Babies who got a single shot that included vaccines against tetanus and whooping cough were at higher risk of having a fever-related seizure on the same day in a new study from Denmark.

However, researchers found the chance of having a seizure was still small after the shots, and kids who got them weren’t any more likely to go on to develop epilepsy than those who weren’t vaccinated, as some evidence had suggested.

The finding is not a reason for parents to avoid the combined vaccine, and is actually “reassuring,” said one expert not involved in the study.

According to the National Institutes of Health, about one in every 25 kids will have at least one fever-related seizure — short-lasting convulsions that don’t cause permanent damage. The seizures are especially common in toddlers.

For the new study, researchers tracked about 380,000 babies born in Denmark between 2003 and 2008, through reports their doctors gave to national health registries.

In Denmark, the child vaccination schedule calls for a combined vaccine given at three, five and 12 months of age against diphtheria, tetanus, whooping cough (pertussis), polio and Haemophilus influenzae type 2, known collectively as DTap-IPV-Hib.

Similar vaccine combinations are given in the United States, researchers said.

Previous studies suggested that an older version of the pertussis vaccine caused fevers and increased babies’ chances of having a related seizure. But it’s been less clear if that risk also applies to newer versions in combined vaccines, according to study author Yuelian Sun, from Aarhus University.

She and her colleagues found that about 7,800 kids, or just over two percent, were diagnosed with a fever-related seizure by the time they were one and a half.

Nine babies had a so-called febrile seizure on the same day as their first combined shot, 12 after the second shot and 27 on the day they got the third shot. That was out of 300,000 to 340,000 kids who had each of the scheduled vaccines.

On the day of the first shot, that risk was about six times higher than would be expected, based on other babies who hadn’t recently been vaccinated, and it was four times higher after the second shot.

However, the risk dipped below average a few days after vaccination, and the researchers found that over the week after getting any of their shots, babies weren’t more likely to have a febrile seizure than they were during any other week.

Up to seven years after getting their shots, vaccinated kids didn’t have any extra risk of being diagnosed with epilepsy, Sun’s team reported Tuesday in the Journal of the American Medical Association.

Out of all 300,000-plus kids, including about 7,000 that never received a DTap-IPV-Hib vaccine, just over 2,200 developed epilepsy during the study period.

“The good news of our paper is that we didn’t find an increased risk of epilepsy,” which is more serious than febrile seizures and may cause brain damage, Sun said.

“The prognosis after febrile seizures is good,” she told Reuters Health.

Dr. Eugene Shapiro, a pediatrics and infectious diseases researcher at Yale University in New Haven, pointed out that the absolute risk of having a febrile seizure was still “very small” on the day of vaccinations — and didn’t come with a greater chance of seizure disorders.

“It’s not a sign of brain damage,” said Shapiro, who wasn’t involved in the new research. “It doesn’t change your risk of ultimately developing epilepsy.”

Sun speculated that babies who had a febrile seizure on the day of their shots could have been more genetically prone to the seizures, and might have had one sooner or later even if they hadn’t been vaccinated.

“The other point is, there are children dying of pertussis,” Shapiro told Reuters Health, pointing to recent outbreaks of whooping cough in California.

“This is definitely not a reason to not get this vaccine. On the contrary, this should be reassuring.”
Read more: http://www.foxnews.com/health/2012/02/22/combined-vaccine-tied-to-fever-related-seizures/#ixzz1n9LVu2U8

Photo Credit Jupiterimages/Photos.com/Getty Images

Epilepsy is a brain disorder that causes recurring seizures. Symptoms, which can be as mild as a brief loss of awareness, or as severe as a full-blown seizure with loss of consciousness, can usually be controlled with medication. Having epilepsy need not stop you from exercising. In fact, Better Health Channel reports that physical activity reduces the risk of seizures. Consult with your doctor to develop a safe and appropriate exercise plan.

