Epilepsy Confrence: May be Part of TNS study.

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vapour

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Hi all. As I mentioned a coupe of weeks ago, I went to the annual epilepsy confrence this weekend in down town LA, where there was a board of awesome neurologists (includig mine) to present topics and answer questions.

I wanted to share some of the things I learned about.

One of the things we learned about was Mindfullness, which in short is a form of meditation. It helps you relax by taking your mind off past and future and the strings of thoughts that arise in your mind onto the present and very simple things.

For example, you simply focus on the now. We had to close our eyes and feel our feet touching the floor, how it felt,...then our buttocks touching the chair.. how tht felt...and so o and so forth... its becoming aware of the very present thing, and it actually really helped me relax !! Its a great exercise.

A social worker also spoke about taking care of ourselves. I could totally relate to her experience in talking to others with epilepsy about hte anger you get after a seizure in the day, and the anger at having to pace yourself slower etc.....and the inner dialogue that goes on in our head.. and to be aware of that,,, and to try and make it positive. (not as good at explaining as they were sorry) but here were some questions she challenged:

Am I taking care of the basics ? (sleep, rest, diet, exercise)
What do I think I need to change ?
What have I done in the past ?
What is my support system?
DO I know how to ask for help?
What do I do to cope with hard times ?
WHat is my inner dialoge ?
Who could I talk to about what Im feeling ?
How can I connect with others in teh same situation


We also spoke about depression in epilepsy and how its grossly un-recognized, and how people with epilepsy have 5x higher suicide rate than the general population, and that if you do suffer from depression to speak with your Neurologist or psychiatrist and get them to work together and not to suffer in silence. That depression does not always present in the typical way


There was much more, but too much for a post. Ill lastly touch on TNS..Its basically a developing treatment still in testing...where you put 2 little electrodes on a nerve that goes across your forehead. Apparently this nerve is some-what responsible for sending signals causing seizures. This treatment aims to stop those signals with the electrodes. So far its had almost 40% success rate in patients with epilepsy. UCLA and USC are doing more studies on it, and my Neurologist told me to call them up.. becuase I meet the criteria and to see if I can get involved...

If its successful for you.. apparently they will implant the electrdoes under your skin....

I called them up this morning and I am expecting some consent forms through the post now..will let you guys know what happens with that. I have never heard of TNS I am trying to find out more.
 
This is great info, especially the list of questions. Meditation can make a difference, even as little as a half hour a day, so it's nice to see it's getting attention.

The TNS sounds like a variation of the RNS and VNS surgeries (involving implants/electrodes under the skin. What kind of surgery is involved?
 
Yes, Vapour

I'd like to know more about the TNS. Who makes it? What exactly does it do? Are there specific seizure types that it helps? I could go on and on..... But more importantly, if it's going to help YOU, then THAT'S even better!!!

Let us know how it goes, PLEASE!!!
 
During the TNS study external electrodes will be placed first. That is one benefit over the VNS .. as they dont know how that works until its already implated... with TNS you know beforehand...

So in the trial I wll be wearing hte electrodes externally, but I dont believe I have to wear them all day and all night, I spoke breifly on the phone to them and she said some only wear it at night...

If the external ones work, and you are one of the 40% lucky to have seizure reduction to a very significant degree.. then they can be permanently be planted under your skin around hte forehead area... and the battery put somewhere under the skin of your stomach (something like that)

will be waiting for my consent forms through the mail, hopefully I will get to go to a consultation and provide much more info if accepted.
 
Vapour,

I'm happy to hear you were able to attend the conference and get the info you needed and get in touch with your neuro. I hope you will be accepted for The Trigeminal Nerve Stimulation (TNS).

Here is some more info on the TNS:

Pilot Study of Trigeminal Nerve Stimulation (TNS) for Epilepsy: A Proof-of-Concept Trial

*Christopher M. DeGiorgio, *†Alan Shewmon, ‡Diane Murray, and §Todd Whitehurst
UCLA Departments of *Neurology and †Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles ; ‡Olive View/UCLA Medical Center, Sylmar ; and §Advanced Bionics, Valencia, California, U.S.A.

