Talk:Epilepsy/Archive 1

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Controversy and Complex Partial Diagnosis

I have no idea what the following means, There has been some relatively mild controversy over the standards for diagnosis for partial-complex seizures and how these standards are applied in practice, both among some surrealists and in particular as regards Mary Baker Eddy, founder of Christian Science.

Would the author care to expand, elaborate, or otherwise make the entry relevant? 1Winston 20:11, 1 September 2005 (UTC)

It appears to me that the purported controversy has to do with diagnosis not made in a usual physician-patient interaction, but with "diagnoses" proposed by various authors - epilepsy professionals or other writers - in historical articles, books, novels or so on. To my mind this sort of "diagnosis" cannot function as an educational or scientific tool, and probably doesn't belong in an encyclopedia article on the topic of epilepsy.

Once I figure out where I think it does belong, I'll put it there. Any suggestions? (I'm not the author of the original text you're referring to, by the way.)

There are many controversies over the standards for seizure classification; they are only mild if you're not involved with them. I have reviewed this topic with reference to the ILAE classifications, but not for publication here in Wikipedia.

-Ikkyu2 21:54, 1 September 2005 (UTC)

Dogs too

It should be mentioned that epilepsy can occur in non-humans too, for example dogs. The hereditary component in dogs might be mentioned here or in another article. --Daniel C. Boyer

Seizure-sensing dogs

I've never heard of that. It sounds remarkable. Can anyone post an external link? Adambisset 16:05, 22 Oct 2004 (UTC)

  • They're usually called seizure alert dogs - there's quite a bit of information available from reputable organisations and charities that can be found through Google, including a few peer-reviewed journal articles through Google Scholar. Dupont Circle 07:50, 5 Mar 2005 (UTC)
  • There are other roles for care dogs in epilepsy besides seizure sensing; check out [1]. --Ikkyu2

Liability

Hey, does Wikipedia bear any responsibility for warning people against basing decisions on our medical articles? I'm a little concerned about the "if seizure persists for 3-4 minutes call EMS" section-- although the advice is technically correct I certainly don't want anyone gambling on it because of us.

Controversy

Possible misdiagnosis of epilepsy in surrealists and the surrealist-oriented

I think the link on the bottom is bullshit, anyone willing to explain? User:Jwk

Yeah, I wondered about it too. Moved it off the article and onto this page for now, unless someone can explain it as more than kookiness.
As the author of the article in question, I would ask why you describe it as "kookiness". I think that every one of my points has at least a colourable basis. --Daniel C. Boyer
The link's now broken, and in addition it was a self-link to original research, which is prohibited by the Wikipedia standards regardless of the merits of the research. If there are no other objections, I will soon clear these statements from the article. -Ikkyu2 21:57, 1 September 2005 (UTC)

I cleared the last of these statements today:

There has been some relatively mild controversy over the standards for diagnosis for partial-complex seizures and how these standards are applied in practice, both among some surrealists and in particular as regards Mary Baker Eddy, founder of Christian Science.

If there is any serious, peer-reviewed scholarly research that links the artistic movement, Surrealism, to this serious medical illness, it needs to be cited explicitly in the future. -Ikkyu2 06:17, 1 November 2005 (UTC)

This is question-begging, to say the least, and suffers from the serious drawback that surrealism is not an artistic movement. --Daniel C. Boyer 22:10, 7 December 2006 (UTC)

Surgery

The American Academy of Neurology, Congress of Neurological Surgeons, American Epilepsy Society, and American Academy of Neurological Surgery all have consensus statements on the role of epilepsy surgery in the care of medically intractable epilepsy. Why was this type of surgery called 'experimental'? I've removed that word. - Ikkyu2 23:02, 27 August 2005 (UTC)


Joan of Arcadia

Article should be revised to explain that the cause of Joan's visitations is highly debatable/controversial, from actual divine visitation, to temporal lobe epilepsy, &c. It's not necessarily true that this is what Joan has and the statement as it stands is somewhat misleading. --Daniel C. Boyer 19:39, 28 Apr 2004 (UTC)

What is Joan of Arcadia doing in this entry, anyway?

Link to ADHD

The symptom of inattention is associated with epilepsy as well as a number of other neurological challenges including ADHD - ADD - Attention Deficit.

Changes

Hello,

Having experienced several Tonic-Clonic Seizures throughout my lifetime and having friends who also have them, I've got some information to add. I, however, feel that I shouldn't make changes but let people who have more experience with Wikipedia do so after they consider what I have to add. This is from the point of view of the person experiencing a seizure, and information most doctors are unaware of:

  • Hallucinations and visions do not exist in all cases. Before losing consciousness and experiencing the effects of the seizure, the person may experience a feeling that is near impossible to express in words (at least at my ability to do so), but the feeling is a feeling that is only experienced before the seizure and simply is referred to as a warning signal by doctors (my doctor told me this).
  • Many people who are treated with Tegretol for epilepsy can take the medicine right after experiencing the warning signal and the effects of the seizure will be nullified except for loss of consciousness. This has not been proven by medical science, but many (including myself) can attest to the effectiveness of this medicine.
  • After a person wakes up from the seizure they may experience a headache similar in pain to a migraine, experiencing some of the effects of migraines or all of them. The person is usually unable to function properly for several hours after experiencing the seizure.


