Exploring the Gut-Brain Connection and Photosensitivity

[Keith]

I've stated more than once that I don't believe all epilepsy is of gut origin, but I'd bet a very large percentage is . . . especially considering the very high rate at which anticonvulsants are ineffective, intractable epilepsy.

For doctors not to know this and/or have nothing to offer their patients when drugs don't work is sadly absurd. That's when people need to begin to be responsible for their own health.

When my seizing dog was seen by 9 clueless vets including a neurologist and were informed of her severe gastrointestinal symptoms, they all shook their heads in wonder and could only offer anticonvulsants. Not one even knew about PCR stool testing as diagnostic tool using microbial DNA detection to identify the culprit. Moreover, vets don't realize they're causing gut damage by combining medications along with vaccines leading to epilepsy. In general, doctors and people are unaware of the importance of the gut to overall health. You bet I'm pissed.

So sorry to learn of your childhood near-drowning accident as cause of epilepsy, kirsten. Of course, I don't believe such an incident would cause epilepsy of gut origin. Have you done much research about brain plasticity in attempt to heal using things like magnesium malate (for malic acid to reduce adhesions (scars), hyaluronic acid to potentially raise hyaluronidase in brain plasticity and MSM sulfur to raise collagen in the brain? What have doctors offered you in attempt to heal the brain?

To suggest I haven't answered people's questions here to the best of my ability is incorrect. To the contrary, I've tried to offer more than what's been asked, i.e., in Janus' situation where I've surmised microbial metabolites of the gut in digestion are secondary seizure triggers due to his TBI.

 

[kirsten]

A few of us have shown you a range of statistics to show you that medical treatments are effective in 70% of cases. Why do you keep going back to saying that there is a very high rate of inefficacy with anti-convulsants?

If you are ready to acknowledge that there is evidence that some epilepsy originates in the brain, perhaps you need to stop making statements that 'epilepsy originates in the gut?'

Please let us know which sorts of epilepsy you believe originate in the gut so that we have an obvious zone for discussion. Which kinds of epilepsy don't begin in the gut, and which do you think do?

You don't answer the hard questions. When you're asked a question that has, after a long debate, become impossible for you to answer, you ignore it and start copying and pasting more studies instead. Any pointed questions that you can't answer, you ignore. You answer questions asked by sick people who think you're equipped to give them medical advice. Those are the questions I dearly wish you didn't answer.

 

[Keith]

Which kinds of epilepsy don't begin in the gut, and which do you think do?

That's a great question I wish you'd help answer. Given Nakamova's list of metabolic triggers and all metabolic possibilities I've been exploring here, which types of epilepsy might begin in the gut? And I'm not talking about secondary triggers, but primary cause.

You seem to believe there's no such thing as the gut as primary cause of epilepsy. But if there were, which types of epilepsy might fit this category?

 

[kirsten]

The hypothesis is yours, and the question is thus yours to answer. Please do answer it, though.

It wouldn't make sense to use Nak's list to arrive at an answer though. You can't use the behaviour of a brain physiology problem to create or hypothesise a digestive problem. They are two different systems that don't behave the same at all.

 

[Keith]

I'd really appreciate your expertise here, kirsten. It will be helpful as I may even write a book on this subject so that epileptics will become more aware of gut origin of seizure activity.

 

[kirsten]

Let's get this back on track: I've asked you a question. It is now your turn to answer it. Put another way, when there is a debate, and one party is tasked with explaining their premise, the burden of proof is on them, not the person who asked the question. It's my job to support my case and your job to support your case.

In terms of adding 'my expertise' (whatever it is, I don't know) to your book, I don't ghost medical content.

 

[Keith]

It's a great question I'm unable to answer right now. But thanks for inspiring me to try. It will take a while to answer though because I need to learn about all the different types of epilepsy. If anyone here has suggestions, I'm all ears.

I will say that Infantile Spasm may be of gut origin. Unfortunately, it's never been studied. All focus is on the brain.

 

[kirsten]

Thank you, Keith, for committing to research more about the different types of epilepsy. I strongly suggest you also review the research that supports the field of epileptology. Please will you let us know of your progress.

 

[Shelley]

Keith, thanks for understanding that when people (who have heard a large range of ideas) want real proof when it comes to our disorder.
As it has been pointed out, one or two unrepeatable instances aren't proof.

It would be great if you can show double blind studies to back up your claims, and not rely on one-off mentions of possible seizure triggers.

