Part III Continuation on Pancreatic Cancer Diagnostic Testing!

6.) Angiography

This is an x-ray test that looks at blood vessels. A small amount of contrast dye is injected into an artery to outline the blood vessels, and then x-rays are taken.

An angiogram can show if blood flow in a particular area is blocked by a tumor. It can also show abnormal blood vessels (feeding the cancer) in the area. This test can be useful in finding out if a pancreatic cancer has grown through the walls of certain blood vessels.  Usually the catheter is put into an artery in your inner thigh and threaded up to the pancreas.

Blood Tests

Several types of blood tests can be used to help diagnose pancreatic cancer or to help determine treatment options if it is found.

Liver function tests: Jaundice (yellowing of the skin and eyes) is often one of the first signs of pancreatic cancer. Doctors often get blood tests to assess liver function in people with jaundice to help determine its cause. Certain blood tests can look at levels of different kinds of bilirubin (a chemical made by the liver) and can help tell whether a patient’s jaundice is caused by disease in the liver itself or by a blockage of bile flow (from a gallstone, a tumor, or other disease).

Tumor markers: Tumor markers are substances that can sometimes be found in the blood when a person has cancer. Tumor markers that may be helpful in pancreatic cancer are:

  • CA 19-9
  • Carcinoembryonic antigen (CEA), which is not used as often as CA 19-9

Neither of these tumor marker tests is accurate enough to tell for sure if someone has pancreatic cancer. Levels of these tumor markers are not high in all people with pancreatic cancer, and some people who don’t have pancreatic cancer might have high levels of these markers for other reasons. Still, these tests can sometimes be helpful, along with other tests, in figuring out if someone has cancer.

In people already known to have pancreatic cancer and who have high CA19-9 or CEA levels, these levels can be measured over time to help tell how well treatment is working. If all of the cancer has been removed, these tests can also be done to look for signs the cancer may be coming back.

Other blood tests: Other tests, like a CBC or chemistry panel, can help evaluate a person’s general health (such as kidney and bone marrow function). These tests can help determine if they’ll be able to withstand the stress of a major operation.

Biopsy

A person’s medical history, physical exam, and imaging test results may strongly suggest pancreatic cancer, but usually the only way to be sure is to remove a small sample of tumor and look at it under the microscope. This procedure is called a biopsy. Biopsies can be done in different ways.

Percutaneous (through the skin) biopsy: For this test, a doctor inserts a thin, hollow needle through the skin over the abdomen and into the pancreas to remove a small piece of a tumor. This is known as a fine needle aspiration (FNA). The doctor guides the needle into place using images from ultrasound or CT scans.

Endoscopic biopsy: Doctors can also biopsy a tumor during an endoscopy. The doctor passes an endoscope (a thin, flexible, tube with a small video camera on the end) down the throat and into the small intestine near the pancreas. At this point, the doctor can either use endoscopic ultrasound (EUS) to pass a needle into the tumor or endoscopic retrograde cholangiopancreatography (ERCP) to place a brush to remove cells from the bile or pancreatic ducts.

Surgical biopsy: Surgical biopsies are now done less often than in the past. They can be useful if the surgeon is concerned the cancer has spread beyond the pancreas and wants to look at (and possibly biopsy) other organs in the abdomen. The most common way to do a surgical biopsy is to use laparoscopy (sometimes called keyhole surgery). The surgeon can look at the pancreas and other organs for tumors and take biopsy samples of abnormal areas.

Some people might not need a biopsy

Rarely, the doctor might not do a biopsy on someone who has a tumor in the pancreas if imaging tests show the tumor is very likely to be cancer and if it looks like surgery can remove all of it. Instead, the doctor will proceed with surgery, at which time the tumor cells can be looked at in the lab to confirm the diagnosis. During surgery, if the doctor finds that the cancer has spread too far to be removed completely, only a sample of the cancer may be removed to confirm the diagnosis, and the rest of the planned operation will be stopped.

If treatment (such as chemotherapy or radiation) is planned before surgery, a biopsy is needed first to be sure of the diagnosis.

 

QUOTE FOR TUESDAY:

“While your initial assessment may include CT scanning and magnetic resonance imaging (MRI), we use more advanced tools to confirm your pancreatic cancer diagnosis and to determine its extent—a process called staging.”

