Category: Epilepsy

Identified need and the mission statement

EACF operates a medical service and client case management services program that is offered to residents of Central Florida. The aim is to promote awareness of disability and epilepsy victims through education and prevention programs. The need for this program is as a result of the fact that epilepsy is highly misunderstood, despite being the oldest recognized neurological disorder. Epilepsy is a devastating condition that affects more people than cerebral palsy, muscular dystrophy, cerebral palsy, or even active cancer patients when pooled together.

EACF is dedicated to improving the quality of life of persons affected by epilepsy/seizure disorders (Carmen, 2011, p. 3). EACF identifies, defines and advocates the needs of persons with epilepsy/seizure disorders, and plan and implement its strategies to meet those needs (Carmen, 2011, p. 3). In order to increase the communitys response and the needs of persons with epilepsy, the program aims at educating and providing information to employers, educators, the medical community, the general public and the families of the victims. The agency ensures that epilepsy persons acquire diagnosis, treatments, and rehabilitation services as well as timely and accurate information with the aim of ensuring that they maintain their productive roles in the society.

EACFs proposal directly tackles the agency mission by improving the quality of life of persons with epilepsy, client advocacy, meeting the needs of persons with epilepsy, and informing/educating the community of these needs, along with disability awareness (Carmen, 2011, p. 4).

Project Description

The community based skill training and work assignment will be carried out by the agencys trained employment controller. The training program is aimed at enhancing self-sufficiency. The extended program is slated to commence from July 16, 2012 so as to give ample time for completion of additional training and sourcing of funds. EACF currently has programs addressing epilepsy education, medical care, social service counseling, and pre-GED and GED training. The proposed program extension would work in conjunction, complement and enhance existing EACF programs (Carmen, 2011, p. 6).

EACF programs includes but not limited to Community Based Employment, Life Skills Training and Basic Financial Planning with Employment Placement for Continued Success for Persons with Epilepsy and Disabilities (Carmen, 2011, p. 56).

The following services will be offered to the clients in the following year:

1. Disability /epilepsy and the indispensable obligations of the job.
2. Disability /epilepsy disclosure.
3. Making out the work values and setting professional goals.
4. Fundamental financial planning/budgeting skills training and personal financial needs.
5. Interrogation, follow-up and what employers would like.
6. Transportation to training and transportation to work.
7. Resources for pointing out job skills training, employers and C.V writing.

In addition, this program will involve the area human resource directors in successful community peers, participants presentation and successful community peers who will be engaged in motivating and mentoring the participants of the program. Community peers will also help optimize the productivity of the volunteers as well as the available agency resources. Multi-media equipment will be used to support the participants through the existing agencys resource center.

Some of the individuals who are targeted in this project will include but not limited to:

1. Future and current EACFS programs clients as well as the service providers, referrals from the areas physicians and disabled persons seeking the agencys intervention.
2. Those who cannot secure employment as a result of disablement which prevents them from acquiring relevant experience.
3. Those who have not been able to retain their jobs in the past due to problems emanating from their physical conditions.

First year costs

The total funds requested during the first year amounts to $958,000. The EACF match amounts to $1000, 000. The agency will plug the budgetary gap through additional fund raising activities such as through corporate and individual fund raising efforts.

Future year costs

State, county and private fundraising, in addition to federal funding will be considered to ensure that the program is finished. More proposals were submitted, and as a result, $30,658 were generated in 2011 and additional $9,605 are expected to come from the foundation funding.

Measures of success

1. Case manager action plan will be availed to each participant with the aim of assisting them with medications and medical services. This will as a result increase the clients epilepsy stabilization and reduction.
2. Employment Program Action Plan (EPAP) will be provided to each participant to monitor the success.
3. The number of all those who will participate in the program will be recorded, in addition to their post/pre testing for skills and knowledge.
4. Checklist and measurement tools will be used to establish the participants achievements and activities.

Required changes

The primary annual goal will be determined by attainment of 110+ total program participants, and an employment anticipation of 75+ persons. The secondary measure of success includes the participants successful completion of the program with increased self-worth, self esteem, as well as the ability to retain their permanent jobs, in addition to the ability to cope and understand their condition. Of additional importance is that the employers should understand the issues surrounding disabled persons employment in a better perspective.

Budget

Reference

Carmen, P. (2011). Business Proposal. New York, NY: Prentice-Hall International, Inc.

Introduction

Technological innovation has improved various processes including healthcare intervention systems. Epilepsy is no exception as medical experts have developed automatic detection machines for analysis of electroencephalogram (EEG) to sense electrical processes in the brain using electrodes to instantiate seizure [1]. Programmed seizure recognition is essential for closed-loop receptive cortical activation processes. This review evaluates various literature on recent technology on epileptic extraction, seizure detection, and prediction strategies. Machine learning techniques are quick and accurate in epileptic seizure detection.

Epileptic Extraction Methods

The two key phases of developing an automatic epilepsy detection system are feature selection and classification. The classifier issues a proper class code to the derived function vector after feature extraction decreases the proportions of the input indicator by preserving descriptive features. In a recent study, Niknazar et al. proposed successful feature extraction strategies for automatic epileptic EEG wave recognition [2]. To distinguish epileptic EEG signals in the sample, two successful feature extraction strategies were introduced. Various machine learning models were used to differentiate epileptic seizure and non-seizure signs. The standard epilepsy EEG database given by the University of Bonn was applied in the study [2]. The detection accuracy was assessed by a 10-fold cross authentication procedure. Decision Tree (DT), Support Vector Machine (SVM), Artificial Neural Network (ANN), and Nearest Neighbor (NN) classifiers are included. The tests were replicated 50 times and for the detection of natural and epileptic EEG signs, 1D-LGP and LNDP function extraction strategies with ANN Classification algorithm achieved average precision of 99.82 percent and 99.80 percent, respectively [2]. The classification findings outperformed several current approaches as 1D-LGP and LNDP were useful extraction strategies for classifying epileptic EEG activities.

Automatic epileptic seizure detection can be efficient in preventing any related issues. In a recent research, Niknazar et al., evaluated EEG-based technology proposed for early detection of seizure to identify the most efficient ones for sensing seizure [1]. The authors extracted seizure tracking properties from intracranial EEG waves obtained through intrusive pre-surgical epilepsy screening of patients with drug-resistant focal seizures at a University Hospital in Freiburgs. Time, intensity, and process space domain features, and similarity/dissimilarity attributes, were factored. The quantitative research approach, ANOVA, was used to examine the output of each function [1]. Various performance analyses were completed on reports from networks in the seizure-onset region and measurements from channels beyond the seizure-onset area. Correlation elements that quantify variable characteristics of the EEG indicator and the varying dynamics of seizures could distinguish ictal states from pre-ictal conditions (p < 0.01) [1]. Of these, the authors proposed function, Bhattacharyya-based dissimilarity indicator, passed a post-hoc examination, indicating that it could differentiate pre-ictal and post-ictal cycles from ictal phases. Bhattacharyya-based dissimilarity sensor was then used to track epileptic seizures, indicating no major change in function output between SOZ-in and SOZ-out reports [1]. Statistical analyses were used to assess the discriminative effect of EEG seizure identification features. As a consequence, the best features to choose for an accurate seizure monitoring device optimized for patients with drug-resistant temporal lobe epilepsy, was the similarity/dissimilarity scales.

Epileptic Seizure Detection Method

Seizures may have an adverse effect on patients mental, social, and physical life. Thus, their diagnoses are largely reliant on laborious manual curation by skilled physicians using EEG signals. The majority of current EEG-based seizure detectors are patient-dependent, requiring a trained detection algorithm for each user. Hence, a new patient can only use it after numerous episodes of the seizures, making it ineffective. In a study, Yang et al. investigated patient independent sensor of epileptic events using CHB-MIT Scalp EEG. To assess the topological trends of the EEG activities, an innovative function extraction technique known as MinMaxHist is suggested [3]. The EEG detectors are then parameterized using MinMaxHist and other feature extraction techniques. Later, a systematic set of function scanning and identification optimization tests are performed, and eventually, an improved EEG-based seizure classification method of 30 functions is introduced, with overall values for precision, Matthews correlation coefficient, tolerance, accuracy, and Kappa [3]. The system with MinMaxHist technologies had a 0.0464 higher classification than the model excluding MinMaxHist functions. The suggested technique outperformed existing approaches in precision and efficiency.

