Brain Research:Type of electromagnetic field therapy improves survival for patients with brain tumor ♦ Reduce epileptic seizures following traumatic brain injury

Type of electromagnetic field therapy improves survival for patients with brain tumor Early research indicates that the use of tumor-treating fields, a type of electromagnetic field therapy, along with chemotherapy in patients with a brain tumor who had completed standard chemoradiation resulted in prolonged progression-free and overall survival.

Brain’s GPS depends on visual landmarks to triangulate location Researchers have found that space-mapping neurons -- the GPS system in the brain -- have a strong dependence on what is being looked at when triangulating location, a finding that resolves a neurological mystery that has vexed scientists for more than four decades.

Using network science to help pinpoint source of seizures The ability to reliably pinpoint the anatomical source of epileptic seizures, different for each patient, remains elusive. New research looks at networks of electrical activity in the brain just prior to the onset of a seizure by studying the recordings of 88 seizures from 22 patients.

Scientists identify mechanisms to reduce epileptic seizures following TBI Halting production of new neurons in the brain following traumatic brain injury can help reduce resulting epileptic seizures, cognitive decline, and impaired memory

What You Need to Know About Epilepsy

Electrical Outbursts in the Brain

When you hear the word epilepsy, you might think of intense seizures with muscle spasms and loss of consciousness. But most epilepsy seizures are surprisingly subtle and may be hard to recognize. These little spells can be an early warning sign of epilepsy, a brain disorder that strikes an estimated 1 in 26 Americans at some point in their lives. The sooner epilepsy is recognized, the sooner it can be treated and seizures prevented.

Most people know surprisingly little about epilepsy, even though it’s the nation’s 4th most common neurological disorder, after migraine, stroke, and Alzheimer’s disease. Epilepsy is marked by repeated, unpredictable seizures that may last for seconds or minutes. Seizures arise from abnormal bursts of electrical activity in the brain that trigger jerky movements, strange emotions or sensations, falls, or passing out.

“Epilepsy can strike people of all ages, from the moment of birth—even in the delivery room—up to older ages,” says Dr. Jeffrey Noebels, an epilepsy expert at Baylor College of Medicine. The condition is most likely to first arise in children and in adults over age 60. “Most types of epilepsy last a lifetime, but some are self-limited, meaning they can go away on their own,” Noebels adds.

The causes of epilepsy are varied. “Defects in genes are probably responsible for the largest fraction of epilepsy cases,” Noebels says. Scientists so far have linked more than 150 genes to epilepsy. “Other types of epilepsy can be acquired through trauma (such as head injury or stroke), infections, brain tumors, or other factors.”

Anything that disrupts the normal pattern of brain activity—from illness to brain damage to faulty brain development—can lead to seizures. But for up to half of people with epilepsy, the underlying cause is simply not known.

Types of seizures can also vary widely, which is why epilepsy is sometimes called a “spectrum disorder.” In some people, seizures may appear only occasionally. At the other end of the spectrum, a person may have hundreds of seizures a day. The seizures can be severe, with convulsions, loss of consciousness, or even sudden death in rare cases. Or seizures may be barely noticeable.

Such subtle seizures—sometimes called partial or focal seizures—can cause feelings of déjà vu (feeling that something has happened before); hallucinations (seeing, smelling, or hearing things that aren’t there); or other seemingly mild symptoms. During some seizures, a person may stop what they’re doing and stare off into space for a few seconds without being aware of it.

“These little spells or seizures can sometimes occur for years before they’re recognized as a problem and diagnosed as epilepsy,” says Dr. Jacqueline French, who specializes in epilepsy treatment at the New York University Langone Medical Center. “They can be little spells of confusion, little spells of panic, or feeling like the world doesn’t look real to you.”

