Blog #146: STUDY FINDS NO SIGN OF BRAIN INJURY DESPITE RECURRENT FOCAL SEIZURES

 

A study analyzed brain tissue from 20 patients with recurrent drug-resistant seizures due to specific types of congenital abnormalities in brain cortex that promoted seizures from that focus. “Despite thousands of focal seizures over a lifetime, no signs of nearby cell loss nor of reactive inflammation—all signs indicative of brain damage—were seen…in the areas surrounding these type II focal cortical dysplasias studied,” researchers at the division of clinical epileptology and neurology at the Carlo Besta Neurological Institute in Milan, Italy reported.¹

The researchers hoped their findings would encourage patients and reduce fears of brain damage associated with this specific type of congenital abnormal brain cortex cells causing their frequent seizures.

About 30% of epilepsy patients in general do not respond to pharmacological therapy and 30% of these patients can be candidates for surgery if the seizure focus can be identified and judged to be safe for removal. Those patients who are seizure-free after surgery that removes these specific types of abnormal brain cells can have their antiseizure drugs gradually withdrawn. Social life, quality of life and productivity improvements would be expected.

The frequency of seizures in this study of these specific brain cell types of abnormality ranged from one/month to 300/month. The duration of their epilepsy ranged from one to 40 years.

This study does not contradict substantial evidence that seizures in general can cause brain changes, especially in the limbic system, i.e., that area sensitive to memory function.

 

 

  

1)     Rossini L, Garbelli R, Gnatkovsky V, et. al. Seizure activity per se does not induce tissue damage markers in human neocortical local epilepsy. Ann Neurol 2017; 82: 331-334.

 

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. His hard-hitting emotional family medical drama, “DINGS, is told from a mother’s point of view. “DINGS” is his first novel. Aside from acclamation on internet bookstore sites, U.S. Report of Books, and the Hollywood Book Review, DINGS has been advertised in a recent Publishers Weekly, New York Times Book Review and the Los Angeles Times Calendar section. DINGS teaches epilepsy and is now available in eBook, audiobook, and soft and hard cover editions.

 

Blog #3: Concussions Are Brain Traumas That Can Cause Seizures

Every so often, Sports Illustrated honors an athlete who must “retire” from a sport because of a head injury (concussion). As a neurologist, I agree that this is a prudent decision. Imagine my frustration and disappointment when, earlier this year, the Pentagon announced that it would not award a Purple Heart to military personnel who suffered “only” a concussion in combat. I knew that this was a grave error.

            A concussion is a disruption of normal brain function that is caused by a traumatic force to the head. Loss of consciousness is not necessary. Most symptoms are transient. These include: disorientation with confusion, slowed movements, loss of balance, slowed thinking, slurred speech, headache, drowsiness, nausea/vomiting, and blurred vision.  Repeated concussions can cause irreversible brain damage and epilepsy (recurrent seizures).

When the patient is checked by a doctor, the physical examination, brain scan, and electroencephalograms are likely to be normal. If the person experiences prolonged or chronic post-concussion symptoms, a neuropsychological evaluation can accurately detect whether a concussion has caused mental dysfunction. Unlike most other conventional war wounds, concussion does not produce an obvious physical abnormality. Even if the person is bleeding, he may not lose consciousness. But concussions can cause long-lasting psychological and physical symptoms that impact their emotional lives in the form of Post Traumatic Stress Syndrome.

            For the first time in my life, I wrote to my congressman to say that it was wrong for the Pentagon to not honor soldiers who have had a concussion. Even though I explained the medical reasons for my argument, I never received a satisfactory response to my letter. But several weeks later, for whatever the reason, the Pentagon reversed its decision: soldiers who have suffered a concussion now qualify for the Purple Heart medal.

 

 

 

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. DINGS is his first novel.