Seizure detection from EEG activity can aid neurologists in analyzing the statuses of epileptic patients. The diversity of epileptic seizures makes it difficult to distinguish the sequence of epilepsy signs from natural ones. Wulandari et al. address the characterization of seizure and non-seizure disorders of epilepsy centered on EEG signal spectrum characteristics [l4]. Empirical Mode Decomposition was applied in extracting these functions. These characteristics were loaded into the Support Vector Machine as data. The authors suggested combining the first 4 IMFs to derive frequency functions, which they tested on two data sets containing only waves from extracranial EEG [4]. The findings match those of Ynag et al. indicating that for SVM kernel activities, the metrics of precision and accuracy using the multiple features of the first selected IMFs outpaced those using single IMF features.

A technology that could alert all patients and physicians to the imminent epilepsy occurrence would vastly improve patients life. Deriche et al. performed research on epilepsy detection suggesting that time and frequency (TF) analysis be used to extract factors capable of distinguishing between regular and abnormal EEG residues [5]. The parameters were derived from the EEG detector Time Frequency vector through Singular Value Decomposition. The results reveal that, regardless of the classification model used, most conventional classification strategies yielded excellent seizure identification results when combined with the suggested TF functionality. The results are consistent with those of Wulandari et al., who found that the novel innovative technology features improve the seizure detection techniques.

Accurate epileptic seizure detection improves a patients response to attacks and overall quality of life. Dash et al. conducted an iterative filtering breakdown EEG alerts to improve seizure detection accuracy. The authors evaluate the suggested approach using Indian digital databases. [6] They apply the iterative filtering decay approach to derive sub-elements from the EEG signal. The approach attains an accuracy of over 99% in seizure detection. The findings clearly match those of Wundari et al. and Deriche et al. that innovative seizure detection techniques are more accurate in detecting epilepsy. Acharya et. use the convolutional neural network to assess EEG signals. In particular, they employed a 13-layer convolutional neural system on dataset from five patients. The technique attained an average accuracy of about 90%, which is a good score [7]. The findings match those of the previous researchers Wundari et al., Deriche et al., and Dash et al. that novel epileptic seizure detectors are accurate.

More researchers investigate the effectiveness of automated detection approaches in assessing seizures. For instance, Sudalaimani et al. also proved the accuracy of innovative seizure detection approached through the use of sub-frequency EEG data from a previous signal [8]. Sharma et al. found an over 78% accuracy in a proposed system; a wavelet decomposition [9]. Zazzaro et al. found a 99% accuracy of a trained classifier through indicator processing matching the findings of Sudalaimani et al. and Sharma et al. [10]. Ullah et al. tested two augmentation systems on a university dataset whose findings confirmed the suitability of the approach in detecting epilepsy [11]. Lastly, Nkengfack et al. also tested a full dispensation network of analysis for seizures. The findings supported the efficiency of the suggested processing chain with an accuracy of 96.25 to 100 percent [12]. Overall, the studies provide matching findings on the efficiency of novel proposed seizure detection systems on recognizing epileptic attacks.

Epileptic Seizure Prediction Methods

Various authors also investigate the role of machine learning method in predicting seizures. Savadkoohi et al. used EEG signal to assess brain electrical activities [13]. They examined the best approach to identify meaningful characteristics from an epileptic EEG. The findings revealed that SVM had a minimal edge over KNN. In another study, Wei et al. converted EEG into two-dimensional figures for multi-network fusion [14]. A sustainable recurring network was suggested to offer a spatiotemporal extensive learning framework to detect seizures. The findings match those of Savadkoohi et al. that the novel prediction model is accurate with a 93.4% precision. Tsiouris et al. used Long-Short Term Memory (SLTM) as that of Wei et al [15]. The findings showed increased seizure prediction using the SLTM as compared to conventional approaches replicating the findings of Wei et al. San-segundo et al. also evaluated various EEG signals using public databases. The findings indicated improved accuracy in detecting seizure. Overall, the reviews attest the importance of machine learning methods in predicting seizures.

Conclusion

Machine learning methods are efficient in early and accurate seizure detection. In this study, various empirical researches are evaluated to understand the application and accuracy of the strategy. Most researches prove that indeed, automated machine detection approaches are efficient in enhancing epileptic seizure detection to improve the patients quality of life. In particular, the proposed technologies include EEG, Long-Short Term Memory, KNN, and other automated detection systems. The findings support machine learning in quick seizure recognition to avoid associated dangers.

Reference List

H. Niknazar., S.R. Mousavi., M. Niknazar., V. Mardanlou., B. N. Coelho. Performance analysis of EEG seizure, detection features. Epilepsy Research, vol. 167, pp. 1-8, 2020, Web.

A. B. Jaiswal, and H. Banka. Local pattern transformation-based feature extraction techniques for classification of epileptic EEG signals. Biomedical Signal Processing and Control vol. 34, pp. 81-92. 2017, Web.

S. Yang., B. Li., Y. Zhang., M. Duan., S. Liu., Y. Zhang/. X. Feng., R. Tan., L. Huang., F. Zhou. Selection of features for patient-independent detection of seizure events using scalp EEG signals. Computers in biology and medicine vol. 119, pp. 1-13, 2020, Web.

D. P. Wulandari, N. G. P. Putri, Y. K. Suprapto, S. W. Purnami, A. I. Juniani, W. R. Islamiyah. Epileptic seizure detection based on bandwidth features of EEG signals. Procedia Computer Science vol. 161, pp. 568-576, 2019, Web.

M. Deriche, S. Arafat, S. Al-Insaif, M. Siddiqui. Eigenspace time frequency-based features for accurate seizure detection from EEG data. IRBM vol. 40, no. 2, pp.122-132, 2019, Web.

D. P. Dash, M. H. Kolekar, K. Jha. Multi-channel EEG based automatic epileptic seizure detection using iterative filtering decomposition and Hidden Markov Model. Computers in biology and medicine vol. 116, pp. 1-11, 2020, Web.

U. R. Acharya, S. L. Oh, Y, Hagiwara, J. H, Tan, H, Adeli. Deep convolutional neural network for the automated detection and diagnosis of seizure using EEG signals. Computers in biology and medicine vol. 100, pp. 270-278, 2018. Web.

C. Sudalaimani, N. Sivakumaran, T. T. Elizabeth, V. S. Rominus. Automated detection of the preseizure state in EEG signal using neural networks.biocybernetics and Biomedical engineering vol. 39, no. 1, pp. 160-175, 2019. Web.

M. Sharma, S. Patel, and U. R. Acharya. Automated detection of abnormal EEG signals using localized wavelet filter banks. Pattern Recognition Letters vol. 133, pp. 188-194, 2020. Web.

G. Zazzaro, S. Cuomo, A. Martone. Eeg signal analysis for epileptic seizures detection by applying data mining techniques. Internet of Things, Mar. 2019. Web.

I. Ullah, M. Hussain, E. Qazi. An automated system for epilepsy detection using EEG brain signals based on deep learning approach.Expert Systems with Applications, vol.107, pp. 61.71, 2018. Web.

L. C. D. Nkengfack, D. Tchiotsop, R. Atangana, V. Louis-Door, D. Wolf. EEG signals analysis for epileptic seizures detection using polynomial transforms, linear discriminant analysis and support vector machines. Biomedical Signal Processing and Control vol. 62, pp. 1-14, 2020, Web.

M. Savadkoohi, T. Oladunni, L. Thompson. A machine learning approach to epileptic seizure prediction using Electroencephalogram (EEG) Signal. Biocybernetics and Biomedical Engineering vol. 40.no. 3, 1328-13411, 2020, Web.

X. Wei, L. Zhou, Z. Zhang, Z. Chen, Y. Zhou. Early prediction of epileptic seizures using a long-term recurrent convolutional network. Journal of neuroscience methods vol. 327, pp. 1-10, 2019. Web.

K. M. Tsiouris, V. C. Pezoulas, M. Zervakis, S. Konitsiotis, D. D. Koutsouris, D. I. Fotiadis. A long short-term memory deep learning network for the prediction of epileptic seizures using EEG signals. Vol. 99, 24-37, 2018. Web.

The word epilepsy derived from Greek Word ‘Epilepsia’ which means ‘Seizure’. Epilepsy is a group of syndromes characterized by unprovoked, recurring seizure/convulsions, over time. Epilepsy is a 2 or more unprovoked seizures and convulsions in more than 24 hours apart.

The brain is the center that controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that normally communicate with each other through electrical activity. A seizure is a sudden, uncontrolled electrical disturbance in the brain, results in changes in behaviour, movements ,feelings, and in levels of consciousness. If the person has two or more seizures or a tendency to have recurrent seizures, than it is called as epilepsy. Most seizures last from 30 seconds to 2 minutes. A seizure that lasts longer than 5 minutes is a medical emergency. A Seizure is a paroxysmal, uncontrolled electrical discharges of neurons in the brain that interrupts normal function results in episodes of abnormal motor, sensory, autonomic or psychic activity (or a combination of these). Seizure are sudden, abnormal electrical discharges from the brain that results changes in sensation, behaviour, movements, perceptions or consciousness.

