Written by Tom Balchin | First published on https://arni.uk.com
Stroke is one of many conditions that can lead to seizures, or epilepsy. You may think of these as ‘having fits’. In the UK this condition affects just under 1% of the population. Around 5% of people who have a stroke will have a seizure within the following few weeks. These are known as acute or onset seizures and normally happen within 24 hours of the stroke.
The good news is that your risk of having a seizure lessens with time following your stroke. But, you’ve really got to take care. I see people regularly who have fits for the first time. It’s never fun, but luckily, as someone who has had controlled epilepsy for over 20 years I know exactly how to identify these very early (it’s not that hard really). Quickly get the person to the floor, gently, into the recovery position and call for an ambulance. If you have a list of all their medications on hand to tell the paramedic, that would be ideal.
You are more likely to have had one if you have had a severe stroke, a haemorrhagic stroke or a stroke involving the part of the brain called the cerebral cortex. My own epilepsy came only after subarachnoid haemorrhage, (an uncommon, very serious and often fatal type of stroke caused by bleeding on the surface of the brain)
The causes of seizures are complex. Cells in the brain communicate with one another and with our muscles by passing electrical signals along nerve fibres. If you have epilepsy this electrical activity can become disordered and a sudden abnormal burst of electrical activity in the brain can lead to a seizure.
There are over 40 different types of seizures that can occur, but the most common ones are partial seizures or generalised seizures.
Partial or focal seizures only occurs in part of your brain. You may remain conscious and aware of your surroundings during a partial seizure (called a simple partial seizure) or you may become confused and unable to respond (a complex partial seizure). The symptoms you experience during a partial seizure will depend on which part of your brain has been affected. You may feel changes in sensation such as a tingling feeling, which spreads to other parts of your body.
Commonly people experience a rising feeling in their stomach (a bit like when you go over a humpback bridge). This is called an ‘epigastric rising sensation’. You may also experience uncontrollable stiffness, twitching or turning sensation in a part of the body such as your arm or hand, and/or disturbances in your vision, such as seeing flashing lights.
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Image credits: Pixabay.com
The European Chronic Disease Alliance (ECDA), the European Public Health Alliance (EPHA) and the NCD Alliance publish the paper “Towards an EU-Strategic Framework for the Prevention of Non-communicable Diseases” concluding that a new EU strategic framework to prevent non-communicable diseases (NCDs) is needed to address chronic diseases, the 21st century’s foremost health threat.
With 70% of respondents to a recent EU Barometer survey wanting to see more EU action on health and with epidemic levels of NCDs undermining people’s well-being, healthcare systems, and Europe’s economic and social prosperity, preventing NCDs should be a main priority for the next European Commission.
The mandate 2019-2024 is an opportunity to act upon commitments made at the UN High Level Meeting on NCDs in September 2018 and follow on the EU Reflection Process on Chronic Diseases to deliver concrete solutions to respond to the main common risk factors. While progress is made on reducing premature mortality from NCDs, longer lives do not necessarily translate into healthy lives.
With stroke being such an important topic among other non-communicable diseases, SAFE and ESO recently organised a panel discussion in the Committee of Regions in Brussels, under the Patronage of The Romanian Presidency, exploring the role of policy in tackling stroke. During the panel discussion, patient representatives and clinical experts called on the EU Institutions to recognize the burden of stroke as its own incredibly important entity, rather than diluting it in the wider classification of cardiovascular diseases. Panelists representing patients and clinicians also called for the EU to facilitate discussions between its Member States on the implementation of the Stroke Action Plan for Europe. As a next step to this meeting, SAFE and ESO begun a follow-up with speakers and participants to move forward with the identified opportunities. The immediate action that came as a result of this panel discussion was SAFE’s participation in the CHRODIS+ Conference, held in Budapest, Hungary on 15 May 2019. At this important meeting, SAFE was represented by Grethe Lunde, SAFE Board Member and a stroke survivor from Norway. SAFE actively participated in discussions on topics such as patient involvement, multi-morbidity, integrated care and employment.
Europeans spend between a quarter and a fifth of their lives in ill-health. 700 billion EUR is spent on treating NCDs in the EU each year – although many chronic diseases are to a considerable degree preventable. The paper proposes basic principles, priorities and actions for such an EU strategic framework, setting out a roadmap to make change happen. For more information, please contact: email@example.com or firstname.lastname@example.org.
