Childhood arthritis is a disease that occurs in children under the age of 16. It causes pain, stiffness, and swelling in one or more of the joints. This pain, stiffness, and swelling are called inflammation. With childhood arthritis, the inflammation lasts longer than six weeks, and is not caused by an injury or other illness. Childhood arthritis is also called juvenile arthritis.
How common is childhood arthritis? It affects 1 in 1,000 US children under the age of 16.
Both boys and girls are affected by childhood arthritis. Arthritis is not just a disease of old people. In fact, approximately one in 1,000 children under the age of 16 suffers from arthritis. Juvenile arthritis is among the most common chronic childhood disorders.
What causes childhood arthritis?
The exact cause of childhood arthritis is unknown. Childhood arthritis does not usually run in families and cannot be passed from one person to another. The onset of childhood arthritis may follow an infection or injury, but these events do not cause the arthritis.
With childhood arthritis, the body’s immune system stops working properly. The immune system’s job is to fight off germs and disease. However, in a child with childhood arthritis the immune system attacks healthy tissues. What triggers this process is unknown.
What can you do about childhood arthritis? If your child has inflammation, in one or more joints for more than six weeks your doctor may perform a physical examination of your child and order tests, such as x-rays and blood tests to find out what is causing the inflammation. There is not just one single symptom, sign, or test that will give a diagnosis of childhood arthritis.
If your doctor thinks your child has childhood arthritis, he or she will usually refer your child to a rheumatologist (pronounced room-a-tol-o-jist). A rheumatologist is a doctor who has received special training in the diagnosis and treatment of problems involving inflammation of the joints, muscles and other parts of the body.
Problems managing anger has always been a concern for patients suffering from addictive disorders. Pioneering research by my mentor, Dr. Sidney Cohen at the UCLA Neuropsychiatric Institute demonstrated the relationship between, anger, violence and the use of alcohol and or cocaine. One of the most popular articles written by Dr. Cohen, was entitled, “Alcohol, the most dangerous drug known to man”. In this and other publications, Dr. Cohen systematically demonstrated the causal relationship between cocaine and alcohol abuse and aggression. Much of this research was done in the 70s and 80s.
Anger has always been a factor in substance abuse intervention. Unfortunately, until recently, it has been overlooked or treated as an after thought by substance abuse programs nationwide. Substance use and abuse often coexist with anger, aggressive behavior and person-directed violence. Data from the Substance Abuse and Mental Health Administration’s National Household Survey on Drug Abuse indicated that 40 % of frequent cocaine users reported engaging in some form of violence or aggressive behavior. Anger and aggression often can have a causal role in the initiation of drug and alcohol use and can also be a consequence associated with substance abuse. Persons who experience traumatic events, for example, often experience anger and act violently, as well as abuse drugs or alcohol. This is currently occurring with recently returned combat veterans from Iraq.
ANGER AND SUBSTANCE ABUSE
Substance abuse and dependence has grown beyond even the bleakest predictions of the past. In the United States alone, there are an estimated 23 million people who are struggling (on a daily basis) with some form of substance abuse or dependence. The toll it is having on our society is dramatically increased when we factor in the number of families who suffer the consequences of living with a person with an addiction, such as:
o Job loss
o Incarceration
o Loss of child Custody
o DUI’s
o Domestic Violence/Aggression
o Marital problems/divorce
o Accidents/injuries
o Financial problems
o Depression/anxiety/chronic anger
Unfortunately, most substance abusers may not even be aware that they have an underlying anger problem and do not “connect” their anger problem to their alcoholism, drug addiction and substance abuse. Therefore, they do not seek (or get) help for their anger problem. But more often than not, their anger is the underlying source of their disorder.
Anger precedes the use of cocaine and alcohol for many alcohol and cocaine dependent individuals. Anger is an emotional and mental form of “suffering” that occurs whenever our desires and expectations of life, others or self are thwarted or unfulfilled. Addictive behavior and substance abuse is an addict’s way of relieving themselves of the agony of their anger by “numbing” themselves with drugs, alcohol and so on. This is not “managing their anger”, but self medication.
When we do not know how to manage our anger appropriately, we try to keep the anger inside ourselves. Over time, it festers and often gives rise to even more painful emotions, such as depression and anxiety. Thus, the individual has now created an additional problem for themselves besides their substance abuse, and must be treated with an additional disorder. Several clinical studies have demonstrated that anger management intervention for individuals with substance abuse problems is very effective in reducing or altogether eliminating a relapse.