TYPES

Partial/Focal seizures

Partial seizures takes place when abnormal electrical brain function occurs in one or more areas of one side of the brain. One third of the person with partial seizures may experience an aura before seizure occurs. An aura is a strange feeling either consisting of visual changes, hearing abnormalities or changes in the sense of smell.

Signs

• muscle contractions, followed by relaxation.
• one side contraction of your body.
• unusual head/eye movements.
• abdominal pain.
• rapid pulse rate
• automatisms
• sweating.
• nausea.

Partial seizure is divided into 2 categories. 1. Simple Partial Seizure 2. Complex Partial Seizure

1. Simple Partial Seizure

The seizure typically last less than 1min. These seizure do not result in loss of consciousness. Symptoms include: Sudden and unexplained feeling of joy, anger, sadness. Involuntary jerking of the part of the body such as an arm, leg. Spontaneous sensory symptoms such as tingling, vertigo, and flashing lights. Person also may hear, smell, taste, see or feel things that are not real. The person may also experience sweating, nausea, or become pale.

2. Complex Partial Seizure

In this type of seizure the person has a change in or loss of consciousness for a period of time. Commonly occur in the temporal lobe of the brain. Symptoms include: Non purposeful movements such as hand rubbing, chewing, swallowing, gagging , lip smacking, screaming, crying, laughing, running, walking in circle, . Repetitious movement such as blinking, twitching, mouth movement etc. When the person regains consciousness the person may complains of being tired or sleepy after seizure.

Generalized Seizure

Generalized seizures involve both sides of the brain and are characterized by bilateral synchronous epileptic discharges in the brain from the onset of the seizure. There is loss of consciousness. There is no warning or aura.

Types of generalized seizures include the following:

Absence or Petit mal seizure.

These seizures are characterized by an altered state of consciousness and staring episodes. Typically, the person’s posture is maintained during the seizure. The mouth or face may move or the eyes may blink. The seizure usually lasts no longer than 30 seconds. When the seizure is over, the person may not recall what just occurred and acting as though nothing happened. This type of seizure is sometimes mistaken for a learning problem or behavioral problem. Absence seizures are uncommon before the age of 5 and occur more often in girls and in children. The EEG demonstrates 3 Hz spike in brain wave pattern. When untreated the seizure may occur upto 100 times a day.

Tonic clonic seizure or Grand mal seizure.

Also called as Grand Mal Seizures. This seizure is characterized by 5 distinct phases that occur. 1. The body, arms, and legs will flex (contract) for 30-40 seconds. 2. Extend (straighten out) 3. Tremor (shake) 4. Clonic period (contraction and relaxation of the muscles) . Cyanosis, excessive salivation, tongue or cheek biting, and incontinence may accompany. 5. Post ictal period. The patient usually has muscle soreness. During the post ictal period, the person may be sleepy, have problems with vision or speech, and may have a bad headache, fatigue, or body aches.

Myoclonic Seizure.

This type of seizure refers to quick movements or sudden jerking of a group of muscles or twitches of the upper body, arms, or legs. These seizures tend to occur in clusters, meaning that they may occur several times a day, or for several days in a row.

Tonic seizure.

Tonic seizures causes stiffening of the muscles, generally those in back, arms, legs, and may cause the person to fall to the ground.

Clonic seizure.

These type of seizures are begins with loss of consciousness and sudden loss of muscle tone followed by limb jerking that may or may not be symmetric . Symptoms include rhythmic , jerking muscle contractions usually affecting the arms, neck and face.

Atonic seizure.

Also known as ‘Drop Attack’. Seizure involves either a tonic episode or a paroxysmal loss of muscle tone and begins suddenly with the person falling to the ground. Conscious usually returns once the person hits in the ground and they have the great risk of head injury.

ETIOLOGY

The exact cause of the seizure may not be known, the more common seizures are caused by the following:

In newborns and infants:

• birth trauma
• congenital problems
• fever
• metabolic or chemical imbalances
• Genetic influence

In children, adolescents, and adults:

• alcohol or drugs
• head trauma
• infection
• Developmental disorder

Other possible causes of seizures may include the following

• brain tumor
• neurological problems
• drug withdrawal
• Overdose of antidepressants and other medications
• Stroke or Transient Ischemic Attack
• Dementia such as Alzheimers diseases
• Traumatic brain injury
• Abnormal blood vessels in brain

PATHOPHYSIOLOGY

Epilepsy differs from most neurological conditions as it has no pathogenic lesion. A variety of different electrical and chemical stimuli can give rise to seizure in any normal brain. The hallmark of epilepsy is a rather rhythmic and repetitive hyper synchronous discharge of neurons either localised in an area of cerebral cortex or generalised throughout the cortex. Neurones are interconnected in a complex network in which each individual neuron is linked through synapses with hundreds of others.

A small electrical current is discharged by neurons to release neurotransmitters at synaptic levels to communicate with each other. Neurotransmitters are divided into basic categories inhibitory or excitatory therefore neuron discharge either excite or inhibit neuron connected to it. An excited neuron will activate the next neuron whereas an inhibited neuron will not. In this manner information is conveyed, transferred and processed in CNS.A normal neuron discharges repetitively at a low baseline frequency and it is the integrated electrical activity generated by the neurons of superficial layer of cortex that is recorded in normal EEG.

If the neurons are damaged , injured or suffer a chemical or metabolic insult a change in the discharge pattern may develop. In case of epilepsy, regular low frequency discharges are replaced by bursts of high frequency discharges followed by a period of inactivity. A single neuron discharging in an abnormal manner usually has no significance. It is only when a population of neurons discharge synchronously in an abnormal way an epileptic seizure may be triggered. The abnormal discharge may remain localised or it may spread to adjacent areas recruiting more neurons as it expands. It may also generalise throughout the brain via cortical and subcortical routes including collosal and thalamocortical pathways. The area from which abnormal discharge originates is known as “epileptic focus”. An EEG recording carried out during these abnormal changes may show a variety of atypical signs depending on which area of brain is involved.

CAUSES OF EPILEPSY

Epilepsy is a general term for seizures. Hair is usually diagnosed only when a person is caught more than once.

When identified, the causes of epilepsy usually include some type of brain injury. For many, however, the cause of epilepsy is not known

Seizures occur when electric currents in the brain go beyond their normal limits. They spread to neighboring areas and create uncontrolled storms of electrical activity. Electrical insulation can infect muscles, causing cramps or dizziness.

Some of the leading causes of epilepsy include:

• Low oxygen at birth
• Head injuries from birth or accidents during adolescence or adulthood
• Components of the brain
• Genetic conditions that damage the brain, such as tubular sclerosis
• Diseases such as meningitis or encephalitis
• Stroke or other type of brain damage
• Abnormal amounts of a substance such as sodium or blood sugar

The use of drug nanocarriers in pharmacoresistant epilepsy is potentially a very useful tool that can be applied to overcome the drug delivery problem. Developing this technology requires a multidisciplinary approach involving the collaborative work of nanotechnology and pharmacology specialists.

However, development of these models requires prolonged experimental periods and low (20 percent or less) percentage of pharmacoresistant subjects obtained (127). Repeated administration of 3-mercaptopropionic acid or pentylentetrazol (47, 128) is a short-term alternative for obtaining animals with overexpression of brain transporters. These procedures however do not induce spontaneous seizure.

Other significant criteria to be considered in the production of nano-sized carriers for AEDs as therapeutic options for pharmacoresistant epilepsy include: 1) nanosystems must be engineered in such a way that AEDs can be masked and bypass the effects of multi-resistant proteins on the BBB that enable penetration into brain parenchyma 2) nanosystems must lead to successful prism.

Among the various types of nanosystems currently evaluated, MnPs have proven to be one of the best strategies for different biomedical uses, such as MRI contrast agents, cell therapy, tissue repair, hyperthermia ablation, drug delivery and carrier systems (140-142). MnPs offer special advantages such as their small size (< 100nm) in addition to their easy and economical synthesis process Suitable for cell membrane penetration (114, 143). Their biodegradability is performed by lysosomal rupture of the iron oxide core resulting in iron ions that are incorporated back into the hemoglobin pool (144) Given the magnetic characteristics of MnPs, intracerebral release from special devices may be controlled by magnetic fields (145) Some reports indicate that MnPs are highly biocompatible and do not induce toxic effects from their administration (146-148). MnPs may represent an excellent strategy for delivering AEDs into the brain parenchyma of patients with pharmacoresistant epilepsy according to this research. Indeed, a previous study indicates that 4 weeks of intraperitoneal administration of MnPs is not producing 'apparent' toxicity, Histopathological changes or adverse effects on the development and conduct of the body (149) However, it is necessary to note that MnPs in the biological environment are also reactive and can cause chemical interactions and toxicological effects (150, 151). On this issue, the MnPs are described as being able to Produce excessive reactive oxygen species, a situation which can result in oxidative stress (152, 153), neuronal damage, proinflammatory effects and BBB permeability modifications (154). Oxidative stress can cause cell death due to damage to the mitochondrial membrane or a malfunction of the electron chain (150, 155), Mutagenesis (156), activation of oncogenes such as Ras (157) or production of end-products detrimental to DNA (158) and subsequent cancer (159). Therefore it is important to determine whether adverse effects are produced after chronic administration of MnPs under different physiological conditions.