Hi there,

Just thought I'd document some changes I've just made:

  • Rewrote 'Categories' section to clear up confusion on simple / partial seizures and to expand. Renamed to 'Types of Epileptic Seizure'. Moved to top.
  • Removed some redundant text from 'Causes' (now covered in 'Types of Epileptic Seizure'). Replaced Epilepsy does not cause mental retardation or brain deterioration, except in cases where brain damage results from Status Epilepticus (see below) with note on cognitive decline in epilepsy.
  • Added link to What to do when someone has a seizure information sheet from Epilepsy Action.

Updated information largely taken from ISBN 0415130514 and ISBN 0631214356.

- Vaughan 00:08, 4 Jan 2004 (UTC)

This 'warning signal' is called an aura. An aura is a very difficult sensation to put into words, but it is often accompanied with dizziness and blurry vision.

Move list

The list of people with Epilepsy is pretty long. Should it be moved to its own article (with a link to it from this article)? —Frecklefoot 15:13, May 20, 2004 (UTC)

The paragraph on kindling and excitotoxicity should probably be moved to Controversy. Not all epileptologists believe that these phenomena are involved in the genesis and evolution of human epilepsy. —Ikkyu2 15:47, Aug 27, 2005 (PDT)

Muhammad had epilepsy?

Well, colour me surprised to read on this page that Muhammad, the Muslim prophet, had epilepsy.. Other than a quote by Dostoevsky, I haven't been able to find any particularly compelling evidence of this, so I pulled it out.. Please let me know if there are any other sources. If Dostoevsky is to be trusted on this one, then surely every other 'person of god' is diagnosable. Tarek 02:22, 25 Nov 2004 (UTC)

More on Muhammad. Epilepsy.com lists Muhammad as having Epilepsy, saying "Mohammed, the founder of the Islam, is reported to have had seizures since the age of three and to have said, "This is a common affliction of prophets, of whom I wish to be counted as one."" Perhaps a footnote on the main page? 1Winston 05:38, 22 JUL 05 (UTC)

I've checked this out and it has been pretty comprehensively debunked by medical historian Owsei Temkin in his book The Falling Sickness: This History of Epilepsy from the Greeks to the Beginnings of Modern Neurology (ISBN 0801848490). To quote from p153...
As is to be expected, the positive bias of Islam was countered by an opposite bias in the Christian world. As to the origin of the diagnosis "epilepsy", everything points to Christian Byzantium, an empire that was no only hostile to Islam but at frequent war with the Arabs. Less than 200 years after Mohammed's death, the Byzantium historian Theophanes (died about 817) told a story which was bound to make Mohammed appear and fraud and to discredit the belief in his divine mission. According to Theophanes, Mohammed
had the disease of epilepsy. And when his wife noticed it, she was very much grieved that she, being of noble descent, was tied to such a man, who was not only poor but epileptic as well. Now he attempts to soothe her with the following words: "I see a vision of an angel called Gabriel and not being able to bear the sight of him, I feel weak and fall down." But she had a certain monk for a friend who had been exiled because of his false faith and who was living there, so she reported everything to him, including the name of the angel. And this man, wanting to reassure her, said to her: "He has spoken true, for this angel is sent forth to all prophets". And she, having received the word of the pseudo-prophet, believed him and announced to the other women of her tribe that he was a prophet. (Theophanes, 1007, Chronographia, vol. 1, p334)
The is the story which was accepted by Western historians, theologians and physicians1. The story has all the earmarks of religious and political propoganda. Hence it was repudiated by Gibbon as "an absurd calumny of the Greeks".
1Footnote here says: Noldeke (736), 1, p25, n5, lists some names and works of this who propogated the story. Of physicians, Gabucinius (388), De comitali morbo, fol 6 f, gives Coelius Rhodigiun (not mentioned by Noldeke) as his source.
I've now removed the mention of Mohammed from the list - Vaughan 12:33, 26 July 2005 (UTC)

Causes

This is straight from the article. "Mutations in several genes have been linked to some types of epilepsy. Several genes that code for protein subunits of voltage-gated and ligand-gated ion channels have been associated with forms of generalized epilepsy and infantile seizure syndromes. Several ligand-gated ion channels have been linked to some types of frontal and generalized epilepsies. Epilepsy-related mutations in some non-ion channel genes have also been identified." My question is, what would one categorize Synapsin I gene under? Is it ion or non-ion gene?

Synapsin I is not an ion channel. -- user:ikkyu2 27 aug 2005

What about forceps as a cause of bleeding and such turned to lesions? --miss lizard

Famous Epilepsy Sufferer

Could there be at least some form of sourcing of famous epilepsy victims before they're put on the page? I've checked through a few of them, and there doesn't seem to be anything connecting them to epilepsy or even any mental disorder. We can't people just naming famous people without some sort of backing up.

This has been bugging me lately! There was, last month, an article in the journal Epilepsy Behavior contesting some of the famous people that, it has been suggested, have epilepsy. I'll see if I can get a copy of the full research. Dupont Circle 09:17, 6 May 2005 (UTC)
Having got hold of the full research, I've removed Pythagoras, Aristotle, Hannibal, Dante Alighieri, Leonardo da Vinci, Cardinal Richelieu, Jean Moliere, Isaac Newton, William III of England, Georg Fridric Handel, James Madison, Sir Walter Scott, Nicolo Paganini, Baron Byron, Edgar Allan Poe, Charles Dickens, Gustave Flaubert, Lewis Carroll, Alfred Nobel, Michelangelo, Pyotr Ilyich Tchaikovsky, Agatha Christie, Truman Capote and Richard Burton. The research states that the most common syptoms leading to epilepsy misdiagnosis in these famous people are psychogenic attacks and alcohol withdrawal seizures Dupont Circle 14:48, 14 May 2005 (UTC)
Ah, great work! That was annoying me a lot to, I'm glad somebody had the will to do something about it. Thanks! --Toomin 08:35, 18 May 2005 (UTC)


