Insomnia (or sleeplessness) is most often defined by an individual’s report of sleeping difficulties.^[1] While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions: “Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?”^[1]

Our friends at CanadaDrugCenter.com shows us graphically exactly who is typically effected and what those consequences are.

Via: Canada Drug Center

In recent years, newer drugs have been created that are called antiepileptic drugs (AEDs). These have been widely used by doctors, and include drugs such as: gabapentin, oxcarbazepine and topiramate. These drugs are now so widely used the new guidance takes them into account.

The director of the NICE center for Clinical Practice, Dr Fergus Macbeth, has made a statement regarding the new guidance. In a comment to the press, he said: ‘We have updated our clinical guidance so that healthcare professionals can be sure that they are prescribing the most clinically and cost-effective treatments for their patients’.

The guidance is detailed, and does offer some key points that physicians should be following when using AEDs. The points include:

• When it is possible, choose the AED based upon the presenting syndrome. If this is not possible, choose on the basis of the presenting seizure type.
• When prescribing sodium valproate to women and girls of present and future childbearing potential, discuss the possible risk of malformation and neuron-developmental impairments in an unborn child, particularly with high doses of the AED or when using as part of polytherapy
• Only prescribe buccal midazolam (ViroPharma’s Buccolam) or rectal diazepam for use in the community for children, young people and adults who have had a previous episode of prolonged or serial convulse seizures; and
• administer buccal midazolam as first-line treatment in children, young people and adults with prolonged or repeated seizures in the community. Administer rectal diazepam if preferred, or if buccal midazolam is not available. If intravenous access is already established and resuscitation facilities are available, administer intravenous lorazepam.

In England and Wales, epilepsy is estimated to affect a possible half a million people.

Peter Benning, the father of Reece, asked the driver of the First Bus vehicle to stop the bus when young Reece began having a fit. While fits are normally short-lived, complications can occur quickly and put the sufferer’s life in danger.

Instead of stopping the bus and wafting for the fit to pass, the driver asked the father and son to leave so that he could continue with his journey. Peter then had to take his son to a nearby florists to call an ambulance. Reece suffers from a form of myoclonic epilepsy. Later that evening, after Reece had been rushed to hospital, he then went on to experience two more seizures. He was, luckily, able to be taken home the next day.

Mr. Benning, who is aggrieved at the way he and his son were treated, is in the process of creating a complaint against First Bus, the company who run the service.

Mr. Benning was angry and shocked after the incident, telling the press: ‘what was I meant to do when I got off the bus? We were treated really poorly.’

A spokesperson for the company has responded to the complaint, assuring Mr. Benning that they are looking into the incident, but claiming that their driver acted responsibly. However, they do intend to look into it more closely.

Mr. Benning lives with his girlfriend and their eight-month-old son, alongside Reece, as well as a stepson. He praised the actions of the florist staff that helped, saying: ‘the staff at Petals florist were just brilliant. They just reassured me all the time’.

It can be very alarming seeing someone undergo an epilepsy seizure, and it can even be quite frightening. However, if an adult is present, there is a lot they can do to make the sufferer more comfortable and even help alleviate the symptoms.

If you do happen to be near someone who does experience a seizure, the very first thing to remember is to not panic. This does nothing for the sufferer, and will only cause you to feel even more stressed and incapable as the seizure goes on. So take a few deep breaths and try your best to ensure the following happens.

The basic clear symptoms involve an alteration of consciousness. This means that the sufferer will generally act like they do not know what is going on, and this will be quite clear when you witness it. Other symptoms include a smacking of the lips, where the sufferer generally seems to be concerned with the dryness of his lips, and will start smacking them or licking them with his tongue. There may be difficulty in breathing or general discomfort with breathing.

If these kinds of symptoms occur and you know the person is an epilepsy sufferer (they will usually make it clear if you know them a little) then you have to go back to the first point about staying calm. This is is absolutely vital for the person, who needs all your help and can generally do nothing to help themselves when they are having a seizure.

Then, make sure that, whatever you do, you do not attempt to move the person anywhere else. There are a couple of good reasons for this advice. If the person is having a seizure, there is every chance they may hurt you or someone else when fitting. This is of course not on purpose, but it can most definitely happen, and can be quite distressing, not to mention painful.

