Ask a Doctor

Our Ask the Doctor section is your chance to get your questions about epilepsy answered by a doctor. Just send us your question. We will submit it to a doctor. When we get an answer, both the question and answer will be posted. Send your question.

The questions below have been answered by epileptologist Dr. Nathan B. Fountain, Director of the FED Comprehensive Epilepsy Program at the University of Virginia in Charlottesville. He is also the President of the Epilepsy Foundation of Virginia:

My son is currently taking Lamictal for his seizures. My wife and i were wondering if his often lack of focus in school might be due to the medicine. Thank you Al Ten Midlothian, Va

Seizure medications, and especially Lamictal, do not usually affect thinking. Most children tolerate them very well without any affect on their school work, personality, memory or thinking. However, some children do have problems either because the particular medication does not agree with them or the dose is too high. All seizure medications, including Lamictal, can occasionally cause a loss of focus through their subtle effects on thinking. They can cause inattention, drowsiness, memory difficulties or difficulty concentrating. There is no simple way to figure out whether the medication is contributing to his lack of focus. If he was a good student and focused until Lamictal was started, then it is more likely that it is the drug. If he had lack of focus prior to starting the medication then it is probably not the medication. A common problem is that the medication started when the seizures started. Thus, you don't know if the change is from the medication, the affects of the seizures on the brain (which is usually minimal) or the social of psychological effects of having seizures. This is best sorted out with your neurologist. >>>>>>>>>>

From: Laurie Kelly [ll.ssnl@verizon.net] In your opinion, what future research could be done to find out what causes the neurons to seize? If only we knew what made the neurons start doing this… Do some of these studies pose ethical problems? Submitted by Laurie, mother of a ten year old girl with partial seizures with secondary generalization (currently controlled by medication)

This insightful question has been poised by all who study epilepsy. There are many researchers studying this exact problem. We actually know quite a bit about what happens when neurons seize based on contemporary neuroscience research. The main problem now is figuring out why the neuron seizes at one moment and not another. Nevertheless, there are a few "designer drugs" available now that were developed to interfere with the processes that cause seizures, such as tiagabine (Gabitril), and pregabalin (Lyrica). Fortunately, this research does not commonly pose ethical problems because there are many animal models of seizures. Clinical research (using humans) is usually done as part of the care of patients with epilepsy. For example, we currently are studying 3 new drugs and 2 new devices for epilepsy at UVA. Many patients volunteer for the studies because it has some chance of helping them and because the results allow us to help others. >>>>>>>>>>>>>>>>

Gina: Is there any evidence that the Atkins diet can stop seizures?

The Atkins diet has not been studied systematically. However, in a Johns Hopkins open-label study of 20 children put on the Atkins diet about 2/3 had a 50% reduction in seizure frequency. It has a risk of high fat content and therefore a high cholesterol content (it significantly elevated the cholesterol in the above noted study). The health risks for children who may need to remain on it for a long time are not known but seem substantial. On the other hand, it is simple to administer and should be considered in people who don't respond to medications. The ketogenic diet is effective in reducing the frequency of seizures, but has not been studied in a way that allows it to be compared with medications. It is somewhat difficult for parents and physicians to administer. However, it is also a good option for people with epilepsy who do not respond to medications. >>>>>>>>>>>>>>>>>

Are there any "seizure belts" like there are "kidney stone belts?" For example, the southeast has a higher rate of kidney stones than other places. Submitted by Laurie Kelly, mom of 10 year old girl with epilepsy

No. Epilepsy is evenly distributed around the country. However, the incidence is higher in developing countries due to higher rates of brain infections and trauma. Overall, about 10% of people will have a seizure at some time in their life. Only 3% will have recurrent seizures and thus epilepsy. Finally, it remits in about 2/3 of people, so that only about 1% of the US population has epilepsy at any one moment in time.

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