Stop Alcohol Addiction

Alcohol Free Forever

This powerful guide walks you step-by-step through exactly what you need to do to free yourself from your alcohol addiction without going through AA meetings or expensive sessions. There are three main types of relaxation techniques you can practice when you feel upset and stressed. If you practice regularly, they will become part of your lifestyle and you may find yourself habitually more relaxed as a result. Part 2 will exercise Neuro Linguistic Programming to release thoughts and a technique of progressive muscle relaxation also negative situations. Because of the mind body connection, exercises to relax the body will also flow through the mind. Much of the stress we feel is because of our resistance to certain feelings or emotions. Alcohol Free Forever is a lifesaver ebook. This guide was extremely eye-opening and the daily emails make it extremely easy to quit and to establish a routine that did not involve alcohol. Continue reading...

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The author has done a thorough research even about the obscure and minor details related to the subject area. And also facts weren’t just dumped, but presented in an interesting manner.

This ebook does what it says, and you can read all the claims at his official website. I highly recommend getting this book.

How to Beat Addiction and Quit Alcoholism Easily

How to beat addiction and quit alcoholism is a collection of 6 eBooks that are all specifically crafted to help people leave addiction and alcoholism. These books were put down by a group of former alcoholics and addicts and hence you can trust them to help you along the way. The three authors that were involved are: Wendy Wilken, Martin Gouws and Stephen Steenkamp. They have all fought a war of alcoholism and addiction successfully and that's why they thought they should help you along the way. The books also come with various bonuses upon purchase. This means that if you purchase any of the books, you will get a special bonus. To successfully quit alcohol and beat addiction, you have to make use of all the books combined. Each of them introduces you to a certain perspective of addiction and alcoholism and hence all of them should be combined to come up with a significant outcome. The book is perfectly fit for alcoholics and drug addicts of all ages, race, social status and levels of addiction. Continue reading...

How to Beat Addiction and Quit Alcoholism Easily Summary

Contents: Ebooks
Author: Wendy Wilken
Official Website: www.a2buys.com
Price: $6.00

Neuropathological Effects Of Alcohol Withdrawal

In humans, alcohol withdrawal seizures have been associated with ventricular and sulcal enlargement as well as significantly smaller volume of temporal lobe white matter and hippocampal sclerosis (Essardas-Daryanani et al., 1994). In animal models, there is evidence that alcohol intoxication can lead to selective damage to specific brain regions, including the hippocampus (Ikonomidou et al., 2000 Walker et al., 1980). Withdrawal from long-term alcohol consumption can aggravate alcohol-induced neurodegeneration. Indeed alcohol withdrawal is associated with augmented loss of CA1 and CA3 pyramidal neurons, mossy fiber-CA3 synapses, and dentate gyrus granule cells (Cadete-Leite et al., 1989 Paula-Barbosa et al., 1993 Scorza et al., 2003). The mechanisms underlying alcohol withdrawal-induced neurodegeneration are not completely understood. However, alcohol withdrawal, but not alcohol intoxication, is thought to be associated with significant increases in free intracellular calcium in...

Methods For Induction Of Alcohol Dependence And For Monitoring Withdrawal Seizures

As in humans, an alcohol withdrawal syndrome that includes generalized tonic-clonic seizures has been observed in the mouse, rat, cat, dog, monkey, and chimpanzee (Ellis and Pick, 1970 Essig et al., 1969 Freund, 1969 Guerrero-Figueroa et al., 1970 Majchrowicz, 1975 Pieper et al., 1972). In all species, the signs of alcohol withdrawal last for 1 to 3 days, after which behavior returns to normal and there is no enhanced seizure susceptibility. Rodents are the most common species used in laboratory studies of alcohol withdrawal seizures. Here we describe methods for the induction of alcohol dependence and for inducing and scoring withdrawal seizures in the rodent species that are most frequently used in laboratory experiments. The intragastric intubation method was originally developed in studies with rats and is mainly applied in this species. In contrast, inhalation methods are most commonly used in mice. The liquid diet procedure is applied in both mice and rats. The experimental...

