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Our actions, thoughts, perceptions, feelings, and memories are underpinned by electrical activity, which passes through networks of neurons in the brain. As a child grows and gains new skills their brain changes rapidly and brain networks are formed and strengthened with learning and experience.

The post Brain function and brain surgery in children with epilepsy appeared first on OUPblog.

Purple Day started with the curiosity and of a girl in eastern Canada, in the province of Nova Scotia, who had epilepsy. It soon became a world-wide success. Purple Day is now an international initiative and effort dedicated to increasing awareness about epilepsy around the globe. Why is it so important to create awareness around people with epilepsy?

The post Purple Day: a day for thinking about people with epilepsy appeared first on OUPblog.

Investigations into the nature of epilepsy, and its effects on those diagnosed with the disorder, can be traced back for almost 2,000 years. From associations with lunar cycles, to legislation preventing those with epilepsy to marry, the cultural and scientific record on epilepsy treatment is one of stigma and misunderstanding.

The post The history of epilepsy: an interactive timeline appeared first on OUPblog.

By Rochelle Caplan, MD

Surely the time has finally come to put our heads together and focus on three seldom connected variables regarding mass murders in the United States: the lack of comprehensive psychiatric care for individuals with mental illness, poor public recognition of the red flags that an individual might harm others, and easy access to firearms.

How should we address the first problem? The fiscal problems this country has faced during the past decade, combined with skewed budget priorities, have lead to a significant reduction in public health care, in particular for mental illness. Insurance companies have limited the time providers have for mental health assessments, the duration and frequency of treatment, and the types of intervention they cover. These cutbacks have forced psychiatrists to do abbreviated and superficial psychiatric evaluations and to prescribe medications as stopgap treatment in lieu of more effective evidence-based therapies. Furthermore, the number of individuals without mental health coverage who also face unemployment, homelessness, or insufficient money to feed and clothe their families — all significant mental health stressors — is steadily rising.

How then can mental health professionals conduct the comprehensive, time consuming evaluations needed to determine if an individual might be dangerous towards others? Self-report questionnaires, another quick method professionals use to conduct psychiatric evaluations, are clearly not the answer. Few people with homicidal or suicidal thoughts acknowledge these “socially unacceptable” intentions or plans on paper. Expert clinical acumen is needed to carefully and sensitively help patients talk about these “taboo” topics and their triggers. A five-to-ten minute psychiatric appointment clearly doesn’t do the job!

The lack of comprehensive mental health care is most sorely evident for such conditions as schizophrenia, as well as psychosis associated with substance abuse, depression, bipolar disorder, neurological disorders, or medical illnesses. In these conditions individuals can be plagued by and act in response to hallucinations that include voices commanding them to kill or visions that incite their aggressive response. Delusions (rigid, pervasive, and unreasonable thoughts) that people threaten them can also cause an aggressive response. Mass murderers might act out their hallucinations and delusions, as in the attempted assassination of congresswoman Gabrielle Gifford and murder of five bystanders, and in the Columbine, Batman, and Virginia Tech massacres.

Lack of time often precludes pediatric professionals from seeing children without their parents and detecting early warning signs of homicidal or suicidal plans. Similarly, physicians might have time to talk to adolescents but not to their parents. As a result, they might miss hearing about red flags of possible aggression by the youth and/or his peers.

The Affordable Care Act (Obamacare) will provide health insurance for more people, but what about quality mental health care? Few mentally ill patients are able to fight for their sorely needed unmet mental health care needs. Due to the stigma of mental illness and the related financial and heavy emotional burden, their families seldom have the power and resources needed to lobby elected officials or use the Internet and other media to publicize their plight.

How can we recognize the red flags of a potential mass murderer? In addition to well-trained mental health professionals with expertise, clinical acumen, and sufficient time with their patients, there is a need to educate the public about severe mental illness. Parents, family members, teachers, community groups, and religious leaders all need instruction to recognize possible early signs of mental illness. This knowledge will help them understand the plight and suffering of individuals with severe mental illness. And, most importantly, this awareness can lead to early referral, treatment, and prevention of violence due to mental illness.

