Absence Epilepsy Seizures Visualized in the Brain

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As originally seen in www.technologynetworks.com

At first, the teacher described her six-year-old student as absentminded, a daydreamer. The boy was having difficulty paying attention in class. As the teacher watched the boy closely, she realized that he was not daydreaming. He often blanked out for a few seconds and wouldn’t respond when she called his name. On occasion, he would blink a lot and his eyes would roll up.

The teacher talked to the boy’s parents about his concerning behavior. His parents took him to the doctor and, after a few tests, he was diagnosed with absence epilepsy and prescribed medication. Absence epilepsy is the most common type of seizure disorders in children.

“In about 80 percent of children with absence seizures, the episodes usually stop around puberty. The other 20 percent will continue to have seizures,” said first and corresponding  author Dr. Jochen Meyer, instructor of neurology and neuroscience at Baylor College of Medicine. “Absence seizures, even if they stop, are a disabling disorder because they cause children to be momentarily absent during periods of their formative years.”

“Many of these children also present with attention deficit disorder that can persist in about 40 percent of patients despite being treated with medication and even after the seizures stop,” said co-first author Dr. Atul Maheshwari, assistant professor of neurology and neuroscience at Baylor. “We need to have a better understanding of what happens in the brain during absence seizures.”

And that is what the researchers achieved in this study. They used a new technology called 2-photon microscopy that allowed them to visualize the firing activity of many individual neurons simultaneously in the brains of awake mice. They combined these observations with electroencephalograms that measured the electrical patterns of the same area of the brain. The results were completely unexpected.

‘It’s like listening to an orchestra without a conductor’

Researchers have known for decades that people having an absence seizure present with a typical electroencephalogram showing a spike-and-wave pattern of electrical activity that repeats for the duration of the seizure.

“The spike-and-wave pattern is very reproducible, and it’s during this period of time that the child would stop and stare. But nobody had studied what the brain cells themselves were doing during one of these episodes,” said co-author Dr. Jeffrey Noebels, professor of neurology, neuroscience, and molecular and human genetics and director of the Blue Bird Circle Developmental Neurogenetics Laboratory at Baylor.

The researchers took a closer look at the firing activity of neurons in an area of the visual cortex of a genetic mouse model of absence epilepsy. They used the new 2-photon microscopy technology to see the firing activity of many brain cells at the same time, in a way similar to people using Google maps to zoom in to look at a group of individual houses in a neighborhood.

“We had predicted from the spike-and-wave pattern of the brain waves that the behavior of the brain cells during a seizure also would be a rhythmical activity. Instead, we saw an uncoordinated firing activity, which was a big surprise,” said Noebels, who also holds the Cullen Endowed Chair in Neurogenetics. “It was always thought that during the ‘spike’ cells would fire, and during the ‘wave’ they would be quiet. That repeated pattern of spike-and-wave is the signature of this kind of epilepsy, so we assumed that it was based on the behavior of the cells that were generating the brain waves. But in fact we found that there appears to be no uniform connection between the cell behavior and the brain waves.”

“Normally the human brain, like an orchestra, is playing beautiful music and every player can understand what the others are playing. We thought that when a seizure started, the ‘orchestra of neurons’ would play extremely loud and intense music. And when the seizure ended, the neurons would go back to playing monotonous music,” Maheshwari said. “Instead, we found that during an absence seizure the volume of the music went down and the ‘musicians’ were playing music without coordinating with others. Most of them were not playing at all, as if the conductor was not there anymore. When the seizure ended, it was like the conductor had returned and organized the musicians to play harmoniously again.”

Interestingly, the reduction in brain cell activity began several seconds before the rhythmic spike-and-wave signature in the electroencephalogram started.

“It might be of interest in the future to further investigate whether the reduction in cellular activity that precedes the seizures could be used to predict them,” Meyer said.

The researchers’ contribution to the field of epilepsy has opened a window into the cellular events that occur in the brain during absence seizures.

“Now that we know that the ‘orchestra’ is disorganized, we can look for ways to treat the underlying causes of the seizures at the cellular level,” Maheshwari said.

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As originally seen in www.technologynetworks.com

Research Update -Tests required before your child’s epilepsy surgery

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As originally seen in eplink.ca

For a child who is having epilepsy surgery, several tests may need to be done as part of the clinical assessment. EpLink researcher Dr. Elysa Widjaja and senior neurodiagnostic technologist Rohit Sharma have put together an information booklet to help parents navigate the different tests that may be required before surgery. Some of these are routine and non-invasive, such as electroencephalography (EEG). Other tests may require injecting dyes into the blood in order to see different areas of the brain more clearly. This booklet offers tips and information on how to prepare for things like a stay in the epilepsy monitoring unit (EMU), and describes the possible risks of each test.

If you’re feeling overwhelmed by the number of tests, this booklet explains why each test is done and what doctors hope to find. For example, a regular MRI (magnetic resonance image) takes pictures of your child’s brain, while a functional MRI shows which parts of the brain are responsible for things like speaking or moving. Some of these tests are designed to identify the area in the brain where seizures are starting. Others try to locate the precise areas responsible for important functions like vision, sensation and hearing so that they can be avoided during surgery. Some tests need to be done while your child is having a seizure, and others are done in the time between seizures.