Epilepsy Description

Seizures, which are triggered by abnormal electrical signals inside the brain, are classified as either partial or generalized. With a simple partial seizure, you don’t lose consciousness, but you may experience unusual sensations, such as seeing flashing lights; there may also be involuntary, jerky motions of legs or arms. According to MayoClinic.com, generalized seizures involve the whole brain. The most severe form is the grand mal seizure, which causes complete unconsciousness, stiffening and shaking, and loss of bladder control. Half the time, the cause for epilepsy is unknown. The other half can be attributed to genetics, head injury, dementia, medical conditions or developmental disorders. According to the Epilepsy Foundation, 3 million Americans suffer from some form of epilepsy.

Benefits of Exercise for Epilepsy

According to Better Health Channel, abnormalities in the brain decrease while people with epilepsy are in the act of exercising. The website adds that being fit and in good physical condition can reduce seizure frequency, as well as decreasing the number of health complaints, such as insomnia, depression, body aches and fatigue. Exercise can also improve self-esteem and help maintain a healthy weight.

Research

There are some studies detailing the benefits and examining the risks of exercising with epilepsy. In a Norwegian study of 204 adult outpatients conducted by K.O. Nakken and published in Volume 40 of the 1999 issue of “Epilepsia,” the author found that only 2 percent of respondents had experienced genuine exercise-induced seizures — these patients tended to have underlying brain lesions — while 36 percent reported that exercising provided better seizure control. The author characterized the risk of serious seizure-related injuries during exercising as modest.

Safety Precautions

It is important not to overdo it when exercising with epilepsy. Better Health Channel cautions against allowing yourself to become overly fatigued and says you should stop exercising immediately if you feel faint, nauseous or dehydrated. Always inform your coach or teammates of your condition, and make sure they know what to do for you if you have a seizure. If you are hiking, jogging or biking solo, notify your friends or family of the route you plan to take, and wear a medical alert bracelet or carry a cell phone with an emergency number programmed in.

Water Safety

The fact that seizures can develop suddenly makes it necessary to use extreme caution around water. MayoClinic.com reports that a person with epilepsy is 15 times more likely to drown while swimming or bathing than a person without the disorder. Always wear a life jacket, don’t swim alone, and make sure your companions not only know what to do in case of a seizure, but are strong enough to hold you up in the water. Swim only where there are lifeguards on duty, and advise them of your condition as well.

When To See a Doctor

According to MayoClinic.com, you should see a doctor if you experience a seizure and have never had one before. The website adds that you should seek emergency medical care if a seizure lasts more than five minutes, if breathing or consciousness isn’t restored at the end of the seizure, if there is a second seizure immediately afterwards, if you are pregnant or have diabetes, or if you have been injured during the seizure.

Read more: http://www.livestrong.com/article/334758-epilepsy-exercise/#ixzz1n7tz5WEF

Anti-epileptic drugs can be very expensive, which is why many people are encouraged to switch to generic forms.

It seems that the drugs are just as effective, but the act of switching to a new formulation can trigger breakthrough seizures.

The substitution of brand-name antiepileptic drugs with cheaper generic equivalents has been an ongoing point of contention among doctors, federal officials and people with epilepsy.

The U.S. Food and Drug Administration claims generic antiepileptic drugs have the same dosage, purity and strength as their brand-name counterparts and the two are interchangeable. But doctors and people with epilepsy remain concerned, citing widespread reports of individuals suffering seizures after switching medication.

A new comprehensive review by pharmacists and doctors at the University of Connecticut and Hartford Hospital shows that it is not the anticonvulsant drugs themselves, but the switching aspect that may be causing the problem.

In a review of 89 different studies dating back to 1950, the researchers found that the efficacy, tolerability and safety of brand-name and generic antiepileptic medications are virtually the same. But switching from one form to the other may cause patients to have more hospitalizations and longer hospital stays. The study results were first reported in a Comparative Effectiveness Review issued by the Agency for Healthcare Research and Quality (AHRQ) in December 2011.

“If you have epilepsy and want to start on an antiepileptic drug, the evidence is compelling that it doesn’t matter if you use a brand- name or a generic product. But if you’re already using one version of drug (generic or brand-name), there may be a concern if you switch to something else,” says C. Michael White, a pharmacy professor at the University of Connecticut and director of the federally-designated UConn/Hartford Hospital Evidence-Based Practice Center in Hartford, Conn.