You must stay with the person who is having the seizure. Never go away to do anything else, even call the ambulance. The person who is having the seizure needs you to be there if complications arise. Things could get more dangerous, for example the airways could become blocked if they have food in their mouth etc. so if you are there they can at least have a chance of surviving.

Move chairs and other hard objects away for the person who is having a seizure. Do this so they do not bump into these objects and cause themselves a serious injury. Then find a soft pillow or similar object and place it under the sufferer’s head. You can do this gently without causing harm.

At this stage it is important for you to try and turn the person onto their side so that they have less chance of choking. This again can be done carefully and gently to protect the sufferer.

Finally, if the seizure lasts anything longer than five minutes, you should stop everything and call the ambulance immediately.

Focused entirely on the United Sates initially, the DNA codes and medical histories of patients will be carefully scrutinized, in an effort to understand how the condition works and how it can be best managed for both patients and families. The condition is now so widespread; it affects people worldwide in their millions, with two million sufferers in the United States alone.

The University has long been respected as a major center for research and treatment for epilepsy, and is lucky to have some innovative technology at its disposal, with departments in neurology and neurosurgery to rival the best on the planet.

The national Institute of Neurological Disorders and Stroke has funded the new study with a generous grant of $25 million. The study will come soon after the development of another similar undertaking, known simply as the Epilepsy Phenome/Genome Project. Daniel Lowenstein directs work at the university and the Phenome/Genome project is something he is heavily involved in. The Phenome/Genome project is extensive, collecting data and information from families of sufferers as well as the sufferers themselves. Over 5000 people are involved in the project.

The new project will use DNA from a large group of people too, and will also use cutting edge techniques to help move the research forward. One of the main aims is to find out why epilepsy treatments work well with one person and perhaps not so well with another.

Epilepsy is a huge problem worldwide, and while it may not be a fatal problem it is still something that can be extremely challenging.

The originator of modern medicine, Hippocrates, described it in detail in his own writings around 2,500 years ago, and ever since then the condition has gradually come to be better understood. The word ‘epilepsy’ itself means ‘seizure’ in Greek, and while it is true that some of the symptoms, such as convulsions, are common to other conditions, epilepsy sufferers are unfortunate enough to have these conditions on a recurring basis.

Lowenstein and his team have one main concern, and that is that epilepsy does not seem to arise from one single mutant gene. This means that the answer must lie with a combination of factors, and his research is aimed at delving deeper into this phenomenon.

There are two sectors the team are interested in. The first is where the epilepsy generates in early childhood, and is the one often associated with developmental disorders as the child grows. Because this is not inherited, the comparison between the genes of the child and the parent should yield results that help identify problem genetic code.

The second group is much more complex. Here the genes are inherited, but they are still, obviously, unique to the person. Going through all of the thousands of different permutations in this sector is going to be a challenge that Lowenstein and his team are looking forward to.

The boy is called Muir, and his eventual diagnosis revealed that he had a severe form of Myoclonic epilepsy.  Muir has now reached the age of fifteen, and while his life is not uncomfortable, the epilepsy has brought him some communication and other developmental difficulties.

The family has taken things very public though, with Ann setting up a special charity that helps young people who have epilepsy. The Muir Maxwell Epilepsy Trust was first set up in 2003 and has since been wholly responsible for raising over £7 million.

The Center has now managed to create a brand new research unit as part of the work the charity does, and is already becoming known for groundbreaking work into the condition. Dr. Richard Chin runs the research centre, and the provision is fast becoming the number one such unit in the UK.

Edinburgh University approached the family and asked them to get involved in the new research provision, and Ann remembers: ‘One of the risks I suppose when we talk about a centre is that everybody thinks about it being a bricks and mortar centre and in the end it will take that form, because they intend to include the Muir Maxwell Epilepsy Centre at the new children’s hospital at Little France when it’s built.’

Dr. Chin makes the point that the success of the new institution is not really centered around the levels of research it does or the papers it produces. Instead he feels that the number of children’s views positively touched by the centre will be a clear indicator of how well it is doing.