We would like to recommend to your attention a Round-Table discussion that held place at last year’s WSC in Montreal, Canada.
This Round Table Discussion reviews strategies for secondary prevention strategies in ESUS and the implications of the recent RE-SPECT ESUS results for clinical practice.
Following completion of this activity, learners will be able to:
- Describe RE-SPECT ESUS clinical trial results
- Outline the benefits and risks of NOACs in ESUS
- Discuss the implications of RE-SPECT ESUS for clinical practice
RE-SPECT ESUS: Optimizing Prevention of Embolic Stroke of Undetermined Source
Mike Sharma MD, MSc, Associate Professor, Division of Neurology, Department of Medicine, McMaster University, Ontario, Canada
Richard A. Bernstein MD, PhD, Professor of Neurology, Feinberg School of Medicine, Northwestern University, Illinois, USA
Hans-Christoph Diener MD, PhD, Professor of Neurology, University of Duisburg-Essen, Germany
Please click here to view video.
This article was first published on ScienceDaily.com
Although the occurrence of first-ever ischemic stroke (strokes due to a blood clot that blocks a blood vessel in the brain) at middle age has been decreasing over time, researchers have found that the decline is not as steep as seen in older adults.
The risk for stroke at midlife declined by approximately 39 percent, while risk of stroke at older age declined by 53 percent, when comparing a recent time period (1998-2005) to a previous time period (1962-67).
“Most strokes at midlife were due to diseases of the arteries (atherosclerosis) caused by a clot migrating from the heart. We also looked at vascular risk factors, such as hypertension and smoking, which have been declining among both age groups over time,” explained corresponding author Hugo J. Aparicio, MD, MPH, assistant professor of neurology at Boston University School of Medicine.
The researchers studied trends in the rate of ischemic stroke among two age groups in the Framingham Heart Study: middle age-35-55 years old and older age-above 55 years old. They estimated the rate of stroke occurring in four time periods, 1962-67, 1971-76, 1987-1991 and 1998-2005. They also looked at risk for stroke calculated using the Framingham Stroke Risk Profile, which gives an estimate for how likely a stroke will occur over the ensuing 10 years.
You can read the full article here.
Image source: Pixabay.com
This article was first published on ScienceDaily.com
A new study from the University of Eastern Finland shows that a moderately high intake of dietary cholesterol or consumption of up to one egg per day is not associated with an elevated risk of stroke. Furthermore, no association was found in carriers of the APOE4 phenotype, which affects cholesterol metabolism and is remarkably common among the Finnish population. The findings were published in the American Journal of Clinical Nutrition.
Findings from earlier studies addressing the association of dietary cholesterol or egg intake with the risk of stroke have been contradictory. Some studies have found an association between high dietary cholesterol intake and an increased risk of stroke, while others have associated the consumption of eggs, which are high in cholesterol, with a reduced risk of stroke. For most people, dietary cholesterol plays a very small role in affecting their serum cholesterol levels. However, in carriers of the apolipoprotein E phenotype 4 — which significantly impacts cholesterol metabolism — the effect of dietary cholesterol on serum cholesterol levels is greater. In Finland, the prevalence of APOE4, which is a hereditary variant, is exceptionally high, with approximately one third of the population presenting as carriers. Yet, research data on the association between a high intake of dietary cholesterol and the risk of stroke in this population group has not been available until now.
The dietary habits of 1,950 men aged between 42 and 60 years with no baseline diagnosis of a cardiovascular disease were assessed at the onset the Kuopio Ischaemic Heart Disease Risk Factor Study, KIHD, in 1984-1989 at the University of Eastern Finland. APOE phenotype data were available for 1,015 of the men participating in the study. Of those, 32% were known carriers of APOE4.
During a follow-up of 21 years, 217 men were diagnosed with stroke. The study found that neither dietary cholesterol nor egg consumption was associated with the risk of stroke — not even in carriers of APOE4.