The same concerns apply whether a person switches from a brand-name drug to a generic version or from one generic version to another, White says. While many individuals with epilepsy may not experience any problems switching medications, some people may have complications and the consequences could be severe.

White cautions that the studies showing this increased risk of seizures and complications do not use the strongest study designs and the results are far from definitive. But given the high level of concern regarding different versions of antiepileptic drugs, White says it was important to release these latest findings to inform doctors and patients alike.

“It is in cases like this where opinions are the strongest,” White says. “Should you act on worrisome but weak evidence knowing that costs for patients and insurers will go up and make it logistically more difficult for the pharmacies or do you wait for higher quality studies to come out before taking action? We wanted to share our findings so people can make informed decisions about their care.”

Finding the right medication therapy is vitally important for people with epilepsy. A seizure-free epileptic who suffers a sudden breakthrough seizure can be seriously injured in a fall or car accident and experience other life-changing consequences that may affect their ability to do such things as drive a car or hold a job.

A number of states including Hawaii, Illinois, Tennessee and Utah, have passed legislation in recent years preventing the substitution of generic antiepileptic drugs for brand-name products without a patient’s consent. Connecticut passed its Patient Prescription Protection Act last year. More than 20 other states have considered passing a law.

“Informed consent is the critical issue here,” says Alexandra Finucane, executive vice-president of the national Epilepsy Foundation. “Many people are able to go from one formulation of an epilepsy drug to another, brand to generic, generic to generic. Some however, are at risk for having a breakthrough seizure when switching among different manufacturers’ formulations.

“The patient and his or her doctor needs to know and consent in advance when a switch is being considered, as there may be a history of problems with switching and a need for monitoring during the change,” Finucane continues. “In some cases, the treating doctor will recommend that the patient stays on the same formulation by the same company. For some people with epilepsy, switching could be a matter of life and death.”

Generic equivalents of popular antiepileptic drugs such as carbamazepine, phenobarbital, phenytoin and valproic acid have existed for more than a decade. With generic drugs costing anywhere from a few cents to five dollars less per tablet than brand-name medication, they have become a popular option for patients, health insurers, and pharmacies looking to save money.

Unless a patient is specifically prescribed a brand-name medication only, pharmacists can substitute a generic equivalent without informing the patient or their physician. Patients also may have little or no ability to maintain one specific generic medication at the pharmacy they visit as pharmacies frequently change their generic brands based on market supplies, costs and other factors.

The American Academy of Neurology has issued two position papers stating that it has concerns with generic antiepileptic medication and that physicians should approve all generic substitutions. The American Epilepsy Society (AES) and the French Chapter of the International League Against Epilepsy have also expressed concerns while the Italian League Against Epilepsy has concluded that while generic medications offer a valuable, low-cost alternative in epilepsy management, generic substitution is not recommended in patients who have achieved remission using a brand-name product.

White says more randomized controlled trials are needed to clarify why switching medication is a problem for some people. The FDA is currently funding three studies that will further explore the efficacy and safety of brand-name and generic antiepileptic medication. The Epilepsy Foundation of America and the AES are also supporting studies regarding the issue.

The clinical trial data reviewed in the UConn/Hartford Hospital study was limited by the small size of the trials reviewed, the short duration of follow-up study and a lack of clarity as to what specific generic products were used. FDA rules require generic drugs to have the same exact amount of active medication as their brand-name equivalent, and that the rate of absorption (e.g., immediate release, delayed release, extended release) be identical. To be equivalent by FDA standards, the amount of drug absorbed must be statistically similar between a generic product and the brand product.

At the Board of Directors meeting held on February 16, 2012, Teri Reed was named the new Board President for 2012. Below is a picture of last year’s president, Sean Fitzgerald, literally passing the gavel on to Teri. Read more about Teri, Sean and the rest of our amazing board members here.