Alcohol Withdrawal Seizures

Ethyl alcohol (ethanol) is a central nervous system (CNS) depressant that exerts diverse behavioral actions. At low blood concentrations, alcohol produces euphoria and behavioral excitation, and at concentrations greater than 0.08 g dl (17 mM), it significantly impairs motor skills. Concentrations of 0.15 to 0.30 g dl induce acute intoxication, which manifests as drowsiness, ataxia, slurred speech, stupor, and coma. The acute effects of alcohol on brain function are believed to result largely from its actions on ligand-gated and voltage-gated ion channels, resulting in alterations in neuronal signaling (Crews et al., 1996 Deitrich and Erwin, 1996 Nevo and Hamon, 1995). Chronic alcohol consumption leads to the development of tolerance and physical dependence, which may result from compensatory changes in neuronal signaling that balance the acute effects of alcohol. Abrupt cessation of chronic alcohol consumption unmasks the compensatory physiologic change, leading to a cluster of...

Singleneuron Firing During Cellular Electrophysiology Of Alcohol Withdrawal Seizures

During alcohol withdrawal-related AGS, the cortical electroencephalogram typically shows no sign of paroxysmal activity compatible with the idea that the seizures are mediated largely in the brainstem (Hunter et al., 1973 Maxson and Sze, 1976). Nevertheless, epileptiform activity has been observed in the hippocampus, but with a significant delay after the onset of AGS, suggesting a role in the propagation rather than in the initial generation of the seizures (Hunter et al., 1973). Acute alcohol intoxication suppresses spontaneously and acoustically evoked neuronal firing in the IC central nucleus, whereas alcohol withdrawal is accompanied by significant increases of these responses (Faingold and Riaz, 1995). Electrophysiologic studies have revealed that, at the transition to seizure, the IC central nucleus exhibits sustained increases in firing that persist during wild running, the initial phase of AGS (Chakravarty and Faingold, 1998). It has therefore been suggested that the IC...

Metabolic Changes Following Alcohol Withdrawal

Alcohol intoxication decreases local cerebral glucose utilization (LCGU) in many areas of the brain, including the limbic system, cerebellum, and motor system (Eckardt et al., 1992). The most striking effects on LCGU are observed in the IC (Grunwald et al., 1993), in accordance with other evidence indicating that this brain site is a major target of alcohol. Alcohol withdrawal is associated with increased brain glucose uptake, oxygen consumption, and blood flow (Eckardt et al., 1992 Hemmingsen et al., 1979 Newman et al., 1985). Significant increases in LCGU with alcohol withdrawal have been reported in motor systems, the auditory system (including IC), and the mammillary bodies-anterior thalamus-cingulate cortex pathway (Eckard et al., 1992), although one study reported decreases with acute withdrawal in most limbic regions and no changes in cerebellum and subcortical structures (Clemmesen et al., 1988). Animals that had experienced spontaneous withdrawal seizures exhibited relatively...

Testing Pharmacological Agents In Animal Models Of Alcohol Withdrawal Seizures

Because alcohol withdrawal-related AGS and HIC can be elicited at the will of the experimenter during a defined period after cessation of alcohol intake, the anticonvulsant properties of pharmacologic agents can be easily studied (unlike the situation with spontaneous seizure models, where seizures occur unpredictably, requiring sophisticated monitoring systems and less robust trial designs). A limitation of these models is that AGS or HIC do not occur in every animal. However, the incidence (and severity) of AGS can be increased with intermittent ethanol administration (C.L. Faingold, personal communication). The peak incidence of AGS occurs at about 24 hours following alcohol withdrawal. Thus pharmacologic agents are typically tested between hour 20 and 28 following alcohol withdrawal, which encompasses a period of high seizure likelihood. Pharmacologic substances are typically administered 30 to 60 minutes before the time at which the AGS is elicited, but the choice of interval for...

Relevance Of Alcohol Withdrawal Seizures In Rodents To The Human Condition

Although alcohol withdrawal seizures in rodents do not represent a perfect model of human alcohol withdrawal seizures, the available evidence indicates that the animal models are valid in many respects. As noted, most alcohol withdrawal seizures in humans are generalized tonic-clonic seizures. Similarly, the various forms of alcohol withdrawal seizures in rodents represent generalized convulsions. In both humans and rodents, the peak incidence of alcohol withdrawal related generalized seizures occurs between 20 to 24 hours following cessation of alcohol intake. In addition to exhibiting shared behavioral features, the brain systems underlying alcohol withdrawal seizures in humans and rodents are likely to be similar across species. There is no cortical paroxysmal activity in the electroencephalogram during auditory-evoked tonic-clonic alcohol withdrawal seizures in rodents (Hunter et al., 1973 Maxson and Sze, 1976). Epileptiform activity is also rare in the electroencephalogram...

