Epilepsy And Parkinson's Disease - ParkinsonsDaily.com

Emotional And Behavioral Changes

Movement Disorders, Parkinson’s Disease, Tremors and Epilepsy

Depression, paranoia, anxiety, and other emotional changes are fairly common in PD patients. Patients may even undergo a 90-degree behavior change and may be unable to manage their feelings.Loss of or decrease in automatic movementsPatients may suffer from a decreased ability to perform conscious movements such as smiling, blinking, or even swinging their arms when talking. In severe cases, they may lose all automatic movements, resulting in partial paralysis.

Epilepsy Drug May Treat Parkinson’s

The epilepsy drug zonisamide may help curb the tremors and other movement problems of Parkinson’s, a Japanese study shows.

Jan. 4, 2007 — The epilepsy drug zonisamide may help curb the tremors and other movement problems of Parkinson’s, a Japanese study shows.

Zonisamide is sold in the U.S. generically and under the brand name Zonegran.

In Parkinson’s disease, the brain cells that make dopamine, a chemical that helps control the body’s movements, gradually falter and die. Symptoms include tremor, movement problems, and unsteady balance.

The disease usually starts between the ages of 50 and 65. There is no cure, but medications can help manage Parkinson’s symptoms.

The new study on zonisamide for Parkinson’s comes from researcher Miho Murata, MD, PhD, of Japan’s National Center of Neurology and Psychiatry, and colleagues. It appears in the Jan. 2 issue of Neurology.

Seizures And Alzheimers Disease Progression

When seizures occur in Alzheimers disease, they appear to be infrequent. However, seizures and epilepsy are known to affect cognitive function, causing cognitive impairment. This poses the question of how seizures affect the progression of Alzheimers disease.

In more advanced Alzheimers patients, the rate of seizures is known to be higher. This suggests that either:

Seizures may lead to increased rates of cognitive decline in Alzheimers patients, or

Seizures may be an epiphenomenon or a marker of more advanced Alzheimers stages.

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Strongest Association Seen For Sodium Valproate

Taking antiepileptic drugs was associated with a subsequent diagnosis of Parkinson’s disease , a U.K.-based case control study suggested.

There was a significant association between AED prescriptions and incident Parkinson’s disease , and the magnitude of the association rose with an increasing number of prescriptions and for those who took more than one AED, Alastair Noyce, PhD, of Queen Mary University of London, and colleagues reported in JAMA Neurology.

Of the four most commonly prescribed AEDs in the U.K., carbamazepine wasn’t significantly associated with Parkinson’s, but three AEDs did have a significant relationship:

Sodium valproate

Previous work — including a study from Noyce’s own group — has shown a link between epilepsy and Parkinson’s disease, and it’s “plausible that may account for some or all of the apparent association between epilepsy and PD,” the researchers wrote.

To further explore that potential relationship, Noyce and colleagues conducted a nested case-control study using data from the U.K. Biobank, which began collection in 2006. Cases were defined as individuals with a hospital-coded diagnosis of PD.

Ultimately, they assessed 1,433 Parkinson’s cases and 8,598 matched controls. Among patients with Parkinson’s, 60.9% were male, median age at diagnosis was 71 years, and about 98% were white.

Primary Source

JAMA Neurology

Stage Four: Symptoms Are Severe And Disabling And You Often Need Assistance To Walk Stand And Move

More people have Epilepsy than Multiple Sclerosis, Cerebral Palsy ...

Stage Four Parkinsons disease is often called advanced Parkinsons disease. People in this stage experience severe and debilitating symptoms. Motor symptoms, such as rigidity and bradykinesia, are visible and difficult to overcome. Most people in Stage Four arent able to live alone. They need the assistance of a caregiver or home health aide to perform normal tasks.

Relationship Between Neurological Diseases And Seizures

Because epileptic seizures can often be subtle, particularly with focal onset seizures, it is unclear precisely how common they are in neurological disease patients. However, the statistics, along with supporting research, suggest that both Alzheimers disease and Parkinsons disease may be risk factors for seizures.