Medical research has found that alcohol, cocaine and methamphetamine dependence are medical diseases associated with biochemical changes in the brain. Traditional treatment approaches for drug and alcohol dependency focus mainly on group therapy and cognitive behavior modification, which very often does not deal with either the anger or the “physiological” components underlying the addictive behavior.
Anger precedes the use of cocaine for many cocaine-dependent individuals; thus, cocaine-dependent individuals who experience frequent and intense episodes of anger may be more likely to relapse to cocaine use than individuals who can control their anger effectively. Several clinical trials have demonstrated that cognitive-behavioral interventions for the treatment of mood and anxiety disorders can be used to help individuals with anger control problems reduce the frequency and intensity with which they experience anger.
Although studies have indirectly examined anger management group treatments in populations with a high prevalence of substance abuse, few studies have directly examined the efficacy of an anger management treatment for cocaine-dependent individuals. A number of studies demonstrating the effectiveness of an anger management treatment in a sample of participants who had a primary diagnosis of post-traumatic stress disorder have been conducted by the Department of Veterans Affairs. Although many participants in these studies had a history of drug or alcohol dependence, the sample was not selected based on inclusion criteria for a substance dependence disorder, such as cocaine dependence. Considering the possible mediating role of anger for substance abuse, a study examining the efficacy of anger management treatment in a sample of cocaine-dependent patients would be informative.
Anger management as an after thought
In spite of the information available to all professional substance abuse treatment providers, anger management has not received the attention which is deserved and needed for successful substance abuse treatment. Many if not most substance abuse programs claim to offer anger management as one of the topics in its treatment yet few substance abuse counseling programs include anger certification for these counselors.
Typically, new substance abuse counselors are simply told that they will need to teach a certain numbers of hours or sessions on anger management and then left to find there own anger management information and teaching material. These counselors tend to piece together whatever they can find and present it as anger management.
Despite the connection of anger and violence to substance abuse, few substance abuse providers have attempted to either connect the two or provide intervention for both. In the Los Angeles area, a number of primarily upscale residential rehab programs for drug and alcohol treatment have contracted with Certified Anger Management Providers to offer anger management either in groups on an individual basis for inpatient substance abuse clients. Malibu based Promises (which caters to the stars) has contracted with Certified Providers to offer anger management on an individual coaching bases.
It may also be of interest to note that SAMSHA has published an excellent client workbook along with teacher’s manual entitled, Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual [and] Participant Workbook.
This publication free and any program can order as many copies as needed without cost. There is simply no excuse for shortchanging substance abuse clients by not providing real anger management classes.
Limited anger management research
What has been offered as anger management in substance abuse programs has lacked integrity. The Canadian Bureau of Prisons has conducted a 15 year longitudinal study on the effectiveness of anger management classes for incarcerated defendants whose original crime included substance abuse, aggression and violence. One of first findings was that in order to be useful, the anger management model used must have integrity. Integrity is defined as using a client workbook containing all of the material needed for an anger management class, consistency among trainers in terms of how the material is taught and a pre and post test to document change made by clients who complete the class.
It is not possible to determine the effective of anger management which is fragmented and not based on any particular structure of theoretical base.
Anger management training is rarely integrated into substance abuse treatment
At the present time, anger management is rarely integrated into any model of substance abuse intervention. Rather, it is simply filler tacked on to a standard twelve step program,
Trends in anger management and substance abuse treatment.
Several years ago, the California state legislature established statewide guidelines for all state and locally supported substance abuse programs. This legislation is included in what is commonly referred to as proposition 36. As a result of this legislation, all substance abuse counselors must have documented training in anger management facilitator certification. This training requires 40 hours of core training plus 16 hours of continuing anger management education of a yearly basis.
What is Anger Management?
Anger management is rapidly becoming the most requested intervention in human services. It may be worthwhile to define what anger management is and is not. According to the American Psychiatric Association, anger is a normal human emotion. It is not a pathological condition therefore; it is not listed as a defined illness in the Diagnostic and Statistical Manual of Nervous and Mental Disorders. Rather, anger is considered a lifestyle issue. This means that psychotherapy or psychotropic medication is not an appropriate intervention for teaching skills for managing anger.