Outgoing President Sean Fitzgerald Presenting Plaque to Incoming President Teri Reed

Key points

• Become informed about the medicines you are taking. Learn their names, their purpose, and their expected side effects. Know how often you are supposed to take them and what dose you are supposed to take.
• Make taking your medicine as simple as possible. Plan times to take your medicines when you are doing other regularly occurring activities, like eating a meal or getting ready for bed. This will make it easier for you to remember to take your medicines.
• Take a list of your medicines with you whenever you visit your doctor. Let your doctor know if you are having problems with your medicine schedule or if you have any changes in your health that might affect your medicine needs, such as a sudden increase in seizures, weight gain or loss, unexpected or intolerable side effects from the medicine, or another medical condition.
• It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medicine to best manage your epilepsy. The goal is to prevent seizures while causing as few unwanted side effects as possible. After the most effective medicine program is determined, be sure you follow it exactly as prescribed.

Medicines do not cure epilepsy, but they can prevent seizures. The medicine used to treat epilepsy work in various ways to help reduce the abnormal electrical impulses in your brain. The specific medicines prescribed for you depend first on what kinds of seizures you have. Your age, activity level, overall physical condition, and other health issues as well as the side effects, health risks, and costs of different medicines, may also help determine what kind of medicine is best for you.

Remember, it can take some time and careful, controlled adjustments by your doctor to find the most effective combination, schedule, and dose of medicine to control your seizures. Preventing seizures with as few unwanted side effects as possible is the goal. It is important to follow your medicine schedule exactly as prescribed.

Antiepileptic medicines are most effective when you maintain the proper medicine level in your body. Your doctor has set up a schedule of medicine dosages that maintains that proper level. Even slight changes in your medicine schedule or doses can throw the whole system off. If you do not take your medicines properly, you could begin (or continue) having seizures.

Taking your medicines properly can help you achieve better control over your epilepsy. If you have lost work or driving privileges, getting seizures under control-and keeping them under control-may help you get back to work or back behind the wheel. Not having seizures means you can avoid the dangers of seizures (falls, drowning, choking) and avoid stays in the hospital.

Here’s how you can get started taking your medicines properly.

Develop a medicine plan

Work with your doctor to develop a medicine plan. Things to consider include:

• Names of all medicines. Write down both the brand name and generic name for your medicines. Have your doctor check the list. You can use this list to verify that the medicines you get from the pharmacy are correct. Get a clear explanation of what the medicine does and why you are taking it.
• Medicine schedule. Be sure you understand how much of each medicine to take and when to take each one. Ask your doctor if you can your medicine schedule can be simpler. This may make it easier for you to remember to take your medicines as directed.
• How to handle missed doses. Even the most careful people miss a dose now and then. Talk with your doctor about what you should do if you miss a dose of your medicine. Discuss and write down what to do for each medicine. What you should do if you miss a dose may differ from one medicine to another.
• Medicine costs. If cost is a consideration in building a medicine plan, ask your doctor whether less expensive, equally effective generic brands would be appropriate for you. For most people who take prescription medicine, taking a generic form of that medicine is less expensive and works just as well as the brand name medicine. But in epilepsy, the very small differences between brand name and generic medicines may cause that medicine to no longer work in controlling your seizures.¹ Talk with your doctor if you are worried that a generic version of your medicine will not work for you. You also may want to ask your doctor for a 90-day supply of your medicines if it costs less. Compare prices between several pharmacies. And consider mail-order pharmacies.
• Medicines to avoid. Some nonprescription medicines and drugs may react with your prescribed epilepsy medicines. Make a list of medicines to avoid, and check with your doctor before taking any medicines on this list.

Get organized

Taking medicines properly means taking the right dose of the right medicines at the right time. To be sure you are taking your medicines properly, you may want to have a system to keep track of when and how you take your pills.

• Make a list of all your medicines and keep it up to date. At every visit with your doctor, review your master list of medicines.
• Plan a daily schedule of medicines. Post your medicine schedule in a prominent place near your medicine cabinet. Take it along when you travel. Record your medicine schedule in a daily planner that has spaces for hourly entries.
• Use a pillbox. Get a pillbox that holds a week’s worth of pills.
• Post reminders. Get sticky note pads and post reminders to take your medicines near clocks or on the bathroom mirror to keep you on schedule.

Taking your medicines

Keep the following in mind as you follow your medicine plan.