Columbia Presbyterian Hospital NYC

Part II on Pancreatic Cancer – Diagnostic Testing from the start.

   

The top of pancreas attaches to the gall bile duct (allowing it into the head of the pancreas) and than there is the mesenteric artery.  Blood supply to the liver, pancreas and gallbladder is via the celiac artery (or celiac axis or celiac trunk). The celiac artery also supplies the duodenum, stomach and esophagus (the foregut and its derviatives). The pancreas is also supplied to some extent by the superior mesenteric artery that goes through the head of the pancreas.  This is how metastasis occurs (spreading) of pancreatic cancer can occur.  These arteries allow cancerous cells thorough the head into the bile duct into the blood stream and metastasis can now happen This can’t occur in the tail of the pancreas, its not attached to anything; which is the best place for it to occur & be diagnosed versus the head of the pancreas due to location.

Pancreatic cancer is hard to find early. The pancreas is deep inside the body, so early tumors can’t be seen or felt by health care providers during routine physical exams. People usually have no symptoms until the cancer has become very large or has already spread to other organs.

For certain types of cancer, screening tests or exams are used to look for cancer in people who have no symptoms (and who have not had that cancer before). But for pancreatic cancer, no major professional groups currently recommend routine screening in people who are at average risk. This is because no screening test has been shown to lower the risk of dying from this cancer, unfortunately.

Genetic History is one of the most common risk factors in getting most cancers, including Pancreatic.  Some people might be at increased risk of pancreatic cancer because of a family history of the disease (or a family history of certain other cancers). Sometimes this increased risk is due to a specific genetic syndrome.

Genetic testing looks for the gene changes that cause these inherited conditions and increase pancreatic cancer risk. The tests look for these inherited conditions, not pancreatic cancer itself. Your risk may be increased if you have one of these conditions, but it doesn’t mean that you have (or definitely will get) pancreatic cancer. 

Knowing if you are at increased risk can help you and your doctor decide if you should have tests to look for pancreatic cancer early, when it might be easier to treat. But determining whether you might be at increased risk is not simple. The American Cancer Society strongly recommends that anyone thinking about genetic testing talk with a genetic counselor, nurse, or doctor (qualified to interpret and explain the test results) before getting tested. It’s important to understand what the tests can − and can’t − tell you, and what any results might mean, before deciding to be tested.

For people in families at high risk of pancreatic cancer, newer tests for detecting pancreatic cancer early may help. The two most common tests used are an endoscopic ultrasound or MRI. These tests are not used to screen the general public, but might be used for someone with a strong family history of pancreatic cancer or with a known genetic syndrome that increases their risk. Doctors have been able to find early, treatable pancreatic cancers in some members of high-risk families with these tests.

Tests for Pancreatic Cancer and even other Cancers:

A.)  Doctor’s Visit

The M.D. is usually the first thing done and the M.D. will ask about your medical history to learn more about your symptoms. The doctor might also ask about possible risk factors, including smoking and your family history.  Your doctor will also do a physical examine you to look for signs of pancreatic cancer or other health problems.

Doctors are also studying other new tests to try to find pancreatic cancer early.  Interested families at high risk may wish to take part in studies of these new screening tests.

B.)  Imaging Testing=It can be used:

  • To look for suspicious areas that might be cancer
  • To learn how far cancer may have spread
  • To help determine if treatment is working
  • To look for signs of cancer coming back after treatment

1.) CT Scan-detailed cross-sectional images of the body/pancreas.  Their are special types of CT known as a multiphase CT scan or a pancreatic protocol CT scan. During this test, different sets of CT scans are taken over several minutes after you get an injection of an intravenous (IV) contrast.  CT-guided needle biopsy: CT scans can also be used to guide a biopsy needle into a suspected pancreatic tumor.

2.) MRI(magnetic resonance imagery)-uses radio waves and strong magnets instead of x-rays to make detailed images of parts of your body. Most doctors prefer to look at the pancreas with CT scans, but an MRI might also be done.  Special types of MRI scans that can also be used are:

-MR cholangiopancreatography (MRCP), which can be used to look at the pancreatic and bile ducts, is described below in the section on cholangiopancreatography.

-MR angiography (MRA), which looks at blood vessels, is mentioned below in the section on angiography.

