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Epilepsy FAQ
Author: Andrew Patrick
Date: Wed, 24 Jan 1996 00:00
Date: Wed, 24 Jan 1996 00:00
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Epilepsy FAQ
Frequently Asked Questions about Epilepsy
Version 3.2 -- 10/13/95
Maintained by Andrew Patrick <andrew@calvin.dgbt.doc.ca>. New
material and suggestions are always welcome.
URL for this FAQ and other information:
http://debra.dgbt.doc.ca/~andrew/epilepsy/
------------------------------------------------------------------------
NOTES
Please note that this Epilepsy information MAY NOT BE ACCURATE OR
COMPLETE. Anyone with serious questions about Epilepsy should
consult their doctor.
Some of this material was prepared by Epilepsy Ottawa-Carleton and
Epilepsy Ontario, and it is used with permission. Please contact me
before you use any of this material in other information products.
------------------------------------------------------------------------
TODO
- replace local information with global info
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Questions covered in this document:
Basic Information
-----------------
What does "Epilepsy" mean?
Is Epilepsy a disease?
What is a seizure?
What is an aura?
When was Epilepsy discovered?
People with Epilepsy
--------------------
What kind of people have Epilepsy?
How many people have Epilepsy?
Does Epilepsy strike at any particular age?
Does Epilepsy occur more in some cultures?
Who are some famous people with Epilepsy?
Types of Seizures
-----------------
Are there different types of seizures?
What is the difference between partial and general seizures?
What are partial seizures?
What are complex partial seizures?
What are absence (petit mal) seizures?
What are tonic-clonic (grand mal) seizures?
What are other types of seizures?
What are "status" seizures?
What are pseudoseizures?
How do you distinguish epileptic seizures from pseudoseizures?
Can seizures occur if a person does not have Epilepsy?
What are the seizures like?
What does it feel like to have a seizure?
How long do the seizures last?
Is there such a thing as a "minor" case of Epilepsy?
Causes and Triggers
-------------------
What causes Epilepsy?
Is Epilepsy inherited?
Is Epilepsy contagious?
Is it caused by a virus?
Can certain things trigger seizures?
Can seizures be triggered by flashing lights?
Can certain foods or drinks cause seizures?
Can lack of sleep cause seizures?
Can low blood sugar trigger seizures?
Can Nutrasweet (Aspartame) trigger seizures?
Does alcohol affect seizures?
First Aid for Seizures
----------------------
How can I help someone who is having a seizure?
What if my child has a seizure during his sleep?
Diagnosis
---------
How is Epilepsy diagnosed?
What types of doctors can diagnose and treat Epilepsy?
Can a person with Epilepsy have a false negative EEG?
Can a person have a false positive EEG for Epilepsy.
Is my child having absence seizures or just day dreaming?
What conditions are sometimes mis-diagnosed as Epilepsy?
Can seizures go un-noticed?
Treatments
----------
Is there a cure for Epilepsy?
Is it fatal?
What kinds of treatments are available?
Are there drug treatments for Epilepsy?
How do drugs work to control seizures?
What drugs are used to treat Epilepsy?
How effective are the drug treatments?
Do these drugs have side effects?
What is a "blood level"?
What are the symptoms of too high a drug level?
How much do the drugs cost?
Is it necessary for all people with Epilepsy to be on medication?
When is surgery used to treat Epilepsy?
What is the likelihood that my child will outgrow a seizure disorder?
Do non-traditional approaches help?
Does transcendental meditation have any effect on Epilepsy?
Does biofeedback help?
Is there a special diet for people with Epilepsy?
What is a ketogenic diet?
Living with Epilepsy
--------------------
Can people living with Epilepsy lead normal lives?
What can people with Epilepsy do to help their health?
Who should know that I have Epilepsy?
Is there prejudice against people with Epilepsy?
Are there any problems having children?
Can medications for controlling Epilepsy harm a nursing baby?
Can people living with Epilepsy drive a car?
Can people living with Epilepsy go swimming?
Can Epilepsy lead to problems at school?
Can Epilepsy cause emotional problems?
Can Epilepsy lead to problems with self-esteem?
Working With Epilepsy
---------------------
What occupations are not appropriate for people with Epilepsy?
Can people with Epilepsy fly a plane?
Is there a problem with job safety?
Can an employer ask about Epilepsy on a job application?
Can an employer ask about Epilepsy during a job interview?
Can I be fired because I have Epilepsy?
Can people with Epilepsy get social assistance?
Epilepsy and Other Disorders
----------------------------
Is Epilepsy related to other neurological problems?
Is Epilepsy related to mental illness?
Can Epilepsy affect intelligence?
Is there a link between memory loss and Epilepsy?
Is Epilepsy related to asthma?
Are there any diseases that persons with Epilepsy more prone to?
Miscellaneous
-------------
Do animals get Epilepsy?
Can dogs sense a seizure in humans before it strikes?
More Information
----------------
Where can I get more information about Epilepsy?
What books are available on Epilepsy?
Where can I find information on the Internet about Epilepsy?
------------------------------------------------------------------------
Topic: Basic Information
------------------------
Q: What does "Epilepsy" mean?
The word "Epilepsy" is derived from a Greek word meaning "a condition
of being overcome, seized, or attacked." People used to believe
that the seizure was caused by a demon, and Epilepsy became known as
a sacred disease. This is the background to the myths and fears
that surround Epilepsy; myths that colour people's attitudes and
make the goal of a normal life more difficult than it needs to be be
for people who have Epilepsy. The word "Epilepsy" means nothing
more than the tendency to have seizures.
Q: Is Epilepsy a disease?
Epilepsy is not a disease. It is a sign or symptom of an underlying
neurological disorder.
Q: What is a seizure?
The brain is a highly complex and sensitive organ. It controls and
regulates all our actions. It controls motor movements, sensations,
thoughts, and emotions. It is the seat of memory, and it regulates
the involuntary inner workings of the body such as the function of
the heart and the lungs.
The brain cells work together, communicating by means of electric
signals. Occasionally there is an abnormal electrical discharge
from a group of cells, and the result is a seizure. The type of
seizure will depend upon the part of the brain where the abnormal
electrical discharge arises.
Q: What is an aura?
Before the onset of a seizure some people experience a sensation or
warning called an "aura". The aura may occur far enough in advance
to give the person time to avoid possible injury. The type of aura
experienced varies from person to person. Some people feel a change
in body temperature, others experience a feeling of tension or
anxiety. In some cases, the epileptic aura will be apparent to the
person as a musical sound, a strange taste, or even a particular
curious odour. If the person is able to give the physician a good
description of this aura, it may provide a clue to the part of the
brain where the initial discharges originate. An aura could occur
without being followed by a seizure, and in some cases can by itself
be called a type of simple partial seizure.
