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Epilepsy News
Epilepsy Ireland Issue 84 Spring 2019
IN THIS ISSUE:
First National Conference • Brexit: will it affect epilepsy medication?
• Kevin O’Connell: my first seizure
on the Consequences of
• Mark O’Reilly: epilepsy and fitness
Sodium Valproate • Prof. Mark Cunningham: the role of
neuroscience
CONTENTS NOTE FROM THE EDITOR Conor Culkin
3. News Update We have another busy issue of Epilepsy News, which includes a
variety of articles I hope you will enjoy. Speakers from the recent
4. Impact of Brexit on
conference on the consequences of Sodium Valproate feature
Medication Supplies
on the front cover of this issue. This important event brought
5. Report on Sodium together professionals and policy makers with the families
Valproate affected by Sodium Valproate and was organised by Epilepsy
6. TFS Award Winning Course Ireland, HSE, OACS Ireland, FACS Forum and Trinity College. On
page 5 we have the latest news on the drug which includes a
7. Overcoming my Epilepsy
HSE report on the issue. Brexit has created uncertainly about
8. The Role of Neuroscience medication and on the previous page we clarify the situation in relation to epilepsy
9. New Light on drugs.
Mitochondrial Epilepsy This issue also includes a revealing personal story from Kevin O’Connell (Page 7) a 19 year
10. Epilepsy and Exercise old journalism student who will document his epilepsy story in a series of articles for
11. Learning to breathe again Epilepsy News. On page 9, Dr. Gareth Morris from FutureNeuro discusses mitochondrial
12. Fundraising epilepsy, a piece which is taken from a new blog called ‘Epilepsy In English’. In addition,
13. Joe Schmidt supports fitness expert Mark O’Reilly offers some exercise tips for people with epilepsy on
International Epilepsy Day how you can start and most importantly be safe while improving your health. On the
following page Epilepsy Ireland member Jenny Snook discusses an alternative treatment
14. Regional Events that helped her anxiety and epilepsy, which is known as ‘The Buteyko Breathing Method’.
Finally, I would like to announce some personal news. After nearly three years editing
Front cover: Epilepsy News and working fulltime as Epilepsy Ireland Communications Officer I am
Pictured at the First National moving onto pastures new. I would like thank everyone who helped contribute to this
Conference on the consequences magazine since the autumn issue of 2016. I hope the articles have been informative and
of Sodium Valproate (l-r) are Geoff thank everyone who has contacted me with feedback and suggestions.
Day (OACS Ireland); Karen Keely
This is a great organisation with lots of dedicated people and I hope I’ve played a small
(Chairperson, OACS Ireland) and
part in Epilepsy Ireland’s success. Best of luck to all for the future.
Dr Peter Turnpenny, (Consultant
Geneticist, Exeter, UK). The
conference was held at Trinity
College on March 22nd. STAFF APPOINTMENT: LUKE MEANY
Luke Meany is the newest
member of the Fundraising and
Communications team here at
Epilepsy Ireland. Luke joined
the team at end of November
as a Graduate Fundraising and
249 Crumlin Road, Communications trainee. Luke
Dublin 12. is highly enthusiastic about
Tel: 01 4557500 his new role and is motivated
Fax: 01 4557013 to help develop numerous
Email: info@epilepsy.ie
fundraising initiatives here at
Web: www.epilepsy.ie
Epilepsy Ireland. Luke studied
Registered Charity Number: Sociology and Social policy in
20010553 UCD and most recently received
CHY Number: 6170 his Master’s Degree in Sociology
and Politics from NUIG.
Design and layout by
PlipSpace.com
Printed by Doggett Print & Design
2
NEWS UPDATE
response to stress are related to seizure then correlated the degree of night-time
activity. supervision (e.g, no supervision; a listening
device, roommate, or physical checks at
https://goo.gl/fXNdJs
15-minute intervals; or 2 of the following:
a listening device, roommate, additional
European Scientific Journal device, or physical checks at 15-minute
Highlights the Contribution of intervals) with outcomes.
