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Portrait of a Child with Epilepsy

Posted Aug 24 2008 1:49pm
ANDI ORANSKY: I do things just like any ordinary person. I do things just like any other teenage girl would enjoy.

ANNOUNCER: For Andi Oransky that means life is filled with friends, school, and family.

ANDI ORANSKY: My parents have been more protective in some ways, but they're just parents.

ANNOUNCER: While Andi Oransky has the hopes and dreams of any 17-year-old, there is something that makes her different.

ANDI ORANSKY: I've had epilepsy all my life.

ANNOUNCER: Epilepsy, a condition that causes seizures, is the most common neurologic problem affecting children.

MICHAEL DUCHOWNY, MD: I think there is still significant social stigma, unfortunately, attached with the diagnosis of epilepsy. And it's important to reassure families that their children are normal in all respects; that there's good treatment available.

ANDI ORANSKY: It didn't upset me at all. I didn't have any feelings towards it.

ANNOUNCER: But Andi's mother has different memories.

FERN ORANSKY: Andi was first diagnosed with epilepsy at three weeks old. She had a shaking of her arm, just like this and it turned out be focal seizures in her left arm. I was really upset.

ANNOUNCER: Epilepsy's impact on a family has much to do with the nature of the seizures, which may vary in frequency and severity.

TREVOR RESNICK, MD: Children who have more frequent seizures, it begins to affect them socially because the kids begin to see them as different.

ANNOUNCER: Epilepsy can be experienced in many different ways.

MICHAEL DUCHOWNY, MD: Generalized seizure comes in several types. The most common is a seizure that involves stiffening, which is called a tonic seizure, or jerking which a clonic seizure. And when both of these happen in the same seizure, it would be called a tonic-clonic seizure.

ANNOUNCER: Andi experienced her epilepsy as partial complex seizures.

MICHAEL DUCHOWNY, MD: Epilepsy is also divided; at least focal epilepsy is divided as to whether or not awareness is retained or lost during a seizure. For example, the arm can jerk and the child is completely aware of it. Other seizures are accompanied by a compromise of awareness and consciousness when the child is simply unaware of what he or she is doing and has no memory for the seizure whatsoever when its over.

ANNOUNCER: This may partly explain why Andi remembers so little of her early epilepsy.

FERN ORANSKY: It was pretty bad, it was very bad, actually. But she doesn't remember very much about it, which I guess is good, in a way.

ANNOUNCER: Yet Andi was seizure-free without medication from age two to age six. It was in that sixth year that epilepsy reappeared.

FERN ORANSKY: It came back with a vengeance, and it as more than just focal seizures at that point. It was all different types of seizures. It was terrible. She was in and out of the hospital like four times in a one year and on a variety of drugs, because they couldn't get her controlled.

ANNOUNCER: At that point, Andi's doctors tried to get her epilepsy under control with a combination of drugs. But, there were problems.

FERN ORANSKY: There were a lot of different side effects. Some of them made her weak, you know, her walking off kilter; she always looked off-balance. Major side effects with her learning. Her cognitive learning ability dropped substantially.

ANNOUNCER: Five years ago, doctors tried using monotherapy, or single medication therapy.

MICHAEL DUCHOWNY, MD: Monotherapy offers many advantages. The most important is that it's very simple to administer. You have one drug. There is no drug-drug interaction and you have the best control over the medication.

The adverse effect profile is very low, meaning that the medications are very well-tolerated. Most pediatric neurologist who deal with children with epilepsy will start with monotherapy.

ANNOUNCER: Now seizure-free for five years, Andi's found success with monotherapy. For a busy teen, taking just one medication simplifies life.

ANDI ORANSKY: I take medication one time a day. I used to take medication three times a day, but I hated taking it and remembering each second.

ANNOUNCER: Treatment still requires adjustment.

ANDI ORANSKY: It makes me think slower and work slower, but I can do the work like any other person.

FERN ORANSKY: Even if there is side effects, I'm used to it, and that's just her at this point, and I don't even know what she would be like without medication.

ANNOUNCER: For Andi, monotherapy works, but that may not always be the case.

TREVOR RESNICK, MD: Adjunctive therapy implies that what you're doing is you're adding on a second drug. So instead of the patient being on one drug, the will be on two drugs. And sometimes we need to do that.

ANNOUNCER: Now Andi's limitations are few.

TREVOR RESNICK, MD: Common sense would tell you that you don't them to go mountain climbing, you don't want them to go deep sea diving and you don't want them to go bungee jumping. Now can they play football? Absolutely. Can they play tennis? Can they go bicycling? Yes.

MICHAEL DUCHOWNY, MD: I stress to all the families that the children should be treated no differently.

ANNOUNCER: Research on epilepsy continues. Stem cell and genetic therapy hold future promise for this difficult disease, but for now Andi Oransky is right where she wants to be.

ANDI ORANSKY: A lot of my friends know the condition of what I have, meaning epilepsy. And none of them care. All of them treat me the same as everyone else.

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