3. ) Ultrasound (US) tests

These tests use sound waves to create images of organs such as the pancreas. The two most commonly used types for pancreatic cancer:

A-Abdominal ultrasound – If it’s not clear what might be causing a person’s abdominal symptoms, this might be the first test done because it is easy to do and it doesn’t expose a person to radiation. But if signs and symptoms are more likely to be caused by pancreatic cancer, a CT scan is often more useful.

B-Endoscopic ultrasound (EUS): This test is more accurate than abdominal US and can be very helpful in diagnosing pancreatic cancer. This test is done with a small US probe on the tip of an endoscope, which is a thin, flexible tube that doctors use to look inside the digestive tract and to get biopsy samples of a tumor (more invasive but more detailed in results of the pancreas).

4.) Cholangiopancreatography

Abdominal This is an imaging test that looks at the pancreatic ducts and bile ducts to see if they are blocked, narrowed, or dilated. These tests can help show if someone might have a pancreatic tumor that is blocking a duct. They can also be used to help plan surgery.  If signs and symptoms are more likely to be caused by pancreatic cancer, a CT scan is often more useful.

A – Endoscopic ultrasound (EUS): This test is more accurate than abdominal US and can be very helpful in diagnosing pancreatic cancer. This test is done with a small US probe on the tip of an endoscope, which is a thin, flexible tube that doctors use to look inside the digestive tract and to get biopsy samples of a tumor.

SPYGLASS. This novel technology provides a direct view of the bile duct system, enabling our doctors to visualize lesions and narrowed areas (strictures) in the ducts and to biopsy them to see if they are cancerous. This approach ensures highly accurate sampling of the area in question. It is an excellent tool to use with confocal endomicroscopy.

B – Magnetic resonance cholangiopancreatography (MRCP):This is a non-invasive way to look at the pancreatic and bile ducts using the same type of machine used for standard MRI scans. Unlike ERCP, it does not require an infusion of a contrast dye. Because this test is non-invasive, doctors often use MRCP if the purpose is just to look at the pancreatic and bile ducts. But this test can’t be used to get biopsy samples of tumors or to place stents in ducts; like ERCP. can do also.

5.) Percutaneous transhepatic cholangiography (PTC): In this procedure, the doctor puts a thin, hollow needle through the skin of the belly and into a bile duct within the liver. A contrast dye is then injected through the needle, and x-rays are taken as it passes through the bile and pancreatic ducts. As with ERCP, this approach can also be used to take fluid or tissue samples or to place a stent into a duct to help keep it open. Because it is more invasive (and might cause more pain), PTC is not usually used unless ERCP has already been tried or can’t be done for some reason.

5.) Positron emission tomography (PET) scan

For a PET scan, you are injected with a slightly radioactive form of sugar, which collects mainly in cancer cells. A special camera is then used to create a picture of areas of radioactivity in the body.

This test is sometimes used to look for spread from exocrine pancreatic cancers.

PET/CT scan: Special machines can do both a PET and CT scan at the same time.

Pancreatoscopy. Here what is used is a small camera to visualize the pancreatic duct.

This test can help determine the stage (extent) of the cancer.  It might be able to detect metastasis (spreading beyond the pancreas).  See the top anatomy picture provided to understand this better by knowing the location of the organ to other parts of the body, if needed.

 

 

QUOTE FOR MONDAY:

“November is a month of empowerment, education and inspiration for communities far and wide who have been touched by pancreatic cancer. It is our opportunity to shine a light on this disease, to elevate our voices to raise awareness and invite others to read our blog for vital information on Pancreatic Cancer. It is a time to educate the world by sharing!”

striveforgoodhealth.com

“Several types of growths can occur in the pancreas, including cancerous and noncancerous tumors. The most common type of cancer that forms in the pancreas begins in the cells that line the ducts that carry digestive enzymes out of the pancreas (pancreatic ductal adenocarcinoma).”

MAYO CLINIC

Pancreatic Cancer Awareness Month – 6 Things to know regarding Pancreatic Cancer!