Irish Neurological Charities The total number of SUDEP instances was
A collaborative paper led by the 3.53 cases per thousand patients. The first
Michael Fassbender shows his Neurological Alliance of Ireland has been residential centre incidence rate was 2.21
support for Brain Awareness Week published in the European Journal of cases per thousand patients in comparison
Internationally renowned actor Michael Neuroscience entitled “Building a Supportive to the second centre where a rate of
Fassbender showed his support for the Framework for Brain Research in Ireland”. 6.12 cases per thousand was recorded.
Love your Brain campaign for National Brain The paper highlights the vital role played Importantly, the study found that the
Awareness Week (March 11th to 17th). In by neurological charities (including first centre had higher levels of nocturnal
his endorsement video, Michael highlights Epilepsy Ireland) in supporting research supervision than the second centre. A larger
the need to raise awareness on behalf of the into neurological conditions in Ireland proportion of patients with SUDEP were
800,000 Irish people living with neurological and profiles a number of NAI member more likely to have nocturnal convulsive
conditions. organisations. seizures compared with control participants.
The campaign aim was to promote greater Overall, the paper provides an important Patients who died from SUDEP were also
awareness and understanding of the brain overview of the landscape for brain research more likely to have a higher frequency of
and brain conditions as well as the need for in Ireland, highlighting the progress and nocturnal convulsive seizures.
more investment in services, research and potential in exploring rare and genetic As nocturnal seizures and sleeping position
prevention. Love your Brain was supported conditions but pointing to the need for often are factors in SUDEP, investigators
by over 20 patient organisations including dedicated investment in neuroscience emphasized the importance of nocturnal
Epilepsy Ireland and research groups were research as well as the development of an supervision in preventing SUDEP.
involved in organising events for Brain infrastructure to support research which
Awareness Week throughout the country. https://goo.gl/1a1r5F
includes technology, legislative changes,
For more information visit loveyourbrain.ie. research networks and support for early
https://goo.gl/wecMtw career researchers and clinicians. FutureNeuro receive funding for
You can download the publication via the new epilepsy treatments
link below. FutureNeuro researcher, Dr. Gary Brennan
The Links between Stress and
has recently received funding as part of a
Seizures https://rdcu.be/biOuo Government investment of €10.8 million in
Professor Stafford Lightman at the University research funding.
of Bristol began investigating the links
between stress and seizures in 2014. This Dr Brennan, who is also a StAR Research
research is vital as although the association Lecturer at the Department of Physiology
between stress and seizures has been noted and Medical Physics, RCSI has received a
it is still not fully understood. Lightman’s grant of €419,472. The funding will enable
team from University of Bristol and the Dr Brennan and his team at FutureNeuro
University of Exeter placed their focus on the to study how gene regulation and protein
research of cortisol. This is a hormone that is generation could inform new treatments for
released by the body in response to stress. epilepsy.
Nocturnal Seizures with Meanwhile, Principal Investigator with
The research team used mathematical and
preclinical models of epilepsy so that they Convulsions Linked to SUDEP FutureNeuro Professor Matthew Campbell
could examine how the hormone cortisol A study which focused on patients with has been awarded €125,610 in funding as
changes the electrical activity in areas of intellectual disabilities who reside in part of a €4.5 million investment by Science
the brain that are generally linked with care homes found that seizures marked Foundation Ireland.
seizures. The team was able to examine how with convulsions that occur at night are
His project will investigate whether restoring
increased levels of cortisol affected seizure more likely to be associated with sudden
the function of a gene which regulates the
activity in comparison to models without unexpected death in epilepsy (SUDEP).
blood-brain-barrier and has been found to
epilepsy. The research team from Leiden University
be disrupted in brain material from epilepsy
Medical Center (Netherlands) examined
The study found that increased levels patients will prevent seizure activity and
the medical records of patients who died
of cortisol alone did not play a role in thereby treat refractory epilepsy.
as a result of SUDEP from two different
increasing the occurrence of seizures. residential care homes over a 25 year period Funding such as the above is a positive
However they also found that exposure to a (1987 – 2012). The investigators identified step both for Irish research and people with
loud sound did increase the occurrence of 60 cases of SUDEP along with 198 different epilepsy.