Q: When was Epilepsy discovered?
Epilepsy is the oldest known brain disorder. It was mentioned more
than 2,000 years before Christ. References can be found in ancient
Greek texts and in The Bible. It wasn't until the mid 1800's,
however, that Epilepsy was given serious study. Thomas Laycock was
the first to introduce a sedative that aided in controlling seizures
in 1857. In 1870, John Hughlings Jackson identified the brain's
outer layer, the cerebral cortex, as the part involved in Epilepsy.
Hans Berger demonstrated that the electrical impulses of the human
brain could be recorded in 1929.
Topic: People with Epilepsy
---------------------------
Q: What kind of people have Epilepsy?
Virtually everyone can have a seizure under the right circumstances.
Each of us has a brain seizure threshold which makes us more or less
resistant to seizures. Seizures can have many causes, including
brain injury, poisoning, head trauma, or stroke; and these factors
are not restricted to any age group, sex, or race and neither is
Epilepsy.
Q: How many people have Epilepsy?
Epilepsy is far more common than most of us realize. Current
estimates indicate that more than one per cent of the population
have had, or will have, some form of Epilepsy in their lifetime.
Q: Does Epilepsy strike at any particular age?
Epilepsy can strike anyone at any age. However, most persons who
develop seizures during their formative years tend to experience a
reduction in the intensity and frequency of their seizures as they
grow older. In many cases the Epilepsy will disappear completely.
50% of all cases develop before 10 years of age.
Q: Does Epilepsy occur more in some cultures?
Epilepsy occurs more frequently in some cultures. In Tanzania, 4%
of the population experiences severe seizure disorders. In this
case, genetic predisposition to lower seizure thresholds is known to
exist. In Canada, 1-2% of the population has Epilepsy.
Q: Who are some famous people with Epilepsy?
Here are just a few people who have been known to have or thought to
have had Epilepsy. Alexander the Great, Julius Caesar, Alfred the
Great, William Pitt and Napoleon were said to have been epileptic.
St. Paul, Buddha, and Mohammed also had Epilepsy. Charles Dickens,
Fyodor Dostoevsky, Byron, de Moupassant, Edward Lear, and Marigiad
Evans wrote about their disorder. These musical greats also had
Epilepsy: Handel, Berlioz, Paganini, and Beethoven. Vincent Van
Gogh the artist had Epilepsy. Science's Isaac Newton, Baseball's
Tony Lazzeri, Hockey player Gary Howatt and British marathon runner
Alan Blinston are just a few of the many thousands of people with
Epilepsy.
Topic: Types of Seizures
------------------------
Q: Are there different types of seizures?
Many varieties of epileptic seizures occur, and frequency and form
of attacks vary greatly from person to person. With modern methods
of treatment, however, most cases can be fully controlled. Because
there are so many nuances in Epilepsy and so many different kinds of
seizures, a specific classification system is being promoted by the
International League Against Epilepsy. The International
Classification of Epilepsy Seizures has been adopted by the medical
community and is gradually replacing outdated seizure terminology
including "grand mal" and "petit mal".
The new classification scheme describes two major types of seizures:
"partial" and "generalized". It also divides each of these
categories into subcategories including simple partial,
complex-partial, absence, tonic-clonic, and other types.
Q: What is the difference between partial and general seizures?
The distinction between "partial" and "generalized" seizures is the
most important feature of the new classifcation system. If the
excessive electrical discharge in the brain is limited to one area,
the seizure is partial. If the whole brain is involved, it is
generalized. In all, there are over 30 different seizure types.
Therefore, the new classification format subdivides the partial and
generalized Epilepsies into a number of different categories.
Q: What are partial seizures?
Partial seizures (formerly known as focal seizures) with elementary
symptomology are often referred to a simple partial. During this
type of seizure the patient can experience a range of strange or
unusual sensations including sudden, jerky movements of one body
part, distortions in hearing or seeing, stomach discomfort, or a
sudden sense of fear. Consciousness is not impaired. If another
seizure type follows, these sensations may be referred to as an
"aura".
Q: What are complex partial seizures?
Complex-partial seizures (formerly psychomotor or temporal lobe
Epilepsy) are characterized by a complicated motor act involving
impaired consciousness. During the seizure the patient appears dazed
and confused. Purposeless behaviours such as random walking,
mumbling, head turning, or pulling at clothing may be observed.
Usually, these so-called "automatisms" cannot be recalled by the
patient. In children this seizure may consist of staring or
lip-smacking, and therefore may be confused with the absence seizure
described below.
Q: What are absence (petit mal) seizures?
Generalized absence seizures (formerly petit mal) are characterized
by 5 to 15 second lapses in consciousness. During this time the
patient appears to be staring into space and the eyes may roll
upwards. Absences are not preceded by an aura and activity can be
resumed immediately afterwards. Typically, they occur in children
and disappear by adolescence. They may, however, evolve into other
seizure types, such as complex-partial or tonic-clonic. The
occurrence of absences in adulthood are rare.
Q: What are tonic-clonic (grand mal) seizures?
The tonic-clonic (formerly grand mal) seizure is a generalized
convulsion involving two phases. In the tonic phase, the individual
loses consciousness and falls, and the body becomes rigid. In the
clonic period, the body extremities jerk and twitch. After the
seizure, consciousness is regained slowly. If the tonic-clonic
seizure begins locally (with a partial seizure) it may be preceded
by an "aura". These seizures are said to be secondarily
generalized.
While the tonic-clonic seizure is the most visible, obvious type of
Epilepsy, it is not the most common. Partial seizures are more
frequently encountered and occur in 62% of all Epilepsy patients.
Complex-partial seizures account for approximately 30% all cases.
Q: What are other types of seizures?
Benign rolandic epilepsy is an epileptic syndrome occurring in young
children that is age limited (you stop having seizures in the teen
years) . Salivation, twitching of the mouth or upper extremity on
one side are typical manifestations. Seizures occur almost
exclusively nocturnally.
Juvenile myoclonic epilepsy is an epilepsy characterized by onset in
childhood or adolescence and is associated with extremity jerking or
generalized tonic clonic seizures ('grand mal') within an hour or
two of wakening from sleep. Seizures which may be precipitated by
sleep deprivation, alcohol intake or coffee (strange) tend to occur
in the morning.