Dostoyevsky suffered greatly from epilespy, and most probably temporal lobe epilepsy. He is widely recorded as defending himself against criticisms from his contemporaries by pointing out that they did not have to work under his pressure. Moreover, he wrote about the feeling that the aura gave him and said that he would gladly sacrifice all else just for that one moment (or words to that effect). His heroes, or antiheroes as he coined them, like Prince Myshkin and Raskolnikov also suffered from epilepsy. I'm very surprised nobody has mentioned the enormous role epilepsy played in the life of one of the greatest writers any language has produced. Some of his many letters on living with epilepsy can be found in 'Selected Letters of Fyodor Dostoyevsky' by Joseph Frank. 193.1.172.163 02:39, 20 May 2006 (UTC)

Actually, I came across my above paraphrased extract from The Idiot online (The Idiot- i.e. Prince Myshkin- was thus called as everybody believed that because he had epilepsy that he was an idiot):

'He remembered that during his epileptic fits, or rather immediately preceding them, he had always experienced a moment or two when his whole heart, and mind, and body seemed to wake up with vigor and light; when he became filled with joy and hope, and all his anxieties seemed to be swept away for ever; these moments were but presentiments, as it were, of the one final second…in which the fit came upon him. That second, of course, was inexpressible. Next moment something appeared to burst open before him: a wonderful inner light illuminated his soul. This lasted perhaps half a second, yet he distinctly remembered hearing the beginning of a wail, the strange, dreadful wail, which burst from his lips of its own accord, and which no effort of will on his part could suppress. Next moment he was absolutely unconscious; black darkness blotted out everything. He had fallen in an epileptic fit.' [The Idiot (1869)] 193.1.172.163 02:50, 20 May 2006 (UTC)

The list of famous names was moved a while ago to List of people with epilepsy. This includes Dostoyevsky, with two references that link to web pages supplying more info. IMO, there is a satisfactory summary on that article. Further elaboration on "the enormous role epilepsy played in the life (of Dostoyevsky)" is welcome and probably should be included in the Dostoyevsky article. Colin°Talk 08:52, 20 May 2006 (UTC)

Adam Horovitz

Adam Horovitz of the Beastie Boys has epilepsy? That needs to be verified in case it is a prank. Decius 20:10, 6 Jun 2005 (UTC)

See the lyrics for 'Skill to Pay the Bills', also I believe he has mentioned it in interviews - Vaughan 19:43, 7 Jun 2005 (UTC)

Frequency?

Does anyone know how frequently one who has epilepsy has a seizure? I know this probably varies greatly, but I'd like to know how often it happens.


It is far too variable to make any blanket statements. Frequencies range from hundreds of discrete seizures per day to one seizure per decade or less. Depending on your epilepsy definition, the latter person may leave and re-enter the group of 'persons with epilepsy' multiple times in their life. - ikkyu2 27 Aug 2005

Pharmacology

I intentionally left out remacemide and ethotoin because they are used only very, very rarely in the treatment of epilepsy. -- Ikkyu2 09:43, 28 August 2005 (UTC)

Is this list of substances (together with the brand name of the drug) really necessay? - None of those drugs should be sold over the counter, and if you are affected, your doctor will prescribe you one of those. Eptalon 13:17, 6 October 2005 (UTC)

Yes, it is. I don't know what your perspective is, but I'm guessing it's that of an epilepsy sufferer. Doctors, pharmacochemists and pharmacists use Wikipedia too, as well as authors, journalists, and others who might be interested in such things. -Ikkyu2 22:07, 6 October 2005 (UTC)

Would you see it adequate then to expand the 'Pharmacology' section to resemble less of a listing of what substances there are and under what brand name they are sold? - Perhaps also give rough guidelines on what supbstance to use in which circumstances? (BTW: Do we have a health warning yet, to the extent that wikipedia cannot replace the visit to a doctor?) Eptalon

Well, I don't see how you could go wrong adding more information. One of the nice things about this list, though, is that it is a list of links to some very nice descriptive articles about the drugs in question. Have you clicked through any of them? As far as wikipedia replacing a doctor's visit, well, it's not clear to me that anyone would think it did. Tripping over a rock cannot replace a visit to the doctor - do we need to put warnings on every rock? -Ikkyu2 16:04, 18 October 2005 (UTC)

Removed text

Under the generalized tonic-clonic seizure section was the following text:

These tend to be accompanied by intense visions or hallucinations, often of a mystical or religious nature. The person with epilepsy may, upon regaining consciousness, hold very strong beliefs deriving from the experience that may persist for some time.

This is not something that's familiar to me, and I think it must have been put there in error. To the contrary, generalized tonic-clonic seizures tend to be unremembered by the people that experience them. There's certainly no basis for the claim that epilepsy causes people to hold unfounded beliefs. People with epilepsy may or may not think rationally or hold strong beliefs - just like any other people, and for the same reasons.

I'm removing it; anyone thinking of putting it back will need to dig up some evidence supporting their claim. -Ikkyu2 02:50, 29 August 2005 (UTC)


Under the Pharmacology heading was the following text:

Preliminary research suggested that omega-3 fatty acids - particularly docosahexaenoic acid (DHA) - also may be effective in treating epilepsy. A 2005 study by Yuen et al, however, reported no lasting benefit of this therapy.

