Neurologist/Epileptologist 🧠⚡️. Help you understand
#Epilepsy
in an easy and simple way. Educator, Entrepreneur. Content creator.
#NeuroTuber
tweets are mine
Do you know that goosebumps can be a
#Seizure
and it is usually arising from the temporal lobe. If one side only goosebumps then it is likely the same side temporal lobe (ipsilateral).
Epilepsy Myth:
Tongue swallow during the seizure ❌👅
It is anatomically impossible to swallow the tongue. During the seizure, DO NOT put anything in the patient’s mouth because it causes injuries. Just put them on the side and keep them safe...🧵
Keppra (Levetiracetam) is NOT for everyone. It is an easy target for ED and other doctors for any seizures. Keppra is a
#psychotoxic
in some patients with psychiatric background so we should choose carefully who to give it to. Avoid in any history of depression, anxiety, bipolar
When the patient is in a nonepileptic seizure (
#PNES
) they are in dissociation state and have no control, so please do not inflict painful stimulation to "wake them up" because they feel and can't respond. Just give them time and support.
#EpilepsyAwareness
#NeuroTwitter
The most under rated AED is
#Zonisamide
✅Broad spectrum treats all seizure types.
✅ given once a day
✅ causes weight loss
✅ decrease headache and intracranial pressure
✅✅Treats alcohol abuse decrease cravings
✅Very Cheap
❌🫘 stones, 🔽sweat, cognitive 🧠
#NeuroTwitter
#Seizures
≠
#Keppra
Keppra is
#psychotoxic
drug and should be avoided in patients with psychiatric history because it can get worse.
Almost daily I see patients put on Keppra as a reflex to seizures from ER or any encounter and come back depressed and angry.
#JustSaying
#Lacosamide
(
#Vimpat
) gets filtered in the kidney. In dialysis and renal failure it is recommended to decrease the target dose to 75% and REPLACE 50% of the regular dose after each dialysis. So if 100 mg bid, give 50 mg after dialysis.
#EpilepsyAwareness
#NeuroTuber
#NeuroTwitter
Israeli air force just bombarded a hospital full of patients and civilians in Gaza killing at least 500 people, mostly children and women after displacing them from their own homes. This is a masacare!
Wow!
@YouTube
recognized my content as high quality and from a reliable source. Great step to fight misinformation and keep the platform safe and reliable.
If
#Keppra
is causing depression and side effects then you can switch to
#Briviact
which has less side effects because it interacts less with NMDA system. Overnight switch 10:1 ratio. 1000 mg Keppra to 100 mg Briviact.
#NeutoTwitter
#EpilepsyAwareness
If one
#antiseizure
drug causes skin reaction, then others likely will do the same. Most common ones are the Aromatic antiepileptics Phenytoin, Carbamazepine, Lamotrigine, Phenobarbital, Oxcarbazepine, Zonisamide.
Risk is about a third. Here is a useful guide
New meta analysis showing risk of recurrence of Transient Global Amnesia
#TGA
of 1 in 8 patients (13%) which is a lot. Migraine, depression and occurrence after intercourse is a risk factor for recurrence
@AANMember
Excellent new article from my mentors at
@MayoClinic
.. Cenobamate might be helpful in generalized epilepsy. Now tested in Lennox-Gastute Syndrome and Dravet Syndrome and genetic generalized epilepsy with great success
Thousands of the
#Epilepsy
patients in Gaza are deprived of lifesaving treatment in this collective punishment against the innocent Palestinian civilians which is a war crime.
Prayers for Gaza 🙏
@AmEpilepsySoc
@EpilepsyFdn
It is possible that a strong seizure shuts down the brain 🧠 and that will stop sending signals to the lungs to breath and heart to work which causes death, stimulate the patient to prevent this and administer CPR of you see no pulse
I ask: ✅ "How often do you forget to take your medications?"
I usually get an honest answer.
I do not ask 🚫 "Do you take your medications?"
Which likely the answer will be "Yes" 🙄
Making a high quality and comprehensive video 🎞️ about
#Epilepsy
🧠 is a long process that can take months between preparation, filming, editing and publishing. It's all worth it!
#EpilepsyAwarenessMonth
There are 33000
#Epilepsy
patients in Gaza right now with no medications and are going into seizures and fatal status epilepticus.
The only advice they were given is to taper their medicine with whatever they had to avoid sudden withdrawal!
@AmEpilepsySoc
My holiday gift. A comprehensive guide on treatment for Nonepileptic Seizures
#PNES
#FND
that makes you an expert 😎. Works for patients, therapists and neurologists.
5 month of constant work 🧠 is finally done 👇🎞️
Happy that my
@YouTube
channel on
#Epilepsy
reached 25000 wonderful community. More than I can see in my lifetime as an Epilepsy doctor. But can impact the life of many online.
Transient Global Amnesia
#TGA
🧠 can happen multiple times. A recent large study from
@mayoneurores
showed recurrence in 13.7% of cases. 1 to 9 times and most had 3 or less events.