Pleases contact your local Epilepsy association or clinic for
additional information. Other seizure terms include: Atonic (Drop
Attacks), Myclonic, Infantile Spasms, Nocturnal, Photosensitive,
Visual, Musicogenic, Jacksonian, Sensory, Bilateral Myclonus,
Atkinetic, Autonomic, Prolonged seizures, and Ictal State.
Q: What are "status" seizures?
Status epilepticus is the term used to describe recurrent seizures
without recovery of consciousness between attacks. This is a medical
emergency and can be life threatening, or cause brain damage.
Immediate action to get the necessary medical care should be taken.
Q: What are pseudoseizures?
Psuedoseizures (or psychogenic seizures) are quite common and can
occur in people who have, or do not have, Epilepsy. The attacks are
triggered by a conscious or unconscious desire for more care and
attention. The seizures start with rapid breathing, triggered by
mental stress, anxiety, or pain. As the person breaths rapidly,
they build up carbon dioxide in their body and change their
chemistry. This can cause symptoms very much like Epileptic
seizures: prickling in the face, hands, and feet, stiffening,
trembling, etc. The appropriate treatment for pseudoseizures is to
calm the person and start them breathing at a normal rate.
Treatment should also involve investigating the mental and emotional
factors that led to the psuedoseizure.
Q: How do you distinguish epileptic seizures from pseudoseizures?
Epileptic seizures and pseudoseizures are distinguishable both by
their nature and symptoms, but the diagnosis can be difficult.
Epileptic seizures are caused by a change in how the brain cells
send electrical signals to each other, while pseudoseizures are
triggered by a conscious or unconscious desire for more care and
attention. Thus, measuring brain activity with an EEG and video
telmetry is important for distinguishing epileptic and
pseudoseizures. Also, pseudoseizures often lack the
exhaustion, confusion, and nausea that is associated with epileptic
seizures. Psychogenic seizures can occur in people who also
experience epileptic seizures.
Q: Can seizures occur if a person does not have Epilepsy?
Epilepsy is a chronic condition of recurrent unprovoked seizures.
Isolated seizures and provoked seizures (e.g., drug or alcohol
induced) are not Epilepsy even though the events are real seizures.
There are many types of non-epileptic seizures. Non-epileptic
seizures differ from epileptic seizures in that there is usually no
evidence of abnormal electrical activity in the brain after the
seizure, and they do not occur repeatedly. Some of the more common
causes of non-epileptic seizures are: low blood sugar, fainting,
heart disease, stroke, migraine headaches, kinked blood vessels,
narcolepsy, withdrawal, and extreme stress or anxiety.
Q: What are the seizures like?
The nature of the seizures varies depending upon the type of
Epilepsy the individual has. Some seizures may be very noticeable
while some may go completely unrecognized. With the most common
types of seizures there is some loss of consciousness, but some
seizures may only involve small movements of the body or strange
feelings. The different seizures types have certain characteristics
that accompany them.
Q: What does it feel like to have a seizure?
Epilepsy is a broad classification for a wide variety of seizures,
so different people's seizures can be very different. Common
feelings associated with seizures include uncertainty, fear,
physical and mental exhaustion, confusion, and memory loss. Some
types of seizures can produce visual and auditory phenomena, while
others can involve a "blank" feeling. If a person is unconscious
during a seizure there may be no feeling at all. Many people also
experience an "aura" before the seizure itself.
Q: How long do the seizures last?
Depending on the type of seizure, they can last anywhere from a few
seconds to several minutes. In rare cases, seizures can last many
hours. For example, a tonic-clonic seizure typically lasts 1-7
minutes. Absence seizures may only last a few seconds, while
complex partial seizures range from 30 seconds to 2-3 minutes.
"Status Epilepticus" refers to prolonged seizures that can last for
many hours, and this can be a serious medical condition. In most
cases, however, seizures are fairly short and little first aid is
required.
Q: Is there such a thing as a "minor" case of Epilepsy?
There are over 30 types of seizures, and some types are more severe
than others. Long tonic-clonic convulsions, for example, can
produce more physical and mental effects than shorter partial
seizures. Some people may experience very frequent seizures (every
few hours), while others can go for months or years without a
seizure. Also, some seizures are easily controlled by drug
therapies, while others may continue regardless of the medication
that is tried.
Topic: Causes and Triggers
--------------------------
Q: What causes Epilepsy?
There is no single cause of Epilepsy. Many factors can injure the
nerve cells in the brain or the way the nerve cells communicate with
each other. In approximately 65% of all cases there is NO known cause.
The following are some of the most frequently identified causes:
- Head injury that causes scaring of the brain tissue.
- Trauma at birth, or high fever.
- Excessively rough handling or shaking of infants.
- Certain drugs or toxic substances when administered in large
doses.
- Interruption of blood flow to the brain caused by stroke, tumour,
or certain cardiovascular problems.
- Diseases which alter the balance of blood or its chemical
structure, or diseases that damage the nerve cells in the brain.
When physicians can identify the underlying disorder, such as those
mentioned above, the condition is referred to as "Symptomatic"
Epilepsy. In some cases, however, the underlying disorder can't be
identified and this is called "Idiopathic" Epilepsy.
Q: Is Epilepsy inherited?
In most cases Epilepsy is not inherited. In a few cases the
tendency towards Epilepsy might be inherited, but even with this
tendency certain conditions must exist in the brain before a person
will experience epileptic seizures. It is most unlikely that
children will inherit the disorder.
Q: Is Epilepsy contagious?
Epilepsy is in no way contagious. No one can get the disorder by
talking to, kissing, or touching somebody with Epilepsy. Epilepsy
can only be transmitted through hereditary transfer. Epilepsy that
runs in families suggests an underlying metabolic or genetic
etiology, and this is the least common of all Epilepsy causes.
Q: Is it caused by a virus?
Epilepsy can be the result of an infection or disease. Some
conditions known to have a risk of resulting in Epilepsy are
meningitis, viral encephalitis, and less frequently mumps, measles,
diphtheria, and abscesses.
Q: Can certain things trigger seizures?
In some cases, epileptic seizures can be triggered by things that
happen in the environment. Seizures can be triggered by flashing
lights or sudden changes from dark to light (or vice versa). Other
people can react to loud noises or monotonous sounds, or even
certain musical notes. It is important for people with Epilepsy to
learn what kinds of events can trigger seizures for them.
Q: Can seizures be triggered by flashing lights?
"Photosensitive Epilepsy" is the name given to a form of the
disorder where seizures are triggered by flickering or flashing
lights. Though it occurs more frequently in girls aged 6-12, it can
occur at any age and regardless of gender.
Q: Can certain foods or drinks cause seizures?
