Ben (Moderator) - 10:50 AM:
Welcome to NorthShore University HealthSystem's latest chat: Epilepsy and Seizures with Dr. Jaishree Narayanan. The chat will begin in 10 minutes, but please start submitting your questions now so we can get to them all.
Dr. Jaishree Narayanan (Evanston Hospital) - 10:52 AM:
Hi, My name is Jaishree Narayanan. I am a specialist in epilepsy. Happy to answer any epilepsy related questions you may have.
Trent (Evanston, IL) - 11:00 AM:
On average, how long can a seizure last?
Dr. Jaishree Narayanan
30 seconds to a minute. Sometimes seizures can last 3 minutes or more. In that case, patient do need to call 911
Adrian (Chicago, IL) - 11:02 AM:
I'm pretty sure I was told at one point to shove a wallet into the mouth of a person having a seziure so they don't bite their tongue off, but then later was told...that will just make them choke more, so don't do that. What are the current recommended steps for immediate assistance while medical help arrives?
Dr. Jaishree Narayanan
You absolutely should not put anything in the mouth of the seizing person. very high risk of choking.
You should turn them to their side, prevent falls and injuries. Don't restrain too hard because they can get agitated.
Nat (Chicago, IL) - 11:05 AM:
Do seizures cause any lasting internal damage, or is the treatment/management of seizures more for any sort of external damage caused as a result of loosing consciousness (ie..falling or choking). I guess what I'm asking is... do seizures cause some sort of brain damage each time you have one?
Dr. Jaishree Narayanan
yes - seizures can cause brain damage especially if they last long. Seizures can also at times stop the heart, affect breathing, change blood pressure. hence seizures can be very risky and need to be treated to avoid external injuries as well as internal damage including death.
John (Niles, IL) - 11:08 AM:
Assuming the epilepsy is not caused by head trauma, are genetics at all tied to epilepsy?
Dr. Jaishree Narayanan
yes some of the epilepsies are genetic but most do not need to have a family history. Seizures can be caused by birth trauma, meningitis, encephalitis, brain tumor, strokes, scars in the brain etc. which need not be genetic.
Sam (Skokie, IL) - 11:12 AM:
How does anti-seziure medicine work? Like is it blocking something? Or adding something missing to the body's chemistry...or something else?
Dr. Jaishree Narayanan
Different medications work in different ways.
Some will block sodium channel which prevents current leakage.
Some increase GABA which inhibits brain activity
Some oppose glutamate which is an excitatory chemical and excess of which can cause seizures.
Some bind to various proteins in the cell membrane to prevent current leakage.
Jary (Highland Park, IL) - 11:17 AM:
Is there a thin line that differentiates between Epilepsy to Seizure? both connected to Neurological concerns & the attack seems likely the same. Are any of these condition treatable? or just preventable? Thank you.
Dr. Jaishree Narayanan
Epilepsy is when a person has had 2 seizures which are not provoked by some cause like alcohol, drugs, high or low glucose etc. or one seizure with an underlying condition in the brain which can trigger further seizures. Epilepsy and seizures are preventable. Some types of epilepsy like temporal lobe epilepsy can be completely prevented by epilepsy surgery. We also have devices that can help seizure control.
Jean (Evanston, IL) - 11:20 AM:
In a very general "elevator pitch" sense...what is happening to the brain during an epileptic seizure?
Dr. Jaishree Narayanan
it is a short circuit in the brain when some or all of the neurons in the brain get hyper excited due to excessive current leaking in.
Evan (Northbrook, IL) - 11:22 AM:
Why am I able to "breathe away" my seizures? If I feel one starting I can sometimes take a deep breath or 2 and then it never goes full "aura" but subsides instead. Like, have you heard of that before or is there any science that explains that?
Dr. Jaishree Narayanan
yes sometimes breathing relaxes you and the seizure resolves because relaxing causes non-excitatory chemicals to release in your brain. Some patient can distract themselves like slap their hand or touch something cold to make their seizures resolve as well.
Evan (Northbrook, IL) - 11:27 AM:
Quick follow up question...I wouldn't rely solely on this method and obviously taking medicine is the way to go...but is it worth my time to do this? Can it prevent the damage you mentioned above? or is it already too late once the chemicals have started to release?
Dr. Jaishree Narayanan
the only way to prevent the damage completely is to prevent the seizure. yes by shortening the seizure duration, the damage is less.
Kelly (Evanston, IL) - 11:29 AM:
I know there are different types of seizures. Can you experience more than one type? If yes, then what would cause you to experience one or the other?
Dr. Jaishree Narayanan
yes one can have more than one type of seizure. if the seizure starts from one side if the brain and stays on that side then you can have symptoms like staring, confusion, shaking of one side of the body etc. When that seizure spreads to involve both sides, then convulsions tend to happen.
Zane (Wilmette, IL) - 11:34 AM:
Are there any new treatments or advancements in the field of epilepsy?
Dr. Jaishree Narayanan
yes there are new medications. there are devices like the Vagus Nerve stimulator, responsive Neuro stimulator, deep brain stimulation and epilepsy surgery all of which an be used to control seizures.
Tom (Evanston, IL) - 11:36 AM:
What sets the NorthShore epilepsy program apart from other health systems?
Dr. Jaishree Narayanan
Well, we have a comprehensive epilepsy program with epileptologists, epilepsy surgeon, neuropsychologists, social worker, epilepsy nurse all of whom work together well given our excellent electronic connectivity. Northshore staff is excellent, very pleasant, competent and have excellent team work.
Finn (Chicago, IL) - 11:41 AM:
I've heard of an EKG test, but what is it, and how does it help diagnose or detect epilepsy?
Dr. Jaishree Narayanan
It is EEG- that is a test where we record the patient's brain waves and it tells us if the patient has epilepsy and which part of the brain the seizure came from
Quinn (Chicago, IL) - 11:44 AM:
I saw "EMU" on the NorthShore website, what is this?
Dr. Jaishree Narayanan
This is Epilepsy Monitoring Unit. This is an inpatient unit where we bring our patients in to record their seizures to determine what type of seizures they have and where the seizures come from to see if they are candidates for epilepsy surgery or one of the devices. This is performed in patients who continue to have seizures despite anti-seizure medications.
Ben (Moderator) - 11:46 AM:
We have gotten through all our submitted questions. We will end the chat a little early. Thank you Dr. Narayanan, for your time and expertise. The chat transcript will be available on www.northshore.org
Dr. Jaishree Narayanan (Evanston Hospital) - 12:01 PM:
Thanks Everyone. It was very nice chatting with you all and hope the answers were useful. I am signing off now.