 

[Keith]

There is a connection between the gut and lesions on the brain. But some lesions are apparently not permanent. Seemingly due to brain plasticity, the brain can heal itself.
http://www.ncbi.nlm.nih.gov/pubmed/7788111

Here are three studies detailing correlation between gut imbalances and brain lesions. What's striking in the Celiac study is how these lesions occur even without intestinal symptoms:
http://pediatrics.aappublications.org/content/108/2/e21.long

we found hyperintense focal white-matter lesions in the brain in 20 of 48 (42%) patients with Crohn's disease, in 11 of 24 (46%) patients with ulcerative colitis, but in only 8 of 50 (16%) healthy age-matched controls

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)90013-6/abstract

extra-intestinal manifestations:
http://www.elsevier.pt/en/revistas/...rohnx00027s-patient-under-adalimumab-90197251

 

[epileric]

There is a connection between the gut and lesions on the brain. But some lesions are apparently not permanent. Seemingly due to brain plasticity, the brain can heal itself.
http://www.ncbi.nlm.nih.gov/pubmed/7788111

Nowhere does it say anything about the gut here. Actually what it does say is that the lesions are possibly caused by seizures

these 'disappearing' lesions may in fact be the consequence of seizures, rather than the cause.

Here are three studies detailing correlation between gut imbalances and brain lesions. What's striking in the Celiac study is how these lesions occur even without intestinal symptoms:

The first study says there is no correlation

There was no correlation between these lesions and dietary compliance

The 2nd study implies a higher likelihood of brain lesions in people with Crohns disease and ulcerative colitis. This is still very preliminary but you can't assume that because of this correlation that having a healthy stomach will give a healthier brain. For all we know it is the lesions causing the stomach problems (I'd say more likely).

The 3rd link is just a case study & makes no mention of gut-brain connection. I have mentioned before that case studies should be documented but seeing things happen in a single person does not show that these things are correlated.

 

[Keith]

Well, then Eric, you probably also believe that brain damage and hypothalamic inflammation cause obesity. Here's a researcher who tends to believe your way of thought:
Obesity is associated with hypothalamic injury in rodents and humans
http://www.jci.org/articles/view/59660

Article about the study interviewing study author:
http://www.digitaljournal.com/article/316939

Given the enormous amount of information now showing gut-brain is a two-way street, I believe the opinion that the brain controls the gut in many cases is obsolete. It's time we focus on the opposite direction, where the gut controls brain function.

Regarding obesity associated with epilepsy, it appears that's also still up for debate, confounded by the fact that being overweight or obese is all too common these days:
http://www.medpagetoday.com/Neurology/Seizures/15785
http://www.epilepsybehavior.com/article/S1525-5050(13)00228-X/abstract

Personally, I believe the hypothesis that brain damage has caused the obesity epidemic is completely backward, even asinine. Children are born with imbalanced gut flora, relegated to lives of obesity, diabetes, epilepsy, heart and lung disease and cancer. It's a matter of microbial predisposition. What science is now discovering is that through diet and other measures, flora populations can be manipulated for better health, including resolving seizure activity.

 

[kirsten]

What science is now discovering is that through diet and other measures, flora populations can be manipulated for better health, including resolving seizure activity.

That is a confident statement. I see you haven't presented a link to back up your claim that flora populations can be manipulated to resolve seizure activity.

I guess you didn't commit to doing that research into the aetiology of epilepsy as you'd claimed.

Just out of curiosity, why do you link studies here for us to read that you have not read?

 

[kirsten]

Regarding obesity associated with epilepsy, it appears that's also still up for debate, confounded by the fact that being overweight or obese is all too common these days:
http://www.medpagetoday.com/Neurology/Seizures/15785
http://www.epilepsybehavior.com/article/S1525-5050(13)00228-X/abstract

Ah, no, Keith. You didn't understand what you cited again. The article says

Almost 40% of pediatric epilepsy patients that have comorbid obesity are overweight

Which is rather than odd statement to make. It's kind of like saying almost 40% of fruits that are apples are apples. Maybe I'm just too tired to understand what they're trying to say there.

Anyway, through that jumble, what we get to is this:

The authors reported that 19.9% of the epilepsy patients were obese, while18.7% were overweight, together accounting for 38.7% of the entire patient cohort. The mean BMI z-score for the patients differed significantly from the CDC standard growth curve (P<0.0001).

In the healthy control group, 13.7% of participants were obese, and 28.4% were overweight. Mean BMI z-score for children in the control group also differed significantly from the CDC growth chart (P<0.0001).