People with Epilepsy should have regular meals at regular intervals
and pay attention to what they eat and drink. Prescription and
non-prescription drugs, as well as food additives, may interact with
anti-convulsant drugs. Alcohol can lower seizure thresholds.
Q: Can lack of sleep cause seizures?
Excessive sleep deprivation can lower seizure thresholds and
possibly result in a seizure. Lack of sleep is known to be an
important precipitating factor in causing seizures. Other factors
that can lower seizure thresholds are high fever, increased
excitement, and changes in body chemistry. It is important for
people with Epilepsy to learn what kinds of events can trigger
seizures for them.
Q: Can low blood sugar trigger seizures?
Hypoglycemia (low blood sugar) can induce epileptic-type seizures.
This condition can be caused by diet or by drugs such as insulin.
This is not really Epilepsy since it is not recurrent seizures that
are due to abnormal brain activity. Here the seizures are directly
caused by the blood sugar levels.
Q: Can Nutrasweet (Aspartame) trigger seizures?
In 1984, there were 3 reports about large amounts of Aspartame
causing a lowering of the seizure threshold and therefore increasing
seizure activity. The Centre for Disease Control in Atlanta did a
review of this and were unable to find any cause or effect
relationship at normal doses. More recently, Aspartame has been
found to be unsuitable for some children with generalized absence
Epilepsy. A Queen's University study looked at the brain-wave
patterns in 10 children and the effects of the artificial sweetener
"Nutrasweet". A 40% increase in abnormal brain-wave activity
associated with absence seizures was found in this study.
Q: Does alcohol affect seizures?
Alcohol can raise and then lower the seizure threshold, and thus
increases the tendency to have a seizure. More important are
interactions between alcohol and seizure medicines. Also, some
drugs of abuse, especially cocaine and amphetamines, can cause
seizures. Some prescription medications when taken in large doses
can also bring on seizures.
Topic: First Aid for Seizures
-----------------------------
Q: How can I help someone who is having a seizure?
The appropriate behaviour for helping someone who has a seizure
depends on the type of seizure it is. While a person experiencing a
tonic-clonic seizure may require some first aid, in most cases there
is little that needs to be done.
Tonic-Clonic (Grand Mal)
------------------------
This type of seizure is often the most dramatic and frightening, but
it is important to realize that a person undergoing an epileptic
seizure is usually unconscious and feels no pain. The seizure
usually lasts only a few minutes, and the person does not need
medical care. These simple procedures should be followed:
1. Keep calm. You cannot stop a seizure once it has started. Let
the seizure run its course. Do not try to revive the person.
2. Ease the person to the floor and loosen clothing.
3. Try to remove any hard, sharp, or hot objects that might injure
the person.
4. Turn the person on his or her side, so that the saliva can flow
from the mouth.
5. Do NOT put anything in the person's mouth.
6. After the seizure the person should be allowed to rest or to
sleep if necessary.
7. After resting most people carry on as before. If the person is
not at home and still seems groggy, weak, or confused, it may be
better to accompany them home.
8. In the case of a child having a seizure, contact a parent or
guardian.
9. If the person undergoes a series of convulsions, with each
successive one occurring before he or she has fully recovered
consciousness, or a single seizure lasting longer than 10 minutes,
you should immediately seek medical assistance.
Absence (Petit Mal)
-------------------
No first aid is required.
Complex-Partial (Psychomotor or Temporal Lobe)
---------------------------------------------
1. Do NOT restrain the person. Protect him or her by moving sharp
or hot objects away.
2. If wandering occurs, stay with the person and talk quietly.
Simple-Partial (Focal)
----------------------
No first aid is required.
Q: What if my child has a seizure during his sleep?
Children are usually awakened by seizures that occur while they
sleep. Thus, a parent of a child with a known seizure disorder is
usually aware when their child has seizures during the night. Only
in those rare cases where a child vomits or experiences other
problems during a seizure is there a need to worry.
Topic: Diagnosis
----------------
Q: How is Epilepsy diagnosed?
The diagnosis and evaluation of Epilepsy requires the physician to
know all about the seizures - when they started, the patient's
appearance before, during, and after a seizure, and any unusual
behavioural occurrences. A background of the family's health history
is also useful. In addition, an electroencephalogram (EEG) may help
detect areas of increased nerve cell activity.
Q: What types of doctors can diagnose and treat Epilepsy?
Any licensed physician is qualified to treat Epilepsy. There are
doctors who specialize in neurological disorders, and these
neurologists can be found practicing in many hospitals and private
practices. Epileptologists may work in an Epilepsy clinic, as well
as in private practices. Usually a referral is required from another
physician in order to see a Neurologists and Epileptologists. Some
people also consult alternative health practitioners who specialize
in holistic healing, acupuncture, or chiropractic treatments.
Often, the first doctor to diagnose Epilepsy is the family doctor.
Most of them have had some experience with it, and will be the one
to refer a person with Epilepsy to a specialist initially.
Pediatricians are also well aware of Epilepsy, since about
two-thirds of all Epilepsy occurs before the age of 14. A
neurologist has specialized training in the disorders of the brain
and nervous system. A neurosurgeon, psychiatrist, or psychologist
may also get involved if the circumstances require them.
Q: Can a person with Epilepsy have a false negative EEG?
An EEG measures the electrical activity on the surface of the brain.
An EEG may appear to be normal if the abnormal electrical activity
is occurring deeper in the brain than the EEG is able to monitor.
Q: Can a person have a false positive EEG for Epilepsy.
Many people who do not have Epilepsy may have some "epileptiform"
activity on an EEG. However, this does not prove that they have a
seizure disorder. Reading EEG's is a highly skilled activity, and a
diagnosis of Epilepsy is based on the clinical picture as well as
the EEG. Other tests, such as CT scans and MRI scans, may be
performed to confirm any findings.
Q: Is my child having absence seizures or just day dreaming?
A child having an absence seizure may appear to the onlooker as if
they are day dreaming or just staring into space. What may be
happening is a sudden period of altered consciousness. To be able
to tell the difference, close observations might have to be done.
Usual behavioral characteristics of a absence seizure may include:
eye blinking, chewing of the mouth, and perhaps a slight rhythmic
movement of the facial muscles, head, or arms. During the seizure
the child may not respond to verbal or physical stimulation.
Immediately after the seizure, the child is able to resume normal
activity. If you observe unusual behaviour in your child, a visit
to a neurologist should be arranged through your family doctor.
Q: What conditions are sometimes mis-diagnosed as Epilepsy?