 

Pancreatic cancer is one of the few types of cancer that haven’t improved in terms of survival rates over the years, according to the Hirshberg Foundation for Pancreatic Cancer Research. In fact, the foundation said the mortality rate is 93-percent within 5-years of diagnosis. And 71-percent will die in first year.  Usually people diagnosed with this disease are told they have 6 months to 1 year survival rate.  There are the few for the many that live longer but know this the major depending factor is also the stage level of cancer your in (I, II, III & IV).  The higher the worse the metastasis.

These stats point to why it’s important to raise awareness about this killer cancer, and to outline some facts and figures. In honor of Pancreatic Cancer Awareness Month in November, here are six things to know, thanks to Jeff Hayward on November 1 informed the world of this information on his blog with facts…

1. Their are Risk Factors

The American Cancer Society says that the average lifetime risk of developing cancer of the pancreas in both men and women is 1 in 65. However, there are certain factors that might make you more likely to face the disease.

Cancer Treatment Centers of America notes that these risk factors include age (most pancreatic cancers form at age-55 or older), gender (males are slightly more likely to develop it), obesity, diabetes, smoking, and more.

2. Heredity

Cancer Treatment Centers of America also notes that about 10-percent of pancreatic cancer cases are thought to be genetic, or passed down from a parent.

These genetic mutations include hereditary breast and ovarian cancer syndrome (BRCA2), familial melanoma (p16), familial pancreatitis (PRSS1), and neurofibromatosis type-1 (NF1), adds the source. Other “inherited syndromes” can raise risks including Lynch syndrome (hereditary nonpolyposis colorectal cancer), Peutz-Jeghers Syndrome, and Von Hippel-Lindau Syndrome.

3. There Were 50,000 Cases 2016

The American Cancer Society estimates there were 53,070 new diagnoses of pancreatic cancer this year in the U.S., and sadly it adds that it expected more than 41,000 of those patients to die from it.

Of those numbers, there were an estimated 27,670 men diagnosed in 2016, compared to an estimated 25,400 diagnoses for women. The death rates are proportionate for both, according to additional statistics from the cancer society.

4. One of Most Prevalent Cancers in the World

The World Cancer Research Fund International notes that pancreatic cancer shares 10th-place in global prevalence with kidney cancer. Worldwide, there were 338,000 cases of pancreatic cancers diagnosed in 2012 alone, notes the source.

Looking at a breakdown of the disease’s age-standardized rates by country, the U.S. comes in 20th at 7.5-cases per 100,000. The top two countries in the world for cancer of the pancreas are Czech Republic (9.7-per 100,000) and Slovakia (9.4-per 100,000).

5. It Often Causes Symptoms When it’s Too Late

Scientific American talks about why this type of cancer is so deadly in a 2011 article making reference to Apple founder Steve Jobs, who died from the cancer.

It notes that patients sometimes don’t seek treatment right away, because symptoms including weight loss, jaundice and abdominal pain don’t begin until the later stages. “They usually start after the tumor is a significant size. By then, chances are, it has metastasized (that is, spread to other parts of the body),” explains the article.

6. There’s More than One Type

The American Cancer Society explains the overwhelmingly common form of this cancer is pancreatic adenocarcinoma, which makes up 95-percent of all cases. These begin in the ducts of the pancreas and sometimes develop from the cells that form pancreatic enzymes, according to the source.

The “other” type of cancer of the pancreas is pancreatic endocrine tumors, otherwise known as neuroendocrine tumors, explains the cancer society. These tumors can be cancerous or benign, and are subdivided into other categories including “functioning NETs” (including gastrinomas, insulinomas and glucagonomas), and “non-functioning NETs” which are actually more likely to cause cancer because they can grow larger before they’re discovered.

Know how it works you have a pancreas medically noted in Anatomy and Physiology as having a head, neck, body and tail.  The location of the cancer can play a major role especially if diagnosed earlier, depending on the location for some.

The head is the widest part of the pancreas. The head of the pancreas is found in the right side of abdomen, nestled in the curve of the duodenum body and tail.  Worse place for pancreas since this allows metastasis faster than other areas of the pancreas. Know this in some cases caught early can make a major change in a longer life for some.

The neck is the thin section of the gland between the head and the body of the pancreas.

The body is the middle part of the pancreas between the neck and the tail. The superior mesenteric artery and vein run behind this part of the pancreas.  This is not connected like the head and if caught early results can be better.