Which shows us, given that BMI is an extremely inaccurate tool invented in 1900 or somewhere thereabouts, that if we average out the higher rates of overweight kids in the healthy groups and the only ever so barely significant higher rates of obesity in epilepsy patients, the control group has more of a weight problem than the epilepsy group. Other than that, we have the new diagnoses swinging the other way:

Obesity is a common comorbidity in children with newly diagnosed untreated epilepsy and correlates with increasing age, idiopathic etiology, and absence of concomitant medication.

In order to figure out what is causing that (if it is happening at all) we have to look at and explore absolutely every other correlation. We can't automatically leap to the conclusion that you think relates to every disease under the sun.

Your other one says

55.2% of patients were overweight or obese, and 31.2% were obese.
Sixty-eight percent of the US adult population is overweight, and 35% is obese.

In other words, there are lower rates of obesity in epilepsy patients than in the rest of the population. In other words this is based on your failure to read, and your trials disprove it:

Personally, I believe the hypothesis that brain damage has caused the obesity epidemic is completely backward, even asinine. Children are born with imbalanced gut flora, relegated to lives of obesity, diabetes, epilepsy, heart and lung disease and cancer. It's a matter of microbial predisposition. What science is now discovering is that through diet and other measures, flora populations can be manipulated for better health, including resolving seizure activity.

Why don't you read the trials and articles you want us to read?

 

[Keith]

Here's one example of studies regarding shifting flora to potentially resolve seizure activity.

One of the leading researchers in the field of autism with focus on seizure activity is Derrick MacFabe. Up to 40% of autistic children are also epileptic.

Dr. MacFabe has studied the microbial short chain fatty acid, propionic acid, in relation to autism and seizure. Here's one of his studies:
http://www.psychology.uwo.ca/pdfs/autism/MacFabe etal07.pdf

Propionic acidemia is a potentially treatable condition. Primary means of treatment include reduction of PPA and amino acid intake in the diet and intermittent eradication of PPA producing bacteria via metronidazole and gut motility agents [134]. Supplementation with carnitine to promote PPA and other fatty acid metabolism [97] offers an additional treatment option for this condition.

Easier reading is this interview where he discusses propionic acid, brain inflammation and seizure activity.
http://cogentbenger.com/autism/interviews/macfabe-interview/

So, for example, as you increase the dose of this compound, the behaviours become worse, the brain inflammation becomes worse so the seizures become worse.

 

[kirsten]

This trial review says there can be no consensus on the prevalence of epilepsy in autism, given that the numbers vary in trials from 5% to 46%. It means we know there are some (pediatric) autism patients who have epilepsy but we don't have a clue how many, or how they correlate.

This variation is probably the result of sample characteristics that increase epilepsy risk such as sample ascertainment, lower IQ, the inclusion of patients with non-idiopathic autism, age, and gender.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692092/
When two diseases sometimes coexist, we can't tell anything about one disease based on something about the other disease. It's like saying family A and family B sometimes hang out at one another's houses, and because family A wears yellow socks, family B's wears yellow socks with Tweety Birds on them that are embroidered into the seams. Family B might never wear socks at all.

Neuroinflammation is neither brain inflammation nor necessarily something that occurs in epilepsy. Brain inflammation has a range of names depending on case--edema might be the most common. Neuroinflammation refers to a nerve anywhere in the body that is degenerating, or swelling as part of an immune response. Epilepsy isn't an immune response.

 

[Keith]

Let's please not discount the obvious association of epilepsy in autistic children where study after study strongly associates autism with gut disorders. This issue of gut-brain origin of autism is rapidly building steam and there's much to derive from it in the field of epilepsy.

Regarding epilepsy viewed as immune response, I think that's really what's at question here in this thread, the central theme being microbial imbalance. I'm glad you brought that up because I've recently learned a few things about immunity of the gut-brain, still barely scratching the surface.

It's about the endocannabinoid system.

Cannabis oil as epilepsy treatment is all over the news these days and scientists still don't really understand why it's apparently effective. There's a new bill introduced this week to make cannabis oil legal nationwide in the USA for epilepsy treatment:
http://www.cnn.com/2014/07/28/health/federal-marijuana-bill/
http://www.pennlive.com/midstate/index.ssf/2014/07/medical_marijuana_legalization.html

Earlier in this thread I posted several studies about how cannabinoids "cool" the intestine as potential mechanism, but there's a lot more to it from brain perspective and the immune system. Here's one more paper, a review I'm just beginning to read:
Cannabinoids and the gut: New developments and emerging concepts
http://www.advancedholistichealth.org/PDF_Files/endocannabinoid system in GI disease.pdf

It gets more interesting when considering cannabinoid receptors of the brain and I'm just beginning to learn about it. What's really interesting is how microbes stimulate release of endogenous cannabinoids which signal the immune system. So, are there missing microbes in epilepsy or overgrown microbes degrading these natural cannabinoids of the body?