Seizures occurring as a result of alcohol withdrawal, fever, or
hypoglycemia can be mistaken for Epilepsy. Other causes of seizures
that do not indicate Epilepsy are strokes, migraine headaches,
calcified blood vessels, narcolepsy, and psychogenic or
pseudoseizures.
Q: Can seizures go un-noticed?
The symptoms of seizures are not always noticeable for on-lookers or
for the person who is experiencing the seizure. Seizure may result
in rigidity in the body, convulsions, chewing of the mouth, unusual
behaviors, or loss of consciousness. Some symptoms may be less
apparent, such as disorientation or unusual sensations. Milder
symptoms do not mean that the seizure is of less importance.
Topic: Treatments
-----------------
Q: Is there a cure for Epilepsy?
There is no known "cure" for Epilepsy. Medications can often
control seizures, but they are not a cure. Some forms of Epilepsy
occur only in childhood, and the person is said to have outgrown the
seizures. In some cases there is a spontaneous remission of the
seizure disorder. Sometimes, surgery to remove the part of the
brain in which the seizures originate can produce a complete and
permanent stop to seizures.
Q: Is it fatal?
Epilepsy itself can cause death if prolonged repeated seizures
("status epilepticus") are not treated properly. Such deaths are
very rare, however. More common is death due to hazards or
accidents that occur when someone has a seizure unexpectedly in a
potentially dangerous situation.
Q: What kinds of treatments are available?
When a physician diagnoses Epilepsy, a specific treatment can be
recommended. The treatment prescribed by the physician is designed
to control the seizures and help the patient to carry on a healthy
life, participating in all normal activities, including most sports.
The two major kinds of treatments are drug therapy and surgery.
Q: Are there drug treatments for Epilepsy?
Treatment of Epilepsy is primarily through the use of special
anti-convulsive drugs. There are many different types of these
drugs, and the type prescribed will depend upon the particular needs
of the individual. The drugs are prescribed either alone or in a
combination. The various drugs or combination of drugs control
different types of seizures.
Q: How do drugs work to control seizures?
The drugs used to control seizures are called anticonvulsants. How
they stop the seizures, change the seizure threshold, or prevent
electrical discharges from occurring is not fully known. The
neurochemical basis for their action is also unknown. Research has
shown that some of the drugs can block the spread of abnormally fast
nerve impulses in the brain, while others can increase the flow of
chloride ions, which stabilize the nerve cells. Research is still
being done in this area.
Q: What drugs are used to treat Epilepsy?
There are many different drugs used to treat Epilepsy. Some of the
more common ones are: Tegretol (carbamazepine), Dilantin
(phenytoin), Mysoline (primidone), Epival (valproate), Frisium
(clobazam), Rivotril (clonazepam), Mogadon (nitrazepam),
Phenobarbitol, Depakene (valproic acid), Zarontin (ethosuximide),
Neurontin (gabapentin), Lamictal (lamotrigine), Sabril (vigabatrin).
There are also many new drugs under development.
The choice of drug is determined by the type of seizure, the side
effects of the drugs, and the age and health of the person. Often a
number of drugs, and combinations of drugs, have to be tried until
the seizures are brought under control.
Q: How effective are the drug treatments?
Most epileptic seizures are controlled by special anti-convulsive
drugs prescribed by a physician. About 50 per cent of those who
take this medication will have their seizures eliminated; 30 per
cent will have their seizures reduced in intensity and frequency to
the point where they can live and work normally. The remaining 20
per cent are either resistant to the medication, or else they
require such large dosages of the drug to control the seizures that
it is preferable to accept partial control.
Q: Do these drugs have side effects?
Many medications for Epilepsy have side effects. These can range
from mild to severe, and will differ depending on the drug and
dosage. Some of the more common side effects of anti-epileptic
drugs are: drowsiness, dizziness, nausea, irritability, and
hyperactivity.
Q: What is a "blood level"?
"Blood level" refers to the amount of anticonvulsant in the blood.
It is measured with a simple blood test and is used to help
determine if a patient's symptoms may be due to toxicity or to side
effects of medication. It is also used to determine if the patient
is taking enough medication to prevent seizures. The therapeutic
range for different anti-convulsants has been determined by testing
blood levels in thousands of patients whose seizures are controlled
and who are not experiencing toxic effects.
Q: What are the symptoms of too high a drug level?
Too high of a drug level may cause a person to experience side
effects such as drowsiness, confusion, breakthrough seizures,
unsteadiness, and nausea. This may require a reduction in dosage or
a change to a different medication.
Q: How much do the drugs cost?
The cost of the anticonvulsant drugs will depend on the dosage
levels needed, the drug being used, and the amount in each
prescription. There is usually a difference in price between a
drug's brand name and its generic equivalent. Ask your doctor or
pharmacist if a generic one is available for you to use, and if it
is appropriate.
Q: Is it necessary for all people with Epilepsy to be on medication?
Treatment of Epilepsy is primarily through the use of anticonvulsive
drugs. There are many different types of drugs and the type
prescribed will depend upon the particular seizure pattern of the
individual. If someone has been seizure free for several years, the
doctor may decide to slowly withdraw the medication.
Q: When is surgery used to treat Epilepsy?
Surgery is used only when medication fails and only in a small
percentage of cases where the injured brain tissue causing the
seizures is confined to one area of the brain and can be safely
removed without damaging personality or functions.
Q: What is the likelihood that my child will outgrow a seizure
disorder? The likelihood of a child outgrowing a seizure disorder
is difficult to answer. Sometimes children do outgrow Epilepsy,
while for others the seizures may stay the same or intensify with
age. Some people experience the same type of seizures throughout
their lifetime. Some epilepsies are known to almost always remit
(for example, Benign Rolandic Epilepsy or Epilepsy with
centrotemporal spikes and rolandic seizures), some are known to
usually remit (e.g., childhood absence) and some are known to almost
never remit (e.g., Juvenile Myoclonic epilepsy). The medical
community cannot predict who will continue to have seizures and who
will not, but they feel that the sooner Epilepsy is diagnosed, the
better it can be controlled.
Q: Do non-traditional approaches help?
Some people with Epilepsy have tried many different approaches to
improve their seizure control. In some cases, the person feels that
they have experienced improvement. However, scientific studies have
not been conducted into most non-traditional approaches. Techniques
known to reduce stress or improve overall health may be helpful to
some people. Other techniques that have been tried are biofeedback,
diets, acupuncture, and meditation.
Q: Does transcendental meditation have any effect on Epilepsy?
The medical community has not determined if things such as
transcendental meditation have any real effect on Epilepsy. It has
been shown that when people know what is happening at a given
moment, some can influence the automatic processes of the body.