Clinical Effectiveness Of Zonisamide

Murata et al. incidentally found that ZNS was effective in treating PD patients. Since then, several clinical trials have been performed to explore the effectiveness of ZNS for the treatment of PD. Based on adequate randomized controlled trials , ZNS is efficacious and safe as an adjunctive therapy in patients with PD . Additionally, the 2018 guideline has supported the use of ZNS for motor symptoms, especially for treating motor fluctuations . We review the clinical trials below further details are summarized in Table 2.

Table 2. Clinical trials on zonisamide effectiveness in the treatment of PD.

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Symptoms Of Parkinsons Disease

The symptoms of Parkinsons disease and the rate of progression differ amongst individuals. Because of the similarity of signs, many people often mistake PD symptoms with the effects of normal aging. PD can be a complicated disorder to diagnose because no definitive tests are available to detect the disease.The early symptoms are typically subtle, difficult to identify, and occur gradually. For example, a person may feel slight tremors while getting out of a chair, notice that their handwriting has become slower or looks too cramped, feel as if they speak too softly, or face difficulty moving an arm or leg. This places a great responsibility on bystanders, as friends and family members may be the first to notice changes in a person with early Parkinsons. One key factor of identification is a lack of animations or expressions in a persons face.

Some common symptoms of Parkinsons disease are as follows:

What Did The Findings Show

Medical Coding Lesson – Alzheimer’s, Parkinson’s, Dementia and Epilepsy

The findings of the study suggested that some of the known early signs of Parkinsons may happen earlier than research has shown. The researchers also identified two new potential early symptoms of Parkinson’s.

Memory Problems, Other Health Conditions

The researchers found that memory problems were more common in people who were later diagnosed with Parkinsons than what previous studies had shown.

In addition, there was a greater association between high blood pressure and type 2 diabetes and an increased risk of Parkinsons seen in these patients.

Hearing Loss

With hearing loss, the researchers looked at hearing problems that were severe enough that a patient need a referral for a hearing test.

This outcome was associated with a later diagnosis of Parkinsons and was present up to 5 years before diagnosis.

Epilepsy

The researchers said that the finding of epilepsy as a possible symptom of Parkinsons was notable. However, Simonet said that Parkinson-like symptoms can also be caused by medications that are used to treat epilepsy.

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Epilepsy Medication Use Weighs On Patients Quality Of Life Study Finds

NeuroX, a project of American telephysicians, notes in a blog post that although seizures have been associated with Parkinsons disease , scientists have not yet identified a definite causal relationship. The post continues:

However, several patients report seizures generally induced by environmental factors that typically start with lightheadedness and end with gagging nausea, intense sweating, and intense vertigo. If left untreated, some patients may suffer from multiple seizure episodes followed by exaggerated flooding emotions. Such patients may have to cease all daily life functioning, and recovery may take days.

It was nice to find this description of a Parkinsons seizure event, as it mirrors my own.

According to a research article published in 2018 in the journal Annals of Neurology, a retrospective cohort study conducted in the U.K. suggested an increased risk of incident epileptic seizures in people with incident Parkinsons. Researchers also found that PD patients with other brain disorders or more than one seizure-provoking comorbidity were at the highest risk of epileptic seizures, compared with PD-free individuals with no seizure-provoking comorbidities.

Over the past two years, I have mentioned surges in my book, Possibilities with Parkinsons: A Fresh Look, and in various columns. I only used the term seizure once to describe a reaction I had to a video game.

What Research Is Being Done

The National Institute of Neurological Disorders and Stroke , a component of the National Institutes of Health, is the primary funder of research on the brain and nervous system. NIH is the leading funder of biomedical research in the world.

PSP is one of the diseases being studied as part of the NINDS Parkinsons Disease Biomarkers Program. This major NINDS initiative is aimed at discovering ways to identify individuals at risk for developing Parkinsons disease and related disorders, and to track the progression of these diseases. NINDS also supports clinical research studies to develop brain imaging that may allow for earlier and more accurate diagnosis of PSP.

Genetic studies of PSP may identify underlying genetic causes. Previous studies have linked regions of chromosomes containing multiple genes, including the gene for the tau protein , with PSP. Researchers hope to identify specific disease-causing mutation and are also studying how genetics and environment interaction may work together to contribute to disease susceptibility.