The tail is the thin tip of the pancreas in the left side of the abdomen, in close proximity with the spleen. This is the end of the pancreas connected to nothing, no ducts or other tissues nearby or connected to it compared to other parts of the pancreas and best place for area of the cancer especially if it is only in the tail, in most cases.

 

 

QUOTE FOR THE WEEKEND:

“A risk factor is anything that increases your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed. In some cases, there is unknown etiology why the person got pancreatic cancer.

Having a risk factor, or even many, does not mean that you will get cancer. And some people who get cancer may have few or no known risk factors.”
American Cancer Society

Pancreatic Cancer: What are the significant risks for getting this disease?

Pancreatic cancer is one of the few types of cancer that haven’t improved in terms of survival rates over the years, according to the Hirshberg Foundation for Pancreatic Cancer Research. In fact, the foundation said the mortality rate is 93-percent within 5-years of diagnosis. And 71-percent will die in first year.  Usually people diagnosed with this disease are told they have 6 months to 1 year survival rate.  There are the few for the many that live longer but know this the major depending factor is also the stage level of cancer your in (I, II, III & IV).  The higher the worse the metastasis.

These stats point to why it’s important to raise awareness about this killer cancer, and to outline some facts and figures. In honor of Pancreatic Cancer Awareness Month in November, here are six things to know, thanks to Jeff Hayward on November 1 informed the world of this information on his blog with facts…

1. Their are Risk Factors

The American Cancer Society says that the average lifetime risk of developing cancer of the pancreas in both men and women is 1 in 65. However, there are certain factors that might make you more likely to face the disease.

Cancer Treatment Centers of America notes that these risk factors include age (most pancreatic cancers form at age-55 or older), gender (males are slightly more likely to develop it), obesity, diabetes, smoking, and more.

2. Heredity

Cancer Treatment Centers of America also notes that about 10-percent of pancreatic cancer cases are thought to be genetic, or passed down from a parent.

These genetic mutations include hereditary breast and ovarian cancer syndrome (BRCA2), familial melanoma (p16), familial pancreatitis (PRSS1), and neurofibromatosis type-1 (NF1), adds the source. Other “inherited syndromes” can raise risks including Lynch syndrome (hereditary nonpolyposis colorectal cancer), Peutz-Jeghers Syndrome, and Von Hippel-Lindau Syndrome.

3. There Were 50,000 Cases 2016

The American Cancer Society estimates there were 53,070 new diagnoses of pancreatic cancer this year in the U.S., and sadly it adds that it expected more than 41,000 of those patients to die from it.

Of those numbers, there were an estimated 27,670 men diagnosed in 2016, compared to an estimated 25,400 diagnoses for women. The death rates are proportionate for both, according to additional statistics from the cancer society.

4. One of Most Prevalent Cancers in the World

The World Cancer Research Fund International notes that pancreatic cancer shares 10th-place in global prevalence with kidney cancer. Worldwide, there were 338,000 cases of pancreatic cancers diagnosed in 2012 alone, notes the source.

Looking at a breakdown of the disease’s age-standardized rates by country, the U.S. comes in 20th at 7.5-cases per 100,000. The top two countries in the world for cancer of the pancreas are Czech Republic (9.7-per 100,000) and Slovakia (9.4-per 100,000).

5. It Often Causes Symptoms When it’s Too Late

Scientific American talks about why this type of cancer is so deadly in a 2011 article making reference to Apple founder Steve Jobs, who died from the cancer.

It notes that patients sometimes don’t seek treatment right away, because symptoms including weight loss, jaundice and abdominal pain don’t begin until the later stages. “They usually start after the tumor is a significant size. By then, chances are, it has metastasized (that is, spread to other parts of the body),” explains the article.

6. There’s More than One Type

The American Cancer Society explains the overwhelmingly common form of this cancer is pancreatic adenocarcinoma, which makes up 95-percent of all cases. These begin in the ducts of the pancreas and sometimes develop from the cells that form pancreatic enzymes, according to the source.

The “other” type of cancer of the pancreas is pancreatic endocrine tumors, otherwise known as neuroendocrine tumors, explains the cancer society. These tumors can be cancerous or benign, and are subdivided into other categories including “functioning NETs” (including gastrinomas, insulinomas and glucagonomas), and “non-functioning NETs” which are actually more likely to cause cancer because they can grow larger before they’re discovered.