With biofeedback, some people can moderate and possibly change
certain functions thought to be involuntary, such as the rhythm of
their brain waves, blood pressure, heart rate, etc. The
significance of this for Epilepsy is not known.
Q: Does biofeedback help?
Biofeedback is the process of moderating, limiting or changing
certain physiological functions previously thought to be
involuntary, such as heart rate, blood pressure, brain waves, etc.
For Epilepsy, a person could be given extensive biofeedback training
and taught behavioural modification techniques through which he/she
control certain physiological functions related to seizures.
Biofeedback training can also be taught as a method of stress
reduction. This in itself can reduce the frequency of seizures in
some persons with stress related seizures. Further study is needed
to ascertain the value of biofeedback in the treatment of Epilepsy.
Non-medical approaches may improve seizure control in some persons,
but should not be undertaken without the knowledge of the physician
prescribing the anti-convulsants. Under no circumstances should
anti-convulsants be stopped suddenly as this may precipitate
prolonged and life-threatening seizures.
Q: Is there a special diet for people with Epilepsy?
Good nutritional habits and a healthy life style may assist in the
maintenance of optimum seizure control. Experiencing a
drastic weight change may mean that either a chemical or metabolic
imbalance is occurring, and you should consult your physician.
Though some anti-convulsants may cause nutrient deficiencies in some
people, a well balanced diet will usually prevent this. Also see
KETOGENIC DIET
Q: What is a ketogenic diet?
A ketogenic diet is very rich in lipids (fats) and oils, but low in
proteins and carbohydrates. This unusually high intake of lipids
and oils creates a condition in the body know as "ketosis". The
metabolic shift that is created may increase the seizure threshold.
Ketogenic diets are not frequently used for seizure control because
it is difficult to maintain the ketosis, and other health risks can
be associated with high levels of fats and oils. Strict medical
supervision is required when using this as a therapy.
Topic: Living with Epilepsy
---------------------------
Q: Can people living with Epilepsy lead normal lives?
Experience has shown that people with Epilepsy have fewer seizures
if they lead normal active lives. This means they should be
encouraged to find jobs, either full or part-time. People with any
disabilities are now protected under amendments to the Human Rights
Code (Canada). However, some jobs, because of the nature of
technical equipment or machinery, may not be recommended for a
person with Epilepsy. It is therefore most important for a young
adult to work with the school guidance department to establish
appropriate career goals.
Q: What can people with Epilepsy do to help their health?
Like any medical condition, Epilepsy is affected by the general
health and well-being of the person affected. So, anything that can
be done to improve the state of the person can have a positive
effect on Epilepsy. This includes diet, exercise, rest, reducing
stress, avoiding depression, and staying away from alcohol and
illegal drugs.
Q: Who should know that I have Epilepsy?
Openness and honesty about Epilepsy is important. A child's teacher
should be informed about the type of seizure, what they look like,
their frequency, and any first aid requirements. There are
advantages and disadvantages to telling an employer. What you tell
them may depend upon how comfortable you are discussing your
Epilepsy, the kinds of seizures involved, and the type of job. An
employer may ask if you have a medical problem that would make you
unable to do your job, but they may not ask generally about your
medication condition.
Q: Is there prejudice against people with Epilepsy?
While much progress has been made in reducing societal prejudice
against Epilepsy, discrimination or rejection may also be a problem
for the person with the seizures. In addition, family and friends
may be overprotective or impose unnecessary restrictions. In the
end, the person with seizures may lose confidence or feel "like a
second class citizen".
Q: Are there any problems having children?
Women who use seizure-controlling drugs must be careful when it
comes to having children. There have been reported cases of birth
defects for these women. While the "normal" rate of birth defects
is 2-3% , women with epilepsy who are not taking medication have a
slightly higher (1/2%) risk of malformations. Women on a single
medication have a risk of about 6-7%, with some differences due to
the particular medication involved. Multiple drug combinations
drastically increase the risk.
This creates a problem because the drugs
may create risks for the baby, but the need for anti-seizure drugs
remains during pregnancy. Seizures may even be more frequent during
pregnancy, and harm both the baby and the mother.
A doctor may decide to change or reduce a woman's medication if she
plans to become pregnant. In some cases, however, the doctor may
recommend that the risks of pregnancy are too great for the mother
and child. Any changes in medication must be considered carefully,
and a woman should never adjust her own medication.
There are some special issues relating to maternal health during
pregnancy for women with Epilepsy, and this may require special
attention.
Finally, some seizure medications can lead to failures of oral birth
control pills.
Q: Can medications for controlling Epilepsy harm a nursing baby?
Always check with your physician if you are on anticonvulsants and
planning to breast feed. Although anticonvulsant medication has
been measured in the breast milk of mothers with Epilepsy, the
amount is usually too low to harm the child.
Q: Can people living with Epilepsy drive a car?
In Ontario, the situation is that anyone with a history of Epilepsy
may drive a motor vehicle, provided the person's physician certifies
that he or she has been free from seizures for a minimum period of a
year. Each case is reviewed by a medical advisory committee.
The situation may be different in your location. Ask your physician
about it, or contact a driver examination centre.
Q: Can people living with Epilepsy go swimming?
It is advised that before a person with Epilepsy goes swimming, they
should consult their doctor. When a person with Epilepsy does go
swimming, they should not do it alone (common water-safety advice
for everyone). It is also recommended that swimming be done in a
supervised pool rather than beaches, lakes, or rivers.
Q: Can Epilepsy lead to problems at school?
Longstanding seizure disorders may be associated with
seizure-induced brain damage and memory problems. Also, children
with Epilepsy may experience learning or concentration problems
because of the neurological disorder or the medications.
If a child who has Epilepsy is having problems at school, either
academically or socially, the teacher and the principal should be
asked to help. If you would like your child to be tested by the
school psychologist, arrange it through the principal. If your
child is having academic problems, ask to see the Special Education
Consultant for the area. In consultation with the child's teacher,
a modified program can be arranged if necessary. Children with
Epilepsy should be allowed to take part in all regular school
activities, including sports.
Q: Can Epilepsy cause emotional problems?
People with Epilepsy may develop depression for both biological and
social reasons. Some longstanding poorly controlled seizure
disorders may be associated with chronic personality changes. Also,
or short durations following temporal lobe seizures some patients
may have emotional "swings" or other thinking difficulties.
While Epilepsy is a medical problem, the person with the seizures
must also make a number of emotional adjustments. The first
challenge is acceptance of the diagnosis. Initially people with
Epilepsy and their families may experience shock or denial. Anger,
fear, and depression are also common. However, with information and
support, people with Epilepsy can understand the condition and
develop positive coping strategies.