As you know diets have so many applications which mean people try them for various purposes ranging from weight loss to other health benefits they offer you. The way you eat and when you eat totally affects the functionality of your brain. The point worthy of being mentioned is that the keto diet can help you cure epilepsy. In fact, anyone having epilepsy can lessen the possibility of getting seizures to a significant level.

What is the ketogenic diet

The keto diet s is a low-carb diet but high in fat which its aim is to induce fat metabolism. When you’re on the keto diet, your body will make use of stored fats in your body in order to get the required amount of energy. In this stage, something is produced in your body and that is Ketones. Your brain needs energy and when your body doesn’t have glucose, it resorts to Ketones for an energy source. The keto diet is an effective weight loss diet and its efficacy has been proven. If you ask those who have already tried this diet, they’d probably start cajoling you into going on this diet. the keto diet suppresses your appetite which is an amazing thing for some people who are willing to lose weight. caused by infections. Not to mention that the keto diet is believed to be the modified type of Atkins.

What is exactly epilepsy?

Purely put, epilepsy is a kind of disorder ( nervous system ) covering so many symptoms. Some are likely to twitch, some may in a sense collapse and others may have a special type of seizures. Millions of people are born with this kind of disorder. Based on the recently published studies on the effects of the keto diet on epilepsy, it’s believed that the keto diet truly lessens the possibility of seizures. It’s an embarrassing condition to have, I mean who wants to lose control of their body and be looked at as a freak by some? Because lots of people don’t talk about the fact that they have it, and it’s not a horribly common thing to have, many people don’t ever think about it enough to find out specifics.

Sometimes it’s genetic, sometimes it starts around puberty, sometimes there is a problem in the brain(tumors, etc) that cause the problem, and sometimes there is no explanation for why the seizures exist. A ketogenic diet for the treatment of epilepsy is no different from the ketogenic diet for weight loss. You can eat eggs, meat, tofu, and some nuts and vegetables. As long as you avoid bread, fruits, grains, rice, potatoes, pasta, and other starches, you can get into ketosis.

What is partial epilepsy?

As the name implies, partial epilepsy impacts on a specific area of your brain. As you know this kind of disorder is followed by special types of symptoms. The occurrence of the symptoms totally depends on which section of your brain has been affected. It’s series range from drooling, unintentional mouth motions, eye movements, unintentional head turning, an unusual feeling of numbness and etc… you may also start a smelling something that others are not or you are likely to hear sounds and that only you’re hearing.

4 types of epilepsy you should know:

1. Generalized• Seizures show up on both the right and left side of your brain
2. Focal • This is partial seizures where only one side of your brain is affected. Focal is divided into 4 separate categories: Focal aware, Impaired awareness, motor, and non-motor seizures.
3. Both focal and generalized • You have both focal and generalized seizures
4. Unknown epilepsy • It’s evident that you have epilepsy but doctors can make a sound decision since you may have had seizures where there were no one seeing you and you were on your own.

How do you know you have epilepsy?

Whilst epilepsy does have some very exact symptoms, not everyone’s symptoms will show up in the same way and yours could be something very different which is only particular to you. Occasionally a seizure could appear with the person being aware of a strange smell, the color they can see that others can not or even a taste or feeling that is unique to you. This is also known as the aura. This will often come about because of a trigger that is particular to that person and again this totally differs from person to person. It may be flashing lights, while for some people it may be loud noises and for others maybe it is sudden cold or extreme heat, etc. Then you may either loose moments where someone will probably say you appeared to be daydreaming, as you simply stop what you were doing, only to just begin again as though there was no gap. This type of seizure is also called a petty mal and it hard to diagnose initially as the sufferer simply ‘checks out’ for a bit! Then there comes the ‘Grand Mal’ where you fall to the floor, lose consciousness and finally you would have a full seizure, often wetting yourself and sometimes injuring yourself. Once you stop fitting, you will slowly start regaining your awareness but will feel groggy and will have an extremely annoying headache which may make you wanna go hit the sack afterwards.

What vitamins do you need to control epilepsy?

1. Taurine (500 mg three times per day): it’s a type of amino acids that are said to be able to inhibit seizures. Not to mention that various studies have already proven this an established claim.
2. Diet: The most popular diet on this planet (ketogenic) diet which is a type of diet being low in carbs, high in fat and moderate in protein. This diet can help your body monitor the seizures. The point which is worth mentioning here is that recent researches and studies conducted on the impacts of the ketogenic diet on epilepsy have shown a strong connection with food allergies and seizures in children. It’s highly suggested that you avoid aspartame, alcohol, caffeine.
3. Zinc: may be depleted by some medications (30 mg per day)
4. Manganese: Depleted in people with epilepsy (5 to 15 mg per day)
5. Magnesium: 500 to 750 mg per day (should be in a 1:1 ratio in persons taking calcium) for normal muscle and nervous system function
6. Folic acid : (400 mcg per day): It’s advised that this vitamin be taken with B12 (100 to 200 mcg per day)
7. B6: this vitamin can help control and monitor seizures especially in children. ( 20 to 50 mg per kilogram of body weight )

Can keto really cure your epilepsy?

The keto diet has been around for years and its validity and reliability as an effective diet has been proven so far. Doctors also recommend this diet to anyone having epilepsy. In fact, out of all the treatments, the keto diet is an established one for adults or children with epilepsy.

According to recent experiments conducted in Houston Health centers, it was proved that a keto diet is an effective approach to cure epilepsy since this diet in a sense c modifies the genes which are already involved in energy metabolism in your brain. This helps your brain in so many ways and causes your brain to stabilize the functions of neurons. The keto s diet is a low carb a diet and it’s been certified that low carb but high-fat diet regimen lessen seizures.

How does the keto diet lessen the seizures?

What do you think is the cause of so many neurons firing at the same time? this occurs during a seizure. This happens simply because the cells of your brain are kinda excitable and these cells in your brain are emitting a lot of excitatory neurotransmitters such as glutamates.

What the keto diet does is that it lessens the number of glutamates in your brain and extends the GABA which hampers the process of seizures. It’s also said that a keto diet can lower inflammation in your brain or any type of inflammation

The final take

Epilepsy is a special kind of disorder which is divided into separable categories based on the symptoms. You may experience a type of symptom that someone else may not. the efficacy of the keto diet is well-known to everyone. Not only is it a good diet for weight loss, but it also helps you cure epilepsy. Doctors recommend that children with epilepsy try this diet because it will lessen the possibility of getting seizures. Various Researches and studies have been conducted in Houston Health centers in order to realize the root cause of epilepsy but unfortunately, no one knows the exact root cause yet. The thing is that various premises have been established so far yet the validity of such hypotheses has not been certified.

Please do bear in mind that, you should speak with a professional in order to get your body checked and see whether you have epilepsy or not. This article has been written in order to give you a good understanding of epilepsy. Under no circumstances should you rely on the information posted on websites like ours. It’s advised that you speak with your physician about this.

Abstract

Cannabis sativa (C. sativa) or medical marijuana, is the entirety of the plant and the internal chemicals. We have cannabinoid receptors within our cells, which allows the cannabis substances to act in order to cause effects. The two major chemicals are Tetrahydrocannabinol, the causation of the psychoactive “high” effects, and Cannabidiol, which has shown positive effects on some functions of the body, and would be the one primary one to reduce of seizures. Epilepsy is referred to as being one of the most common neurological diseases, according to International League Against Epilepsy. It is defined as a brain disorder represented by perturbation of the cerebral physiological function which engenders episodes of excessive neuronal activity caused by a neuronal hyper-excitability, as well as psychological, social, and cognitive corollary. Although, there is still limited quality evidence of marijuana actually making an impact, there is some.