Precipitating factors in early epilepsy

Avoiding factors that precipitate seizures can be very important. The common factors are listed in Table 1.32 (p. 54). Excess alcohol intake (or its abrupt withdrawal) was a predominant factor in 6 of first seizures in one UK series, and accounted for 27 of first seizures in those between the ages of 30 and 39 years. Sleep deprivation may also be a precipitating factor for seizures in susceptible individuals, and is often a contributory factor in those abusing alcohol. Photosensitivity is encountered mainly in adolescents with idiopathic generalized epilepsy, and is described on p. 56.

If At First You Dont Succeed

His past medical history includes hyperthyroidism and hypertension, which he treats with medications. As a result of his seizures, he has fractured both wrists and his right foot and has suffered numerous lacerations on his face and scalp. He has no allergies and does not abuse drugs nor does he drink alcohol or smoke. F is the only one in his family with epilepsy. His social life is very limited because of his seizures and limited cognitive and social skills. His mother is overprotective. His stepfather mostly ignores him. A prior evaluation included a normal EEG and a normal magnetic resonance imaging (MRI) study. He takes phenytoin (100 mg four times daily) and primidone (250 mg four times daily).

The Obvious Cause Of Seizures May Not Be The Underlying Cause

The patient is a 48-year-old man with a previous history of alcohol and drug abuse. He presented to the emergency department following a generalized tonic-clonic seizure. He had no history of seizures and no history of head trauma, but he did have a recent history of alcohol abuse with decreasing amounts over the last several days, although he had not totally stopped drinking.

Treatment and outcome

Following the episode of status epilepticus, it was determined that long-term phenytoin was necessary. He was therefore discharged on phenytoin 300 mg daily and did well for the next 3 months. He attended Alcoholics Anonymous and remained free of further seizure activity. On two office visits 6 weeks apart, the patient had a normal examination, including a normal cognitive status.

Side Effects That Imitate Seizures

She used low-estrogen oral contraceptives and daily multivitamins. She was married with two children of elementary-school age, and she had worked as a nurse before her second child. She did not drink alcohol or smoke tobacco. Her health was currently good and she reported a positive mood. Her current medication for seizures was carbamazepine 1400 mg day in three divided doses.

Common Clinical Practice

When clear triggering factors such as sleep deprivation, photic stimulation or excessive alcohol intake have been identified, specific measures to avoid them should be adopted by the patient, as in JME 41 . The pharmacological sensitivity is probably the same as in JME, with VPA being the first-line treatment, together with LTG, TPM and possibly LVT. Zonisamide may be another option in the future.

Behavioral Features And Brain Mechanisms

Spontaneous seizures are observed between 24 to 60 hours following cessation of alcohol consumption, and their incidence reaches a peak between hour 36 and 48 of the withdrawal period (Clemmesen et al., 1988 Gonzalez et al., 1989). The behaviors observed include myoclonic jerks, facial and forelimb clonic seizures, rearing, falling, tonic-clonic seizures, and tonic seizures. The neuronal networks that generate these behaviors are as yet unknown. However, the similarity to amygdala kindled seizures suggests that they may originate in the limbic system. Interestingly, studies with 2-deoxyglucose autoradiography have implicated amygdala neurons in the generation of spontaneous seizures associated with alcohol withdrawal (Clemmesen et al., 1988). Handling-induced convulsions are characterized by the occurrence of tonic-clonic seizures with routine handling as well as tonic or tonic-clonic seizures on tail lift or after spinning. The network for HIC is still poorly understood. Seizures...