Q: Can Epilepsy lead to problems with self-esteem?
It is important to remember that people with Epilepsy can, and do,
live full, productive lives. If self-esteem becomes a problem, open
discussion with supportive friends, family, or a professional
counsellor can help you develop new ways of coping and a new sense
of hope.
Topic: Working With Epilepsy
----------------------------
Q: What occupations are not appropriate for people with Epilepsy?
Given that they are trained with appropriate sets of skills and/or
education, the vast majority of people with Epilepsy are capable of
performing any job. Some exceptions to the rule are: occupations in
the military, commercial airlines, and fire brigade as the lives
of others may be endangered should a seizure occur. Consideration
should be give to the type of seizures and how well they are
controlled by medication.
Q: Can people with Epilepsy fly a plane?
Persons with Epilepsy may not be able to fly a plane. There are
strict standards that must be met by anyone wanting to get their
pilot's license. Each person is individually assessed and must meet
a regime of standards set up by the Civil Aviation Medical Centre.
Q: Is there a problem with job safety?
Employers hiring someone with Epilepsy are often concerned that job
safety will be compromised in the event of an injury caused by a
seizure in the workplace. One study revealed that the accident rate
of workers with Epilepsy was lower than those employees without
disabilities. Liability is not a factor as long as the employee has
been placed in an appropriate job and reasonable accommodation is
provided as necessary.
Q: Can an employer ask about Epilepsy on a job application?
Under the Ontario Human Rights Code (Chapter 53, Section 22(2)), it
is illegal for an employer to ask about medical problems on the
application form. A person with Epilepsy (or any other health
problem) is not required to respond to any medical related question.
A copy of the Ontario Human Rights Code and A Guild to the Ontario
Human Rights Code is available by calling Access Ontario at
(613) 238-3630.
Q: Can an employer ask about Epilepsy during a job interview?
In the Ontario Human Rights Codes (Chapter 53, Section 22(3)),
nothing precludes the interviewer from asking questions about your
health status, however it MUST relate to your ability to perform the
essential duties of the job. They may ask "Do you have any medical
problems that would make you unable to do the job?", but they MAY
NOT ask "Do you have any medical problems?" A copy of the Ontario
Human Rights Code and A Guild to the Ontario Human Rights Code is
available by calling Access Ontario at (613) 238-3630
Q: Can I be fired because I have Epilepsy?
The Ontario Human Rights Code does not permit employers to fire an
employee because they had a seizure at work, or have Epilepsy.
Before a person is dismissed, the employer must show that
"reasonable accommodation" (Chapter 53, Section 23(2)) has been made
to help the person keep their job. Accommodations are determined by
doing a physical demands analysis, which is a breakdown of the exact
physical requirements necessary to perform the job. Access Ontario,
at (613) 232-0489, will be able to provide you with more Ontario
Human Rights Information.
Q: Can people with Epilepsy get social assistance?
A person who has Epilepsy may qualify for assistance to prepare for
and to obtain employment under the Ontario Ministry of Community and
Social Services' Vocational Rehabilitation Services Program.
Assistance may take the form of vocational assessment, counselling,
academic, or technical training or job placement. Application
should be made to the nearest office of the Ontario Ministry of
Community and Social Services, listed in the blue pages in the
telephone directory.
A person who is severely disabled by seizures, and unable to compete
in the work force, may apply for assistance under Ontario's Benefits
Program, often called GAINS-D. Application should be made to the
nearest office of the Ontario Ministry of Community and Social
Services, listed in the Government of Ontario section of the blue
pages on the telephone directory.
Two other kinds of financial assistance are available in Ontario,
depending on a person's income: General Assistance, usually referred
to as welfare, is available for anyone in urgent need of financial
aid. Special Assistance is for a person who is employed, but has
extraordinary needs such as a high prescription drug costs.
Application for each of these assistance programs should be made
through the municipal social service department.
Topic: Epilepsy and Other Disorders
-----------------------------------
Q: Is Epilepsy related to other neurological problems?
Epilepsy is not necessarily associated with other neurological
problems or learning disabilities. Occasionally, the source of the
seizures may be reflected in other neurological deficits. Also,
medication for seizures may cause sedations and thus decrease the
rate of learning. People with Epilepsy have the same range of
intelligence as the general population.
Q: Is Epilepsy related to mental illness?
Epilepsy is not related to mental illness. Because of the
involvement of the brain, Epilepsy has been mistakenly associated
with psychiatric disorders. Epilepsy differs from psychiatric
disorders in that seizures last for very brief periods and begin and
end abruptly. Further, when not having seizures, people with
Epilepsy need not have any changes in their mood or behaviour.
Q: Can Epilepsy affect intelligence?
Seizures can affect intelligence, so prompt diagnosis and rapid
control of seizures is important. There is also a risk if seizures
are prolonged and there is a significant reduction in oxygen in the
brain during seizures. However, these are extremely rare
occurrences. In the case of developmentally delayed persons with
Epilepsy, it is most likely that the cause of the developmental
delay is also the cause of the seizures. In most cases, people with
Epilepsy have normal intelligence.
Q: Is there a link between memory loss and Epilepsy?
Some people with Epilepsy do experience a difficulty in recalling
distant and recent events. Often, this is caused by the medications
used to treat Epilepsy, or by regular seizure activity. People
affected in this way can learn to compensate by using lists and
reminders, and by creating an organized environment.
Q: Is Epilepsy related to asthma?
Asthma occurs in children with Epilepsy at about the same frequency
as it occurs in the general population. Likewise, the reverse is
also true. The drug theophylline can trigger seizures.
Q: Are there any diseases that persons with Epilepsy more prone to?
People with Epilepsy who are on medications may experience side
effects that makes them more susceptible to other diseases and
disorders. One common condition is Hyperplaxia, an over-growth of
the gums caused by the drug Dilantin. Other common problems are
liver dysfunction and depression.
Topic: Miscellaneous
--------------------
Q: Do animals get Epilepsy?
Epilepsy can occur in animals. Like humans, Epilepsy in animals is
really just abnormal electrical activity in the brain.
Q: Can dogs sense a seizure in humans before it strikes?
It is possible that some dogs are able to detect pre-seizure changes
in the physiology of some people with Epilepsy before the person
becomes aware of them. In many cases, the person with Epilepsy is
aware of an aura before the onset of the main part of the seizure.
Not enough is known about how dogs can detect seizures before their
onset to know exactly what sense(s) are involved in this detection.
However, one might hypothesize that since dogs can detect chemical
changes due to fear, seizures that are preceded by a sense of fear
might also produce detectable changes.