Prompt recognition and early treatment of these symptoms are essential because firearms are so easily obtained in the United States. To get a driver’s license, individuals complete a Driver’s Ed course, pass a knowledge test, take driving lessons, drive a car with an adult for a fixed period, and then take a driving test. The underlying assumption is that irresponsible driving can physically harm others, the driver, and property. For this reason, individuals with epilepsy who experienced a seizure within the past year are barred from driving. Shouldn’t the same principles apply to guns? Yet, individuals can obtain guns without prior psychiatric evaluations, and there are no laws and regulations to safeguard these weapons in homes to prevent children and individuals with severe mental illness from gaining access to them. Reports on accidents caused by children and suicide by adolescents with their parents’ guns are common. According to a Center for Disease Control study, 1.6 million homes have loaded and unlocked firearms (Okoro et al., 2005).

As a child psychiatrist and parent, I regard the Newtown horrific mass murder of elementary age children as a final wake up call so that we will never again ask, “How many more children have to die?” Nothing can justify this preventable tragedy to the parents and families of their murdered beloved ones. The time has come to halt the unrelentless chipping away of our mental health care services and quality of care for mental illness, to educate the community about severe mental illness, and to implement strict controls on access to firearms.

Rochelle Caplan, M.D. is UCLA Professor Emeritus of Psychiatry and past Director the UCLA Pediatric Neuropsychiatry Program. She is co-author of “How many more questions?” : Techniques for Clinical interviews of Young Medically Ill Children (Oxford University Press) and author of Manual for Parents of Children with Epilepsy (Epilepsy Foundation). She studies thinking and behavior in pediatric neurobehavioral disorders (schizophrenia, epilepsy, attention-deficit hyperactivity disorder, high functioning autism) and related brain structure and function; unmet mental health need in pediatric epilepsy; and pediatric non-epileptic seizures.

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The post How many more children have to die? appeared first on OUPblog.

Almost 7 PM, and the skies, awaiting a near-full moon, are dark. Within this pervading stillness, I read the final pages of William Fiennes's memoir, The Music Room.

Do you know this story? Have you heard about the castle in which Fiennes grew up, and how it shaped him? Have you heard about his brother, Richard, who suffered from severe epilepsy, lived for Leeds United soccer games, exalted the wing work of herons, and erupted, often, into the smithereening hands of fury before he retreated—confused, ashamed? There were other siblings and other tragedies in this ancient place. There were also two parents who honored Richard for what he could be and gave him everything he was capable of receiving. Two parents who, in Fiennes's telling, emerge as parents in memoirs rarely do—which is to say supremely good, outrageously gentle, never self-glorifying, never self-pitying, and still, despite so much, utterly present and in love with life.

There is hush throughout this book—a tumble through past and present, a drift across here-we-were and here-we-are, time in a collision with time. There are long slides of description regarding a castle that cannot be contained by words, or mapped, and then, embedded, are scenes of aching, particulate precision (Richard tracks a heron, Richard skates on a frozen moat, Richard burns his mother with a frying pan, Richard sings, Richard smashes ancient glass, Richard accuses, Richard lays a heavy (loving) hand upon Mum, Richard will not bathe, Richard celebrates Leeds, Richard recites a poem from memory, Richard suffers, William is there, William watches, William wonders). Then, like marks of punctuation (something solid, something fixed), there are episodic histories of epilepsy science, the scarred and fuming brain revealed.

One senses no opportunism in this story—only the need to tell it. Only the need to let it be known that a castle was a home, and a brother was loved, and parents did their best, and a boy became a man who became a writer who wants to remember, and does.

It's that simple. And it isn't.

Markus Reuber, MD, PhD, MRCP is a Senior Lecturer in Neurology at the University of Sheffield. Steven C. Schachter, MD is a Professor of Neurology at Harvard Medical School. Christian E. Elger, MD, PhD, FRCP is a Professor of Epileptology, University of Bonn.  Ulrich Altrup, MD a Professor of Experimental Epileptology at the University of Munster, together they wrote Epilepsy Explained: A Book For People Who Want To Know More.  The book is both concise and comprehensive, truly full of the information you need and explanations on why you need to know it.  Below we have excerpted a bit about how parents should approach the problems epileptic children face at school.