The findings suggest that moderate cholesterol intake or daily egg consumption are not associated with the risk of stroke, even in persons who are genetically predisposed to a greater effect of dietary cholesterol on serum cholesterol levels. In the highest control group, the study participants had an average daily dietary cholesterol intake of 520 mg and they consumed an average of one egg per day, which means that the findings cannot be generalised beyond these levels. One egg contains approximately 200 mg of cholesterol. In this study, about a fourth of the total dietary cholesterol consumed came from eggs. Furthermore, the generalisability of this study is also weakened by the fact that the study population did not have a pre-existing cardiovascular disease at baseline and the size of the study population was relatively small. Therefore, the findings of the study should be verified in a larger cohort as well as in people with a pre-existing cardiovascular disease, who are currently advised to limit their intake of cholesterol and eggs.
Story Source: University of Eastern Finland. “Dietary cholesterol or egg consumption do not increase the risk of stroke, Finnish study finds.” ScienceDaily. ScienceDaily, 20 May 2019. <www.sciencedaily.com/releases/2019/05/190520093448.htm>.
More than 70 events in over 25 countries take place between 13 and 17 May in first ever European Public Health Week
Ahead of Europe Day, the public health community in Europe prepares to unite. Between 13 and 17 May, more than 70 events across at least 25 countries will celebrate healthy populations and raise awareness about public health. Everyone is invited to organise and join these local, national and regional activities of the first ever European Public Health Week (EUPHW).
Initiated by the European Public Health Association (EUPHA), co-organised by the European Commission and supported by the WHO Regional Office for Europe, the innovative initiative launches on Monday 13 May in a two-hour kick-off in Brussels. EUPHW event organisers will answer questions from the
audience in the room and via live streaming, and participants will join a “walkinar” through a city park to promote ‘physical activity’, the theme of the first day.
Events will continue throughout the week. Promotion of healthy cities, safe roads and clean air and water is the theme of day two, dedicated to ‘Healthy environments’. Day three, ‘Care 4 care’ reminds European citizens to take care of what takes care of them by investing in a strong, skilled health
workforce and promoting wellbeing in addition to treating diseases. The importance of a healthy diet while taking care of our planet is the theme for Thursday, ‘Sustainable and healthy diets’. On the final day of the week the focus will be on ‘Youth mental health’, promoting stable and supportive homes,
schools and social environments for Europe’s future generation.
Activities include workshops, lectures, webinars, games, sports classes, online campaigns, roundtable discussions and exhibitions, in several languages at local, national, regional and European level. EUPHA Executive Director Dineke Zeegers Paget, said: “We initiated the European Public Health WEEK to
show the full picture of public health by collaborating with our European partners and members. Public health goes far beyond health, involving people from all disciplines, from environment to occupational therapy. And this week also goes far beyond the European Union – we are covering the 53 countries of the WHO European Region. All of us have the right to health and our health needs to be safeguarded in
order to fully participate in society.”
EUPHA President Azzopardi Muscat, said: “We are two weeks away from the European elections and this initiative highlights that healthy populations require a commitment from all of us to ensure truly that nobody is left behind. Whilst Europe leads the way in many health indicators, there remains
much to do to achieve health-related targets in the sustainable development goals and there is no room for complacency in the face of growing inequalities and emerging challenges.”
Public health weeks have taken place in other countries in the past, such as the United States of America and Austria. Thomas Dorner from the Austrian Public Health Association said: “We have organised the Austrian Public Health Week for four years. It is very important to raise awareness of public health, particularly at a time when misinformation could be dangerous for people’s health. We are very glad to see that such initiatives are taking place from local to global level to celebrate healthy populations.”
For more information, visit eupha.org/European_Public_Health_WEEK_2019
What is EUPHA?
The European Public Health Association, or EUPHA in short, is an umbrella organisation for public health associations in Europe. Our network of national associations of public health represents around 20’000 public health professionals. Our mission is to facilitate and activate a strong voice of the public health network by enhancing visibility of the evidence and by strengthening the capacity of public health professionals. EUPHA contributes to the preservation and improvement of public health in the European region through capacity and knowledge building. We are committed to creating a more inclusive Europe, narrowing all health inequalities among Europeans, by facilitating, activating, and disseminating strong evidence-based voices from the public health community and by strengthening the capacity of public health professionals to achieve evidence-based change.
EUPHA’s definition of Public Health
“The science and art of preventing disease, prolonging life and promoting health and well-being through the organised efforts and informed choices or society, organisations, public and private, communities and individuals, and includes the broader area of public health, health services research, health service delivery and health systems design.”
This activity received funding under an operating grant from the European Union’s Health Programme (2014-2020).