Over the phone 📞with the pharmacist:
"My name is Dr. Danoun"
💊:"spell that sir"
me: D as in Diazepam
A as in Aspirin
N as in Nicardipine
O as in Oxcarbazepine
U as in Urogepant
N as in Nimodipine
😎
I think he got it
⚠️The fact that the patient is aware and awake during the seizure, especially shaking the left side of the body, does not mean that the seizure is nonepileptic. same if the EEG is normal does not rule out focal aware seizures because it needs about 10 to 20 cm3 brain area 🧵...
What is the real cause of psychogenic nonepileptic seizures
#PNES
?
No, not stress, anxiety or depression.
It's a biological response to internal conflicts and it is a real condition.
Full review in this third video of the PNES series with Prof LaFrance:
Well said! Keppra is not for everyone. Yes it is easy to use which makes it a seductive choice for doctors "set it and forget it" but really we should look at the psychiatric background of the patient before starting Keppra
Now, everyone gets started on Keppra (Levetiracetam)
There is little consideration for worsening anxiety & depression, change in personality, and irritability.
A change in medications does not mean a change in risk.
Every medication has its own risk.
Choose wisely!
Successful Free
#Epilepsy
day in Palestine!
✅ Evaluated 37 patients
✅ Trained 8 medical students 🧑🏻⚕️and 2 junior doctors
✅ Performed media interviews 📺 about the new epilepsy treatments
✅ Gave hope and happiness to the community 🙏
Thanks
@IlaeWeb
Palestine for the support
What predicts the babie's IQ? NO it is not the father's IQ and not even the average of both parents. It is ONLY the mother's IQ. We learned this very well studying the cognitive effects of
#Epilepsy
treatments on the baby.
#JustSaying
😁
#NeuroTuber
#NeuroTwitter
When you see recurrent Transient Global Amnesia
#TGA
think about the possibility of Seizures with postictal Amnesia. It can be misleading. I had a case and finally diagnosed with
#Epilepsy
after having a GTC.
@rd_jacobson
It has to do with the organization of the autonomic function control system in the brain and it's connection to the body which is ipsilateral
Epilepsy myths:
Walking barefoot helps epilepsy. ❌
#Epilepsy
is not a static electricity that can be grounded. It is a neurological condition that affects the brain cells electricity.
#Keppra
is NOT for everyone who shakes, faints, gets confused or wanders without a clear cause. First you should not start AEDs just in case this was seizures and second Keppra is not for everyone because of all the psychiatric complications. Choose the AED wisely 🥸
Mechanism of action of Levetiracetam (Keppra) and the 2nd generation Brivaracetan (Briviact) is preventing excitatory neurotransmitters from getting out by blocking synaptic vesicle protein 2A (SV2A) which is the only ASM that does that!
Full explanation🔗
Neuropharmacology gurus!
Levetiracetam in ESRD on hemodialysis requires half dose supplement after dialysis. What is the case with Brivaracetam? Does it need extra dose? Will hemodialysis filter out BRV?
Tonic
#seizures
can lead to falls and are considered one of the most common seizure types leading to injury. Patients need to wear a helmet to protect the head.
Did you know about 21 million people worldwide are diagnosed with
#epilepsy
in 2021? Epilepsy’s pathophysiology involves the aberrant electrical activity of neurons in the brain. This typically stems from an imbalance between excitatory and inhibitory neurotransmitters, with
Today I got to volunteer for a research study in
#MEG
that our group is working on studying the brain changes in multiple sclerosis.
@HenryFordNeuro
@HenryFordNews
Psychogenic Nonepileptic Seizures
#PNES
is NOT:
😨"All in your head"
🤯"You are faking it"
😵 "Make it stop"
🤐 "You do it to get attention"
🚫 "Stop the drama"
it is REAL 🧠 and needs specific treatment.
#EpilepsyAwarenessMonth
#FND
Important question in
#epilepsy
is:
What is the best seizure detection watch ⌚?
Multiple options available. I discussed them in details with the world expert on seizure detection
@BenHBrinkmann
from
@MayoClinic
and Dr Krauss From
@HopkinsEpilepsy
🔗👇
Prayers with our innocent civilians in Gaza. The worst part is demonizing the victim to justify the masacar against them. The lies started about them and no one is fact checking what they claim. Thousands of people are being killed every day!
I love when I see my patients now and they already watched my
@YouTube
videos on
#Epilepsy
and they know a lot of helpful information. Makes the discussion much easier.
#EpilepsyAwareness
works!
I did not miss an AES meeting since I was PGY2, but this year I had to miss it due to unexpected emergency 😔. Greatful that I was still able to give my two EEG course lectures via video and participate in
#AES2022
... See you next year
We have a saying in Arabic that goes:
"Give your dough to the baker, even if he will eat half of your bread"
Comes in handy when referring to subspecialists
New study showed that cigarettes smoking has x4 increase risk of
#Seizures
in people with
#Epilepsy
Note: Varenicline (Chantix) might increase risk of Seizures so better to avoid it.
If your
#Epilepsy
is controlled then a neurologist will be great for you, if your seizures are not controlled, it's time to see the Epileptologist, they are the best for you,
#TotallyNotBiased
😎