Selection Of An Experimental Model

There are various tradeoffs in the choice between spontaneous seizures or seizures elicited by audiogenic or handling stimulation as the endpoint in studies of alcohol withdrawal seizures. Spontaneous seizures may have greater face validity to human alcohol withdrawal seizures because human alcohol withdrawal seizures occur paroxysmally without an apparent eliciting stimulus. Spontaneous alcohol withdrawal seizures in rodents are observed over a time course similar to that in humans. However, spontaneous seizures in experimental animals are mainly myoclonic seizures, whereas alcohol withdrawal seizures in humans are mostly generalized tonic-clonic seizures, as are vestibular or auditory-evoked seizures in animals. Such reflex seizures may have significantly different underlying pathophysio-logic mechanisms from alcohol withdrawal seizures in humans, which are not elicited by audiogenic or vestibular stimulation. (It is notable that some features of the alcohol withdrawal syndrome in...

Cellular And Molecular Mechanisms

Although alcohol is the most widely used psychoactive agent, the pharmacologic basis of its intoxicating effects is incompletely understood. Similarly the molecular mechanisms underlying alcohol dependence and withdrawal are obscure. Nevertheless, it is well recognized that alcohol affects the functional activity of many receptors and ion channels, including NMDA (Lovinger et al., 1989, 1990), kainate (Carta et al., 2003), serotonin (Lovinger and White, 1991), GABAa (Davies, 2003) and glycine (Mihic et al., 1997) receptors, and G protein-coupled inwardly rectifying potassium channels (Kobayashi et al., 1999) and calcium channels (Walter and Messing, 1999). In most cases, the effects of alcohol on these targets occur at high concentrations. However, the effects of alcohol on certain GABAA receptor isoforms occur with concentrations within the intoxicating range. Acute alcohol potentiates these GABAA receptor isoforms and therefore enhances GABA-mediated inhibition through allosteric...

Alcohol and Sedative Drug Withdrawal

Seizures can occur upon sudden alcohol and sedative drug withdrawal, particularly when these drugs have been used for prolonged periods. Although this is much more common in people with epilepsy, seizures in this context can also occur in people without epilepsy. When planned in advance, the period of alcohol withdrawal should be accompanied by the temporary administration of benzodiazepines, which will control not only the anxiety state induced by alcohol discontinuation, but will also increase seizure threshold. The approach to the safe discontinuation of sedative drugs is different, and requires decrease of dosages over a long period of time. In people with epilepsy, rapid withdrawal of barbiturates or benzodizepines are well known seizure precipitants, and the discontinuation of these drugs should be done over weeks or months. When epilepsy is more severe, there is a definite risk of an increase in seizures even with slow discontinuation of barbiturates, and thus small dosages of...

Arriving At The Bedside Making The Diagnosis And Assessing Risk Of Prolonged Seizures

According to the operational definition of SE, once a patient is seizing for 5 min or more, they are considered to be in SE. The patient should be commenced on oxygen and vital signs monitored. Intravenous access should be established and blood sent for routine labs and blood culture. Blood glucose should be checked with finger-stick and if low, 50 ml of 50 dextrose should be given. If one suspects malnutrition or alcohol dependence, 100 mg intravenous (i.v.) or intramuscular (i.m.) thiamine should be given prior to the glucose load. The history and exam need to be completed quickly and efficiently, with three key questions in mind

Frequency and Provoking Factors

Ance with the intake of antiepileptic drugs. Such noncompliance may be driven by cultural factors (such as the perception by relatives that the patient is taking too much medication, or that the medication will prove harmful in the future), by the inconsistent availability of antiepileptic medications in public pharmacies, and or by inadequate personal resources to access these medications. The temporal relationship between seizure occurrence and missed medication, as well as with other known provoking factors (such as excessive alcohol intake and sleep deprivation) should always be considered.

Visual stimuli photosensitivity and photosensitive epilepsy

Epilepsy arising in the occipital region. In idiopathic generalized epilepsy, myoclonus, absence and tonic-clonic seizures can be precipitated by photic stimuli, and factors such as sleep deprivation or alcohol intake have additive effects partying can involve all factors, and seizures are common the morning after the night before. Alternating patterns (such as in some video games, or when looking down large escalators) can precipitate seizures in photosensitive patients, as can disco lights or poorly tuned TV screens (which flicker at the mains alternating current frequency of 50 Hz in the UK and Europe, but not in the USA). Other common stimuli include bright light shimmering off moving water, or the flickering of light through trees from a moving vehicle, and the transition from relative darkness into bright light. Most photosensitive patients have non-photically induced seizures also, but photic seizures can be prevented or reduced by wearing glasses with tinted or polarized...

