures that have been very difficult to control with conventional anti-seizure medications. The seizures began 6 weeks after birth. Seizure type consisted of both grandmal and absence seizures. The birth was full term and normal without any complications. The cause of the seizures were not known. All neurological testing was normal including MRI of the brain. She was put on standard anti-seizure medications but these failed to improve her condition. Development was normal up until 6 months of age. At this point, the child was seizing sometimes in excess of 50 times a day. The relentless nature of the seizures led to severe developmental delays and spacicity of muscles. The left side of her body was also paralyzed. By the time she was 6 years old, she was confined to a wheel chair and had minimal communication skills. She presented to my office with her mother in October of 1998 in hopes that an alternative approach would help to improve her condition. At this time the only medication she was on was the anti-seizure medication (Depecot) and she was also on an anti-ketogenic diet but these treatments had minimal impact on her condition. The following is the protocol I recommended for this patient: T (sodium thiosulphate), Bufo (homeopathic), Valerian, Omega –3 fatty-acids, and lipoic acid. One month following the initiation of the above recommendations, the patients' mother reports that her daughter is greatly improved. She now has many days with out seizures and at most, has one seizure/day. The seizures she does have seem less intense. Psycho-motor skills also seem improved. The patient is standing more, interacting with her family, with increased eye contact and appropriate emotional responses. Sleep is also greatly improved. Previously, it took L.I 4-5 hours to fall asleep and now falls to sleep within minutes. The speech therapist also observes marked improvement in L.I.'s Condition. The diagnosis that fits this case best is infantile spasms also known as West Syndrome. It is a relatively serious seizure disorder that most often begins around 4-5 months of age. There are several factors that may lead to this disorder including genetic, Tuberous Sclerosis, other structural abnormalities of the brain and certain metabolic conditions such as PKU. The condition is also know to be associated with low oxygen or high blood sugar at birth as well as certain uterine conditions such as cytomegalovirus, herpes and rubella. Some researchers have also implicated vaccinations as being a possible cause of this condition. In many instances there is no apparent cause. The course of the disease is variable. A small percentage seem to be minimally affected and have a good prognosis. It is estimated that 20-30% of patients died from the condition within 2-3 years. The remaining cases have chronic seizures, mental and developmental handicap. A few will go on to develop Lennox-Gastaut Syndrome which is characterized by very severe and violent seizures with drop attacks. Response to treatment is also very variable. Historically, traditional anti-seizure medications have given poor results. Of the regular medications valproate and vigabatrin have shown the best results. Adrenocorticotrophic hormone (ACTH) has also been found to be effective in controlling some of these seizures. A small percentage of children will have a favorable response to pyridoxine (vitamin B6). Please note that since high doses of vitamin B6 may cause nerve damage it should be used under the supervision of a qualified physician. Discussion of L.I.'s Protocol: Dr. Revici found that many seizure disorders could be addressed by balancing various metabolic states. He corrected metabolic offbalance with the evaluation of a variety of medical conditions, including seizures. The two types of metabolism, anabolic and catabolic need to be inbalance in order for the body to be healthy. When derangement's in either of these processes occur, the stage for pathology is set. In the case of seizure disorders, Dr.Revici found that if the metabolism was too anabolic, seizures were more likely to be initiated. By balancing this metabolic imbalance by the administration of catabolic agents, such as sodium thiosulphate or magnesium thiosulphate Bufo: is a homeopathic remedy indicated for seizure disorders in the homeopathic Matura medica. Homeopathic theory stipulates that homeopathy works by inducing the bodies innate healing capacity and not by suppressing symptoms. Boericke's homeopathic materia medica give the following indications for the use of bufo: actions on the nervous system, Epileptic syndromes, and mental delay in children. Valerian: this is a non-toxic herb that has a long history as a sleeping aid. The active ingredients, valeprotriate is known to have an affinity for the GABA receptor on the cell membrane of neurons. This is how it is thought to have anti-spasmodic activity and may help in controlling seizures. Omega– 3– fatty acids: This is an essential fatty acid found in fish and flax seed oil. Although it is not know to have specific effects on seizure disorders it is a very important part of the cell membrane in neurons as well as other cells and it helps to stabilize the cell membrane. This stabilization may help control electrical impulses that if not controlled may lead to seizures. Lipoic acid: is also not know to specifically control seizures but, it is a lipid soluble antioxidant and there for also has a positive effect on cell membranes. It passes easily through the blood brain barrier and is known to help detoxify the body from heavy metals such as mercury. It also has a positive effect in balancing the metabolism of carbohydrates. Summary: Epilepsy remains a prevalent disorder that often presents a challenge to current modes of treatment. As this case illustrates, seizure disorders may be difficult to control even with potent medications. Although not a cure, there may exist non-toxic options that may either reduce or iliminate the need for anti-seizure medications, which have a wide range of side effects from fatigue to suppression of the immune system. It is very important that anybody with a seizure disorder be evaluated and treated by a competent health care professional. Never stop any seizure medications unless you are under the supervision of a physician. |