Know how it works you have a pancreas medically noted in Anatomy and Physiology as having a head, neck, body and tail.  The location of the cancer can play a major role especially if diagnosed earlier, depending on the location for some.

The head is the widest part of the pancreas. The head of the pancreas is found in the right side of abdomen, nestled in the curve of the duodenum body and tail.  Worse place for pancreas since this allows metastasis faster than other areas of the pancreas.  The head of the pancreas is connected to other body organs and near lymph nodes making it the ideal place for metastasis (spreading) to occur.   Know this in some cases caught early can make a major change in a longer life for some.

The neck is the thin section of the gland between the head and the body of the pancreas.

The body is the middle part of the pancreas between the neck and the tail. The superior mesenteric artery and vein run behind this part of the pancreas.  This is not connected like the head and if caught early results can be better.

The tail is the thin tip of the pancreas in the left side of the abdomen, in close proximity with the spleen. This is the end of the pancreas connected to nothing, no ducts or other tissues or other body glands of the body that put it near by lymph nodes or connected to and best place for area of the cancer especially if it is only in the tail, in most cases, since less chance of spreading the cancer.  Also if only in the tail of pancreas, surgery will entail removal of that part of the organ with chemo a few months and resolved in most cases.  Just follow up visits to your chemo doctor for however long the M.D. directs you.

QUOTE FOR FRIDAY:

“Many wonder if they’ll ever lead a “normal” life again. Well, a “normal” life is still possible. That is to say, someone diagnosed with seizures can still do the same daily functions as someone without epilepsy.Several Advanced Neurosurgery Associates (ANA) children and adults are illustrative of the potential to live a normal life with epilepsy.  It’s all in controlling the seizures.”

Advanced Neurosurgery Associates (ana-neurosurgery.com)

Part III National Epilepsy Awareness Month: Types of Seizures, and Types of Treatments for Epilepsy/Seizures!

Old Lists Below on Seizure Classification:

Most Updated List on Classifications of Seizures by the Epilepsy Foundation:

Expanded Seizure Classifications

 

Types of seizures whether with a etiology or unknown:

I-Partial seizures (seizures beginning local)

1-simple partial seizures-(the person is conscious and not impaired).  With motor symptoms, autonomic symptoms and even psychic symptoms.

2.)-Complex partial seizures-(the person is with impairment of consciousness)

II-Generalized seizures-(bilaterally symmetrical and without local onset).

3.) Tonic clonic seizures – Grand Mal

See Above the most updated,being 2017, on classifications of seizures list by the Epilepsy Foundation.

Treatment:

1-Epilepsy is sometimes referred to as a long-term condition, as people often live with it for many years, or for life. Although generally epilepsy cannot be ‘cured’, for most people, seizures can be ‘controlled’ (stopped) so that epilepsy has little or no impact on their lives. So treatment is often about managing seizures in the long-term.

Most people with epilepsy take anti-epileptic drugs (AEDs) to stop their seizures from happening. However, there are other treatment options for people whose seizures are not controlled by anti-epileptic drugs (AEDs).

2-The ketogenic diet is one treatment option for children with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and can often have positive effects on behaviour.

3-Vagus nerve stimulation therapy is a treatment for epilepsy that involves a stimulator (or ‘pulse generator’) which is connected, inside the body, to the left vagus nerve in the neck. The stimulator send regular, mild electrical stimulations through this nerve to help calm down the irregular electrical brain activity that leads to seizures.

There are several ways to treat epilepsy. How well each treatment works varies from one person to another. Vagus nerve stimulation therapy is a form of treatment for people with epilepsy whose seizures are not controlled with medication.

4-There are different kinds of epilepsy surgery. One kind of surgery involves removing a specific area of the brain which is thought to be causing the seizures. Another kind involves separating the part of the brain that is causing seizures from the rest of the brain.

Surgery may be possible for both adults and children, and might be considered if:

  • you have tried several AEDs and none of them have stopped or significantly reduced your seizures; and
  • a cause for your epilepsy can be found in a specific area of your brain, and this is an area where surgery is possible.

