News for April 28th 2009
WHAT IS EPILEPSY? THE DEFINITION OF AN EPILEPTIC SEIZURE AND DOES EPILEPSY STOP?
In someone with established epilepsy, the EEG between seizures may also show abnormal discharges which are not apparent to the doctor in terms of observed behaviour, nor are they associated with any change perceived by the person with epilepsy. Although the abnormal discharges of the EEG are clearly a fragment, as it were, of a seizure, they are not usually regarded as seizures. Our definition of an epileptic seizure, therefore, is a paroxysmal discharge of cerebral nerve cells apparent to the person and/or an observer.
Anything which increases the excitability of a group of nerve cells may cause a paroxysmal discharge. For example certain gases or chemicals, developed for use in war, are designed to cause disabling seizures amongst the enemy.
Does epilepsy stop? There is one encouraging point that all those with epilepsy must remember—the number of people who have epilepsy at any one time is much less than those who have had epilepsy in the past. An approximate estimate of the average duration of epilepsy can be obtained by dividing the average prevalence by the average annual incidence. This gives a figure of about 11 years. However artificial this figure may be, it underlines the point that epilepsy can and does usually stop. A great number of people with epilepsy fare better.
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Edited: April 28th, 2009
SKIN PROBLEMS: CREEPING ERUPTION
Creeping eruption is the intensely itching skin disease caused by tiny parasitic worms (the larvae of insects) crawling around just under the surface of the skin. Wandering aimlessly, the larvae move about one inch daily, leaving irregular, red, slightly raised tracks in the skin rather like miniature mole tunnels.
Also known as Cutaneous Larva Migrans, this condition occurs when human skin is parasitized by the eggs of worms that normally infest other species (e.g: dog, cat, or cattle hookworms), the American Family Physician (35#6:163) reports. The same sort of situation arises when horse flies or deer flies lay eggs in human skin, but the resulting maggots that hatch and live there are much larger and cause “hot spot” lesions that resemble boils.
Larvae remain trapped under the surface of our skin only if their species are not adapted to ours. When “human” hookworms get into us, however, the larvae not only causes redness and irritation at the site of entry through the skin, but they soon move on through the bloodstream to the lungs (temporarily producing cough and bloody sputum) to settle ultimately in our intestines. There they develop into adult worms that cause us to bleed internally and become anemic. Only when parasites are in the wrong species are they unable to migrate and to complete their life cycles.
Fortunately, when any of these conditions is recognized, it can be cured with appropriate medications. The moral of this story, then, is to visit a dermatologist without delay if creams do not quickly take care of itchy red lesions of the skin.
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Edited: April 28th, 2009
HERPES SIMPLEX IN CHILDREN: SYMPTOMS, HOME CARE AND TREATMENT
Signs and symptoms
Oral herpes (type 1 infection) causes multiple ulcers of the membranes of the mouth (lips, cheeks, tongue, and palate) or the eyeballs. The ulcers are painful and are accompanied by painful, red, swollen gums and swollen lymph nodes in the neck. The child’s fever may climb to 40.6°C. The canker sores have a distinctive appearance and are easily distinguished from other mouth sores such as gumboils. Canker sores are open, red ulcers which have a scooped-out appearance, unlike gumboils which protrude above the surface of the membranes. When oral herpes appears as fever blisters, the blisters can be mistaken for impetigo. Fever blisters, however, are usually more painful. To confuse the diagnosis, fever blisters may become further infected with impetigo.
Oral herpes lasts seven to ten days, but the virus remains in the body and may cause recurrent outbreaks. This recurrent condition is contagious each time it appears.
Genital herpes (type 2 infection) causes painful ulcers and blisters on the genitals. Like oral herpes, genital herpes is contagious when the blisters are present and often recurrent.
Home care
For oral herpes, give aspirin or paracetamol to relieve pain. Have the child eat bland, soothing foods such as ice cream, gelatin desserts, puddings, and milk. Encourage an older child to rinse the mouth with a mild table salt solution. Canker sores can be treated in older children with triamcinolone in dental ointment form, or with thick solutions of local anesthetic available from the pharmacy. Antibiotic ointment applied to fever blisters may prevent painful cracking and lessen the chances of impetigo developing. For genital herpes, warm soaks help relieve inflammation and pain. There is a drug that has been used by adults to lessen the recurring attacks, but this drug has not been tested in children.
• Herpes simplex of the eyeball is serious and requires the immediate attention of an eye doctor.
• Herpes can be severe in an infant. Adults or children with herpes should be kept away from the baby. If a baby contracts herpes, consult a doctor.
• There is no cure for recurrent herpes.
Medical treatment
The doctor will probably prescribe eye drops to treat herpes of the eyeball. An experimental drug, Cytosine arabinoside (Ara-C) is available to treat life-threatening complications of herpes, such as may occur in infants. If a child with herpes has a severely ulcerated mouth, hospitalization may be necessary for intravenous fluids to be given until the child can swallow normally again.
A Caesarean section (delivery by surgery) may be performed in the case of a pregnant woman who has genital herpes and whose baby might be exposed to the disease during a normal delivery.
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Edited: April 28th, 2009