The American Association of Anger Management Providers defines anger management as a skill enhancement course which teaches skills in recognizing and managing anger, stress, assertive communication and emotional intelligence. Anger is seen a normal human emotion which is a problem when it occurs too frequently, lasts too long,
Performance characteristics of Paranoid personality Disorder
1. Widespread suspicion. Involuntary, non-despiteful actions are often misinterpreted as hostility or discrimination. They suspect that they will be hurt without sufficient basis and act with inordinate vigilance and defense.
2. Things around are interpreted as the “conspiracy” which does not meet the actual situation.
3. Easy to produce morbid jealousy.
4. Conceited excessively. They always think they are right. They attribute frustration or failure to others.
5. They often hate others and can not tolerate other people’s wrong.
6. They often argue and antagonize others. They often pursue unreasonable rights or interests stubbornly.
7. Neglect or mis-doubt the facts that are not accordant with their thought. So it is difficult to change their thought through truth and principle.
Paranoid personality disorder Treatment
1. Be aware of performance characteristics of paranoid personality disorder. Build up a right and objective awareness of self and voluntarily generate requests of changing personality defects. This is a further prerequisite for psychotherapy.
2. Go into training of making friends. Learn to trust others and eliminate a sense of unease. The principles and essentials are following.
(1) Maintain a positive attitude in good faith towards making friends. Believe that most people are friendly and reliable. Never maintain a distrustful and highly subjective attitude towards your friends. It must be pointed out that the purpose of making friends is to seek friendship and help, share thoughts and feelings, and overcome paranoid personality disorder.
(2) Try your best to help your friends actively especially when they are in trouble. This helps to get each other’s trust and consolidate the friendship. A friend is best found in adversity.
(3) Similar personality and temperament help psychological compatibility and improve friendship. In addition, gender, age, occupation, cultural education, economic level, social status and hobbies are also psychological compatibility issues. This is a psychological basis for consolidating cooperation and friendship.
3. Self therapy. People with paranoid personality often run to an extreme, which is associated with the irrational beliefs. Therefore, in order to change the paranoid personality, analyzing self irrational beliefs is very important.
(1) I can not tolerate a shred of treachery.
(2) There is no good person in the world. I only believe in myself.
(3) As for other people’s offensive, I must launch a strong counterattack and let them know that I am stronger than them.
(4) I will never show gentleness because it may give people the feeling that I am not strong enough.
Now make over these concepts and remove extreme elements.
(1) I am not King; occasional treachery should be forgiven.
(2) Good guys and bad guys still exist in this world, and I should trust those who are nice.
(3) As for other people’s offensive, it may not be the best way of launching an immediate counterattack. What is more, I must discern whether I am under a real attack.
(4) I dare not express my true emotion, and this fact per se is a representation of weakness.
Once relapse comes to you, rational concepts I have mentioned above should be meditated in order to prevent extreme behaviors.
4. Go into training of correcting hostility and distrust. People with paranoid personality often express hostility and distrust to people around them. Following trainings are helpful to overcome this mentality.
(1) Constantly remind yourself not trapped in the vortex of hostility. This will significantly reduce the hostility and psychological reaction.
(2) Understand that a good relationship is based on mutual respect. Learn to thank people for their help to you.
(3) Learn to smile on everyone you know. You may not get used to that at the beginning or do it unnaturally, but you must do it and do it well.
(4) Learn to be tolerant and patient in life. Making a living in such a complex world, conflicts, disputes, and frictions are inevitable. At this time, you must be patient and restrained. Never let yourself be burned with confusion and irascibility.
I focus on relationships and mental health. You can find many answers form my blog – www.justrealm.com.
Let’s be honest. Television and Internet media are replete with stories about missing or deceased women and sociopathic men. Either there are more sociopaths in the world or the media is covering it more. Either way, it’s unsettling, especially to single women.
Single women (especially previously-married ones) are prime pickin’s for married men and sociopaths. As a not-unattractive female who’s divorced, and a person who minored in psychology and earned two degrees, I have gathered enough education and personal experience to know what I’m saying is true. And as a former counselor, counseling mostly females, I’ve heard enough stories to fill a book.
Just in case you’re thinking, “Hey, wait! Not all married men are sociopaths!” let me concur. But do you know which ones are? That is the point of this article! What is a sociopath?