He says: ‘The three main themes of the centre are related to the three primary questions that clinicians and patients are always faced with. The first is, what is the cause of epilepsy? Because in 70 per cent of cases we don’t know the cause.’

‘Second is, what is the best treatment? We’re addressing this in a general holistic sense, we’re talking about that quite loosely, not just drugs but early detection and intervention, particularly on learning and behavioral problems associated with epilepsy, because this is one area which is severely unrecognized and can be severely mismanaged. Lots of people think of epilepsy as just seizures and it’s far more than that. The learning and behavioral problems are largely ignored.’

‘The third is the psychological aspects of epilepsy – how does it affect the child, how does it affect the family, what are the financial, social and behavioral effects it has on them?’

Muir, the boy who inspired the project, has just turned 15, and currently boards at a special school called Donaldson’s School, which has excellent provision for speech and language.

Epilepsy affects millions of lives, and such work helps give hope to not just the sufferers, but their families too.

Epilepsy Action is the charity organizing the day, and celebrities and notable figures such as David Cameron and Rolf Harris will be joining schoolchildren and other members of the wider community in getting their doodles done. Winning schools with doodles that are deemed to be the best will take in £250 in prize money to be used for the school’s educational requirements. The winning school overall will have the major honour of having their work displayed on the National Doodle Day website. Certificates go out to all schools taking part.

The fundraising events manager at the charity is Phillippa Cartwright, and she said to the press recently: ‘Schools across the UK have helped us raise over £220,000 since the very first National Doodle Day in 2004. This money is vital in helping us support the 600,000 epilepsy sufferers in the UK.’

Epilepsy affects one in every 103 people in the UK, and the levels of diagnosis are incredibly high, with over 80 people being diagnosed with the condition on a daily basis. Epilepsy Action helps hundreds of thousands of people every year, with a startling level of results. It offers an information center, and a network of advice with branches ranging across the country. The reach is wide, and staffed by volunteers as well as paid employees.

Diary design company Dodo-Pad is sponsoring the event, and they offer a wide range of dairies and organizer products that take the stress out of organizing a busy life. Their products can be seen at www.dodopad.com

There are really two types of epilepsy seizures, one a partial seizure and the other a full seizure. The full seizure is generally referred to by physicians as ‘general’. The doctors who treat epilepsy classify the two types according to how much of the brain is affected. A general seizure will affect the whole brain, while a partial will only affect the brain to a lesser extent.

A partial seizure is further broken down into symptoms where you can either suffer a simple partial seizure, or a complex partial seizure. Symptoms of a simple partial seizure (where you feel more than you would during a complex one) include:

• Changes in the way things can look, feel, sound or smell
• The unique feeling of déjà vu
• An intense sensation of ‘pins and needles’ in your legs
• Intensifying emotions, such as fear and excitement
• Some involuntarily movement (or twitching) on one side of your body

A more complex partial seizure, where you may not remember anything at all that happens to you, has symptoms such as:

• A rubbing of the hands
• Smacking of your lips
• Moving your arms involuntarily
• A rubbing of your muscles
• Increased chewing or swallowing

If you have a partial seizure, you will have little to no awareness during it, and no memory of it.

When it comes to general seizures, unconsciousness is generally what happens. This can be quite alarming, especially the first few times it happens, but people generally get control of their general seizures (or at least the people around them do).

Symptoms include:

• Absences, which generally affect children more than adults. This is where the child loses awareness of his or her surroundings for under thirty seconds
• Myoclonic jerks are where your body trembles and twitches involuntarily.
• A full Clonic seizure occurs were you may lose consciousness and twitch for longer than you would with a Myoclonic seizure
• An Atonic seizure is where your muscles relax, and you often fall to the ground when this one occurs

In some situations, sufferers can experience what is known as an ‘aura’. These occur moments before a seizure, and generally make the sufferer feel lightheaded, or that the world is becoming somewhat unreal or dreamlike. There will be a change in the sense of smell, and a strong sense of deja vu.

While some symptoms can be spotted, it is generally advised to be up to date with the personal circumstance of anyone who you know suffers from epilepsy. This is because some symptoms may be more pronounced in them than in others. Knowing this information will help you to help them a when a seizure occurs.