Exploring the Gut-Brain Connection and Photosensitivity

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KarenB

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RE: boy with sudden egg allergy

Well, not sure how it works on the modified Atkins, but on the classic Ketogenic diet, you have MODERATE protein (too much protein is harmful to body function plus excess protein converts to glucose) - -so a 6 year child would be getting between 6 to 9 grams of protein per meal, and one egg is about 7 - 8 grams of protein (depending on egg size). So, Jon would never consume more than 3 eggs per day. So if that boy was really consuming 10-15 eggs a day, that would be an enormous amount of protein.

We are removing egg from Jon's meals for the time being, as it seems to be one cause of the diarrhea.

Yay!! Jon has now gone 3 days without a seizure!! Longest since August when everything hit the fan.
 
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KarenB

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Keith, that 2nd article you posted on the skin-gut-brain axis looks quite interesting -- I skimmed it, and intend to read in full later today when not so busy.

As far as cooking the egg yolk or not...when our daughter had a severe egg allergy as a young child -- immediate hives, breathing issues...we discovered that if the egg was completely cooked, she could eat it without incident. But if sunny side up or scrambled but still pretty wet, she would get hives, but not if it were cooked "dry." Just to be on the safe side, we didn't give her eggs, but she was able to eat them in stuff like muffins or something -- small amounts, completely cooked. So...guess the protein changes as it's cooked.

I developed a mild egg allergy as an adult -- not sure, though, if it's a true allergy or just psychological. When I was pregnant with our first son (24 years ago), my husband made breakfast for me, and cooked scrambled eggs, and after eating them, I immediately ran into the bathroom to vomit. Now...I never had morning sickness with any of my pregnancies...so that was quite surprising -- however, did go into labor that night, so maybe that had something to do with it. But now...whenever I eat egg, I start getting queasy. So...rarely eat egg, unless it's small amounts in baked goods. (Now I have to figure out what to do with all those eggs in my fridge, cause my husband isn't too fond of eggs either!!)
 

KarenB

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Keith, that 2nd article you posted on the skin-gut-brain axis looks quite interesting -- I skimmed it, and intend to read in full later today when not so busy.

As far as cooking the egg yolk or not...when our daughter had a severe egg allergy as a young child -- immediate hives, breathing issues...we discovered that if the egg was completely cooked, she could eat it without incident. But if sunny side up or scrambled but still pretty wet, she would get hives, but not if it were cooked "dry." Just to be on the safe side, we didn't give her eggs, but she was able to eat them in stuff like muffins or something -- small amounts, completely cooked. So...guess the protein changes as it's cooked.

I developed a mild egg allergy as an adult -- not sure, though, if it's a true allergy or just psychological. When I was pregnant with our first son (24 years ago), my husband made breakfast for me, and cooked scrambled eggs, and after eating them, I immediately ran into the bathroom to vomit. Now...I never had morning sickness with any of my pregnancies...so that was quite surprising -- however, did go into labor that night, so maybe that had something to do with it. But now...whenever I eat egg, I start getting queasy. So...rarely eat egg, unless it's small amounts in baked goods. (Now I have to figure out what to do with all those eggs in my fridge, cause my husband isn't too fond of eggs either!!)
 

Nakamova

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Yay!! Jon has now gone 3 days without a seizure!! Longest since August when everything hit the fan.
Excellent! That's so great.

I mostly eat hard-boiled eggs myself, I'm less fond of fried, scrambled, or poached. I think it's a texture issue for me. Maybe you could make Easter Eggs with all those extras? The kind where you poke a hole and blow out the insides, then paint and thread the egg to hang on a "tree". Or maybe you could have an egg-carrying race... Or maybe avgolemono soup? It doesn't taste like eggs, just like a nice chicken soup.
 

KarenB

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Does anyone know if photosensitive seizures can have a delayed reaction? Usually, Jon has a seizure immediately after the "trigger" -- whether it's being too close to the TV screen, or the sun reflecting off the water, or getting fixated on a bright light, etc.

However, yesterday, we had a busy day with lots of potential triggers -- Jon walked with his Dad down to the university (bright sun), then a little later we headed off to the mall (so Jon could play in the ball pit) -- mall had lots of bright lights (which triggered super-hyperactive behavior) and some flashy lights around the children's play area, and then on the way home it was mid-afternoon, and the bright sun was at an angle where it was either coming in the one window of the taxi, or reflecting off other cars and coming in the other window. I was trying to shade Jon's eyes from that, which he resisted, and he kind of groaned a couple times, but didn't have a seizure (unless the groans were a sort of simple partial)

But then last night he had a tonic seizure at 2:30 AM (just 1/2 hr shy of 4 days seizure free). So...wondering if maybe it was just the excitement of a busy day, or a delayed reaction from all the light triggers during the day.

Could also have been a Diazepam withdrawal seizure -- this is day 4 of going from 3 mg to 2.

At any rate, the seizures are definitely slowing down -- praise God!
 