Topic: More Information
-----------------------
Q: Where can I get more information about Epilepsy?
There are a number of information sources about Epilepsy.
Here is a partial list, and I welcome suggestions for other
things to be added here.
Epilepsy (Ontario) Ottawa-Carleton
B3-180 Metcalfe St.
Ottawa, Ontario, Canada
K2P 1P5
(613) 594-9255
Epilepsy Ontario
5385 Yonge Street, Suite 207
Willowdale, Ontario, Canada
M2N 5R7
Telephone: (416) 229-2291
Epilepsy Canada
1470 Peel St., Suite 745
Montreal, Quebec, Canada
H3A 1T1
(514) 845-7866
Epilepsy Foundation of America (EFA)
8000 Corporate Drive, Suite 120
Landover, MD 20785
1-800-225-6872 or 1-800-EFA-1000
E-mail ntsa@aol.com
National Institute of Health
1-800-352-9424
Additional information on the Ketogenic diet can be obtained from:
The Johns Hopkins Pediatric Epilepsy Center, (410)955-9100 or The
Charlie Foundation to Help Cure Pediatric Epilepsy, (800)FOR-KETO.
In many areas there are local associations that may be valuable
to you.
Q: What books are available on Epilepsy?
EPILEPSY AND THE FAMIILY by Richard Lechtenberg. Harvard Univ.
Press, 79 Garden Ave, Cambridge, MA 02138-1311
LIVING WELL WITH EPILEPSY by Robert J. Gumnit, Demos Publications,
1990, 156 Fiftth Ave, NY, NY 10010
EPILEPSY AND YOU, by Frank O. Volle and Patricia A. Heron
DOES YOUR CHILD HAVE EPILEPSY? by J.E. Jan, R.G. Ziegler, G.
Erba, Austin PRO-ED Press, 5341 Industrial Oacks Blvd, Austin, TX
78735
CHILDREN WITH EPILEPSY: A PARENTS GUIDE, by Helen Reisner, Woodbine
House, 5615 Fishers Lane, Rockville, MD 20852
ONE MIRACLE AT A TIME, HOW TO GET HELP FOR YOUR DISABLED CHILD -
FROM THE EXPERIENCE OF OTHER PARENTS, by Irving Dickman, PACER
Center, Inc 4826 Chicago Ave, Minneapolis, MN 55417
THE EPISODE, by Richard Pollak * This one is listed as fiction
HAVING EPILEPSY, THE EXPERIENCE AND CONTROL OF ILLNESS by Joseph
Schneider and Peter Conrad, Temple Univ Press, Broad and Oxford
Streets, Philadelphia, PA
PSYCHOPATHOLOGY IN EPILEPSY, SOCIAL DIMENSIONS by Steven Whitman and
Bruce Hermann, Oxford University Press, 16-00 Pollitt Drive, Fair
Lawn, NJ 07419-2799
SEIZURES AND EPILEPSY IN CHILDHOOD: A GUIDE FOR PARENTS by John
Freeman, EileenVining and Diana Pillas, The John Hopkins University
Press, 701 West 40th St, Balitimore, MD 21211
A GUIDE TO UNDERSTANDING AND LIVING WITH EPILEPSY, Orrin Devinsky,
F.A. Davis Company, 1915 Arch Street, Philadelphia, PA 19103
BRAINSTORMS: EPILEPSY IN OUR WORDS, by Steven Schachter, Raven Press
1185 Avenue of the Americans, NY, NY 10036
THE BRAINSTORMS COMPANION: EPILEPSY IN OUR VIEW, by Steven
Schachter, Raven Press, 1185 Avenue of the Americas, NY, NY 10036
THE EPILEPSY DIET TREATMENT: AN INTRODUCTION TO THE KETOGENIC DIET
(Demos Press, 1994) by John Freeman, Millicent Kelly, and Jennifer
Freeman
CHALLENGE OF EPILEPSY by Sally Fletcher (Aura Publishing Company/20
Sunnyside Ave., #A150/Mill Valley, CA 94941)
Q: Where can I find information on the Internet about Epilepsy?
There are two Epilepsy-related mailing lists: "Epilepsy-List" is
intended for general discussions about Epilepsy and seizure
disorders. Most traffic is from people living with Epilepsy or
their friends and family. The companion list, "Epilepsy-PRO" is
intended for discussions about Epilepsy and seizure disorders by
professionals working in this field. To find out about these lists,
send mail to "listserv@calvin.dgbt.doc.ca" and include the command
lines "info epilepsy-list" and/or "info epilepsy-pro".
There is an Epilepsy Home Page on the web that has several links,
including one for the Ketogenic Diet. The URL is
http://www.swcp.com/~djf/epilepsy/index.html. The Ketogenic Diet
link shows the URL http://www.swcp.com/~djf/epilepsy/ketogenic.html.
Mass General Hospital and Harvard sponsor a neuro forum where people
can ask questions about seizure disorders, meds, etc. The address
is http://dem0nmac.mgh.harvard.edu/neurowebforum and you may try
http://dem0nmac.mgh.harvard.edu/epilepsy/epihome.html.
[Note: that is a "zero" in the hostname: dem0nmac. -- ASP]
The Charles A. Dana foundation, which has opened a website at
http://www.dana.org/, supports brain research and school reform by
means of grants and public education initiatives.
Sites people have mentioned:
http://neurosurgery.mgh.harvard.edu/
http://www.med.stanford.edu/touchstone/listserv.html
ftp://ftp.win-uk.net/pub/users/copernic/medical.resources
http://www.ibmpcug.co.uk/~copernic/meda.htm
[I sure I have missed some here, please send me additions. -- ASP]
------------------------------------------------------------------------
CONTRIBUTORS
The following people have helped to build and improve this material:
Chris Hayes <chayes@antenna.nl>
"Dale J. Frederick" <djf@swcp.com>
David Blum, M.D. <dblum@mha.chw.edu>
Dr Michael Chee <mchee@technet.sg>
Francoise Becker <BECKERF@cna.org>
Kay.A.Akins@att.com
Lisa Kiczuk <lkiczuk@mindport.net>
Martha Turner <"ACRPHL::MWTR"@ACR.ORG>
"Megan G Graham" <MEGAN.G.GRAHAM@cdev.com>
Richard Coppen <dickibus@copernicus.win-uk.net>
kris thompson <kthompso@lib.drury.edu>
--
Andrew Patrick, Ph.D. <andrew@calvin.dgbt.doc.ca>
Networks Services & Interfaces Laboratory
Communications Research Centre
http://debra.dgbt.doc.ca/
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