The Ethical Dilemmas behind Using Marijuana for Epilepsy The discovery of cannabinoid receptors in the CNS, led to searching for endogenous substances and the receptors interacting, and identifying ‘endogenous cannabinoids’, the more important ones being; arachidonic acid derivatives anandamide and arachidonoyl glycerol. Evidence has shown that endocannabinoids are very important when it comes to controlling the synaptic transmissions and regulation rates of neuronal firing. In the CNS, the CB1 receptors expressed pre-synoptically on glutamatergic and GABAergic interneurons, and activation of these receptors causes inhibition of transmission. The endo-cannabinoid signal pathways’ involvement in the pathophysiology is inferred by clinical and experimental observations. Seizures mostly affect the endocannabinoid system. Marijuana has two neuro-active components: tetrahydrocannabinol (THC), which is psychoactive, and cannabidiol (CBD) which is not, but they both influence the endocannabinoid system to counteract the seizure.

History and Research

The Ethical and Unethical Appeals

In every situation, controversial issue or not, there are two sides, within those side there are subcategories. What appears to be positive and/or ethical, and that which appears to be negative and/or unethical, being the two main categories. However, these ‘right or wrong’ principles are to be used as a guide to make good moral judgements when solving moral issues. The Double Effect focuses on four constraints to be met in order for the ending effects to be ethically warranted. The first being: if the act’s effects are weighed individually, it must be either neutral or positive, the second being: the negative effect must not be a means of the positive yield, he third being: the negative effect is unintentional, and the fourth being: the reasoning behind preforming the act, must be commensurate. (Kelly G., Medico-Moral Problems) When looking at the ethics of a dilemma such as this, it is important to look at every angle.

The Ethical Appeals

Medical marijuana is used as a way to treat body issues, and in this case to help lessen the suffering of a person who deals with episodic spasms, the cannabis is simply used for relieving the person of their pain, which justifies it for the first constraint. The relief of the pain is not, in turn, caused by a negative act which meats the second constraint. The third is met via the up-holding of a physician-patient relationship by being able to discuss, recommend, and educate their patients and the patient having the right of informed consent. The fourth is met by the question of whether or not the relief of a patient’s pain is worth more than the potential harm that could come to be. The only thing is, with this situation, there is only some in-depth data, but very little in the way of repetition of studies and data collection of marijuana’s effects on epilepsy.

The Unethical Appeals

According to the Drug Enforcement Agency, cannabis and products derived from it is considered Schedule I drugs. Drugs in this category is often abused and not accepted for medical use currently. They are also considered to be the most dangerous drugs of the drug schedules, and could cause severe psychological or physical dependence, despite it being less so than benzodiazepines and opiates. Hence the concerns regarding accurate placement and information. Due to this federal regulations, legal problems, and the lack of cannabidiol, research is difficult, meaning the data is not necessarily accurate. Also the use of cannabis in children brings up the concern of potentially risking their developing brains with severe and negative consequences, which begs the question of potential dismissal regarding of the Principle of No Maleficence. A popular question is; how do you know what the product says it is, is actually what you get, well FDA testing or oversight is not required; the FDA has issued warning letters to some producers after testing some products and finding that the label was not accurately portrayed, so one does not know what they get at times. Additionally the lack of human case studies comes into play regarding the lack of reconfirming data and evidence of the causes and effects of using cannabis for epilepsy.

Relations to Colorado

Marijuana has been legal here since 2000, and one of the leading techniques used in helping with seizures using cannabis called “Charlotte’s Web” developed by Edward Maa: the Chief of the Comprehensive Epilepsy Program at Denver Health and Hospitals. Children’s Hospital Colorado has also lead a few studies in which they found that; of the pediatric epilepsy patients who used a CBD-related treatment, 33% of 75 experienced at least a 50% seizure reduction. Also, due to our advancements over time, and cannabis being legal, many people move here just for the treatments.

References

1. MACEDO, A. L. S. P., MACEDO, B. S. P., NEIVA, G. R., & DE MORAIS NEIVA, V. A. (2019). Use of Cannabidiol in Epilepsy Treatment: Literature Review. Brazilian Journal of Surgery & Clinical Research, 27(3), 69–70. Retrieved from https://libdb.ppcc.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=138164556&site=ehost-live&scope=site
2. Perry, M. S. (2019). Don’t Fear the Reefer—Evidence Mounts for Plant-Based Cannabidiol as
3. Treatment for Epilepsy. Epilepsy Currents, 19(2), 93–95.
4. https://libdb.ppcc.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=135815382&site=ehost-live&scope=site
5. Khan, A. A., Shekh, A. T., Khalil, A., Walker, M. C., Ali, A. B., & Shekh-Ahmad, T. (2018).
6. Cannabidiol exerts antiepileptic effects by restoring hippocampal interneuron functions in a temporal lobe epilepsy model. British Journal of Pharmacology, 175(11), 2097–2115. https://libdb.ppcc.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=129815691&site=ehost-live&scope=site
7. Kolikonda, M. K., Srinivasan, K., Enja, M., Sagi, V., & Lippmann, S. (2016). Medical Marijuana
8. for Epilepsy?. Innovations in clinical neuroscience, 13(3-4), 23–26.
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911937/
10. Perucca E. (2017). Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last?. Journal
11. of epilepsy research, 7(2), 61–76. doi:10.14581/jer.17012 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/
12. Rosenberg, E. C., Tsien, R. W., Whalley, B. J., & Devinsky, O. (2015). Cannabinoids and
13. Epilepsy. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 747–768. doi:10.1007/s13311-015-0375-5
14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604191/

Despite the significant clinical and therapeutic progress for centuries, people with epilepsy continue to suffer from discrimination due to the idea of epilepsy is caused by spirits or divine experiences.

Epilepsy is one of the most common serious brain disorders but is often surrounded by prejudice and myth, which can be overcome only with enormous difficulties. Epilepsy was frequently documented in ancient times. Throughout the ages, in different parts of the world and in different cultures, epilepsy has been associated with many misconceptions. However, its sudden and dramatic seizures, have been so mystifying. People with epilepsy were regarded as “being chosen” or “being possessed,” depending on the prevailing popular belief; this affected treatment and society’s attitudes towards people with epilepsy.

The belief that epilepsy is contagious, dates to antiquity when people used to spit at a person with the condition and refused to use the same dish. In the early Christian churches, clergy and synods segregated people with the problem of epilepsy from the faithful, because they were afraid that the people with the disease would desecrate the holy objects and would infect the communion plate and cup. Such beliefs are also common during the late Middle Ages.

Due to the idea of epilepsy is caused by spiritual or divine experiences, people with the problem of epilepsy were facing many challenges from family, friends, and society. Due to the belief, people couldn’t get a job, attend social events and live their life as other fellow human beings did. This brought psychological, social, and economical problems to the people. The psychological, social, and economical problems were creating more problems and complicate the situation.

Epilepsy is a chronic neurological disorder in which the nerve cells, or neurons, in the brain fire signals abnormally and cause a recurrent seizure, of which there are many varieties. These seizures have many causes and treatment options. In some cases, they can even be completely controlled, epilepsy was not always known to be a medical issue also thought to be caused by spirits or divine experiences.

The advancement in technology over the years open the gate to know more about epilepsy and seizures, like how and why they occur in some cases and the advancement helps to identify symptoms and signs on specific areas of the brain activated by the abnormal electrical activity and classify. If the abnormal activation is on the entire brain or a large part of the brain involved and loss of awareness without any warning is called generalized epilepsy. If the seizure starts from a small area of the brain and may experience a warning, known as an aura, named focal epilepsy.

The history of epilepsy is intermingled with the history of human existence; the first reports on epilepsy can be traced back to the Assyrian texts, almost 2,000 B.C. Many references to epilepsy can be found in the ancient texts of all civilizations, mostly in the ancient Greek medical text like the Hippocratic collection of medical writing. However, it was not until the 18th and 19th centuries, when medicine made important advances and research on epilepsy was emancipated from religious superstitions such as the fact that epilepsy was a divine punishment or possession.

The study by physiologist Fritsch and psychiatrist Hitzig “On the Electric Excitability of the Cerebrum”. The experiment was done by provoking seizures by electric stimulation in the brain cortex of dogs. The study helps to identify the pathophysiology of epilepsy and the topographic localization of epileptic seizures and epileptic mechanisms, which shows epilepsy derives from the brain. On the other side advancement in the field of the microscopic structure of the brain and the nervous system, helps to describe the structure of neurons and synapses. Another study during the 1940s, important discoveries were made in the field of psychomotor epilepsy, showed that changes in the behavior of monkeys could be associated with temporal lobe lesions research identifying various neural pathways within the brain and pointing out the important role in alert wakefulness as a background for sensory perception, higher intellectual activity, voluntary movements, and behaviors.

EEG and the electrophysiology of epilepsy which shows the association of electric stimuli and brain activity and examined the electrical activity of nerve-muscle preparations before epilepsy happens and explored the possibility of whether similar changes in electrical potential occurred in the brain during the normal functioning time of the brain. A study on the electrophysiology of epilepsy shows electric changes in the brain during experimentally induced seizures, associating epileptic attacks with abnormal electric discharges.