Parents Should Tell Teachers About Their Child’s Epilepsy

When teachers know that a child has epilepsy, they can try to help.  Teachers will understand that a child’s performance can vary if antiepileptic drugs have to be changed.  Teachers can also try to make sure that a child with epilepsy is accepted by their classmates and does not feel excluded.

Most children with epilepsy are otherwise healthy.  Often, the only thing they know about their seizures is how people around them will react to the attacks.  Poorly informed adults may react to seizures  with fear or panic, which the children may not understand at all.

In some children, epileptic seizures are caused by other diseases, for instance disorders of the body’s metabolism.  Such children may have other problems as well as epilepsy.

Children who only have epilepsy can do just as well at school at other children.

Like all students, those with epilepsy should feel safe and accepted.

Whether these goals are achieved depends on other people’s understanding of epilepsy, their ability to respond to seizures, and their beliefs about the abilities of students with epilepsy.

Epilepsy education and awareness should be part of the school curriculum whenever one or more students at the school have epilepsy.  Because seizures are unpredictable, anyone at school may need to respond to a seizure.  Epilepsy education usually involves bringing in outside speakers from a local Epilepsy Foundation affiliate or a nearby epilepsy center.

Ideally, epilepsy education should begin before there is a crisis at school, rather than after a seizure has caught everyone by surprise.  Therefore, the parents of a child with epilepsy (or college students themselves) should consider notifying the school before classes start.  Discussion of the best response to a seizure can be supplemented with specific instructions from the student’s doctor and input from the school nurse and health educator.

Take a look at – and listen to – this delightful e-card from Barefoot Books: author Amy Tan narrates the poem from the recently-published Motherbridge of Love. Once you’ve heard the poem and been given a glimpse of the lovely illustrations by Jose Masse, you’ll understand why this would be a perfect book to read as a bedtime story, especially but certainly not only if you have adopted children of your own. There’s a special story behind it too, since the author of the poem is unknown: but it highlights the questions an adopted child might have about where they come from and who they are. I was fortunate to be able to catch up with Xinran, founder of the Mothers’ Bridge of Love charity, to whom the poem was sent and to which the royalties for the book will go – you can read the interview here; and here’s a photo of Xinran with Amy Tan, taken when they met recently during Xinran’s whistle-stop tour of the States.

Another recently-published picture-book featuring adoption is Grace Lin’s gorgeous The Red Thread: An Adoption Fairy Tale. It has all the traits of an enduring fairy tale – and love as the overriding principle. It creatively incorporates the “ancient Chinese belief that an invisible, unbreakable thread connects all those who are destined to be together.” This is something that many adoptive parents of children from China become aware of during their sometimes long, emotional journey through the adoption process. Grace has indeed turned it into the stuff of fairytales. She talked about the book in her charming interview with 7-Imps back in May; and Just One More Book featured it a few weeks ago.

Both these books are valuable additions to the slowly increasing number of picture-books which focus on adoption; and each in its own way has those qualities which will keep them special for years to come.

For more books featuring adoption, check out Rose Kent’s great Personal View on the PaperTigers main website: “Three Cheers For Adoption Books – And Why We All Should Read ‘Em”, with her recommendations for children of all ages. Chicken Spaghetti has put together a list of books for National Adoption month, as has Andrea Ross in her revealing podcast Thicker than Water: True Family Ties for Swimming in Literary Soup.

…And don’t forget, the auction of Snowflakes for Robert’s Snow: For Cancer’s Cure is still going on - Auction 2 starts tomorrow! Grace Lin’s own snowflake is featured in the PaperTigers Gallery along with others by artists from around the Pacific Rim…

PaperTigers most recent (and last-of-the-year) issue celebrates National Adoption Month, ‘Children’s Books & Good Causes‘ and more. I encourage you to check out the new interviews, articles, reviews, gallery features, etc. And to expand on the issue’s focus, here are two more quality adoption-related books worth sharing at home or in the classroom: Joanna Catherine Scott’s The Lucky Gourd Shop, and Uma Krishnaswami’s Bringing Asha Home.

For more adoption-related posts, check here, here and here.