Epilepsy, migraine

Sleep Hygiene especially for Migraineurs and those with Epilepsy

By Virginia Thornley, M.D., Neurologist, Epileptologist
February 15, 2018

Introduction
Many neurological diseases are affected by lack of sleep most significantly migraine and epilepsy. A person performs suboptimally with lack of sleep with inattention and lack of coordination. In someone with a neurological condition, the symptoms become even more manifest. Weakness becomes more prominent, double vision may be more pronounced and difficulty speaking will become more prominent. Sleep plays a vital role in the restorative function of the body.

Stages of sleep, why adequate and continuous sleep is refreshing
Sleep is divided into 2 categories, Non-REM (rapid eye movement) sleep and REM sleep. During non-REM sleep, there are 4 stages. Stage 1 and 2 constitute drowsiness which transitions into light sleep. The electroencephalogram is a study that reflects brain activity. Stages 1 and 2 demonstrates sleep complexes including vertex waves then K complexes. Sleep spindles occur during stage 2 sleep. During stages 3 and 4 also known as slow-wave sleep, delta waves which are the slowest waves between 1-3 Hertz start to occur. Stage 4 shows delta waves of greater than 50% of the recording. People enter these stages of sleep and then subsequent REM sleep. REM sleep is where dreaming occurs.

One can go through a few cycles of these so that you wake up refreshed. Continue reading

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By Virginia Thornley, M.D., Neurologist, Epileptologist
February 16, 2018

Introduction
Epilepsy is a condition involving 2 or more seizures. A seizure occurs when the electrical impulses in the brain do not cease and as a result, become recurrent resulting in excess cerebral activity. Typically, it occurs in the grey matter of the cortex, although seizures can be seen in white matter diseases such as in multiple sclerosis. Manifestations depend on the area involved. Etiologies are vast and are due to underlying structural abnormalities in the brain which may arise due to autoimmune processes, neoplastic causes (cancer), infectious diseases, traumatic etiologies or drug-induced causes. At times, there is no structural damage and may be genetic in predisposition. The seizures are similar in nature because the same underlying part of the brain is activated causing the same type of seizure. Different clinical manifestations signify a different or new area involved. If a seizure spreads to the entire brain it manifests as convulsions with clinical symptoms of loss of consciousness and whole body rhythmic jerking.

What to avoid if you have seizures

Sleep deprivation
Sleep deprivation causes seizures to occur. When the brain is well rested it performs at maximal capacity. When it performs at suboptimal conditions such as sleep deprivation or fatigue, neurological conditions become more manifest.

Missing meals
Missing meals can give rise to seizures. When you miss a meal your blood glucose or sugar is lower. This low level of sugar also known as hypoglycemia can cause seizures to occur.

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Drugs
Certain medications can reduce the threshold of seizures including ciprofloxacine, certain cephalosporins and tramadol. Some psychotropic agents such as clozapine and chlorpromazine can lower the seizure threshold. It is best to avoid these agents and ensure your physicians know all your conditions. Amphetamines can also cause seizures and lower the seizure threshold.

Drugs of abuse
Some drugs are notorious for causing seizures such as cocaine. Cocaine can cause the blood vessels to constrict leading to strokes which can result in brain damage and seizures can result. Alcohol, if consumed by those with a genetic predisposition, can give rise to seizures. Excessive alcohol abuse can give rise to alcohol-induced seizures.

Other lifestyle changes 

Because loss of consciousness may be involved, potential harm can occur. Avoiding heights such as ladders, cliffs, the edges of train platforms or subway platforms can help avert harm. Using the back burner while cooking help prevents burns. Avoiding driving for at least 1 year of seizure freedom can prevent accidents, some states require only 6 months. Avoiding the operation of heavy equipment such as forklifts, cranes can prevent accidents. Avoidance of swimming alone may prevent drowning, same is true with avoidance of taking baths alone.

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It is an excellent idea to get a medics alert bracelet especially for young patients who may have a seizure late at night in public. After a seizure, patients may appear incoherent, disoriented and confused. It is also good to keep a list of medications.
Keeping everything clear around the patient can prevent injury.

An excellent resource for information and support is the Epilepsy Foundation. They provide a wealth of non-medical services including support and assistance in job-related issues. Some branches even have summer camps for children.

https://www.epilepsy.com/

Introduction/Disclaimer

Epilepsy

Epilepsy: Living with Epilepsy

Avoiding heights such as ladders, cliffs, the edges of train platforms or subway platforms can help avert harm. Using the back burner while cooking help prevents burns. Avoiding driving for at least 1 year of seizure freedom can prevent accidents, some states require only 6 months.

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