Surgical procedures were one of the treatment options performed during the 19th century on epileptic patients. Heyman in 1831 was the first one to perform surgery on an epileptic patient due to a brain abscess. At the beginning of the 20th century, a procedure called hemispherectomy was introduced as a neurosurgical procedure. However, important advancements were not made in epileptic surgery until the 1930s. One of the advancements in the development of surgical techniques in epileptic surgery was the introduction of EEG.

One of the surgical procedures that contributed to the evolution of the surgery of epilepsy was a surgery done by Penfield along with Jasper and Theodore Brown Rasmussen in the Neurologic Center of the University of Montreal. The procedure was removing epileptogenic lesions on an epilepsy patient. According to the Montreal procedure, through the administration of local anesthetic on specific areas of the brain, the surgeon removes the skull and the conscious patient describes to the surgeon his/her feelings so that the surgeon can identify the exact location of seizure activity. Then the surgeon proceeds the procedure in the removal of brain tissue in a specific location reducing the side effects of surgery. Through his operations, the surgeon was able to identify various brain centers and to create maps of the sensory and motor cortices of the brain. Another technique was the use of parallel X-ray beams that would avoid distortions of the skull, vessels, ventricles, and the frame and grids used for guiding the placement of intracranial electrodes.

At the beginning of the 1980s, the advent of modern diagnostic techniques such as MRI, PET, and SPECT (single photon emission tomography), 31P and 1H-MR spectroscopy, and MEG (magnetoencephalography) revolutionized epileptic. The advancement leads to the application of microsurgery led to selective operations with fewer complications.

Early 19th-century epilepsy was considered incurable and mostly the management was preventive and only one drug was used which is called bromine. Accidents, injuries, lead poison, and other kinds of poisoning in the parents of children, arteriosclerosis, and high blood pressure are thought to be the cause of epilepsy. Education of an epileptic child and parents will minimize the impact and easier for treatment and better improvement. The prevention methods were rubber between teeth, not giving treatment during the seizure. Epilepsy does not prevent us from doing whatever we want Julius Cassar, Napoleon, Alexander, Mohamed, and peter the great was some of the notable people in the world with the problem of epilepsy.

Treatment of epilepsy until the 1850s mostly consisted of herbal and chemical substances. In 1857, Sir Locock discovered the anticonvulsant and sedative traits of potassium bromide was a huge discovery to treat epilepsy. Starting from that, potassium bromide became a choice treatment for humans with epileptic seizures and nervous disorders until the 1912 discovery of phenobarbital by German physician Hauptmann. The introduction of animal models in the study of the properties of the anticonvulsant drug contribute to the development of new antiepileptic drugs, this leads to the discovery of a new drug called phenytoin in 1938. The drug Phenytoin became the first-line medication for the prevention of partial and tonic-clonic seizures and for acute cases of epilepsies or status epilepticus, giving an alternative therapeutic choice for patients not responding to bromides or barbiturates. In 1946, a new antiepileptic drug was added in the quiver of antiepileptic therapy, trimethadione; it was reported by Richards and Everett to prevent pentylenetetrazol-induced seizures and to be effective especially in the absence of seizures.

The last decades many new antiepileptic drugs such as vigabatrin, lamotrigine, oxcarbazepine, gabapentin, felbamate, topiramate, tiagabine, zonisamide, levetiracetam, stiripentol, pregabalin, rufinamide, lacosamide, eslicarbazepine, and perampanel were used. Carbamazepine was the first drug to be licensed by the FDA and ended clinical use of some of the drugs like felbamate due to its associated complications. Research in antiepileptic drugs is a very active field of study and many drugs are currently under development in clinical trials including eslicarbazepine acetate, brivaracetam, and retigabine.

One of the important advancements in epilepsy treatment was the development of vagus nerve stimulation (VNS) techniques, this technique is very important especially for patients experiencing serious adverse effects of antiepileptic drugs. VNS involves the implantation of a programmable signal generator (neurocybernetic prosthesis NCP) in the chest cavity, and the stimulating electrodes carry electrical signals from the generator to the left vagus nerve.

Alternative or complementary therapies have emerged in the therapy of epilepsy including relaxation therapies such as massage, aromatherapy, reflexology, and chiropractic therapy, holistic therapies such as herbal medicine, homeopathy, Ayurvedic medicine, and traditional Chinese medicine (herbal remedies plus acupuncture), traditional and psychological therapies such as autogenic training, neurofeedback, and other psychological therapies, and music therapy. Recent studies have pinpointed the use of cannabidiol and medical marijuana for the treatment of epilepsy.

The first connection between heredity and epilepsy was made in 1903 by Lundborg, a Swedish physician, his analysis was pioneering. He was able to trace back the disease in the family since the 18th century. However, the most important evolution in the field of the genetics of epilepsy took place during the last twenty years; in 1989, Leppert was the first to identify the link between chromosome 20 and idiopathic human epilepsy syndrome in a family with benign familial neonatal convulsions. The growing evidence on the connection between various genes and epilepsies is the cutting edge of modern epilepsy research, and in the next decades, new exciting discoveries are going to change epileptology. The identification of reliable biomarkers would greatly facilitate differential diagnosis, eliminate the trial-and-error approach to pharmacotherapy, facilitate presurgical evaluation, and greatly improve the cost-effectiveness of drug discovery and clinical trials of agents designed to treat, prevent, and cure epilepsy.

This historical journey offered thoughts from professionals and unprofessional people regarding epilepsy in ancient and present times. It’s somewhat unsatisfactory that, despite the significant clinical and therapeutic progress for centuries and the action of some progress, misconceptions stay and people with epilepsy still suffer from prejudice and discrimination. The media usually compounds these issues by spreading inaccurate information. There square measure only a few alternative sicknesses that suffer therefore greatly from such untruth. However, the lives of illustrious individuals with epilepsy might function as an example to others, to the media, and to anybody prejudiced against individuals with the condition. Yet, to boost the standard of life of individuals with epilepsy worldwide, significant efforts are required to teach the media and the general public, likewise the professionals and the individuals with epilepsy themselves.

The fascinating history of epilepsy relates to the history of humanity; early reports on epilepsy return to the traditional Assyrian texts, scanning amounts of just about 4000 years. the primary hallmark within the history of unwellness is that the medical practitioner texts that set unsure the divine origin of the disease. Major advances within the understanding of epilepsy came to a lot of later, throughout the eighteenth and nineteenth century; theories on epilepsy throughout this era square measure developed on a solid scientific basis and epileptics square measure for the first time treated as patients and not as possessed. Throughout this era, experimental studies were conducted, and advances were created within the pathology of the disease and the affiliation of epilepsy with varied psychiatrical symptoms. The arrival of the twentieth-century crystal rectifier to the in-depth understanding of the mechanisms of the disease, the event of effective medication, and neuroimaging strategies. Finally, one should mention the important advances in the molecular biology of the disease and the connection of various genes with various forms of epilepsy.

Imagine if a brain can primarily run on fatty foods such as bacon and cheese, well believe it or not a brain can most definitely only run on foods such as that nature. It may be hard to believe but the ketogenic diet is one of many diets that aren’t well known by the average human. Due to the fact that few people know about it, they do not know of the benefits that come along with doing such a diet. This fat-fueled way of life known as Keto can in fact be used as a way to help with epilepsy, a common seizure disorder that many humans develop or inherit genetically. Epilepsy and Keto have a history of helping children lessen the chance of seizures or getting rid of the seizure disorder itself. Keto signals the production of ketones which will aid in making the violent abnormal activities in the brainless violent. The correlation between both the disorder and diet go back to the 1920s as a treatment for epilepsy. Much research has been done about the topic but the research that will be presented will gradually connect the pieces together to prove that such a diet can in fact help with lowering the rate of epilepsy that can lead to the death of a person if not dealt with. The Keto diet does in fact help with epilepsy because the cells the ketosis stage produces are called ketones. Ketones become the primary energy source for the brain that increases efficiency and performance, which explains why the brain is referred to as fat-fueled. It is all because of the ketones that are produces at a rapid rate if the diet is followed properly.

