The Epilepsy Program at Neurological Surgery, P.C.

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Epilepsy and Blindness:

On 2/16/09, I (Dr. Ettinger) commented in an article in the New York Times http://www.nytimes.com/2009/02/17/health/17voic.html?8br on the inspirational story of a remarkable artist, John Bramblitt who suffered from epilepsy and progressive visual loss. Over time, he lost his eyesight completely and yet did not permit this to be an obstacle to creating remarkable paintings. I would like to add the cautionary note that while seizures themselves may be associated with all sorts of visual phenomena, it is very rare for individuals with epilepsy to become blind. Sometimes, the underlying condition giving rise to the seizures will have more to do with this complication than the seizures themselves. It is important that a person with typical epilepsy should not worry that their seizures will suddenly lead to this kind of complication.

Last updated 3/2/09

New Antiepileptic Drug for Partial Seizures:

The FDA has recently announced its approval of a new antiepileptic drug (AED) as add-on treatment of partial seizures (seizures of the type that begin in a part of the brain). This medication goes by the brand name Vimpat® (generic name lacosamide) and appears to have new mechanisms of action against seizures. This treatment has shown promise in substantially reducing seizures in individuals whose seizures were uncontrolled by previous medications. The addition of more treatments for partial seizures is a very welcome event, as some seizures do not respond adequately to the currently available medication treatments. Additionally, some seizures have the potential of responding to a treatment but sometimes the medication had side effects or is not well-tolerated. Having more choices then, opens additional options to try to control the seizures.

Last updated 2/2/09.

Suicidal Thoughts and Antiepileptic Drugs:

Recent warnings by the Federal Drug Administration (FDA) regarding the risk of suicidal thoughts and acts as a potential side effect of antiepileptic drugs (AEDs), has provoked much concern and controversy. Many of us involved with committees for the national Epilepsy Foundation and the American Epilepsy Society, have been concerned that this warning could lead individuals to abruptly stop their medications which in turn could lead to many seizure-related complications. As we wrote in a commentary for the Epilepsy Foundation (please see www.epilepsyfoundation.org/epilepsyusa/news/FDA-Requires-Warnings-about-Risk-of-Suicidal-Thoughts-for-Antiepileptic-Medications.cfm , ideas about the risk of suicidality from AEDs are based upon a very controversial interpretation of the data. Even if the risk is genuine, it is very small compared to the risk of withholding antiepileptic therapy. We advise anyone with concerns about this issue to contact their physician and never to stop their medication on their own.

Last updated 2/2/09.

Depression and Epilepsy:

A number of recent publications including a major consensus statement from experts in the field of epilepsy and mood disorders (Barry JJ, Ettinger AB, Friel P, et al. Consensus statement: The evaluation and treatment of people with epilepsy and affective disorders. Epilepsy Behav 2008 ) attest to the importance of discussing any feelings of depression you may have with the doctor. Many individuals have questions about the relationship between depression and epilepsy. Readers are referred an "Ask the Expert" series hosted by the national Epilepsy Foundation. www.epilepsyfoundation.org/about/expert/mood-disorders.cfm?renderforprint=1& for further information.

Last updated 2/2/09.

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