I've removed this, because the therapy is ineffective. Listing therapies known to be ineffective for epilepsy would be pointless as well as very long. -Ikkyu2 06:08, 1 November 2005 (UTC)

ictal headache

In about half of cases of temporal lobe epilepsy, very strong ictal headaches[1] may occur, often misdiagnosed as migraine with aura. However, these headaches may be much more intense, and are sometimes even accompanied by temporary blindness.

This is a problematic paragraph for a number of reasons. First of all, the prevalence of ictal headache is nothing like 50% in any kind of seizure. Ictal headache is exceedingly rare. Post-ictal headache, which happens after a seizure, probably has a prevalence close to 50%. Secondly, headaches are probably better termed 'painful' rather than 'strong', to avoid confusion. Thirdly, migraine headaches are often accompanied by temporary blindness, and while it is difficult to compare subjective symptoms from patient to patient, it is probably a mistake to suggest that any sort of headache can be 'much more intense' than a migraine.

I will be altering this paragraph in the near future. -Ikkyu2 15:08, 29 August 2005 (UTC)

Fixed. -Ikkyu2 16:05, 18 October 2005 (UTC)

Category:Epileptics ?

What do you all think of the creation of such a category, or a similarly-named one, like "People believed to have had epilepsy"? There's a brief list of a few famous epileptics on this page, but there are dozens more equally famous cases throughout history, and I think putting them in a category would probably be more efficient than expanding the list. -Silence 02:36, 31 October 2005 (UTC)

Thanks for asking the question. Firstly, can I point out that in many countries, the use of the word "epileptic" as a description of a group of people (as opposed to a medicine or type of seizure) could cause offence. For example, The Guardian style guide says "We do not define people by their medical condition: seizures are epileptic, people are not."
Generally, I am opposed to posthumous diagnosis - which would be required for most historical figures. Usually this is done in order to write a sensational book or magazine article rather than for the advancement of science or medicine. However, in the case of epilepsy, there is a more controversial issue: the assumption that anyone who had "visions" must have been having seizures. Usually these are religious figures (see section on Muhammad above) and there is a real risk of offence being taking by followers. Whilst it is certainly true that some people who have certain seizures (e.g. temporal lobe) say they have visions or become deeply religious, it cannot be proved the other way round for historical figures. IMO posthumous diagnosis is speculation, not fact, and doesn't belong in an encyclopaedia.
Therefore I would only be happy with a list of people known to have epilepsy (as diagnosed by their doctor) and only if the information was in the public domain (and therefore verifiable). This would certainly include some dead people, but perhaps not enough to be an interesting distinction.--Colin 19:28, 31 October 2005 (UTC)
Well, that's why I suggested a phrasing like "People believed to have had epilepsy"; not as elegant, but it would avoid both using "epileptic" as a noun and making it sound like we're saying "these people definitely had epileptic seizures". I can understand your hesitation, but if noteworthy sources can be found and cited hypothesizing that a historical figure had epilepsy, why hide that information? Surely Wikipedia isn't scared of interesting cited psychological analyses of historical figures, no matter how speculative, else how could you explain List of people believed to have been affected by bipolar disorder, [[Speculation of famous people who might have autism], etc.? In fact, I'd be just as happy if we used the exact same format as those lists for the epilepsy one, as it would allow more citing and explanations than a categorization system would (though we could always do both), and thus avoid most of the chance of offending people by referencing the claims. But, regardless of how broad our standards are, I think some sort of distinct list or category is mportant, and it'd help cut down on the slightly overlong list of people currently on Epilepsy. -Silence 22:29, 31 October 2005 (UTC)
My thoughts: a) posthumous diagnosis is an armchair sport that does not belong in any kind of reference work. b) The wikipedia category system is worthless, but mostly harmless. c) 'epileptic' as a noun: stigmatizing, offensive, and bad grammar to boot. d) The long list of persons who may or may not have had epilepsy should be moved to an article of its own, with a title something like 'Famous people with epilepsy (maybe).' -Ikkyu2 05:07, 1 November 2005 (UTC)
In fact, I went ahead and did this. -Ikkyu2 06:05, 1 November 2005 (UTC)
Since you will find all kinds of references to famous people posthumously diagnosed with epilepsy, I think it makes since to include such a list and discuss the issues related to such posthumous diagnoses. That way, when someone like me, researching epilepsy because my son has complex partial seizures, finds out that someone like Muhammed supposedly had epilepsy, we can get better information than the lists of famous people put out by epilepsy foundations and support groups. 1Winston 21:13, 1 November 2005 (UTC)
I don't agree. In my opinion, retrospective diagnosis is always incorrect - it is an oxymoron, because it presupposes 'diagnosis', which is a process that requires a live person and a physician interaction. Applying a modern definition of epilepsy to people who lived thousands of years before such a definition could even be formulated or understood reveals a fundamental misunderstanding of the historical process and its ability to convey truthful information, as well as the medical process which creates a truthful diagnosis. Since others who wish to diagnose retrospectively may differ with my opinion, and yet can never prove their diagnoses, the entire topic consists necessarily of unresovable controversy - a can of worms best left closed. -Ikkyu2 06:49, 2 November 2005 (UTC)

This discussion is continued on Talk:List of people believed to have epilepsy.