What some people don’t understand about the Keto diet is that it isn’t just another diet that promotes fast weight loss. The ketogenic diet is a lifestyle people choose to follow which consists of having a high fat intake and little to no carbohydrates (carbs). It may sound insane to let go of delicacies such as cake, and hamburgers but there are many to take the challenge head-on to live a better lifestyle. The average ratio of food intake is four to one. The four to one ratio refers to the consumption of only one gram of protein per four grams of fat. Carbohydrates cease to exists because the main goal of a person is to get their body into a starvation mode that is referred to as ketosis. In this phase, a person will cause their body to naturally go into the body’s state of ketosis where it uses the fat stored in the body as a source of energy instead of the glucose that is produced when carbohydrates are consumed as “Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until you start eating carbohydrates again” For a person to achieve this body’s special state, one must completely cut out foods that have carbohydrates and sugars for good. Each and every person has to count their macros which varies per person but must intake about 75% fat, 20% protein, and 5% carbohydrates that naturally come in foods meaning things such as bread will become the worst enemy when achieving this state and maintaining it. The foods that are involved in attaining and maintaining keto “typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables”. A high-fat diet may not sound the most pleasing to the average human because of the word “fat” They think it’s impossible to do such a thing and immediately get a red flag. Today’s society is not properly educated because the word fat has been and is still being seen as fat. The fats that people automatically think are being consumed are saturated and trans fats which are indeed bad but the fat the ketogenic diet requires is the good fats.

Many people will question the correlation between the Keto diet and Epilepsy, and they are not to blame. If the person doesn’t have enough background information on both topics the connection between the two wouldn’t be as clear. Epilepsy is a chronic disorder that involves abnormal activities that occur in the brain due to energy deficit and many other things that can be violent towards humans. “The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals” meaning these seizures that are only considered a symptom until more occur can happen any day of the week, any time of day. Epilepsy as stated before is a chronic seizure disorder that has many causes that affect the wide range of infants to adults.

Now that there is a basic idea present of both the keto diet and the seizure disorder called epilepsy, ketones can be introduced. “Ketone bodies,” are byproducts of the body breaking down fat for energy. This only happens when your carbohydrate intake is low, and your body switches into a state of ketosis” (Perfect Keto Blog). “Technically, ketones are organic compounds that contain a carbonyl group (a carbon atom double-bonded to an oxygen atom) that is single bonded to two hydrocarbon groups made by oxidizing secondary alcohols.”. Just like many other molecules and compounds in the human body ketones are just another glucose that the body produces to keep it functioning properly, specifically in the brain. Studies have shown that the brain is more effective when it is running on ketones in comparison to the average glucose that is produced. The reasoning behind why ketones are good is because most diseases and disorders are all tracked back to and assumed to occur because of energy deficit which is something seizures do when not fed enough energy to work with. Abnormal actions begin to happen in the brain because glucose isn’t good enough of an energy source to supply the brain to run at all times. The way ketones are used as an energy source is by crossing blood-brain barriers to cross through to the brain to supply it with quick and efficient fuel The body can produce three types of ketones that each has its own function which is known as acetoacetate, beta-hydroxybutyric, and acetone. Both acetoacetate and beta-hydroxybutyrate are responsible for transporting energy from the liver to other tissues in your body may sound unsafe for your body to use ketones instead of its natural energy source known as glucose, ketone bodies are completely safe as any excess amount of them are eliminated through your breath and urine. There shouldn’t be anything stating that ketones are harmful to one’s body and that the ketogenic diet is not safe to do when there is proof all over the place showing and telling people that the results are very effective and can possibly change their life as well.

The brain to each and every single individual is one of the main reasons why we are alive and can make choices and have a conscience. “The brain is one of the more important organs in our body and it’s set up in a special area. It’s put inside a bony, protective skull and it’s got its own little border guard; the border guard only lets certain substances into it. This border guard is called the blood-brain barrier. We might think that when we cut ourselves or have an accident and we’re bleeding that the same blood flows into our brain, but it does not. It goes up through our neck and then it flows near the blood-brain barrier and only certain substances are allowed into the brain, like proteins. The blood-brain barrier basically makes sure that only the right stuff gets in and the right stuff gets out.” (Barbra). This is one of many reasons why ketones that run into the bloodstream and through the blood barrier are allowed in the brain. Ketones are a part of the group of special things that are allowed to enter and exit the brain whenever necessary. It has been proven that ketones are in fact a better alternative to glucose that can put a person at risk of disorders such as obesity, “added sugar in processed foods like soft drinks and breakfast cereals could elevate your body’s glucose levels, causing health issues like obesity or cognitive decline—and high glucose levels have been tied to memory problems in studies.” (Barbra). It is well known that the brain is the part of the body that contains the most fat at nearly 60% according to google. The most logical thing would be to take under consideration that the brain will need an energy source that will be able to supply the entire brain to not only function properly but to exceed its normal capacity and to work effectively, avoiding abnormal activities that cause a person to have a seizure which could possibly kill them depending on the severity. This is now in reference to a fat-fueled brain due to the fact that ketones are produced from the liver to use throughout the body replacing glucose.

A fat-fueled brain is a key to the development of a person who is trying to prevent seizures and to promote and enhance brain energy production and productivity. “The Emory research team studied the link between diet and epileptic seizures on the behavioral, cellular, and genetic level. They found, as had others, that in rats fed the KD the resistance to seizures develops slowly, over one to two weeks, in contrast to rats treated with conventional anticonvulsant drugs. On the cellular level, they found that the anticonvulsant effect of the ketogenic diet did not correlate with a rise in plasma ketone levels or with a decrease in plasma glucose. Because longer treatment with the KD was necessary to increase the resistance to seizures, they concluded that changes in gene expression might hold the key to the diet’s anticonvulsant effects.” Many researchers have taken under consideration that energy deficit amongst all the disorders has been quite a huge contributor to the disorder itself and the answer was lying beneath the research that had been done with the ketogenic diet itself. In the early 1920s, there has been researching done, and was concluded that children with epilepsy on the ketogenic diet had significant results with 10-15% having fewer seizures too about 20% losing the abnormal actions that occurred in their brains causing the seizures. As it was stated earlier ketones are the most efficient fuel source to the brain as it improves its performance and there shouldn’t be any arguments going against it when it had been scientifically tested and proven to work effectively. “There’s nothing wrong with sugar, provided it’s in an appropriate amount. When you get too much glucose, bad things start to happen. We end up having the risk of obesity, diabetes and so forth.” (Barbra).

Epilepsy is a neurological and physical condition, meaning that it affects the brain and the nervous system. The brain is the control center of the body that regulates voluntary and involuntary responses. There is a normal electrical function constantly firing throughout the brain by communication of nerve cells. When a seizure occurs, the brain is temporarily interrupted by a spur of abnormal electrical signals. It is similar to cars driving on a freeway, getting from point A to point B; if there is an earthquake, the stream of driving cars gets interrupted, and damage is done to the freeway and surrounding areas. There are 40 types of seizures that affect different regions of the brain and they do not all-cause shaking, convulsion, and unconsciousness. For each seizure type, there are certain stimulants that trigger the given effects. These triggers can range from flashing lights, geometric patterns, certain foods, stress, lack of sleep, substance use, and more. The different types of epilepsy are due to varying underlying causes. Genes play a big role in the development of epilepsy as it can be an inherited genetic tendency or a mutation in the person’s genes. Traumatic brain injuries have been linked to the development of epilepsy, but research has found that even if seizures begin after an injury or a structural change to the brain, those who experience seizures already had some level of genetic likelihood. Epilepsy may be attributed to the combination of inherited genes from your parents and/or some degree of brain injury. Genetic conditions such as neurofibromatosis and tuberous sclerosis, which are structural conditions, affect the brain by producing growths on nerves and brain structures, causing another factor in seizure development.

Seizures occur when the excitatory and inhibitory circuits within the brain are imbalanced. These circuits create a positive or a negative change in brain activity, and when they are being thrown off their regular pathways it causes abnormal functioning within the brain. When epilepsy is diagnosed, physicians’ standard and most probable form of treatment is medication. Anti-epileptic drugs (AEDs) work to decrease excitation (positive changes) or increase inhibition (negative changes). These prescriptions work to control the seizures and as symptomatic relief to its effects, but they do not cure epilepsy. Since they do not act as a cure, they are typically prescribed as lifelong medications with adverse effects. AEDs have negative properties that limit their effectiveness due to the difficulties they cause for patient management. Long-term use of a variety of AEDs causes withdrawal symptoms, harmful interactions with other drugs, adverse effects, as well as an economic hardship. During clinical trials for AEDs, where the drug developers test the effects of their drug, there were no observations of the rare, yet severe side effects that these medications can cause. The clinical trials did not consider or recognize that patients with epilepsy take these prescriptions for several years, or even lifelong. The long-term adverse effects went unnoticed because the trials did not mimic the experience and duration of an actual patient. Every medication comes with its personal set of side effects, but many reactions found with long-term use of AEDs were unexpected and extreme. Effects have been seen to create unpredictable moods, abnormal behavior, and alter cognitive function. In more detrimental findings, these drugs can cause visual changes, aplastic anemia, hepatitis, liver failure, pancreatitis, and more. These conditions pose a major health risk as aplastic anemia is damage to bone cell growth, hepatitis/liver failure is when your liver gets inflamed and then shuts down entirely, and pancreatitis is also inflammation to a major organ. Living with these effects on top of the condition of epilepsy is very difficult as far as patient management goes.