Whether you are suitable for surgery is something that you may like to talk about with your GP or neurologist. If you meet these criteria and are considered for surgery, you will need to have further tests before you can have the surgery.

If you are referred for surgery you will probably go to a specialist centre for tests. There are many different pre-surgical tests you might have before you can be given the go-ahead for surgery. This could include further MRI scans, an EEG (electroencephalogram) and video telemetry (an EEG while also being filmed). Other types of scans may also be done, which trace a chemical injected into the body. This can show detailed information about where seizures start in the brain.

Memory and psychological tests are also used to see how your memory and lifestyle might be affected after the surgery. These types of tests also help the doctors to see how you are likely to cope with the impact of having this type of surgery.

The tests will confirm whether:

  • the surgeons can reach the epileptogenic lesion during surgery and can remove it safely without causing new problems;
  • other parts of your brain could be affected by the surgery, for example the parts that control your speech, sight, movement or hearing;
  • you have a good chance of having your seizures stopped by the surgery; and
  • you have any other medical conditions that would stop you from having this kind of surgery.

The results from the pre-surgical tests will help you and your neurologist decide whether surgery is an option for you, and what the result of the surgery might be.

Your specialist will also talk with you about the possible risks and benefits of having surgery.

For many people the results show that surgery is not an option: the majority of people who are recommended for surgery, and have these tests carried out, are unable to have surgery.

Take the action and make your life one without seizures occurring putting your life on HOLD you need to TAKE CARE OF YOURSELF!    That is all up to you, the patient diagnosed with it or questioning if they have seizures.

Part II National Epilepsy Awareness Month

 

Part II covers what is Idiopathic Epilepsy (Unknown Cause), how to diagnose this condition!

Their epilepsy that is diagnosed with a IDIOPATHIC cause – meaning unknown cause and the patient could grow out of it in childhood in some cases (not all) depending on the type of seizure disorder and if the child doesn’t grow out of it the condition becomes chronic (for life).

Although heredity has been known since antiquity to cause epilepsy, the progress to date in identifying the genetic basis of epilepsy has been limited primarily to the discovery of single gene mutations that cause epilepsy in relatively rare families. For the more common types of epilepsy, heredity plays a subtler role, and it is thought that a combination of mutations in multiple genes likely determine an individual’s susceptibility to seizures, as well as the responsiveness to antiepileptic medications.

Epilepsy can be caused by genetic factors (inherited) or acquired (a etiology—cause) , although in most cases it arises in part from both. The neurology and neurological sciences of Stanford Epilepsy Center Dr. Robert S. Fischer Ph D. presents in the article Genetic Causes of Epilepsy.

He also presents in this article our genes are the instruction set for building the human body. Genes reside on chromosomes.

Going to the basics is every person has 46 chromosomes, carrying a total of about 30,000 genes. We get half our chromosomes from our mother and half from our father. While genes determine the structure of our body, they also control the excitability of our brain cells. Defective genes can make hyperexcitable brain cells, which are prone to seizures.

In recent years, several epilepsy conditions have been linked to mutations in genes, but the matter is complicated by the fact that different genes may be involved in different circumstances.

In general, the most common epilepsy conditions, including partial seizures, seem to be more acquired than genetic.

Gene testing will soon be able to identify predispositions to epilepsy, allowing doctors to help a patient get treatment and to assist with family counseling. One day, doctors may simply be able to swap a patient’s cheek, test his or her genes, and predict response to various epilepsy medicines, eliminating much of the trial and error in medication choice that goes on today. Eventually, we may even be able to repair or replace defective genes that predispose a person to epilepsy, a process called gene therapy.

Lastly, Dr. Robert Fischer Ph D presented in his article, that I found very interesting, the general population has about a 1% risk of developing epilepsy.  Meanwhile, children of mothers with epilepsy have a 3 to 9% risk of inheriting this disease, while children of fathers have a 1.5 to 3% risk of inheritence. Still, the actual risk is upon the specific type of epilepsy. For example, partial seizures are less likely to run in families than are generalized seizures. In any event, with the usual forms of epilepsy, even if a parent does have the condition, there is more than a 90% chance that their child will not. So most epilepsies are acquired than inherited.

Clearly, genes determine a great deal of who we are, including our possible risk for epilepsy but slim versus a actual cause. But what happens to us in life and what we do is still the larger part of the risk for epilepsy.