ARTICLE TEXT
Thirty to forty percent of adults with epilepsy are refractory to antiepileptic drug (AED) treatment (1). For those for whom AEDs fail, epilepsy surgery is extremely effective. Unfortunately, many patients are not ideal surgical candidates or have limited access to specialized epilepsy centers. For such patients, neurostimulation is a promising adjunct to AEDs (2). Trigeminal nerve stimulation (TNS), via cutaneous branches in the face, offers the opportunity of a minimally invasive method of neurostimulation. Response can be assessed before surgical implantation with self-adhesive cutaneous electrodes (3,4).

In their seminal report, Fanselow et al. (3) found that TNS significantly reduced pentylenetetrazol-induced seizures in rats. Seizure severity and duration were reduced in a frequency-dependent fashion at frequencies >100 Hz (3). Bilateral stimulation was more effective than unilateral stimulation, and stimulation was well tolerated (3).

Recently, we reported the first two humans to be treated with TNS for epilepsy (4). We now present the results of a pilot feasibility study of TNS in seven subjects with intractable epilepsy who completed at least the first-month treatment visit, including the two subjects reported previously (4).
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Thanks Cint, I found alittle like that online also, the study is also being done with USC as well as UCLA>....

The only thing thats been going through my mind has been "is my neurologist suggesting I take part in this study because I have refractory epilepsy"

Been kinda upsetting actually... I am doing better on the lamictal tegretal combo.. MUCH better... but still minor breakthroughs occassionally....

To be part of this study you have to be between 18-70 years old, and have tried at least 2 seizure meds, and have at least 2 complex partials a month, or tonic clonics a month...

There is probably more too.. these were just the baiscs on the handout, but my neuro said I would be able to do it.. she was at the confrence...

Will be getting the forms in the mail probably anyday now...

I think I am getting the flu :((((( need a hug.. sniff sniff.
 
Well, having refractory epilepsy is somewhat upsetting, but at least there are still options out there. I also have refractory epilepsy, had the VNS after having an unsuccessful left temporal lobectomy and have tried 10 meds. I was having 3-5 complex partial seizures a day before the lobectomy and after surgery, they went into several TC's a month. Now with the VNS, I have both types of seizures once in a while, even with the VNS set on the highest setting in order for some control.

Take care and get your rest.
 
Hey Cint.

Not sure if its refractory yet....but it may well be..and yeah.. that would be upsetting, and since currently I am still having brea-throughs (though alot beter) I can understand how you must feel.. except I dont have Tonic Clonics.

There is some debate as to whether epilepsy is progressive apparently, that scares me, it may well be for some people.

Sometimes its hard enough explaining to others the different types of seizures, that I dont even get to hte point where I can explain even if I just have a few simple partials in the day (twitching) it can debilitate me....becuase of my auras and after effects.... the whole day is basically gone.

I get extremly angry when this happens, but I could totally relate to what the social worker said at the confrence, she must have had other people with E tell her how frustrating it is when you have a seizure and the day is ruined etc...

Right now Im not getting nausea.. which is a big bonus. As well as the seizures being a whole lot better .. so are the auras... and this may sound weird.. but for me... the auras can be worse...hate the nausea and feeling like Im falling into my stomach and the tingling all over... ughhhhhh..

If it ever gets to the point (and ive thought about this alot lately) where it is refractory, and Im having breakthroughs like I was a few weeks ago.... and surgery is mentioned.. Id probably go for it...just because of how debilitating this can be...alot of times I will be laid down and my leg muscle will be twitching and I feel nauseas... but nobody around me has any idea...I often dont say anything.... I just lay there.. and I get hte impression they think Im lazy perhaps...it sucks.

Ill keep you updated as time goes on with the TNS, hopefully Ill get hte paperwork soon, and I will be able to be a part of it.
 
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