(Benign) Rolandic Epilepsy

I have recently become aware of Benign Rolandic Epilepsy, a particular type of Epilepsy that is based in the "rolandic strip" area of the brain (temporal lobe area, near speech center). It is often called "benign" because children tend to grow out of it by puberty (but this is not always the case). Perhaps someone who is more of an expert on the topic could provide information on this type of epilepsy on the main page? 1Winston 21:27, 1 November 2005 (UTC)

This is on my list of things to do; there just aren't enough hours in the day lately, it seems. -Ikkyu2 06:38, 2 November 2005 (UTC)

Ikkyu2, I see that the main page is expanding. Excellent! 1Winston 20:53, 4 January 2006 (UTC)

Legal Implications

This section has no references to backup the statements it makes. Since the law is complex, I think that this is essential. There are some good informal articles on US law on Epilepsy.com (e.g. Driving, Driving and the Law and Driving and Epilepsy). Someone familiar with US law could perhaps summarize the complex situation.

Similar references are needed for laws in other countries. I'll try to dig out some UK references later ... --Colin 15:40, 16 January 2006 (UTC)

The law is different in each of the 50 states, and in many states it's ambiguous, particularly with respect to how long one must go seizure-free before regaining one's license. I shudder at the thought of trying to 'summarize' it. -Ikkyu2 20:02, 16 January 2006 (UTC)
I also don't think the UK rules for driving with epilepsy belong in this article. Honestly, the UK is a tiny country, and most people who read this article will never even visit it. The article should confine itself to discussion of epilepsy; it's getting too long already. A quick summary of the fact that many places prohibit people with epilepsy from driving, and the kind of stigma this generates, is sufficient. -Ikkyu2 09:33, 17 January 2006 (UTC)
I agree this single article is "too long already". However Wikipedia:What Wikipedia is not states "After a point, splitting an article into separate articles and leaving adequate summaries is a natural part of growth for a topic". There is plenty scope for splitting this article. With a bit of work, the Seizure syndromes section could split off to an Epilepsy (seizure syndromes) article; the Types of seizure section could be a summary of the Seizure article; the Pharmacologic treatment section a summary of the Anticonvulsant article, etc. Similarly, if the Legal implications section grows too large (and it isn't big yet), it could be summarized into a paragraph and a new article Epilepsy (legal implications) spawned. Why shouldn't Wikipedia contain information on this for several countries? I think if you reduce the information to the level you are suggesting then, to be honest, any reader with an interest in epilepsy wouldn't learn anything they didn't already know. Epilepsy is such a huge subject that it is destined to outgrow one article.
Regarding "the UK is a tiny country". I don't think that is a relevant argument and has been done to death on Wikipedia. FYI: the UK has 60 million people who don't regard themselves as irrelevant. That is a fifth of the US 300 million. Its laws are increasingly being harmonised with the European Union (population 450 million). It has shaped the laws of most of the Commonwealth countries (population 1.8 billion) and UK law continues to be regarded as important internationally. --Colin 10:51, 17 January 2006 (UTC)
Certainly the UK is important and relevant, and I'd be the first to acknowledge the importance of English common law in shaping the laws of most civili(s|z)ed countries. Discussion of how and when to contact the DVLA, however - I presume that's the same as what we would call the DMV - is not going to be relevant to very many folks. If I wanted to disrupt the article to make a point, I could put down a long list of regulatory agencies for countries as diverse as Uganda and the United Arab Emirates, and the result would not be a better article. -Ikkyu2 16:11, 17 January 2006 (UTC)
      • I can appreciate this point, but I beg to disagree.
        • We are editing in the English Wikipedia, and by default that is going to consist of editors and (more importantly) readers largely from USA, Canada, UK, Australia & N.Z., so relevant links that give further information relevant to these countries is not unreasonable.
        • Other people are welcome to add information about how epilepsy impacts on patients in their own country, and this information is to be welcomed as it will both inform and give a wider scope to the readers understanding (well certainly my own).
        • I do not see medical articles currently being overrun by contributions from hundreds of other countries and so any regional information will currently add to the breadth of human experience documented by WP across the world (something that I thought WP tries to encourage)
        • I suspect links to regulations in France and Canada might not unreasonably appear in the French Wikipedia, that in countries in North Africa and the Middle East in the Arabic wikipedia.
        • Finally if one really wants to start restricting regional obscurity, then might I suggest (in jest) that all drug names only be the WHO recommended International Nonproprietary Names and we dispense with United States Approved Names ? That would affect almost every current medical & drug article ! Personally I find the use of both names in articles informative; both for when I treat Americans here in the UK and when trying to follow programmes such as E.R. :-) David Ruben Talk 19:24, 17 January 2006 (UTC)
What about the 50 US states, each with its own DMV and different requirements? -Ikkyu2 00:38, 18 January 2006 (UTC)
Hmmmm - well certainly I would like WP to mention that there is variation across the various states, what happens if a driver with a valid driving license from one state drives across a state line into another state (where a license would not have been granted) - is this legal in the US ? Given the complexity in the US, what help is there for patients to understand the disparate rules, ie is there a good national epilepsy organisation whose web site can help direct patients to the information relevant to their state? If so that site should be listed as reference I think (at least for the UK the single government site suffices) David Ruben Talk 00:51, 18 January 2006 (UTC)
State Driving Laws, at the Epilepsy Foundation website. The EF website is already listed under 'Worldwide Epilepsy Organizations;' it does have a lot of good US-centric information, but it's been several years since the Epilepsy Foundation of America dropped the 'A' and adopted a world-wide focus. -Ikkyu2 04:02, 18 January 2006 (UTC)
Also, all 50 states have license reciprocity agreements. Your license is issued in one state; all 49 other states, PR and Guam will accept it as a valid driver's permit, even if they wouldn't have issued you a license. That's hardly relevant in an article about epilepsy. -Ikkyu2 16:52, 25 January 2006 (UTC)

Pokémon seizures

The section of the Pokémon episode that was linked to some 12,000 Japanese children's seizures was repeated on the Japanese evening news of December 16, 1997 causing another large outbreak of seizures. Can anyone find any information on this? It would probably be in Japanese. -Gaston33 21:12, 28 January 2006 (UTC)

Todd's Paralysis

Would it make sense to reference Todd's palsy/Paralysis in the main article? 1Winston 20:02, 1 March 2006 (UTC)

The Institutes for The Achievement of Human Potential

I have removed the following text, plus a previous edit with much the same advert for The Institutes for The Achievement of Human Potential (IAHP).