Illicit and abused drugs

The US national probability survey of drug use (NHSDA) explored the prevalence of alcohol dependence in the general population using the DSM-IV criteria. Among current male drinkers, 4.6 of adolescents (aged 12 17 years) met criteria for the past year dependence, and the rate increased to 8.5 in the 18 23 age group. Approximately, 5 of the population reported heavy drinking, defined as 5 or more drinks per day for at least 5 days a month (Rouse, 1996) . Currently, it is not clear if alcohol dependence is more frequent in patients with epilepsy and the lack of studies precludes strong conclusions. In a review performed by Chan (1985), the prevalence of alcoholism ranged from 12 to 36 in patients with seizures. The validity of this report is limited by a lack of distinction in the majority of the studies between alcohol withdrawal seizures and epilepsy. This is likely to result in an overestimation of the comorbidity of alcoholism and epilepsy (as opposed to seizures). A more recent...

Clinical History Screening Questionnaire

History of alcohol consumption, substance abuse and exposure to various toxins should be elicited and documented. Whether consumption of large amount of alcohol, especially adulterated alcohol, is a risk factor for epilepsy is not certain.19 But in a study in Togo,15 attributed epilepsy to alcohol consumption in 8 of the 237 patients studied. The tropical world is the major region for the production and distribution of narcotics. In the developing world psychotropic drug consumption is on the rise. Over indulgence of substance abuse can provoke epileptic seizures.30 Benzene hexachloride, a pesticide used in India, has been associated with seizures.31 Consumption of certain fruits can result in fatal convulsive encephalopathy, this is more often described during famine. In Burkina Faso and other African countries epidemics of fatal convulsive encephalopathy in children have been reported following consumption of unripe ackee fruit (Blighia sapida)31,33 The traditional healers provoke...

Distinguishing Isolated Epileptic Seizures from Epilepsy

Epilepsy is a disorder of recurrent seizures, so a single event, even if it is unequivocally epileptic, does not make a diagnosis of epilepsy. Even recurrent epileptic seizures, if they are clearly provoked, for example as a result of alcohol withdrawal or use of procon-vulsant agents, do not warrant a diagnosis of epilepsy. Treatment in these situations is not AEDs, but avoidance of the provocative insult where possible. More detailed discussions of the differential diagnosis between isolated epileptic seizures and epilepsy are presented in Chapters 1 and 4. Whether epileptic seizures are isolated or recurrent, however, the next step in providing care is to determine whether there is an underlying treatable cause. If epileptic seizures are due, for example, to an intracranial infection or a brain tumor, once this underlying cause is treated and epileptic seizures stop, a diagnosis of epilepsy is not warranted. Only if a treatable underlying cause is not identified is identified,...

Management Of Provoked Seizures

Seizures can be provoked by acute metabolic disturbances, treatment with certain drugs (see Section 3.13) and drug withdrawal (eg alcohol, benzodiazepines, barbiturates). Provoked seizures may occur in the context of drug abuse (heroin, cocaine, methadone, amphetamine, ecstasy). The risk of recurrence of such provoked seizures can be reduced by correction or withdrawal of the provocative factor. The risk of seizures related to acute alcohol withdrawal can be reduced by short term treatment with lorazepam.121 Commencement of longer term AED treatment is only indicated if unprovoked seizures occur.

Seizures versus Epilepsy

As described in Chapter 1, not all seizures indicate the presence of epilepsy. Epilepsy is the chronic persistence of a brain dysfunction, which leads to recurrent epileptic seizures. Some individuals may have a single epileptic seizure, while others may have a few recurrent seizures during life, always related to a specific transient provoking factor. These people do not have epilepsy. Examples include generalized seizures in susceptible individuals under conditions of alcohol withdrawal or prolonged sleep deprivation, or excessive use of illegal stimulant drugs such as cocaine or amphetamines. Still others may harbor specific lesions, such as cortical tumors or parasitic cysts, which may clinically present with a few seizures, but whose tendency to further episodes is eliminated by resection or medical treatment of the lesion.