Using the official diagnostic version from The DSM-IV-TR® and The American Journal of Psychiatry (diagnostic manuals) and my own training and experience, here’s some help in understanding the sociopath.
Essentially, a sociopath will glibly lie, charm and use others, without a moment’s remorse over hurting anyone.
They’re often, but not always, more charismatic, charming and sexy than the average person.
Sociopaths can feign every kind of emotion; yet they know only “feral” [wild, savage, deadly] pleasures.
Sociopaths find rewards in the hunt.
Their joys are in conquest and in winning.
They understand love, know how to manipulate it, but can not feel either love or empathy.
They have a Grandiose Sense of Self.
They feel entitled to certain things as “their right.”
Shallow Emotions are all they have!
When they show what seems to be warmth, joy, love and compassion it is more feigned than experienced and serves an ulterior motive. They are outraged by insignificant matters, yet remain unmoved and cold by what would upset a normal person. Since they are not genuine, neither are their promises!
Manipulative and Conning, oh yeah!
They never recognize the rights of others and see their self-serving behaviors as permissible. They appear to be charming, yet are covertly hostile and domineering, seeing their victim as merely an instrument to be used. They may eventually dominate and humiliate their victims.
When I think “sociopath” I think of Ted Bundy and Scott Peterson; however, not all sociopaths are murderers! I had decades of close exposure to a sociopath who destroyed everyone who cared about him, and there’s not a hint of remorse in his behavior, attitude, or conversation. As a matter of interest, this particular person talks like he has been victimized by everyone in his life! Each woman he has had a relationship with in the last seven years has eventually tired of his bid for pity and his hair-trigger temper and each one has exited rapidly.
The problem with honest, decent people is that we don’t expect others to be dangerous or predatory.Since we don’t expect it, we don’t see it even when it’s right in front of us. So let’s talk about the weaknesses of lonely, trusting, unmarried women.
In case you’re thinking, “What does this have to do with my life?” here’s an example. Let’s say you, like me, are a Christian woman who has met a man who professes to also be a Christian. Here are some questions you can ask yourself, as I have:
Have I lost my in-loveness with God? Juggling all the demands of parenting, job, maintaining a house, a yard, and possibly a pet can leave a woman emotionally depleted. Meeting that charming “Christian” who makes me feel like a woman again is mighty tempting! Do I find myself assuming that the answer lay in some man, some adventure, or some emotional “rush”? Am I so needy that I am now vulnerable?
Is he doing the hard work of healing, or does he wear his hurt like a badge? Do I ever get the sense that he has submitted his life and will to God? Has he forgiven those who hurt him? Are there any signs that he is learning or growing, or is he constantly playing for my pity?
Am I more interested in romance than relationship? Does this man appear to be my ideal, my fantasy, my answer to an inner craving for attention? Am I tempted to chuck reality in favor of feeling flirty, experiencing intense passion, and escaping from the mundane, ordinariness of life?
Although I feel desired, do I feel affirmed, valued and honored? In short, are my dreams less important to him than my body? Does he affirm my dreams and treasure my personhood – all that I am, with my shadow side, imperfections and ordinariness?
Am I more attracted to his persona than to his character? Yes, he’s funny, charming, intelligent, and successful. And his moves! Oh, my goodness! It’s hard to forget those moves, and it seems to be dominating my thinking. Is who I am getting lost in this frenetic high?
Is he living up to his commitments or making promises he doesn’t keep? Is he doingjust enough to earn my trust, so that when my suspicions are raised, I feel foolish pressing for answers?
Do I feel free to voice my questions? Has he given me his home address or phone number? Can he meet me for real dates, or only for an hour and always before an “important meeting”? Does he take me only to lunch, but never to dinner? Does he return cell phone calls any time, even on the weekends? Does he give me excuses for not being available on holidays, like, “I’m visiting my 85 year old mother out-of-state.”?
Does my “gut” know something is off? If so, have I called the church he attends to see if his recent address still lists him as married? Have I checked for the divorce record at the county clerk building? Have I questioned others about his singleness?
Do I feel I’m losing my dignity? Little things add up: Do I feel “less than” when he leaves? Do I find self-doubt increasing inside myself? Does he have a cute little way of belittling me in front of others? Are his jokes derisive of women?