Established in 1955, IAHP is a non-profit organization dedicated to improving the health and development of children who have some form of brain injury, including children diagnosed with Epilepsy. The IAHP claims that with a home program consisting of a healthy diet, clean air, and respiratory programs many of these children can be well without the need for medication. The IAHP publishes the results of its treatment for over 1700 children on its website. (visit IAHP website[2]).

User Jollygood has added this and similar text/links to Cerebral palsy, Autism, Attention-deficit hyperactivity disorder, Down syndrome. I request that he/she refrain from re-submitting any link or text about this organisation to the epilepsy article until they can present independent, peer-reviewed evidence in a respectable journal that this company's approach is both safe and effective.

I refer the reader to an article on the IAHP web site: A BILL OF PARTICULARS ON SEIZURES AND ON DISCONTINUING ANTICONVULSANT DRUGS by Edward B. LeWinn, MD, FACP, The Institute for Clinical Investigation which it totally at odds with all established medical practice:

  1. Claims that seizures cause no harm and that status epilipticus is caused by anticonvulsants and may be best left untreated by them.
  2. The only medical article referenced is an editorial (i.e. opinion piece, not peer-reviewed research) in a thirty year old journal. This editorial refers to a situation of 1970's America, which lacked most of the anticonvulsant drugs in common use today.
  3. The only anticonvulsants discussed are phenobarbital and phenytoin, neither of which are first-line drugs for children in developed countries and the former is well known to have negative cognitive consequences.
  4. Insists that all anticonvulsants be eliminated from all children (detoxification).

Further skeptical information about their program is also discussed on QuackWatch. --Colin 23:47, 11 February 2006 (UTC)

A note on the use of "Institute" in a title in England
  • You are not, as far as I can see, allowed to.
  • Unless there is something special about it, so for instance the Institute of Physics (with their nice building) qualifies, but a random company whcih did not have some special role in maintaining the standards of a profession or discipline does not and copanies house woudl not register them, neither would the charity commissioners. In this instance, England's socialist inclinations seem superior to the USA, but that is just opinion. Midgley 17:00, 4 June 2006 (UTC)

Controversy

The epilepsy article used to have a section labeled 'Controversy'. Nearly any article in an NPOV encylopedia should probably have such a section. If the IAHP has its own Wikipedia article, verified, NPOV, and passing the strict WP inclusion criteria, I would not be averse to a no more than one-sentence link to that article from the 'Controversy' section of this article. The sentence would have to emphasize that most reasonable people, including experts on epilepsy, found the contentions of the IAHP to be impossible, dangerous, harmful, offensive, unverifiable, and false. Ikkyu2 03:32, 12 February 2006 (UTC)

Why "Morbus Comitialis"?

Why was this disease called Morbus Comitialis ('disease of the assembly hall')?

Any knowledge?--Calm 12:02, 25 March 2006 (UTC)

Have a look at He Hath the Falling Sickness by Stanley M. Aronson, MD. It appears the Romans had several names, so the article should probably reflect that rather than picking just one. I have read more than one source explain that the assembly was broken up if someone had a seizure. This is relevant to the discussion regarding stigma rather than just history. Colin°Talk 13:21, 25 March 2006 (UTC)

Could someone proofread the Simple English article?

Hello there, I have basically created (and am one of very few contributors) to the Simple English article on Epilepsy(simple:Epilepsy). In there, I sate with easy words, what epilepsy is. I have recently added a (also simple) section on what to do if one sees someone having a seizure (i.e. Emergency tips). Could someone of you (who are probably specialistsa in the medical, if not neurology department) have a quick look, and put things right? - Thanks -- 16:32, 1 May 2006 (UTC)

Removed text (AED side effects / magnesium/vb6)

I have removed the following paragraph:

Side effects reported for antieleptic drugs include cognitive impairment, microcephaly and birth defects [3]. Low serum biotinidase activity has also been reported in children taking valproic acid [4].

I'm not disputing that these effects can occur nor am I trying to say that this article should not discuss AED side effects. However, if it does, it should be in fairly general terms and mention effects common to a lot of AEDs. There are lots of pretty unpleasant effects that vary from drug to drug. These are covered in great detail on each drug's page. A fuller discussion of AED side effects could go in the anticonvulsant article. Particular problems with the above paragraph are:

  1. The 1st article from PNAS only mentions "cognitive impairment, microcephaly and birth defects" in the introductory paragraph in the abstract. The article itself is about neurodegenration of the rat brain. So a better source would be a study of the incidence of these side effects in the human population.
  2. The 2nd side effect is extremely technical and specific to just one drug. This should go in the valproic acid article if anywhere. It is also essential to explain what "Low serum biotinidase activity" means since Wikipedia is a general encyclopedia, not a medical textbook.

I have also removed:

Magnesium and vitamin b6 exerted a positive non-specific influence on the mental states of patients with epilepsy, depression and anxiety during an experiment [5].