KarenB

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OK, Keith, working my way through that article on the gut-brain-skin axis -- and it looks like it's a 2 way street. Psychological stress can cause issues with small bowel transit time, encouraging over-proliferation of bacteria, and permeability. Yet, erradication of SIBO relieves psychological distress.

AND -- benefit of Omega 3 fatty acids is mentioned -- we noted significant improvement with Jon with the fish oil supplements.

With regard to skin issues -- Jon doesn't have significant problems, but he sometimes gets pimples around his mouth -- he had one this week (which is unusual for an 8 year old child -- our Chinese friends are telling us that the meds are bringing the "heat" out -- it's that whole yin yang thing with Chinese traditional medicine). Other times he has a very light rash on his arms or sometimes on his trunk -- it can almost go unnoticed except in bright light. And about a year ago he presented with real hives all over his body that came and went -- that went on for about a week -- his pediatrician put him on Claritin, and they cleared up. But at the time he had the hives he was seizure fre and wasn't having diarrhea.

Interesting that the article mentions that stress reduces the "good" bacteria -- Lactobacillus and Bifidobacteria

And also, "emerging research shows that the gut microbiota contributes to glucose tolerance" (possibly why Jon continues to have elevated blood glucose levels, inconsistent with children on Keto diet?)
 

Keith

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KarenB

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Blood sugar levels are always higher just after a meal, especially a high carb meal (at that point, it might be as high as 180). Two hours after a meal, they would drop to more normal levels, and upon awakening in the morning (after about 8 hours or more of not eating), one would usually see the lowest levels. For a healthy person, the "fasting" blood sugar (upon awakening) would be between 70 to 100. Fasting for more than 8 hours or so brings on a state of ketosis, blood sugar drops as the body begins using the body's fat or protein (muscle) for energy rather than carbs.

Kids on the ketogenic diet have slight fluctuations in blood sugar, but not as extreme, because they are consuming very few sugars/carbs, so insulin production is very regular. Blood sugar levels for Keto kids are usually range between 60 to 80, regardless of whether it's upon arising, or fairly soon after eating. When we see blood sugar rise above 80 or so (which is perfectly normal for the general population), we get concerned, because it usually means something is wrong with the diet (hidden carbs), or something is wrong with the child (stress and illness raises blood sugar levels -- seizures will raise blood sugar levels for about 30 minutes or more, depending on how severe the post-ictal state is). So, because any sort of illness or stress could raise blood sugar levels, a microbial infection could be a potential source of chronic, unexplained rise in blood sugar.

Fasting lowers blood sugar levels because the body switches its energy source, but it is conceivable that it could also affect microbial infection because microbes prefer glucose for energy over fat, and a reduction in microbial infection could then lower blood sugar. However, to me, it seems more likely that a consistent, ongoing ketogenic diet would reduce an over-abundance of microbes more effectively, because intermittent fasting would help temporarily, but then when carbs are again consumed, the microbes are going to get happy and start producing again.

Usually, the lower the blood sugar, the better the seizure control, and low blood sugar levels usually go hand in hand with higher ketone levels.
 

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Does anyone know if photosensitive seizures can have a delayed reaction?
I think photosensitive epilepsy is considered a "startle" epilepsy -- the seizure is an immediate reaction to a sensory input. So some of the other factors you mentioned are more likely to have played a role in his seizure.
 

KarenB

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Thanks for that, Nakamova -- wasn't aware of "startle epilepsy" --

so...that could be to different sudden stimuli? For instance...Jon also sometimes has a seizure after drinking cold water...

...but, in the past he also had seizures after swimming in cold water or being in a cold wind -- but not immediate -- the seizure would occur maybe an hour later, or even that night. This was when his seizures were infrequent -- maybe just one every month or so. But when he was only having a few seizures, and they consistently happened after swimming in cold water, we tagged that as a trigger -- even though it was a delayed reaction (he did have a cluster of seizures immediately after being on a golf cart in a cold wind
 

Nakamova

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Startle epilepsies tend to happen fairly soon after the stimulus -- so a particular sound or smell or touch or movement or light occurs and then seizure follows.

I'm not sure if external temperature changes would fall into this category since I think vascular issues play a contributing role. Exposure to cold air, and drinking cold water might act as a triggers for Jon in a fashion similar to the "ice cream headache". When something cold touches the roof of the mouth, it can stimulate the trigeminal nerve. This nerve response causes rapid constriction and swelling of blood vessels that lead to the headache. If the nerves are over-sensitive it might trigger a seizure. (The trigeminal nerve is suspected to play a role in migraine auras too).
 

KarenB

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Well, we knew drinking cold water triggered seizures (when his threshold is low, as it currently is) -- now we know why!!

I know that body temperature changes is (getting cold or hot) is an issue with Dravet Syndrome -- kids will often have a seizure after a bath. But I wonder why with that specific epilepsy? And whether other epilepsies also have this trigger. I know that the hypothalamus controls the body's thermostat...
 

