"Only dull people are brilliant at breakfast" -Oscar Wilde |
"The liberal soul shall be made fat, and he that watereth, shall be watered also himself." -- Proverbs 11:25 |
“I would recommend taking medication,” Dr. Barkley said. “The intervals tend to get shorter and shorter, and people tend to have recurrent seizures.”
He explained: “The brain learns from practice. The more you practice, the better you get, whether you’re playing the piano or having seizures. The more you have, the more you’re going to have. Most neurologists feel that the best way to intervene is to get the seizures under control as quickly as possible.”
Dr. Robert S. Fisher, director of the epilepsy center at Stanford University and a past president of the American Epilepsy Society, said: “In my view, it would be reasonable not to treat. It sounds like he went 14 years between seizures, and that’s a lot of pills to take to prevent the next seizure 14 years from now. The new ones are better than the old ones in terms of side effects, but they all have potential side effects and risks.”
Doctors say a complete medical workup is needed to find out if the two reported seizures were really the only ones that have occurred, because people with epilepsy can have mild seizures that they are not aware of. Neurologists often ask family members whether patients have certain symptoms, like daydreaming or blanking out for brief intervals, and not snapping out of it when others try to speak to them. Other symptoms may include dizziness, sensations in the stomach, feelings of déjà vu or noticing odd smells or tastes in the mouth — experiences that the patient may not recognize as seizures.
Often, Dr. Barkley said, a patient will report having had one seizure, but when asked about these other symptoms will say, “Oh, yes, that happens all the time.”
If such symptoms are frequent, it may sway the decision in favor of treatment.
Dr. Cynthia L. Harden, a professor of neurology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, said it would be important to perform brain-wave studies to look for abnormal electrical activity in the brain, to get an idea of where the seizures may be starting and how frequent they are.
Dr. Harden said such studies during sleep were especially useful, and could help in making the decision about treatment. In people with epilepsy, Dr. Harden said, sleep deprivation can be a potent cause of seizures. The chief justice has had a busy schedule recently, including a two-week trip to Europe during which he attended conferences and taught.
Labels: health, JOhn Roberts