seizures. This indicates that other age and residential control cases. They
components of our body’s biological https://goo.gl/wVLiR3
3
IMPACT OF BREXIT ON EPILEPSY MEDICATION
SUPPLIES IN IRELAND Steps taken include:
• Re-routing supply chains to remove the transportation/
importation via the UK
• Ensuring that adequate reserves of AEDs are in place within
Ireland
• Relocating drug licences anchored in the UK to other European
countries
All the responses received from individual manufacturers have
been collated on our website: https://goo.gl/hzv5Ck
Based on feedback and conversations that we have had with
manufacturers on this subject, we do not have any current
concerns that there will be any disruption to the supply of AEDs
Concerns have been raised in the media in recent months in Ireland in the coming months. Should this change in any
regarding possible interruptions to the supply of essential way, we will provide updates on our website and social media
medications in Ireland that might occur in the event of a no- channels.
deal Brexit. Currently, about 60% of all medications used in
Ireland are imported from or pass through Britain.
In January, the Taoiseach said that the Government was
monitoring a ‘watchlist’ of drugs which could be subject to
shortages in a no-deal Brexit. The medications on this list were
not disclosed but reports indicate that the greatest concern is
around specialist drugs that have for example a short shelf life
or those that require storage at very low temperatures. These
special categories do not include anti-epileptic drugs (AEDs).
Tanaiste Simon Coveney later disputed the existence of any such
‘watchlist’.
60% of all medications used in Ireland are imported from or pass
The government has consistently pointed out that even if there through Britain.
is a no-deal Brexit, there will not be an immediate effect in
In addition, the Department of Health, Health Products
relation to the supply of medicines in Ireland. The government
Regulatory Authority (HPRA) and HSE have put plans in place
have also warned against stockpiling medications, which is
to minimise the risks of supply interruptions. The Department
something that could actually cause a supply disruption in itself.
does not anticipate any immediate impact on supplies following
Brexit. The HPRA have requested manufacturers to immediately
engage with them if they believe that Brexit may impact on their
ability to supply a medicine to the Irish market.
It should however be noted that from time to time, shortages
in a particular medication can occur for a variety of different
reasons. Both the HPRA and the Irish Pharmacy Union report
information on product shortages and this is monitored by
Epilepsy Ireland on an ongoing basis. For example, we recently
highlighted a temporary shortage of Epilim 100mg and the
steps that are being taken to ensure patient safety. These
temporary shortages, unrelated to Brexit may continue to occur
An Taoiseach, Leo Varadkar, said that the Government was from time to time and EI will continue to monitor and report on
monitoring a ‘watchlist’ of drugs. these in the coming months.
In February, Epilepsy Ireland reached out to all the major Further Information:
pharmaceutical companies who supply anti-epileptic drugs • HPRA Brexit Updates - hpra.ie/brexit
(AEDs) in Ireland, requesting a brief update on their plans to • Department of Health Brexit page - health.gov.ie/?s=brexit
ensure supply of their AEDs within Ireland over the coming • Irish Pharmaceutical Healthcare Association - www.ipha.ie
months.
The feedback we have received indicates that manufacturers If you have any concerns about medication supplies, please
have taken a range of positive steps over the past 18 months to contact your pharmacist or get in touch with Epilepsy Ireland
ensure that there will be no interruption to supplies of AEDs in at 01 4557500 or your local Epilepsy Ireland office (see page 14
the coming months, regardless of what kind of Brexit occurs. for details).
4
HSE REPORT ON PRENATAL EXPOSURE TO
SODIUM VALPROATE 1975 – 2015
• There is no single source of data relating to the use of valproate
in pregnancy in Ireland. Furthermore, while some individual
datasets might have held useful information, the inability to link
these datasets meant that they were of little value. The analysis
therefore relied to a large extent on international data.
• It was not possible to take account of variation in the duration of
valproate use during pregnancy, dosage prescribed to individual
women or whether valproate was used as a standalone drug or in
conjunction with other epilepsy drugs. All of these factors would
influence the rate of disabilities.