Alcohol and toxininduced seizures

Alcohol abuse is a potent cause of acute symptomatic seizures, and indeed of epilepsy, in many societies. There are various mechanisms. Binge drinking can result in acute cerebral toxicity and seizures. Alcohol withdrawal in an alcohol-dependent person carries an even greater risk of seizures. Withdrawal seizures are typically tonic-clonic in form, occurring 12-24 hours after withdrawal, and are associated with photosensitivity. Seizures can also be caused by the metabolic disturbances associated with binge drinking (notably hypoglycaemia, hyponatraemia and hepatic failure), the cerebral damage due to trauma, cerebral infection, subdural haematoma, the chronic neurotoxic effects of chronic alcohol exposure or to acute Wernicke's encephalopathy due to thiamine deficiency. It has been estimated that 6 of patients with alcoholism investigated for epilepsy have an additional identifiable causative lesion. The risk of a first generalized tonic-clonic seizure in chronic alcoholics is...

Aetiology And Risk Factors

The causes of adult onset epilepsy are very varied (47, 52). Both idiopathic epilepsy and epilepsy attributable to birth trauma may begin in early adulthood. Other important causes of seizures in adulthood are head injury, alcohol abuse, brain tumours and cerebrovascular disease. In devel

Alcohol

In people with pre-existing epilepsy, acute alcohol intoxication and, even more potently, acute alcohol withdrawal can precipitate generalized seizures. A 20-fold increase in the incidence of seizures is found in patients consuming large quantities of alcohol, and avoidance of alcohol is sometimes all that is required to prevent seizures. Anti-epileptic drug treatment in alcoholic patients is often problematic, owing to interactions, systemic toxicity, poor compliance and psychosocial problems. Where possible the patient should abstain from alcohols, and drug treatment can probably be avoided. Seizures are also common in the 24 hours after acute alcohol withdrawal, taking the form of myoclonus and tonic-clonic convulsions, sometimes with photosensitivity. This period can be covered with benzodiazepine or clomethiazole therapy under medical supervision.

The Circumstances

An epileptic seizure can occur anywhere, anytime. A description of the circumstances should first determine whether the seizure is a new acute event, or whether it is a typical seizure for someone with long-standing epilepsy. If it is a single event, it is paramount to identify and then treat acute symptomatic seizures that reflect a potentially life-threatening underlying condition. It is also necessary to distinguish between provoked seizures that are not likely to recur, and those that might indicate the initial symptom of a chronic epileptic disorder. The physician should collect data on seizure evolution and also on the usual circumstances surrounding seizure occurrence. This also allows the application of measures to prevent both the attacks and their potential harmful consequences. The physician should elucidate precipitating events such as menses, sleep deprivation, alcohol intake, emotional changes,

Descriptive cohorts

Descriptive studies reported the following putative risk factors youth, male sex, remote symptomatic epilepsy, structural findings on neuropathology, severe epilepsy, unwitnessed seizures, alcohol abuse, abnormal EEGs with epileptiform changes and greater variations, mental handicap, psychotropic medication, African-Americans, lack of compliance with treatment, abrupt medication changes and low antiepileptic drug (AED) levels 69,70 . These should only be considered variables for further study.

Lifestyle measures

Lifestyle manipulation can be very helpful in many cases of idiopathic generalized epilepsy, especially in adolescence. The avoidance of sleep deprivation, sleeping late after a late night, and excessive alcohol intake can be very beneficial. Many patients learn to recognize dangerous times, and take individual avoidance measures. Alternative or complementary medicine can be a useful adjunct to therapy (see pp. 110-12). Photosensitive patients should be counselled to avoid relevant stimuli (see p. 56). Occasionally, patients with established mild epilepsy can avoid drug treatment altogether with these simple measures. Patients with juvenile myoclonic epilepsy typically also have psychosocial problems which have been attributed to an 'unstable personality' (although this is unfair to most such patients) and in one series psychiatric difficulties were found in 14 . These should be addressed.

Sodium Valproate

A recent review of generalized epilepsy with GTC seizures only 41 suggested that counselling to patients with primary GTC seizures should be the same as in JME. The patient needs to avoid clear triggering factors such as sleep deprivation, photic stimulation and excessive alcohol intake. The pharmacological sensitivity is probably the same as in JME, with a selective efficacy of VPA 42 . One review on treatment options in IGE does not clearly separate this syndrome from JME and other IGE syndromes and stresses the first-line place of VPA 43 . One meta-analysis found no evidence to support the use of VPA vs. CBZ as the treatment of choice for patients with GTC seizures as part of generalized epilepsy. However, the number of patients in the GTC seizure subgroup was small and confidence intervals were wide, so the authors considered that they had not been able to exclude the existence of an important therapeutic difference 44 .

