Webinar: Adult Epilepsy: Common Clinical Issues and New Therapies

Mon, Nov 2, 2015
1:00pm to 2:00pm ET

Description

A webinar featuring Mayo Clinic neurologists Jeffrey Britton, M.D., Gregory Cascino, M.D., Jerry Shih, M.D., and Joseph Sirven, M.D.. The physicians discuss a variety of adult epilepsy topics including:

  • Seizure medications: when to start and when can they be stopped.
  • Maximizing safety for patients with epilepsy.
  • Indications for admission to epilepsy monitoring unit.
  • New surgical therapies such as laser thermoablation.

Would you like to:

Learn more about Epilepsy

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Location

Online

How does a patient get an appointment/consultation with Mayo neurologists/neuroendocrinologists at the same time? What is required?

Are there any particular supplements or over the counter medicines that have been shown to be more active at causing seizures?

Why does fever or illness lower the threshold of seizures?

When considering persons who do not have epilepsy, what are precautions for them to take from having a seizures in their lifetime? I have been cured for over 24 years and like to have family/friends to take precautions.

Does epilipsey/seizures cause memory loss/ recall or is it more likely to be caused by medication? I take Depakote and have been on it for about 27 years.

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?

@user_ch7453696

Can we get some info on catamenial epilepsy? Or seizures that seem to be leaning towards drug-resistant?

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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:

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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.

@Kaia

Have you used Charlottes Web oil? I hear a lot of good about it for some. Others (like my daughter) would probably need the whole indica plant oil. Living in a state that does not allow it is very hard.

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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.

@sbruce

What is your opinion on Charlottes Web oil?

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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.

@user_ch7453696

How does a patient get an appointment/consultation with Mayo neurologists/neuroendocrinologists at the same time? What is required?

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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.

@sbruce

Why does fever or illness lower the threshold of seizures?

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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

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…

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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 800-446-2279 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).

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