• Store medicines properly. Keeping medicines in a place that is too hot, too cold, or too humid (a place that is humid has a lot of water vapor in the air) may reduce their effectiveness. Find out from your doctor or pharmacist how to properly store your medicines. Always remember to store medicines out of the reach of children.
• Watch for side effects. Ask your doctor or pharmacist what side effects to expect. Be sure to tell your doctor if you are having side effects from your medicines.
• Post a list of medicines to avoid in a place where you can refer to it whenever you need to. Always check with your doctor before taking any additional medicines, prescription or nonprescription. This includes any herbal pills or dietary supplements.
• Take your medicine list with you for each visit with your doctor. And take time to review it.
• Notify your doctor immediately if you start having more seizures than usual. Let your doctor know if you have any changes in your health that might affect your medicine needs, such as weight gain, pregnancy, or another medical condition.

Pill, after pill, after pill…

From prescription to over-the-counter, medicinal mistakes put at least 1.3 million Americans at risk of premature death each year. The wrong combination of foods and drugs, at the wrong time could make a life or death difference. For Debra Jacobson, it was blood pressure meds.

“Everybody that has high blood pressure must take this,” Jacobson told Ivanhoe.

At her worst, she hit a dangerous 210 over 190! Normal is 120 over 80.

“He took my pressure and he sent me to another doctor he said ‘you’re gonna die’ I said… ‘not
ready!” Jacobson laughed.

Her doctor’s advice? It all came down to medicine.

“He said you need to take it at night and since I’ve been taking it at night my pressure in the morning is normal, and it never was,” Jacobson said.

Within three days she saw a drastic change. Dr. Alan Ackermann says taking blood pressure meds at night can cut your risk of heart attack and stroke by one-third!

“I wish I could take them to our stroke center and that will drive the point. It’s called a silent killer for a reason,” Dr. Alan Ackermann, Board certified cardiologist told Ivanhoe.

Another mistake? Mixing cholesterol-lowering meds like statins with grapefruit.

“It can be half a grapefruit,” Dr. Ackermann explained.

They share the same pathway of metabolism in the liver. When combined, some statins can cause drug levels to become toxic. The grapefruit breaks down some statins too quickly, making them too toxic too fast. To be safe, talk to your doctor about what you’re taking and time your meds for eight to 12 hours after you eat grapefruit. Another deadly combo? Alcohol and acetaminophens. While most won’t shoot whiskey with their Tylenol, popping just one to stave off a morning hangover could put you at risk for liver failure!

“If you go out, drinking and you get a headache after the night I would encourage you not to take any Tylenol especially if you’ve had alcohol within the past four to six hours,” Dr. Ackermann said.
Not a drinker? Not off the hook! Most women know smoking while on birth control can cause blood clots, but just one cigarette could cause a blocked artery in your lung. And if you’re past the childbearing age you’re still at risk…

“Any institution of hormones, hormone replacement therapy and the addition of smoking increases the risk for these events,” Dr. Ackermann explained.

Finally, the same pills you take for pain could be raising your blood pressure!

“Most people aren’t aware ibuprofen, Motrin, Advil do contain salt in it and that has been associated with an increase in high blood pressure,” Dr. Ackermann said.

As much as 20 points higher! Dr. Ackermann says when it comes to managing your meds, awareness is key. Whether it’s watching what you do or when you do it, like Debra it could save your life.

You may want to think twice before you pop that extra Tylenol! A new study found that taking just a little more than the daily-recommended dosage or 3,000 milligrams — could add up over several days, and lead to a dangerous overdose.

It can look as if a child is simply in a daze, awake but daydreaming. Yet inside their brain, a flurry of high-frequency signals is firing from neurons resulting in a so-called absence seizure. Photograph by: Submitted photo, Fotolia.com

It can look as if a child is simply in a daze, awake but daydreaming. Yet inside their brain, a flurry of high-frequency signals is firing from neurons resulting in a so-called absence seizure.

A Canadian-led research team has developed a new drug that completely suppresses absence seizures in rats, and could have groundbreaking effects on the treatment of epilepsy in children.

The findings were published Wednesday in the peer-reviewed science journal Science Translational Medicine.

The team began testing the drug on humans in December and expects to finish the first phase of clinical trials later this year, said neuroscientist Terry Snutch, the senior author of the study.