There are many thousands of epilepsy-related studies. It is not clear why this study on "A use of Magne-B6 in the treatment of anxiety-depressive states in patients with epilepsy" deserves to be mentioned here. This article should focus on the main treatment practices in-use (whether mainstream or alternative). So unless "Magne-B6" is a standard treatment somewhere, it doesn't really belong here.

Colin°Talk 08:40, 2 May 2006 (UTC)

It is not clear why it should be removed. It is an experiment published in an academic journal which has found the supplement to be effective. Anyone else editing this article would like to comment? --Mihai cartoaje 09:26, 2 May 2006 (UTC)

I'd welcome input from another editor. Not everything "published in an academic journal" is notable enough to get a mention in Wikipedia. This particular study is very small scale (25 people), short term (28 days), and non-randomized. It was published two years ago and a search on Medline does not indicate that this is a treatment others have felt compelled to investigate further. The short abstract is all that we can read (the article is not available online and is in Russian). The abstract conclusions are rather lame … "positive non-specific influence on patient's mental state" … "emerged on 14th day of the treatment and achieved a statistically significant level to 28th day". Finally, this is a study on mental health, not epilepsy treatment. I am somewhat baffled as to why epilepsy patients were chosen but presumably that is made clear in the full paper. I have added a sentence in "Other treatments" that mentions several systematic reviews of alternative treatments. Colin°Talk 17:10, 2 May 2006 (UTC)

This study has compared magnesium suphate vs. diazepam or phenytoin to prevent seizures [6]. It has found that,

In this trial, magnesium sulphate was associated with a significantly lower rate of recurrent seizures and lower rate of maternal death than that observed with other anticonvulsants.

--Mihai cartoaje 12:33, 3 May 2006 (UTC)

A brief glance at the medical literature (and Wikipedia articles on Pre-eclampsia and Magnesium sulfate) would concur that this is a well known treatment for preventing seizures in pre-eclampsia in various parts of the world. It is not conventionally used as an anticonvulsant so this is a niche.[7] If you feel it deserves wider mention than the above two articles, then anticonvulsant or seizure would be the place and it should be discussed in context with seizures in pre-eclampsia rather than seziures from other causes. Seizures in pre-eclampsia are nothing to do with epilepsy and so this info does not belong here. Colin°Talk 13:00, 3 May 2006 (UTC)

Drug trade names

Is it really in anyone's interests to list the trade names of the generic drugs used to treat epilepsy? Most companies seem to market things under different names depending on the continent they're on; in other cases several companies will market the same drug prepared in their own way under different names. (Sodium valproate, for example, is explicitly marketed as Epilim in the UK by one company; however I believe something very similar is marketed under an entirely different name in the US.)

I propose we remove the trade names instead of trying to keep up with pharmaceuticals' marketing wings. —The preceding unsigned comment was added by Ithika (talk • contribs) 19:51, 27 May 2006.

The generic name is preferred in Wikipedia for precisely those reasons. However, we have to bear in mind that Wikipedia is intended for a general audience rather than for pharmacists or physicians. I've noticed that US patients and doctors tend to use the trade name, whereas UK patients and doctors tend to use the generic name. There are exceptions: I've yet to hear anyone say "levetiracetam" (Keppra) - probably because the drug company deliberately composed a tongue-twister of a name. I wouldn't want the reader to be put off by lots of scientific and hard-to-pronounce names, or for them to fail to spot the drug they were familiar with.

Sodium valproate, valproate semisodium, and valproic acid are particularly troublesome (they are variations on the same drug) because their trade names vary from country to country and also on whether it is a tablet, capsule, syrup or injection.

I think the current list is reasonable, and should remain restricted to the original/popular brand for English-speaking countries.

Colin°Talk 22:18, 27 May 2006 (UTC)

I recently discovered that someone in my doctor's office was using this very page to learn how to spell these drugs' names for the purpose of transcribing my dictations. So, yes, it's useful to someone. --ikkyu2 (talk) 02:57, 18 July 2006 (UTC)
If you go to e.g. the page for sodium valproate, it lists the different formulations available by country. I'd suggest that's a better way of doing it than including all the information about the drug in all the pages where it's mentioned? Nmg20 11:56, 18 July 2006 (UTC)
You won't find such a list of country trade names outside of the valproate articles and even those lists are pretty short - see www.crazymeds.us/depacon.html for one person's (not entirely accurate) attempt to list them all. The valproates have a long history and are the most troublesome in terms of trade names. We all agree there shouldn't be too much detailed drug info on this page which is about Epilepsy as a whole. I do think that a little extra info is justified here and that a long list of generic drug names would be a total turn off for anyone outside of a pharmacists. Most modern drugs have one primary trade name and in this age of globalisation, it is standard throughout the English-speaking world. Colin°Talk 14:30, 18 July 2006 (UTC)

Alternative treatments

In a recent edit (4th June) User:Midgley dropped the "yet" from the "reliable evidence" statement on acupuncture, psychological interventions, vitamins and yoga. I believe the "yet" is justified for two reasons:

  1. The Cochrane Collaboration use it themselves (wrt acupunture) [8].
  2. All four reports contain:
  1. Some evidence (of possibly very poor standard, such as anecdote) that the treatment works
  2. A rational explanation of why it could work
  3. A request for further trials

The last point is IMO the strongest justification for saying "yet". This is not a done-deal. There are no huge damning studies that say it is pointless to waste more time on these treatments. There are in fact some studies that suggest there may be something in them (though they fail to meet the Cochrane Collaboration's very high standards). The edit has resulted in text that says "there is nothing here, move along now". This is POV and fails to reflect the conclusion of the referenced reports. Therefore, I would like the "yet" restored.