If you ask yourself these questions and your “gut” is telling you something is not right, do as I have done: run as fast as you can in the opposite direction! Yes, we are luckier than those women who have been murdered by sociopaths; however, may I remind you that there are many forms of death? A man who kills my spirit, robs me of my dignity and my will to live is just as dangerous, in my book! And if I marry him? Well, I don’t think I have to spell out that one!
If you’d like to learn more about the traits of sociopaths, written in simple layman language, I recommend The Sociopath Next Door by Martha Stout, PhD (a psychotherapist with a knack for writing great books).
Dr. Stout says that as many as 4% of the population are conscienceless sociopaths who have no empathy or affectionate feelings for humans or animals. [Other sources say one in 5 of our population are sociopaths.] As Dr. Stout (The Myth of Sanity) explains, a sociopath is defined as someone who displays at least three of fifteen distinguishing characteristics, such as
deceitfulness,
impulsivity and
a lack of remorse.
Such people often have a superficial charm, which they exercise ruthlessly in order to get what they want.
Dr Stout offers these guidelines for your protection:
o In a contest between your instincts and what is implied by the role a person has taken on-as educator, doctor, boss-go with your instincts!
o When considering a new relationship of any kind, practice the rule of threes: one lie, one broken promise, one neglected responsibility may be a misunderstanding. Three says you’re dealing with a liar, and deceit is the linchpin of conscience-less behavior. Do not give your money, your work, your secrets or your affections to a three-timer!
o Suspect flattery. It is the material of counterfeit charm and nearly always involves an intention to manipulate.
o If necessary, redefine your concept of respect. Do not mistake your fear, anxiety or awe for respect. Respect should be reserved for those who are strong, kind and morally courageous.
o Remember what is really important: protecting yourself. You may never be able to make your friends or family understand why you are avoiding a particular person. Avoid him anyway.
o Question your tendency to pity too easily. Pity should be reserved for innocent people, not those who actively campaign for your sympathy. [Have you heard of codependency?]
o Challenge your need to be polite in all circumstances. Do not be afraid to be unsmiling and calmly to the point.
Girls, the bottom line is be self-aware and self-protective. And above all, don’t expect any man to fill all your needs. That only makes you more vulnerable to the unscrupulous men out there. Have a wide circle of friends, stay involved in church and other group activities, and don’t forget Who you can trust the most. Don’t lose touch with Him! I know, from experience, He will protect you.
April Lorier is an award-winning poet, writer, Author, Christian Speaker, Columnist, and former music teacher.
As a pastor’s daughter and a survivor of severe child abuse, April Lorier has an intimate knowledge of child abuse in and out of the church. She founded COPE, Inc, for the retraining of abusive parents. Her testimony before the CA State Legislature helped with the passage of The Child Abuse and Neglect Reporting Act (CANRA), signed by Ronald Reagan.
Her autobiography, “GOD’S BATTERED CHILD: Journey from Abuse to Leader” (2007) is available at Amazon, B & Nobles, Target and at gods-girl.com
Enjoying her swing (Education Read West Syndrome – Infantile Spasms) Image by Photography By Shaeree
Paige was diagnosed with West syndrome or West’s Syndrome (September 2010) it is an uncommon to rare epileptic disorder in infants.
The syndrome is age-related, generally occurring between the third and the twelfth month, generally manifesting around the fifth month. There are various causes ("polyetiology"). The syndrome is often caused by an organic brain dysfunction whose origins may be prenatal, perinatal (caused during birth) or postnatal.
It is either Cryptogenic or Idiopathic.
Cryptogenic
When a direct cause cannot be determined but the child has other neurological disorder, the case is referred to as cryptogenic West syndrome, where an underlying cause is most likely but, even with modern means, cannot be detected. Currently the cryptogenic group is often combined with idiopathic while referred to as "cryptogenic".
Sometimes multiple children within the same family develop West syndrome. In this case it is also referred to as cryptogenic, in which genetic and sometimes hereditary influences play a role. There are known cases in which West syndrome appears in successive generations in boys; this has to do with X-chromosomal heredity.
[edit] Idiopathic
Occasionally the syndrome is referred to as idiopathic West syndrome, when a cause cannot be determined. Important diagnostic criteria are:
Regular development until the onset of the attacks or before the beginning of the therapy no pathological findings in neurological or neuroradiological studies no evidence of a trigger for the spasms
Those are becoming rare due to modern medicine.