In addition, some cognitive tests will be done to learn more about how your child thinks. These tests help to determine if surgery may put your child at risk for language and memory problems. Your team will use these tests to measure things like intelligence, working memory, vocabulary, problem-solving, processing speed, and emotions and personality.

All of these tests aim to make your child’s epilepsy surgery as successful as possible. Click here to see the booklet.

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As originally seen in eplink.ca

Colleagues dive in to help with fundraiser

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As originally seen in www.orilliamatters.com

When Corey Henderson takes his leap of faith next month, he won’t be jumping alone.

The Orillia man’s Skydiving for Epilepsy fundraiser caught the attention of his colleagues at Shoppers Drug Mart on Westmount Drive. Instead of one person jumping from a plane in August, there will be at least 10.

“I’m overwhelmed and surprised that people want to jump with me,” Henderson said. “I have the best work family.”

He organized the fundraiser in memory of his wife, Catherine, who died in 2015, at age 37, of complications from having an epileptic seizure.

Terri Knicely wanted to help her co-worker, so she rallied the troops and Shoppers.

“My main reason was Corey. He’s become a really good friend of mine,” she said.

It’s no small undertaking for Knicely and Henderson, both of whom suffer from anxiety and have a fear of heights.

“I’m petrified,” Knicely admitted.

She’s not the only one.

“I’m terrified of heights,” said co-worker Virginia Bramer, who will also skydive. “I won’t even go on the big rides at Canada’s Wonderland.”

But, because she was soliciting donations for the fundraiser, she felt she should go all in.

“If I’m asking people to give money to the cause, I should be taking part in it,” she said.

Colleague Theresa Cox admitted she, too, is “getting really terrified” in the lead-up to the event, “but it’s something I’ve always wanted to do and I get to support a friend.”

It’s more than simply supporting a friend, though. It’s also about raising money for Epilepsy Canada and raising awareness about a disorder “a lot of people really don’t know about,” Cox said.

“You just don’t hear about epilepsy as much as you do about other diseases,” Bramer added.

While the number of skydivers has gone from one to 10, the sky’s the limit. Anyone is invited to join in and jump out during the fundraiser, which will take place Aug. 11 at Skydive Toronto in Cookstown. Those taking part must pay the associated costs of the skydive, but Skydive Toronto will donate $50 from each jump to Epilepsy Canada.

For those who don’t want to skydive, there are other ways to help. Henderson and his colleagues will be at the Downtown Orillia Summer Block Party on July 28 to raise money and awareness. They will also have a raffle, with prizes including box-seat tickets to a Toronto Argonauts game.

People are also welcome to attend the Aug. 11 event, even if they’re not jumping. There will be activities for kids on site, and Henderson’s three young children will be selling Kool-Aid for donations.

A $10,000 fundraising goal has been set. Donations, and registration information to take part in the event, can be made here. Knicely also started a GoFundMe page that can be found here.

While the money is appreciated, Henderson also wants to shed light on epilepsy and the effects it can have on those who have the disorder, and their families.

“If we can make (Epilepsy Canada) famous even for 15 minutes, I’ll be happy with that,” he said.

Keep up with the fundraising efforts on the Skydiving for Epilepsy Facebook page.

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As originally seen in www.orilliamatters.com

Mother underscores importance of diagnosing ESES epilepsy early

 

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As originally seen on epilepsyontario.org

Jennifer Young says parents should be aware of the symptoms of Electrical Status Epilepticus during Sleep (ESES) epilepsy, a condition that appears in childhood and does not present itself through seizures but rather as learning difficulties and behavioural changes.

Jennifer’s son was diagnosed with ESES when he was seven years old and in Grade 2. It was a “very sudden change,” she says.

The first sign Jennifer says she noticed in her son was that he was suddenly having learning difficulties at school. He then began experiencing behaviours he had not previously had; he had done well in school his previous year. His clothes were also bothering him so much he had a difficult time getting out of his pyjamas in the morning, and he couldn’t wear gloves in winter because they bothered his hands.

She took her son to their family doctor. An MRI and an EEG were ordered. While the MRI didn’t show anything, the EEG showed some abnormalities, so Jennifer’s son was eventually referred to a neurologist at McMaster University Medical Centre, who ordered a sleep-deprived EEG test which shed more light on his condition.

What doctors discovered was that Jennifer’s son was having epileptiform discharges that were not causing visible seizures in his sleep.

“They had him on treatment right away,” Jennifer says.

Jennifer says her son’s symptoms seemed “psychological.” There was no visible indication her son had been having seizures, so she credits the family’s doctor for pushing for more testing. It was the doctor’s diligence, she says, that led to her son being diagnosed with ESES.

“If it wasn’t for her, I don’t know where we would be; she has done a lot for us on our whole medical journey,” Jennifer says.

Jennifer says some of the symptoms parents may notice in children with ESES epilepsy are sudden changes in behaviour; ADHD-like symptoms, including difficulty in school; language regression; and difficulty sleeping.

Because Jennifer’s son was diagnosed early, doctors were able to control the epileptic activity he was experiencing with medication. But if ESES epilepsy is not detected early, it can become more severe.

Now nine years old, Jennifer’s son is enjoying a better quality of life, Jennifer says, adding that he continues to be monitored by his neurologist. He plays baseball, spends time with other children and his schoolwork has improved.

“It’s day and night,” Jennifer says. “It was unbelievable to get our son back.”

As originally seen on epilepsyontario.org

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