The symptoms of these small seizures generally depend on which brain regions are affected. Over time, these types of seizures can give rise to more severe seizures that affect the whole brain. That’s why it’s important to get diagnosed and begin epilepsy treatment as soon as possible. “If you notice a repeating pattern of unusual behaviors or strange sensations that last anywhere from a few seconds to a few minutes, be sure to mention it to your doctor or pediatrician,” French says.

Over the past few decades, NIH-funded scientists have been working to develop better approaches for diagnosing, treating, and understanding epilepsy. The condition can now be diagnosed through imaging tools like MRI or CT scans, by testing blood for defective genes, or by measuring the brain’s electrical activity. Seizures can often be controlled with medications, special diets, surgery, or implanted devices. But there’s still a need for improved care.

“Traditional medications for treating epilepsy are effective but problematic,” says Dr. Ivan Soltesz, who studies epilepsy at Stanford University. “About 1 in 3 patients has drug-resistant epilepsy, meaning that available drugs can’t control the seizures. In these cases, surgical removal of brain tissue may be the best option.” When the drugs do work, he explains, they can also cause numerous side effects, including fatigue, abnormal liver function, and thinking problems.

One issue with today’s medicines is they aren’t targeted to the malfunctioning brain cells. Rather, they tend to affect the whole brain. “The drugs are also not specific in terms of the timing of treatment,” Soltesz says. “The medications are always in the body, even when the seizures are not occurring.”

He and other researchers are working to create highly targeted epilepsy therapies that are delivered only to malfunctioning brain regions and only when needed to block a seizure. So far, they’ve developed an experimental approach that can stop epilepsy-like seizures as they begin to occur in a mouse. The scientists hope to eventually translate those findings for use in people who have epilepsy.

In another line of NIH-funded research, a team of scientists is studying a deadly and poorly understood condition called SUDEP (for sudden unexpected death in epilepsy). “Most people with epilepsy live long and happy lives. But SUDEP is the most common cause of the shorter lifespan that can occur with epilepsy,” says Noebels. “It’s been a real mystery. We haven’t known who’s at greatest risk for this premature death. It can happen to different people who have epilepsy, from all walks of life.”

Noebels and his colleagues have identified several mouse genes that seem related to both sudden-death seizures and heart rhythm problems. The researchers are now searching for similar human genes that may help predict who’s most at risk for SUDEP. “We believe that SUDEP doesn’t have to happen—that we can learn about it, predict it, and eventually find better ways to prevent it in every patient,” Noebels says.

You can take steps to reduce some risk factors for epilepsy. Prevent head injuries by wearing seatbelts and bicycle helmets, and make sure kids are properly secured in car seats. Get proper treatment for disorders that can affect the brain as you age, such as cardiovascular disease or high blood pressure. And during pregnancy, good prenatal care can help prevent brain problems in the developing fetus that could lead to epilepsy and other problems later in life.

“We’ve made exciting advances to date in our understanding of epilepsy, its prevention, and treatment,” says French. “But there’s still much we have to learn, and much we’re actively working to improve.”

Health Research: Doctors often misdiagnose zinc deficiency ♦ Scientists identify amino acid that stops seizures in mice ♦ Drug improves cognition in Alzheimer's disease

HIV drug PrEP not linked to greater risk for depression A randomized, placebo-controlled trial of daily oral HIV preexposure prophylaxis (PrEP) in men and transgender women who have sex with men -- reported no link between taking Truvada for oral PrEP and experiencing depression.

Scientists identify amino acid that stops seizures in mice An amino acid whose role in the body has been all but a mystery appears to act as a potent seizure inhibitor in mice, according to a study. In a series of experiments, the amino acid D-leucine, found in many foods and certain bacteria, interrupted prolonged seizures, a serious condition known as status epilepticus, and it did so just as effectively as the epilepsy drug diazepam -- the choice of treatment for patients in the throes of convulsions -- but without any of the drug's sedative side effects.

Drug improves cognition in Alzheimer's disease-mouse model in spite of diet Long-term administration of a drug that mimics the hunger-signaling hormone ghrelin protected Alzheimer’s disease-model mice from memory deterioration, despite a high-glycemic-index diet, scientists report.