Clinical presentation
The epileptic seizures which can be observed in infants with West syndrome fall into three categories, collectively known as infantile spasms. Typically, the following triad of attack types appears; while the three types usually appear simultaneously, they also can occur independently of each other:
Lightning attacks: Sudden, severe myoclonic convulsions of the entire body or several parts of the body in split seconds, and the legs in particular are bent (flexor muscle convulsions here are generally more severe than extensor ones).
Nodding attacks: Convulsions of the throat and neck flexor muscles, during which the chin is fitfully jerked towards the breast or the head is drawn inward.
Salaam or jackknife attacks: a flexor spasm with rapid bending of the head and torso forward and simultaneous raising and bending of the arms while partially drawing the hands together in front of the chest and/or flailing. If one imagined this act in slow motion, it would appear similar to the oriental ceremonial greeting (Salaam), from which this type of attack derives its name.
Paige was first put on Vigabatrin which she outgrew a month later. She was admitted again into Kingston General Hospital to begin a treatment called ACTH.
Therapy
Compared with other forms of epilepsy, West syndrome is difficult to treat. To raise the chance of successful treatment and keep down the risk of longer-lasting effects, it is very important that the condition is diagnosed as early as possible and that treatment begins straight away. However, there is no guarantee that therapy will work even in this case.
Insufficient research has yet been carried out into whether the form of treatment has an effect upon the long-term prognosis. Based on what is known today, the prognosis depends mainly on the cause of the attacks and the length of time that hypsarrhythmia lasts. In general it can be said that the prognosis is worse when the patient does not react as well to therapy and the epileptic over-activity in the brain continues. Treatment differs in each individual case and depends on the cause of the West syndrome (etiological classification) and the state of brain development at the time of the damage.
Due to their side-effects, two drugs are currently being used as the first-line treatment: ACTH and Vigabatrin.
[edit] ACTH
ACTH – Use primarily in United States
Side effects are: Weight gain, especially in the trunk and face, hypertension, metabolic abnormalities, severe irritability, osteoporosis, sepsis, and congestive heart failure.
[edit] Vigabatrin
Vigabatrin (Sabril) – Approved in several countries, including most of Europe, Canada, Mexico, and more recently the United States.
Side effects are: Somnolence, headache, dizziness, fatigue, weight gain, decreased vision or other vision changes
Vigabatrin is known for being effective, especially in children with tuberous sclerosis, with few and benign side effects. But due to some recent studies[4] showing visual field constriction (loss of peripheral vision), it was not approved in the United States until mid-2009. It is currently debated that a short use (6 months or less) of Vigabatrin will not affect vision. Also, considering the effect of frequent seizures on day to day life and mental development, some parents prefer to take the risk of some vision loss.
Other
When those two are proving ineffective, other drugs may be used in conjunction or alone. From those, corticosteroids (prednisone) are often used. In Japan, there is a good experience with pyridoxine therapy. Further, topiramate (Topamax), lamotrigine (Lamictal), levetiracetam (Keppra) and zonisamide (Zonegran) are amongst those drugs most widely used.
The ketogenic diet has been shown to be effective in treating infantile spams,[5] up to 70% of children having a 50% or more reduction in seizure.
I have uploaded videos for those who wonder what the Syndrome is and looks like.
I posted pictures of my beautiful baby girl because people need to understand being chubby or overweight may not always be caused by overfeeding. My daughters was caused by the ACTH treatment which is a steroid.
Sisterly Love – Even When Her Sister was sick her big sister was right there. Image by Photography By Shaeree
Paige was diagnosed with West syndrome or West’s Syndrome (September 2010) it is an uncommon to rare epileptic disorder in infants.
The syndrome is age-related, generally occurring between the third and the twelfth month, generally manifesting around the fifth month. There are various causes ("polyetiology"). The syndrome is often caused by an organic brain dysfunction whose origins may be prenatal, perinatal (caused during birth) or postnatal.
It is either Cryptogenic or Idiopathic.
Cryptogenic
When a direct cause cannot be determined but the child has other neurological disorder, the case is referred to as cryptogenic West syndrome, where an underlying cause is most likely but, even with modern means, cannot be detected. Currently the cryptogenic group is often combined with idiopathic while referred to as "cryptogenic".
Sometimes multiple children within the same family develop West syndrome. In this case it is also referred to as cryptogenic, in which genetic and sometimes hereditary influences play a role. There are known cases in which West syndrome appears in successive generations in boys; this has to do with X-chromosomal heredity.