-- Colin°Talk 20:07, 4 June 2006 (UTC).

It is predicting the future. If evidence of effectiveness is found, then there will be no need for anyone to say "yet". Until it is, it has not been found. Rather than predicting the future, I suggest adding a note on the rational basis on which it might work - and that evidence to confirm that continues to be sought. That seems to me more encyclopaedic. Midgley 20:16, 4 June 2006 (UTC)

The Institutes for The Achievement of Human Potential

The other change is from "unscientific" to "dangerous". This is potentially libellous. If you read their web site, it appears they take great care to taper AEDs and supervise the process by medical staff. Whilst many may regard them as quacks, to call their methods "dangerous" really does demand a reference quoting a significant authority. If such a published statement can't be found, I ask that it revert back to the previous word.

-- Colin°Talk 20:07, 4 June 2006 (UTC).

It is dangerous. If it was not dangerous, there would be no need to take great care. 25% relapse [9], every AED's enclosed patient advice leaflet will remark on the need to avoid suddenly stopping... sudden death in epilepsy is a complication more frequent in untreated epilepsy ... [10] ... Midgley 20:23, 4 June 2006 (UTC)

The IAHP don't stop the medication suddenly so that point isn't valid here. Yes, there are risks in having untreated epilepsy. However, you need prove that they are allowing children to continue to have seizures and not treat them with widely approved methods. If (as they claim) the children stop having seizures then there is no "untreated epilepsy". I should point out that between 25 and 39% of "difficult-to-treat" epilepsy turns out to not be epilepsy after all (see Non-epileptic seizures) and this may account for some of their success rate (and one can certainly argue those children are much better off without AEDs). I'm certainly no advocate of IAHP, but I still maintain that you have to prove (on the article page, with a reference) that specifically their methods are "dangerous". Colin°Talk 20:37, 4 June 2006 (UTC)

If this group is claiming that children stop having seizures and therefore their methods aren't dangerous, the onus is very much on them to prove that these children stop having seizures, isn't it? If they've done so - and I haven't looked into the claim - then fine - otherwise what they're doing is dangerous. Nmg20 23:42, 12 July 2006 (UTC)

Classification

The following text was removed and replaced with a picture, which only illustrates one of the 5 different classification schemata. Furthermore, the image illustrates how individual seizures are classified, not how epilepsies are classified. Not all epilepsies involve only one seizure type.

Epilepsies are classified five ways:

  1. By their first cause (or etiology).
  2. By the observable manifestations of the seizures, known as "semiology."
  3. By the location in the brain where the seizures originate.
  4. As a part of discrete, identifiable medical syndromes.
  5. By the event that triggers the seizures, as in primary reading epilepsy.

Knock yourself out with further article "improvements," kiddoes - I'm out of here. -ikkyu2 (talk) 01:41, 12 July 2006 (UTC)

Are you sure? It looks like it's there now, and I can't see when it's been out of the article... Nmg20 23:39, 12 July 2006 (UTC)
I agree. The text was not removed. However the text that introduced the diagram was incorrect in saying this is how "epilepsy is commonly classified". The diagram showed a basic hierarchy of seizure types only. Epilepsy requires multi-axis categorisation - there isn't one simple hierarchy. Colin°Talk 18:18, 13 July 2006 (UTC)
I put the diagram in and would just like to point-out that the classification--was entitled epilepsy 'cause that's what the article is about.
As for the criticism of one simple hierarchy -- I sometimes wonder whether Wikipedia goes to far with detail. Any case, I think the seizure classification would be better placed in the article Seizure. IMHO, the seizure section should be reduced to a paragraph and have a {{main|seizure}} to link to the (main) article on Seizures. Nephron  T|C 19:58, 13 July 2006 (UTC)
I totally agree with "main article" suggestion - I made a similar suggestion in Talk:Seizure nearly a year ago. Perhaps I'll get round to it! The Seizure article's equivalent section is currently unsatisfactory. I liked the diagram, but found that it was difficult to continue using that format if the hierarchy was to be expanded. That's a shame, because pictures help make articles more accessible. I don't think we've gone too far with detail. Epilepsy is a complex topic and most people (including a majority of the medical profession) have only the most rudimentary understanding of it. Colin°Talk 07:55, 14 July 2006 (UTC)

Seizure types has now been created. It initially has content taken from Epilepsy. Both Epilepsy and Seizure now have a {{main|Seizure types}} link in their appropriate sections. The topic now has room to expand. Colin°Talk 17:35, 19 July 2006 (UTC)

Diagnosis of Epilepsy

The NSE article refered to in the text is very interesting and there is much to agree with. It is a bit of a polemic and I feel contains rhetoric that shouldn't make its way into an encyclopedia article. I've toned down the intro and the paragraph added to the Diagnosis section.

I've also removed the statements about "the most common" or "second only to migrane". The word "common" is a bit general when there are complications to do with prevalence, incidence and age. This aspect really needs a paragraph or two in its own section. For example, stroke and alzheimer's are also extremely common, but only tend to affect the elderly. Migrane isn't in the same league as epilepsy in terms of how serious a condition it is (I appreciate it can be very disabling, but it rarely requires emergency hospital treatment or is a significant cause of death).

Colin°Talk 11:04, 13 July 2006 (UTC)

If you consider backache as a neurological condition, it trumps all the other neurological conditions *put together* in terms of total cost to society. Most of that is due to days of productive work lost. I agree that 'most common' or 'most important' is not really a very insightful way of classifying a kind of human trouble. --ikkyu2 (talk) 02:52, 18 July 2006 (UTC)