A person given this diagnosis in the 1970’s, or before  and even up to the early 1990’s was quiet about ever letting people know about this since in the 1970’s and back with lack of knowledge, information to the public and definitely technology versus now.  Epilepsy is much more an accepted disease in the overall community compared to 20-25 years ago and back.  Heck in the 1970’s and back these patients when having a seizure episode were characterized as “Freaks”.  This was due to ignorance and lack of information to society/community but due to the past 20 to 25 years with the computer used more as a must in our lives with media, television and even our government they all have made it possible for society everywhere in the world to learn and understand diseases with acceptance in wanting to help those, particularly the US, but we still need a healthier America. It will take time to get there with the many multicultural lives that all live in the U.S. which practice differently on how important a healthy diet is with exercise balanced with rest.  Also including stress well controlled is not always in America on their top priority list in living.  Stress can even be a catalyst for a seizure but not the cause.

For a person diagnosed with or without a cause of epilepsy these steps in learning about the disease with higher technology and continuous research with medications over the years has allowed them to be able to live a completely healthy life doing the same things other people do without the disease but only if the patient is UNDER COMPLETE CONTROL  which includes being COMPLIANT with your Rx; this does exist in America.

Compliant meaning taking their medications everyday as ordered by their neurologist with yearly or sooner follow-up visits with blood levels of the anti-seizure medications there on.  This is the only way one with chronic epilepsy is guaranteed that living this way MAY stop the seizures from occurring (inactive epilepsy you can call it — meaning you’ll always have the disease but can put the seizure activity in a remission by medications preventing the seizure.)

Other main causes of epilepsy include:

  • Low oxygen during birth.
  • Head injuries that occur during birth or from accidents during youth or adulthood.
  • Brain tumors.
  • Genetic conditions that result in brain injury, such as tuberous sclerosis.
  • Infections such as meningitis or encephalitis.

How Epilepsy is Diagnosed:

The purpose for intial visits is for the Neurologist to determine if the patient is having a seizure or something else and to determine what diagnotic tooling tests to start with to help the doctor to find out the problem.  Apart from the description of the seizure, there are other things that can help to explain why your seizures have happened. Your medical history and any other medical conditions will also be considered as part of your diagnosis.

If you have a seizure you may not remember what has happened. It can be helpful to have a description of what happened from someone who saw your seizure, to pass on to your GP or specialist.

Here are some questions that may help you or someone who witnessed your seizure to record useful information about what happened.

Before the seizure

  • Did anything trigger (set off) the seizure – for example, did you feel tired, hungry, or unwell?
  • Did you have any warning that the seizure was going to happen?
  • Did your mood change – for example, were you excited, anxious or quiet?
  • Did you make any sound, such as crying out or mumbling?
  • Did you notice any unusual sensations, such as an odd smell or taste, or a rising feeling in your stomach?
  • Where were you and what were you doing before the seizure?

During the seizure

  • Did you appear to be ‘blank’ or stare into space?
  • Did you lose consciousness or become confused?
  • Did you do anything unusual such as mumble, wander about or fiddle with your clothing?
  • Did your colour change (become pale or flushed) and if so, where (face or lips)?
  • Did your breathing change (for example, become noisy or look difficult)?
  • Did any part of your body move, jerk or twitch?
  • Did you fall down, or go stiff or floppy?
  • Did you wet yourself?
  • Did you bite your tongue or cheek?

After the seizure

  • How did you feel after the seizure – did you feel tired, worn out or need to sleep?
  • How long was it before you were able to carry on as normal?
  • Did you notice anything else?

For F/U (follow up) visits is for the neurologist to see how well your seizures are under control by taking drug blood levels of the anti seizure medication your taking to make sure the medication is in a therapeutic drug level and if not he or she will make dose changes in the med(s) your on.  Possible do a EEG (electroencephalogram); the only test to decipher if you have spikes in your brain waves indicating you had a seizure determining from which lobe of the brain is having the seizures (a 26 lead to wires on the brain, which is painless).  Go to the expert for keeping you on the right track.  Its just like based on the principle why a person gets a check up on there car by seeing the mechanic (the car’s doctor) who fixes it.  The expert,  the Neurologist,  fix your seizures or get them under control.