Bacteria stimulate the arachidonic pathway, initiating immune response. Arachidonic acid is an endogenous free fatty acid endocannabinoid substrate of prostaglandin synthesis. Brain (and gut?) cannabinoid receptors (CB1) activate the arachidonic acid cascade resulting in raised prostaglandins of the PGE2 variety.
http://cvi.asm.org/content/9/1/132.long
http://www.ncbi.nlm.nih.gov/pubmed/11166698

PGE2 mediates the brain's immune system (does cannabis oil wake-up the brain's immune system to halt seizure as well as "cool" intestines?):
http://brainimmune.com/brain-immune-signaling-focus-on-pathogen-recognition-and-pge2-synthesis/

Maybe cannabis oil binds CB1 receptors before arachidonic acid, calming the immune system to halt seizure activity. I need to learn more about CB1 agonists and antagonists.

Here's what seems a very important mechanism for cannabinoids halting seizure: inhibiting release of glutamate:
http://jn.physiology.org/content/85/1/468.long
http://www.jneurosci.org/content/26/21/5794.long
http://www.jneurosci.org/content/23/35/11073.abstract

 

[Keith]

This issue appears to dovetail with obesity and insulin resistance when considering precursor of arachidonic acid is Anandamide, also known as the "bliss molecule" (sanskrit word ananda means joy, bliss, delight).

Anandamide is formed from lipids during enzymatic reaction of NAPE to form NAE which also controls food intake:
New study shows therapeutic bacteria prevent obesity in mice
http://medicalxpress.com/news/2014-...l&utm_source=facebook.com&utm_campaign=buffer

 

[epileric]

Let's please not discount the obvious association of epilepsy in autistic children where study after study strongly associates autism with gut disorders. This issue of gut-brain origin of autism is rapidly building steam and there's much to derive from it in the field of epilepsy.

Autism is associated with epilepsy but that does not make epilepsy associated with autism. It's like saying that allergies are associated with sneezing so if I sneeze I must have an allergy.

Regarding epilepsy viewed as immune response, I think that's really what's at question here in this thread, the central theme being microbial imbalance. I'm glad you brought that up because I've recently learned a few things about immunity of the gut-brain, still barely scratching the surface.

Who the heck ever made an association between epilepsy & the immune system???? It sounds like you're just pulling theories out of your butt. Neural misfiring is not an immune response nor has there ever been anything to even imply (let alone prove) as much. You'd make your points much better if you kept things relevant.

It's about the endocannabinoid system.

Cannabis oil as epilepsy treatment is all over the news these days and scientists still don't really understand why it's apparently effective. There's a new bill introduced this week to make cannabis oil legal nationwide in the USA for epilepsy treatment:
http://www.cnn.com/2014/07/28/health/federal-marijuana-bill/
http://www.pennlive.com/midstate/index.ssf/2014/07/medical_marijuana_legalization.html

Maybe it helps but maybe it doesn't. The problem is that so far all the "proof" is anecdotal and legitimate research has not found much. You have to remember hundreds of years ago people swore how they were "cured" by bloodletting because their "humors" were not balanced yet we now know that the humoral theory is totally false. I think that's a great example of how we have to be careful in accepting anecdotal evidence, even when from numerous people. Like the old saying goes "the plural of anecdote is not evidence".

I am not sure why I'm even discussing those points since the issue at hand was on the gut-brain connection & obesity you change topics totally to marijuana and ridiculous claims of epilepsy being an immune response. You'd have a better chance of making your point if you kept things relevant.

 

[Keith]

Who the heck ever made an association between epilepsy & the immune system???? It sounds like you're just pulling theories out of your butt. Neural misfiring is not an immune response nor has there ever been anything to even imply (let alone prove) as much.

I'm not the first person to believe seizures actually have a purpose. One theory is to raise lactic acid where lactate is used as fuel to raise blood sugar in gluconeogenesis, ameliorating hypoglycemia.
http://onlinelibrary.wiley.com/doi/10.1034/j.1399-6576.2003.00115.x/abstract

Seizure also lowers pH in the brain which is the mechanism for halting seizure.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673408/

So, the question becomes, what's causing blood sugar and pH imbalances to begin with? Who's toying with the immune system? Imbalanced gut flora is strongly implicated. Of course, this doesn't apply to all forms of epilepsy, but I'd bet a very large percentage, even over 50% considering such a large percentage of intractable epilepsy of nearly 40%.