Doctors often misdiagnose zinc deficiency, unaware of impact of excess zinc Doctors often misdiagnose zinc deficiency, and seem to be unaware of the impact of excess zinc on the body, shows a small audit of clinical practice. Zinc is an essential trace element that is required in daily quantities of 5.5 to 9.5 mg for men, and 4 to 7 mg for women. But zinc supplements are usually only available in formulations of 45 or 50 mg. The US recommended tolerable limit is 40 mg/day

Tamper-resistant pill dispenser aims to stamp out medication misuse You can whack it with a hammer, attack it with a drill, or even stab it with a screwdriver. But try as you might, you won't be able to get into this pill dispenser. Which is exactly the idea.

Pediatric Research: Number of childhood cancer survivors increasing ♦ New genetic clues to pediatric seizure disorders ♦ Element of surprise helps babies learn

Number of childhood cancer survivors increasing, most have morbidities

The prevalence of childhood cancer survivors is estimated to have increased, and the majority of those who have survived five or more years beyond diagnosis may have at least one chronic health condition

Element of surprise helps babies learn

Cognitive psychologists have demonstrated for the first time that babies learn new things by leveraging the core information they are born with. When something surprises a baby, like an object not behaving the way a baby expects it to, the baby not only focuses on that object, but ultimately learns more about it than from a similar yet predictable object.

Study finds new genetic clues to pediatric seizure disorders

Researchers have identified a new genetic mutation at the heart of a severe and potentially deadly seizure disorder found in infants and young children. The finding may help scientists unravel the complex biological mechanism behind these diseases. Epileptic seizures are the result of bursts of electrical activity in the brain caused when groups of neurons fire in an abnormal pattern.

One test can predict which kids will become nearsighted

A study of 4,500 U.S. children over 20 years has identified a single test that can predict which kids will become nearsighted by the eighth grade: a measure of their current refractive error. The refractive error, or eyeglasses prescription, results from mismatches in the size and optical power of the eye that lead to blurry vision

FDA Seizes Hundreds of Rogue Pharmacy Websites.

Don't order medicines from web sites that claim to be Canadian pharmacies. Most are not legitimate pharmacies, and the drugs they supply are illegal and potentially dangerous.

Claiming to be a Canadian pharmacy is one of the hallmarks of Internet sites that sell illegal prescription drugs which, in many cases, are not made in Canada at all, but in a number of other countries. (Even if an online Canadian pharmacy is legitimate, in general, U.S. citizens cannot legally import prescription drugs from other countries. But that's a separate issue. We're talking here about fraud.)

There are many other false claims being made, but this one figured prominently in the June 2013 seizure of hundreds of rogue pharmacy websites.

This is according to Special Agent Daniel Burke, senior operations manager in FDA's Cybercrimes Investigations Unit, a special team created in March 2013 in the agency's Office of Criminal Investigations (OCI). Cybercrimes are illegal acts involving a computer and a network. This unit works with other domestic and international agencies to track down the operators and suppliers of websites that illegally sell prescription medicines. The agents' methods include high-tech detection in which they follow the cyber-trail of these pharmacies, and go undercover to infiltrate the criminal world.

Burke explains that medicines offered by these sites are often stolen or counterfeit. An unsuspecting consumer may be buying a medicine that does not have the active ingredient that will make it effective, or it may have undisclosed ingredients that could endanger their health or even be life-threatening.

"Consumers are able to buy prescription drugs, unapproved drugs and potentially counterfeit drugs without a full understanding of the risks that they take when they do that," says OCI Director John Roth. "What worries me is that people naively believe that these medicines are safe."

Illegal Pharmacy Websites Seized

In June, FDA—working with international regulatory and law enforcement agencies, including the U.S. Attorney's Office in Denver, Colorado—seized and shut down 1,677 illegal pharmacy websites. Many of the websites appeared to be operated by a criminal network that represented itself as various Canadian pharmacies.