Animal models of PSP and other tau-related disorders, including fruit fly and zebrafish models, may identify basic disease mechanisms and lead to preclinical testing of potential drugs. Other studies in animal models focus on brain circuits affected by PSP, such as those involved in motor control and sleep, which may also yield insights into disease mechanisms and treatments.

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Increased Risk Of Epilepsy In Older Patients With Neurodegenerative Disease

Leah Blank is an Assistant Professor in the Departments of Neurology and Population Health, Science and Policy at the Icahn School of Medicine at Mount Sinai. Allison Willis, Associate Professor in the Departments of Neurology and Epidemiology is the director of the Department of Neurologys Center for Translational Neuroepidemiology in the Perelman School of Medicine at the University of Pennsylvania.

Geriatricians frequently care for people with neurodegenerative diseases and are often the first point of contact when new neurologic symptoms occur. In patients with neurodegenerative disease, distinguishing between non-epileptic confusional episodes and seizures may be difficult but important, as there are potential harms from missing a treatable seizure as well as from inappropriately prescribing anti-seizure medication.

We have long known that the cell death and disorganisation that occurs in diseases such as Alzheimers Disease and Parkinsons increases the risk of developing seizures, but we do not have good population-level data on the burden of epilepsy in these conditions. In our Age and Ageing paper, we used a large national U.S. dataset to report the rate of developing epilepsy after a new Parkinsons or Alzheimers diagnosis. We also explored other sociodemographic factors and comorbid neurologic disease that might be associated with an increased risk of epilepsy in the older adult, neurodegenerative population.

Mds That Look Like Seizures

These are MDs that look like seizures due to the occurrence of episodic involuntary movement. Subcortical mechanisms are involved, thus explaining why EEG does not show epileptic activity in most cases.

Hemifacial spasm is an MD of the seventh cranial nerve which is characterised by either brief or persistent, intermittent twitching of the muscles innervated by the facial nerve. Primary HFS likely results from compression of the seventh nerve at the root exit zone in the posterior cranial fossa by an aberrant or ecstatic vessel, whereas secondary causes are seen after VII nerve palsy or brainstem lesions. HFS may be mistaken for EPC involving the face .

Periodic limb movements are sleep-related phenomena characterised by periodic episodes of repetitive and highly stereotyped limb movements, which most often occur in the lower extremities. PLMS can be associated with brief arousals in sleep and autonomic reaction, and is defined as the presence of > 15 movements per hour and a complaint of insomnia and/or excessive daytime sleepiness with no other explanation for these symptoms. PLMS are frequently seen in restless legs syndrome but can also occur in sleep disordered breathing, narcolepsy and rapid eye movement sleep behaviour disorder, as well as in several medical conditions, like renal failure, essential hypertension and PD, or associated with medication intake . PLMS may mimic focal seizures, and in some cases further investigation is required.

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Epilepsy Could Be Risk Factor For Developing Parkinsons

Epilepsy and hearing loss are among some of the risk factors for developing Parkinsons disease later in life, according to a new study in JAMA Neurology.

Dr Christina Simonet and colleagues aimed to investigate common risk factors for Parkinsons disease and how early these can occur before a Parkinsons disease diagnosis is made. The research wanted to focus on an ethnically diverse group of people from less affluent backgrounds.

The study used the electronic health records from GP practices in East London of over a million people between 1990 and 2018. They compared people with Parkinsons disease stated in their medical record to those without. People with neurological diseases that get worse with time, such as dementia and multiple sclerosis , were not included in the study.

The researchers found that people with Parkinsons disease tended to be older and more often male, compared to the group without. Loss of hearing and epilepsy were found to be risk factors for Parkinsons disease, which havent been well reported before.

According to the NHS website, Parkinsons disease is thought to affect around one in every 500 people. The researchers found that people with epilepsy are 2.5 times more likely to be diagnosed with Parkinsons disease than the general population. This means for every 500 people with epilepsy, two or three people will go on to have a diagnosis of Parkinsons disease.

There is more information on this study on the JAMA Neurology website.

What Causes Parkinson Disease

Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts dont know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.

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