[edit] Idiopathic
Occasionally the syndrome is referred to as idiopathic West syndrome, when a cause cannot be determined. Important diagnostic criteria are:
Regular development until the onset of the attacks or before the beginning of the therapy no pathological findings in neurological or neuroradiological studies no evidence of a trigger for the spasms
Those are becoming rare due to modern medicine.
Clinical presentation
The epileptic seizures which can be observed in infants with West syndrome fall into three categories, collectively known as infantile spasms. Typically, the following triad of attack types appears; while the three types usually appear simultaneously, they also can occur independently of each other:
Lightning attacks: Sudden, severe myoclonic convulsions of the entire body or several parts of the body in split seconds, and the legs in particular are bent (flexor muscle convulsions here are generally more severe than extensor ones).
Nodding attacks: Convulsions of the throat and neck flexor muscles, during which the chin is fitfully jerked towards the breast or the head is drawn inward.
Salaam or jackknife attacks: a flexor spasm with rapid bending of the head and torso forward and simultaneous raising and bending of the arms while partially drawing the hands together in front of the chest and/or flailing. If one imagined this act in slow motion, it would appear similar to the oriental ceremonial greeting (Salaam), from which this type of attack derives its name.
Paige was first put on Vigabatrin which she outgrew a month later. She was admitted again into Kingston General Hospital to begin a treatment called ACTH.
Therapy
Compared with other forms of epilepsy, West syndrome is difficult to treat. To raise the chance of successful treatment and keep down the risk of longer-lasting effects, it is very important that the condition is diagnosed as early as possible and that treatment begins straight away. However, there is no guarantee that therapy will work even in this case.
Insufficient research has yet been carried out into whether the form of treatment has an effect upon the long-term prognosis. Based on what is known today, the prognosis depends mainly on the cause of the attacks and the length of time that hypsarrhythmia lasts. In general it can be said that the prognosis is worse when the patient does not react as well to therapy and the epileptic over-activity in the brain continues. Treatment differs in each individual case and depends on the cause of the West syndrome (etiological classification) and the state of brain development at the time of the damage.
Due to their side-effects, two drugs are currently being used as the first-line treatment: ACTH and Vigabatrin.
[edit] ACTH
ACTH – Use primarily in United States
Side effects are: Weight gain, especially in the trunk and face, hypertension, metabolic abnormalities, severe irritability, osteoporosis, sepsis, and congestive heart failure.
[edit] Vigabatrin
Vigabatrin (Sabril) – Approved in several countries, including most of Europe, Canada, Mexico, and more recently the United States.
Side effects are: Somnolence, headache, dizziness, fatigue, weight gain, decreased vision or other vision changes
Vigabatrin is known for being effective, especially in children with tuberous sclerosis, with few and benign side effects. But due to some recent studies[4] showing visual field constriction (loss of peripheral vision), it was not approved in the United States until mid-2009. It is currently debated that a short use (6 months or less) of Vigabatrin will not affect vision. Also, considering the effect of frequent seizures on day to day life and mental development, some parents prefer to take the risk of some vision loss.
Other
When those two are proving ineffective, other drugs may be used in conjunction or alone. From those, corticosteroids (prednisone) are often used. In Japan, there is a good experience with pyridoxine therapy. Further, topiramate (Topamax), lamotrigine (Lamictal), levetiracetam (Keppra) and zonisamide (Zonegran) are amongst those drugs most widely used.
The ketogenic diet has been shown to be effective in treating infantile spams,[5] up to 70% of children having a 50% or more reduction in seizure.
I have uploaded videos for those who wonder what the Syndrome is and looks like.
I posted pictures of my beautiful baby girl because people need to understand being chubby or overweight may not always be caused by overfeeding. My daughters was caused by the ACTH treatment which is a steroid.
Enjoying My Rocking Chair (Educational Read) Image by Photography By Shaeree
Paige was diagnosed with West syndrome or West’s Syndrome (September 2010) it is an uncommon to rare epileptic disorder in infants.
The syndrome is age-related, generally occurring between the third and the twelfth month, generally manifesting around the fifth month. There are various causes ("polyetiology"). The syndrome is often caused by an organic brain dysfunction whose origins may be prenatal, perinatal (caused during birth) or postnatal.