The medicines sold on these websites were described as "brand name" or "FDA-approved" when they were neither. Products purchased by federal agents bypassed safety controls required by FDA, including that they be used with a valid prescription and under the supervision of a licensed health care provider.

Some of the illegal sites used the names of well-known U.S. retailers to trick consumers into believing that there was an affiliation with those stores. Examples include www.walgreens-store.com and www.c-v-s-pharmacy.com.

The banner of FDA's Cybercrimes Investigation Unit is now displayed on the seized sites to identify them as illegal.

Burke says it was dogged online detective work by federal investigators who monitored site traffic, "followed the money trail," and tracked the bogus sites back to an operation based overseas. An estimated 10,000 such sites are believed to be part of this network, he says. The U.S. investigators turned over their findings to local authorities via the international police organization Interpol.

Undercover Investigations

Burke estimates that there are 40,000 to 60,000 domain names that could be tied to illegal online pharmacies at any given time, and that this number is in a constant state of flux. (A domain name is used to identify and locate computers on the Internet.)

He and other operatives have gone undercover in other countries, with the cooperation of foreign law enforcement, to lure out the suppliers of these illegal medicines and to track down the site operators.

The drugs that these rogue pharmacies sell typically come from Southeast Asia, the Middle East, North Africa and South and Central America. The site operators are in the U.S. and all over the world. FDA coordinates its investigations with law enforcement agencies in many other countries, Burke explains. In some cases, the suspects are turned over to authorities in the country in which they were based; in other cases they are extradited to the United States for prosecution.

FDA is expanding its law enforcement presence overseas as well. In 2014, the first permanent OCI agent overseas will begin an assignment at Europol—the European Union's law enforcement agency—in The Netherlands.

Consumer Advice

Websites that illegally sell prescription drugs also potentially present non-health related risks, such as identity theft, computer viruses or credit card fraud. FDA asks consumers to report suspected criminal activity at www.fda.gov/oci.

FDA provides information on how consumers can identify a fake online pharmacy and offers advice on how to find a safe online pharmacy at BeSafeRx: Know Your Online Pharmacy.

"Consumers should also beware of offers that some sites make to attract customers, such as offering a commission or a referral bonus for bringing in new customers. They might offer 'bonus pills' with a purchase," says Burke. "They're unscrupulous."

Problems in Diagnosing Epilepsy

Many People with Epilepsy have more than one condition. If more physicians became aware of and understood how often adults with epilepsy reported other medical conditions, these physicians could then screen, diagnose, and treat these conditions to prevent complications in patients with epilepsy.

Epilepsy is a group of disorders all involving recurring seizures but of different types, causes, and severity. Epilepsy affects about 2.3 million U.S. adults. Adults with epilepsy more often report other conditions affecting the heart, lungs, skin, joints, and stomach, as well as pain complications compared to people without epilepsy.

If more physicians became aware of and understood how often adults with epilepsy reported these medical conditions, physicians could then screen, diagnose, and treat these conditions to prevent complications in patients with epilepsy. Physicians can also work with other healthcare providers, public health agencies, the Epilepsy Foundation, and other groups to ensure that adults with epilepsy can manage their epilepsy.

] In many cases a cause of Epilepsy cannot be identified; however, factors that are associated include brain trauma, strokes, brain cancer, and drug and alcohol misuse among others.

Nearly 80% of epilepsy occurs in developing countries. Epilepsy becomes more common as people age. Onset of new cases occurs most frequently in infants and the elderly. Epileptic seizures may occur in recovering patients as a consequence of brain surgery.

Epilepsy is usually controlled, but not cured, with medication. However, more than 30% of people with epilepsy do not have seizure control even with the best available medications. Surgery may be considered in difficult cases Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as syndromic with vastly divergent symptoms, all involving episodic abnormal electrical activity in the brain and numerous seizures.

Source CDC