Webinar: Adult Epilepsy: Common Clinical Issues and New Therapies

The webinar has concluded. In the following week Dr. Shih, Dr. Sirven, Dr. Cascino and Dr. Britton will work on answering questions they didn't get to during the webinar.

Thank you for addressing the questions. Yes she has had several video eeg's and we were always told that they were seizures - not all of the movements but majority. Thank you again. How does one get an appointment and do you do telephone appointments for questions? You are touching on a lot of things - time/length of seizures, can they cause more damage, how long do you let back to back seizures go on even though they are only 10-15 secs long but not even a minute apart. Oh so many questions. So hard...

THANK you! This has been amazing!

I was diagnosed with epilepsy when I was 15. I am now 23 almost 24, and have been seizure free for almost 8 years. I have yearly appointments with my neurologist. I am on 3 different seizure medicaitons, Lamictal, generic Klonipin, and generic Keppra. I am also on Straterra due to the side effects of my seizure medications causing me to have ADD. I take my medications twice a day at the same time (5:30AM and 5:30PM). My fiance and I have been wondering about having children before I turn 30. What do you suggest about the ways I could safely get pregnant but still be able to stay on my medications?

For some women with epilepsy, the occurrence of seizures correlates to their menstruation and ovulation cycles. This is called catamenial epilepsy. Progesterone dominates the hormonal cycle for women, except during ovulation and menstruation when estrogen is higher. Estrogen tends to excite the brain, whereas progesterone calms the brain. To treat catamenial epilepsy, we may consider increasing seizure medications around the time of ovulation and menstruation to help control the seizures. This video may be of help to you: https://www.youtube.com/watch?v=SOt8SqX4spA.

At least half of all people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest surgery or other therapies. You'll have regular follow-up appointments with your doctor to evaluate your condition and medications. Learn more about surgery and other therapies: http://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/treatment/txc-20117241.

There has been a lot of interest and attention paid to the therapeutic possibilities of a marijuana extract called cannabidiol (CBD) for epilepsy. While there are well-publicized examples of individual patients who appear to have benefitted from this treatment, there is a shortage of clinical data establishing its effectiveness and safety. Mayo Rochester does have a clinical trial of CBD for a specific form of epilepsy called Lennox-Gastaut syndrome, so that we can learn more about its therapeutic use and limitations. Mayo is open to use of any therapy that has established effectiveness and safety.

Given CBD is derived from marijuana, and marijuana is still considered a Class 1 narcotic by federal law, it is difficult to perform research on its use in epilepsy and other conditions. State laws regulate whether a physician can use CBD and other forms of medical marijuana in clinical care, and this patchwork of state-by-state variability has created a very confusing situation for patients and physicians. This link provides information from Mayo Clinic regarding this issue: http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/medical-marijuana/art-20137855.

There has been a lot of interest and attention paid to the therapeutic possibilities of a marijuana extract called cannabidiol (CBD) for epilepsy. While there are well-publicized examples of individual patients who appear to have benefitted from this treatment, there is a shortage of clinical data establishing its effectiveness and safety. Mayo Rochester does have a clinical trial of CBD for a specific form of epilepsy called Lennox-Gastaut syndrome, so that we can learn more about its therapeutic use and limitations. Mayo is open to use of any therapy that has established effectiveness and safety.

Given CBD is derived from marijuana, and marijuana is still considered a Class 1 narcotic by federal law, it is difficult to perform research on its use in epilepsy and other conditions. State laws regulate whether a physician can use CBD and other forms of medical marijuana in clinical care, and this patchwork of state-by-state variability has created a very confusing situation for patients and physicians. This link provides information from Mayo Clinic regarding this issue: http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/medical-marijuana/art-20137855.

There are no neuroendocrinology subspecialists on staff in the Mayo Clinic Department of Neurology at the present time. Members of the Department of Neurology work in collaboration with the Division of Endocrinology and Metabolism when caring for patients with endocrinologic issues. While appointments can be coordinated between the Department of Neurology and Division of Endocrinology and Metabolism, there are no Endocrinology staff who are considered neuroendocrine subspecialists per se at this time. A clear understanding as to the patient needs referable to the request for a neuroendocrinologist would need to be assessed in order to see if an appropriate appointment would be available.

A seizure threshold is the level of stimulation at which your brain will have a seizure. People with epilepsy may be considered to have a lower-than-normal seizure threshold. This means that only slightly increased brain stimulation may induce a seizure for someone with epilepsy. One’s seizure threshold is mostly determined by genetics, but other factors can lower your threshold. Fever and illness may lower one’s threshold. This may be most important in pediatric patients with a genetic predisposition to febrile seizures in childhood.

Kaia, you can schedule an appointment at any of our three campuses by clicking on the link located on this page below the webinar video or by calling 480-301-8484 for our Arizona campus, 904-953-0853 for our Florida campus, 507-538-3270 for our Minnesota campus or 855-MAYO-KID for our Children’s Center. We don’t offer phone consultations at this time.

Most brief focal seizures do not lead to clinically significant damage to the brain. The seizure types most likely to be associated with brain damage include generalized tonic-clonic (grand mal) seizures and prolonged focal seizures (i.e. those going on for several minutes at a time).