Snutch, a professor and Canada Research Chair in the Michael Smith Laboratories at the University of British Columbia, said his team is cautiously optimistic the drug will have the same effect on humans.

“It’s far enough along that we would know in relatively short order,” he said. “We are quite confident that it will interact with the human channel in the same way that it does in the rats to alleviate the epilepsy.”

Although the drugs have only been completely tested on rats so far, earlier tests on cloned human cells had the same effect, said Snutch.

Absence seizures are a symptom of epilepsy that most commonly affects children.

During an absence seizure, the person will appear conscious but in a daze. The seizures can disrupt a child’s ability to learn in school, and can also be dangerous, especially if they occur while a person is swimming or driving.

“The kids and teenagers that have these absence seizures can have hundreds of them in a day,” said Snutch. “They just come and go very, very rapidly.”

The new drugs, called Z941 and Z944, work by blocking the flow of calcium ions into what are called T-type calcium channels in the brain.

Scientists believe absence seizures are caused by a mutation in the T-type calcium channels that causes them to fire at a high frequency, allowing too much calcium to enter, said Snutch.

“This T-type calcium channel (mutation) causes the frequency and the patterning of that firing to go haywire up to hundreds of times a day,” he explained.

The mutation was first discovered in 2009 by Terry O’Brien, one of the co-authors of Wednesday’s study and a professor of medicine at the University of Melbourne in Australia.

The new drugs, which can be taken in pill-form and are easily absorbed in rats, completely block the flow of the calcium ions into the calcium channels.

In rats with absence epilepsy, the drugs suppressed their seizures by 85 to 90 per cent.

However, as calcium channels are responsible for a number of important bodily functions like heartbeat, the researchers said they needed to ensure the drug only targeted those that fire at a high frequency causing the seizures.

“The drugs that we’ve developed act in a very specific way so they block the T-type channels but not all of them,” said Snutch.

As a result, it is expected the drugs should have minimal negative side effects for the patients, he said.

Other medications currently used to treat epilepsy don’t completely control absence seizures, and often cause severe side effects, including sleepiness, blurred vision and diminished motor control.

Aside from epilepsy, Snutch said the new drugs could also be used to treat chronic pain.

T-type calcium channels are also found in the neurons outside the brain and are responsible for sending pain signals to the brain, said Snutch.

In rats, Snutch said the drugs have been effective in blocking the T-type channels that affect pain signalling.

“The hope is that the drugs will be useful for multiple indications,” he said.

The study was a collaborative effort between researchers at the University of British Columbia, Zalicus Pharmaceuticals Ltd. in Vancouver, and the University of Melbourne in Australia.

tfletcher@postmedia.com

Twitter.com/ThandiFletcher

Until now it has only been possible to generate tissue from the cerebral cortex, the area of the brain where most major neurological diseases occur, by using controversial embryonic stem cells, obtained by the destruction of an embryo. This has meant the supply of brain tissue available for research has been limited due to ethical concerns and limited availability.

Scientists at the University of Cambridge say they have overcome this problem, showing for the first time that it is possible to reprogram adult human skin cells so they develop into neurons found in the cerebral cortex.

The newly created cells will help re-create brain diseases such as Alzheimer’s in the lab, while providing what scientists call “previously impossible insight” to allow them to develop and test new drugs to stop these devastating diseases from progressing. The findings will also enable scientists to study how the human cerebral cortex develops, how it “wires up” and how learning disabilities occur.

Dr Rick Livesey, who led the research at the university’s Gurdon Institute, said, “’The cerebral cortex makes up 75 per cent of the human brain. It is where all the important processes that make us human take place. It is, however, also the major place where disease can occur. We have been able to take reprogrammed skin cells so they develop into brain stem cells and then essentially replay brain development in the laboratory. We can study brain development and what goes wrong when it is affected by disease in a way we haven’t been able to before. We see it as a major breakthrough in what will now be possible.”

Dr Simon Ridley, head of research at Alzheimer’s Research UK, said, “Turning stem cells into networks of fully functional nerve cells in the lab holds great promise for unraveling complex brain diseases such as Alzheimer’s.” The findings are published in the journal Nature Neuroscience. The findings were funded by Alzheimer’s Research UK and the Welcome Trust.