It is either Cryptogenic or Idiopathic.
Cryptogenic
When a direct cause cannot be determined but the child has other neurological disorder, the case is referred to as cryptogenic West syndrome, where an underlying cause is most likely but, even with modern means, cannot be detected. Currently the cryptogenic group is often combined with idiopathic while referred to as "cryptogenic".
Sometimes multiple children within the same family develop West syndrome. In this case it is also referred to as cryptogenic, in which genetic and sometimes hereditary influences play a role. There are known cases in which West syndrome appears in successive generations in boys; this has to do with X-chromosomal heredity.
[edit] Idiopathic
Occasionally the syndrome is referred to as idiopathic West syndrome, when a cause cannot be determined. Important diagnostic criteria are:
Regular development until the onset of the attacks or before the beginning of the therapy no pathological findings in neurological or neuroradiological studies no evidence of a trigger for the spasms
Those are becoming rare due to modern medicine.
Clinical presentation
The epileptic seizures which can be observed in infants with West syndrome fall into three categories, collectively known as infantile spasms. Typically, the following triad of attack types appears; while the three types usually appear simultaneously, they also can occur independently of each other:
Lightning attacks: Sudden, severe myoclonic convulsions of the entire body or several parts of the body in split seconds, and the legs in particular are bent (flexor muscle convulsions here are generally more severe than extensor ones).
Nodding attacks: Convulsions of the throat and neck flexor muscles, during which the chin is fitfully jerked towards the breast or the head is drawn inward.
Salaam or jackknife attacks: a flexor spasm with rapid bending of the head and torso forward and simultaneous raising and bending of the arms while partially drawing the hands together in front of the chest and/or flailing. If one imagined this act in slow motion, it would appear similar to the oriental ceremonial greeting (Salaam), from which this type of attack derives its name.
Paige was first put on Vigabatrin which she outgrew a month later. She was admitted again into Kingston General Hospital to begin a treatment called ACTH.
Therapy
Compared with other forms of epilepsy, West syndrome is difficult to treat. To raise the chance of successful treatment and keep down the risk of longer-lasting effects, it is very important that the condition is diagnosed as early as possible and that treatment begins straight away. However, there is no guarantee that therapy will work even in this case.
Insufficient research has yet been carried out into whether the form of treatment has an effect upon the long-term prognosis. Based on what is known today, the prognosis depends mainly on the cause of the attacks and the length of time that hypsarrhythmia lasts. In general it can be said that the prognosis is worse when the patient does not react as well to therapy and the epileptic over-activity in the brain continues. Treatment differs in each individual case and depends on the cause of the West syndrome (etiological classification) and the state of brain development at the time of the damage.
Due to their side-effects, two drugs are currently being used as the first-line treatment: ACTH and Vigabatrin.
[edit] ACTH
ACTH – Use primarily in United States
Side effects are: Weight gain, especially in the trunk and face, hypertension, metabolic abnormalities, severe irritability, osteoporosis, sepsis, and congestive heart failure.
[edit] Vigabatrin
Vigabatrin (Sabril) – Approved in several countries, including most of Europe, Canada, Mexico, and more recently the United States.
Side effects are: Somnolence, headache, dizziness, fatigue, weight gain, decreased vision or other vision changes
Vigabatrin is known for being effective, especially in children with tuberous sclerosis, with few and benign side effects. But due to some recent studies[4] showing visual field constriction (loss of peripheral vision), it was not approved in the United States until mid-2009. It is currently debated that a short use (6 months or less) of Vigabatrin will not affect vision. Also, considering the effect of frequent seizures on day to day life and mental development, some parents prefer to take the risk of some vision loss.
Other
When those two are proving ineffective, other drugs may be used in conjunction or alone. From those, corticosteroids (prednisone) are often used. In Japan, there is a good experience with pyridoxine therapy. Further, topiramate (Topamax), lamotrigine (Lamictal), levetiracetam (Keppra) and zonisamide (Zonegran) are amongst those drugs most widely used.
The ketogenic diet has been shown to be effective in treating infantile spams,[5] up to 70% of children having a 50% or more reduction in seizure.
I have uploaded videos for those who wonder what the Syndrome is and looks like.
I posted pictures of my beautiful baby girl because people need to understand being chubby or overweight may not always be caused by overfeeding. My daughters was caused by the ACTH treatment which is a steroid.
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