Question of Epilepsy

Summary Question of Epilepsy is a 30-minute VHS videotape presenting seven dramatizations of questions about epilepsy. In the first scene, an extended family is gathered for a family event and casually discusses the epilepsy of Paul, an adolescent family member. They mention its psychosocial impact on others and how they and he have adjusted to coping with epilepsy. The second dramatization deals with the causes of epilepsy. After a children's bicycle race, two young boys go riding without their helmets. The father of one boy calls him back and reminds him to wear a helmet whenever he rides a bicycle. The father tells the other boy's mother about a child who rode a bike without a helmet and received a head injury that caused epilepsy. The father mentions that anyone can develop epilepsy at any age other causes of epilepsy include rare diseases, birth defects, and alcoholism. In the third scene, a man and a woman are editing a videotape showing elementary school students enacting what...

Magnesium sulphate

Although magnesium is effective at preventing eclampsia, there is no evidence that increasing magnesium serum concentrations to supranormal levels has any benefit in status epilepticus. Indeed, such a policy can result in motor paralysis and hypotension. However, serum magnesium can be low in alcoholics and patients with acquired immune deficiency syndrome (AIDS), and in these patients intravenous loading with 2-4 g magnesium sulphate over 20 minutes may help with seizure control and the prevention of arrhythmias.

Clorazepate

Clorazepate is a benzodiazepine used in adjunctive treatment of seizure disorders, anxiety and alcohol withdrawal. It is a prodrug which is rapidly converted to nordiazepam, the major active metabolite produced by diazepam. Ninety per cent of clorazepate is converted in the stomach to nordiaze-pam in less than 10 minutes. Clorazepate is 100 bioavailable by the intramuscular route, and conversion to nordiazepam occurs more slowly in the blood. Clorazepate and nordiazepam are 97-98 protein bound. The time to peak concentration is 0.7-1.5 hours. The volume of distribution ranges from 0.9 to 1.5 l kg, and is greater in the elderly and in obese subjects. The elimination half-life of clorazepate is 2.3 hours, but the half-life of nordiazepam is about 46 hours, longer in the elderly and neonates. Nordiazepam is excreted predominantly by the kidneys (62-67 ) with

Psychosocial needs

Attending to the psychosocial, cognitive, educational and vocational aspects is an important part of caring for people with epilepsy. The implications of the diagnosis and the treatment rationale should be discussed with the patient and family to dispel any misconceptions and to ensure good adherence to medication. Support should be offered if lack of knowledge in society or stigma is an impediment for the use of the patient's full capacity and provokes job discrimination. Patients should be advised to refrain from activities that may precipitate the occurrence of seizures, e.g. sleep deprivation, excessive alcohol intake and illicit drug use. Counselling should be provided to women of childbearing potential about the effects of their epilepsy and its treatment on fertility, contraception and pregnancy. Clinicians should make their patients with epilepsy familiar with the laws regulating driving in their country.

Panic disorder

There is good evidence, based on clinical accounts, that PD is not a homogeneous disorder. In some people pure PD exists with panic attacks in the absence of any other psychopathology. However, sizeable proportions of those with PD are comor-bid for agoraphobia or depression or both. It has been reported that women with PD are more likely to report depression, anxiety or agoraphobic avoidance than men with this diagnosis (Chambless and Mason, 1986). Increased anxiety and depression in affected women was also noted by Oie et al. (1990). Whilst women may show greater agoraphobic avoidance, men may increase their alcohol intake to cope with their symptoms. Although these differences in the associated symptoms and behaviours between the manifestations of PD in men and women exist, the core features of panic attacks appear to be relatively similar across the sexes. Hence, although in therapeutic terms it is clearly important to consider the whole syndrome with which the patients present,...

Alcohol No More

Alcohol No More

Do you love a drink from time to time? A lot of us do, often when socializing with acquaintances and loved ones. Drinking may be beneficial or harmful, depending upon your age and health status, and, naturally, how much you drink.

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