I believe that alternative treatments for epilepsy are promising therapies that have proven to show efficacy, and there should be more efforts for patient awareness and education. Often, patients with epilepsy have been prescribed medication or several medications and are not told of their method of action, adverse effects, or general toll they make take on the body. My sister has epilepsy, specifically convulsive seizures or grand mal seizures. This means the electronic pathways that are affected instantly involves the whole brain, causing the person to immediately lose consciousness and seize for 1-5 minutes. She reached a point where she was taking twelve prescriptions a day to manage the seizures and the many side effects, and problems only continued to occur. Against the doctor’s orders, she quit the medications and tried alternative therapies such as meditation, more exercise, a change in diet, and cannabidiol (CBD). Medical cannabis has 85 different chemical compounds which are called cannabinoids. The most common component of the makeup is tetrahydrocannabinol (THC), but the anticonvulsant effects and properties are derived from cannabidiol (CBD). Cannabidiol targets and interacts with specific channels and receptors in the brain, which regulates the transmission and electrical, firing. The Epilepsy Foundation stated the FDA approval for CBD as a treatment option after successful clinicals trials were reported.

Relaxation techniques have been shown to decrease seizure frequency and improve the quality of life. The goal of this therapy is to teach the patient to recognize any kind of pre-seizure signs or activity and then apply taught relaxation techniques. This therapy effectively reduces seizure rates by direct cause, as well as indirectly improving seizure control through better sleep.

Herbal medicine is also another successful complementation therapy for epilepsy. Studies published in Chinese medical literature dictated two remedies that were beneficial to intractable (uncontrolled) epilepsy. One remedy was a makeup of thirteen different herbs, that imitated similar effects to phenobarbitone, an AED. This remedy was given to 100 children over the span of 8 months. Another study administered zhenxianling, a specialized herb, to 239 patients over two years. Seizure frequency was reduced by more than 75% in two-thirds of the patients from these studies. I believe that western medicine should take action to conduct more research on the effects of alternative therapies to epilepsy such as techniques, lifestyle changes, and eastern medicine as a more natural, and less invasive approach to epilepsy control.

Epilepsy is a common chronic neurological disorder that affects people of all ages. It is caused by abnormal electrical activity in the brain. A person with epilepsy experiences a sudden episode of seizures, which may include sensory disturbance, unconsciousness, and repetitive muscle jerking (Wlodarczyk et al., 2012). The treatment is the daily intake of antiepileptic drugs (AEDs) regimen. More than 90% of pregnancies proceeds without complications in women with epilepsy, although there is the slight increase in adverse effect outcome that is found, it is advised that women with epilepsy should do careful planning of pregnancy, pregnancy counseling and delivery management (Viinikainen et al., 2006). Complications associated with epilepsy during pregnancy include prolonged labor, vaginal bleeding, surgical delivery, preeclampsia (which occurs in 5-6% of all pregnancies), and frequency of seizures (Viinikainen et al., 2006). There are many interactions between epilepsy and pregnancy, but the main concern is the effect of AEDs on the development of the fetus. The maternal is advised to take the AEDs treatment to prevent the detrimental effect of epileptic seizures on themselves and the fetus (Meador et al., 2008). The problem with outcome exposure of these AEDs is that they increase the risk of congenital malformation, fetal death, feeding difficulties, neonatal hemorrhage, low birth weight neurocognitive development, and childhood epilepsy on the child (Viinikainen et al., 2006), these effects make it difficult to manage epilepsy during pregnancy. What also needs to be considered is the risk that is linked with uncontrolled seizures on the maternal and the fetus, the effect of pregnancy on the controlled seizure, the potential development of toxicity of the epilepsy drugs treatment (Battino and Tomson, 2007). The aim of this literature review is to discuss the management of epilepsy during pregnancy with an emphasis on the teratogenic effect of antiepileptic drugs as well as the control of seizures during pregnancy, and the effect of pregnancy on the AEDs.

About 3.8% of women with epilepsy experience epileptic seizures free throughout their pregnancy period of all maternal deaths in the United Kingdom convulsion, this is greatly more than expected from the commonness of epilepsy in pregnancy (Battino and Tomson, 2007). Seizures may be detrimental, causing physical damages and sometimes lead to the death of the patient with epilepsy (Battino and Tomson, 2007). Seizures are not likely to contribute greatly to the increased risk of birth defects. Even though the total risk is low, but many studies have reported that a larger than expected number of maternal deaths in the United Kingdom is caused by epilepsy seizures. Most maternal stops taking their treatment as soon as they realize that they are pregnant. Mortality of maternal and fetus is partly related to the seizure occurrence after stopping AEDs treatments (Battino and Tomson, 2007). The fetus effect depends mainly on the type of seizure the maternal might be experiencing. For instance, some seizures might be harmless on both the maternal and the fetus while others are detrimental and might lead to death. There are convulsive seizures, this includes maternal falls that might lead to injury of both the maternal and the fetus or even abruptio placentae if there is blunt trauma to the abdomen. Most of the uncontrolled convulsive seizure leads miscarriages (There are many anecdotal and case reports of miscarriage following a generalized seizure), intracranial bleeding, and suppression of fetal heart rate (Tomson et al., 2013). While uncontrolled tonic-clonic seizures may have a less harmful effect on the fetus compared to convulsive seizures. But this is still potentially dangerous to the maternal and the fetal, although strict evidence is lacking, this is generally also assumed to be more harmful to the fetus than are antiepileptic drugs (Battino and Tomson, 2007). Even though the absolute risk is very low, it is important to have seizures control for maternal health.

“The physiologic changes that take place during pregnancy can affect any level of the disposition of the drugs from absorption, distribution, metabolism to excretion. Every pregnancy represents a singular occurrence of genetic variation and environmental factors, and AEDs may interact differently with any of these in the individual and, also differently from pregnancy to pregnancy’ (Wlodarczyk et al., 2012). Pregnancy can remarkably affect the pharmacokinetics of the AEDs with the potential consequences for seizure control as well as the drug exposure to the fetus (Tomson et al., 2013). Epilepsy and pregnancy studies have reported that the AEDs differ in their teratogenic potential, some AEDs are less harmful (carbamazepine, phenytoin, or lamotrigine) while others are dangerous (valproic acid) and they increase the risk of congenital malformation, also the harmful effect of these epileptic drugs on the fetus are dose-dependent (Meador et al., 2009). The dose-dependent tells us that the maternal and fetus susceptibility to the teratogenic effect of the AEDs with similar exposure in the type and dose of the drug as well as the normal genetic factors are likely to contribute to the major congenital malformation in children who are a mother is epileptic (Tomson et al., 2015). During pregnancy, the plasma volume progressively increases and affects the drug disposed of within the body. The total drug plasma concentration decline, and in some cases, this may lead to adverse seizure control. The storage of fat increases and the elimination of the fat-soluble drug becomes slow. The duration of fat-soluble accumulates in the system depends on the absorption and elimination of that drug within the system. It was observed that exposure to these drugs during pregnancy leads to cardiac malformation, hypospadias, and facial cleft (Wlodarczyk et al., 2012).

Women with epilepsy are more likely to have obstetrical complications during pregnancy than are women in the general population (Yerby, 1991). Pregnancy has multiple influences on the effect of seizure control in most epilepsy cases. Even though population-based studies stipulate that symptoms decline in 15-30% of women, they improve in a similar proportion of women. This could partly indicate random variation. About one-third of women with epilepsy experience an increase in a seizure. The relationship between seizure frequency before pregnancy and increased seizures during parturition were studied by many clinical studies, as well as epilepsy and pregnancy registries, and it shows that the effect of pregnancy may vary from one patient to another and in different pregnancies of the same patient. It was also found that the seizures were more frequent in pregnancies with a male (64%) as opposed to a female (30%) neonate (Knight and Rhind, 1975). Some women might not experience any seizures during pregnancy, others might have a fluctuation of seizures while others experience unchanged seizures during this period.

The management of epilepsy during pregnancy is difficult because both the maternal and the fetus are at risk (Viinikainen et al., 2006). The seizures control treatment needs to be improved by introducing new and safer AEDs. There is no evidence regarding the non-teratogenic AEDs or that may lack developmental toxicity. Although, independent studies have reported a substantial risk for malformations associated with the valproic acid drug as compared with other AEDs. Women with epilepsy who are planning pregnancy should avoid the use of the valproic acid drug. Although, there are some women with juvenile myoclonic epilepsy, where seizure control is only maintained by the valproic acid drug. In this case, it should be noted that a low dose of this drug may not be harmful compared to other drugs (Battino and Tomson, 2007).