A study published September 2014 in the Journal of Neurology, Neurosurgery, and Psychiatry tested 24 patients with medication-resistant epilepsy. Patients who used 3 capsules of fish oil daily had fewer seizures than those who took placebo and also those who took 6 capsules of fish oil daily. Two people using the 3-capsule dose were in fact seizure-free during the 10-week trial. This is a small patient group and results are preliminary, but using 3 capsules of fish oil daily seems safe and reasonable.
According to a study published in the British Medical Journal, September 2014, use of benzodiazepines for 3 months or more is associated with increased risk of developing Alzheimer’s, with longer exposures increasing the risks. Drugs with longer half-lives, such as diazepam and clonazepam, had a greater risk than shorter-acting drugs such as lorazepam and alprazolam. These findings were adjusted for symptoms that could indicate a future dementia diagnosis, including depression, anxiety, and insomnia, which are some of the main reasons for use of these drugs. The association was seen in patients on benzodiazepines 5 years or fewer before the Alzheimer’s diagnosis. Use of these drugs in the elderly should be limited, according to the researchers.
As many as 50% of Parkinson’s patients develop dementia, usually late in the course. A new study in Neurology in August 2014 has found that some “non-motor” features may be predictors. These features are orthostatic hypotension (blood pressure falling with standing), rapid eye movement sleep behavior disorder (acting out dreams during sleep), color discrimination, and gait dysfunction (especially “freezing”). Rapid eye movement behavior disorder is the single most important feature in increasing the risk of dementia. Neither daytime sleepiness nor insomnia was associated with dementia. Visual hallucinations, subjective memory loss, and depression did predict dementia.
This study is preliminary but is helpful to give patients and families an educated opinion.
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High Dietary Sodium Shown To Increase Exacerbations of Multiple Sclerosis
This conclusion is based upon a recent study published in the Journal of Neurology, Neurosurgery, and Psychiatry, August 2014, from centers in Argentina and the US. Three papers, which were published in 2013 in the journal Nature, showed that in animals, sodium might play a role in MS and autoimmune disorders, including rheumatoid arthritis and type 1 diabetes mellitus.
The World Health Organization guidelines are as follows regarding sodium intake: Low is less than 2 grams per day, medium between 2 and 4.8 grams a day, and high more than 4.8 grams a day. Many studies have shown that more than 7 grams per day is associated with higher mortality from cardiovascular diseases. High sodium increases activity of Th17 cells, which are implicated in MS and other diseases.
In the high sodium group, more than 4 grams a day, relapses and new MRI lesions were increased almost fourfold. The results are not definitive but` they suggest a simple mechanism to reduce disease activity.
For details, see Neurology Today, October 2, 2014.
Many people with multiple sclerosis as well as those with other chronic diseases use complementary and alternative medicine (CAM) treatments. Fifty to 70% of patients with MS do so. Exclusive CAM use among patients with MS ranges from 10% to 30%. Exclusive means the patients do not use standard disease-modifying drugs.
According to a study published in International Journal of MS Care, Fall 2014, four themes characterize the participants’ treatment assumptions: (1) Conventional medicine contains chemical substances that affect the body in negative ways; (2) CAM treatments can strengthen the organism and make it more capable of resisting the impact of MS; (3) the patient’s active participation is an important component of the healing process; (4) bodily sensations can be used to guide treatment selection.
This choice is not due primarily to dissatisfaction with conventional medicine but rather that active decision-making and a feeling of personal control are more important factors. What may seem like an irrational act from a physician’s point of view may be a rational choice when viewed from the patient’s perspective. It is part of a general trend among health-care consumers toward health optimization and performance enhancement.
Physicians should collaborate with these patients and try to combine conventional medicine with complementary and alternative medicine.
Dr. Jack Florin, MD