Keith

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RE: gut-eye connection
Another association with eye inflammation is rheumatoid arthritis, including and especially juvenile arthritis and associated uvetis:
http://onlinelibrary.wiley.com/doi/...sCustomisedMessage=&userIsAuthenticated=false

http://www.ncbi.nlm.nih.gov/pubmed/14552595

There's a lot of research regarding rheumatoid arthritis of intestinal origin via gut dysbiosis:
http://arthritis-research.com/content/4/S1/5
http://www.uptodate.com/contents/arthritis-associated-with-gastrointestinal-disease

Also lots of connection in autism and arthritis where autism is strongly associated with IBD and epilepsy:
http://www.arthritistoday.org/news/autism-autoimmune-disease.php
http://www.nytimes.com/2012/08/26/o...disorders-and-autism.html?pagewanted=all&_r=0

Interesting 1936 association of epilepsy, arthritis and infection cured via Appendicectomy:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2122029/

The appendix is now viewed as a bank of flora, not a useless organ:
http://www.sciencedaily.com/releases/2007/10/071008102334.htm
 
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KarenB

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Diarrhea cleared up now -- blood sugar at a great 77 this morning -- and seizure free for 41 hours.
 

Keith

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Another gut-brain connection including hypothalamus, intestine and eyes is AMPK, targeted in diabetes, obesity . . . and there are important relationships to fasting and AMPK levels in the brain where fasting increases AMPK in the hypothalamus and then it lowers via eating. It's activated by the diabetes drug metformin.

AMPK is an enzyme researched heavily due to its central role in metabolism. I'm still trying to understand all the connections to intestinal health including how its deficiency may promote intestinal barrier permeability/damage via adenosine allowing microbial overgrowth/virulence. And I believe there are connections to histamine receptors. Will get rightbackatcha; still learning about AMPK activation and inhibition.
http://physrev.physiology.org/content/89/3/1025.long

AMP-activated protein kinase—an energy sensor that regulates all aspects of cell function
"its ancestral role may have been in the response to starvation"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185962/

Hypothalamic AMPK Regulates Glucose Production:
http://diabetes.diabetesjournals.org/content/early/2010/07/27/db10-0221

Hypothalamic AMPK and fatty acid metabolism mediate thyroid regulation of energy balance:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935934/

AMP plays a role in the neurotransmitter acetlycholine synthesis (which is crucial for making stomach acid (HCL)) via acetate which is made by anaerobic flora:
http://mmbr.asm.org/content/69/1/12.full

AMPK activation and butyrate tighten the intestinal barrier:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728689/

Butyrate improves insulin sensitivity:
http://diabetes.diabetesjournals.org/content/58/7/1509.full
 
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KarenB

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Thanks Keith, will try to look at those later today, when get back from church.

Jon continues to do much better -- no diarrhea, and going on 3rd day seizure free. I'm hoping/praying a remission is in the near future.
 

KarenB

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OK, after going 3 1/2 days without a seizure and 3 days without diarrhea, Jon had a mild (photosensitive triggered) seizure at 10 this morning and THEN diarrhea this evening. He has been on exactly the same meals for about a week -- nothing had changed yesterday or today with regard to food.

So...we're looking at a definite link, but the interesting thing is that the seizure is coming BEFORE the diarrhea. Going back through log of past 2 weeks (prior to that he was having seizures every day, so hard to find patterns, but now he's going several days between seizures), we have seen this pattern emerging -- seizures, followed by diarrhea.

Up to now, we've been operating on the assumption that the diarrhea is causing malaborbtion of meds and of fats in the Keto diet. But in this case, Jon had no obvious GI symptoms before the seizure -- just a normal BM a couple hours before. So...the diarrhea didn't cause the seizure.

So...did the seizure cause the diarrhea? Is this some sort of autonomic thing?
 

Nakamova

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Maybe the stress of the seizure caused the diarrhea? One of the autonomic responses to stress is that colon contractions speed up, and in some cases, this increase in colon activity will cause diarrhea.
 

KarenB

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Maybe...but here was a gap of time between the seizure and the diarrhea -- he had the seizure about 10 in the morning, and the diarrhea at 7 in the evening.

I would expect an autonomic response to be more immediate.

And yet, there seems to be a link between the 2 -- when he's seizure free, he's also usually diarrhea free -- and this time (and a couple others) the seizure precedes the diarrhea.

Of course, if he's having autonomic type seizures involving the GI tract, he may be experiencing discomfort for some time before either having a seizure or having diarrhea -- but because he's now non-verbal, he's not really able to communicate that. I do know that yesterday, before he had the seizure, he kept wanting to go upstairs and back to bed, and didn't really want to do anything -- just lie around.

Two more seizures this morning, but no more diarrhea (yet, at least). This last group of seizures may be from Diazepam wean -- he went from 2 mg to 1 mg on Sunday night, then one seizure Monday morning, and two this Tuesday morning.
 
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