• No account could be taken of differences in socio-economic
status or urban-rural area of residence. Both of these factors are
believed to influence the rate of valproate usage.
• The analysis is premised on the licensed prescribing of valproate
A group of parents who include Karen Keely of OACS Ireland at the for epilepsy and bipolar disorder but does not include off-licence
very first Sodium Valproate Conference in Trinity College Dublin prescribing e.g. for migraine.
which was co-hosted by Epilepsy Ireland in March. Also pictured
are Consultant Neurologist Prof. Colin Doherty and Senator Rose Because of these significant limitations, the report concludes
Conway-Walsh. that the estimates should only be viewed as “a broad guide
As part of its Valproate Response Project established in 2018, the for those tasked with planning diagnostic and management
HSE has prepared a Rapid Assessment report of the number of services for people affected by this issue”. It continues “the true
women and children exposed to sodium valproate (Epilim) in impact of valproate on women and children will only become
Ireland over the past 40 years. apparent as data is collected prospectively…”.
Valproate can cause birth defects and problems with the While the estimates should be considered in light of these
development and learning of the child if their mother takes the limitations, they are nonetheless very significant in that they
medicine during pregnancy. Children exposed to valproate in greatly exceed both the number of confirmed FVS diagnoses
the womb are at a high risk of serious developmental disorders made by the Department of Clinical Genetics at Crumlin
(in up to 30-40% of cases) and congenital malformations (in Hospital (less than 50) and the 400 cases estimated by the FACS
approximately 10% of cases). The HSE’s Vaproate Response Forum in 2017.
Project was set up to: ensure the safe prescribing of Epilim Despite a wide range of actions taken in recent years to raise
in women, prevent current and future harm and develop a awareness of this issue including direct communications from
pathway of care for diagnosis and treatment of children who HSE to women on valproate last year, only a small percentage
have been affected by past exposure to Valproate. of those affected have yet been diagnosed with FVS. Epilepsy
The Rapid Assessment Report aims to provide an estimate of Ireland and OACS Ireland continue to work closely with HSE on
the likely prevalence of specific major congenital abnormalities delivering a comprehensive response to this issue, including
and neuro-developmental disorders associated with the drug expanding diagnostic FVS services, putting in place a package of
(known as FVS – Foetal Valproate Syndrome). Until now, there community supports and implementing a new Women’s Health
has been no Irish data on this but estimates are vital in planning in Epilepsy programme.
the services and supports that affected families require. Some of The full HSE Rapid Assessment report can be downloaded from
the report’s estimates include: www.epilepsy.ie/content/valproate-epilim-guidelines.
• Between 1975 and 2015, approximately 3,126 babies were Videos from the recent Sodium Valproate Conference will be
potentially exposed to valproate in utero. Of these, it is estimated available at epilepsy.ie.
that 873 were born between 2000 and 2015 (i.e. currently 18
years old or younger). OACS Ireland
• From 1975 and 2015, between 153 and 341 children will The Organisation for Anti-Convulsant (OACS) Ireland supports
have experienced a major congenital malformation and and represents families with Foetal Valproate Syndrome. If you
up to 1,250 children will have experienced some form of or your child has been affected by valproate exposure or if you
neurodevelopmental delay following exposure to valproate in the would like to know more, please contact oacsireland@gmail.
womb. com; Twitter - @oacsireland.
• An estimated 43 – 95 children under the age of 16 today will For the latest updates, see www.epilepsy.ie and our social
have experienced a major congenital malformation as a result of media channels. If you are a woman on sodium valproate
valproate exposure and 349 will have experienced some form of please do not stop taking the drug unless you have been
neurodevelopmental delay. advised by a medical professional.
However, the HSE analysis is subject to a large range of
assumptions and limitations and the report must be interpreted
with these in mind. These include:
5
KICK START YOUR CAREER WITH EPILEPSY IRELAND’S
AWARD WINNING FREE COURSE!
For many people with epilepsy further What attracted you to TFS in some sort of experience towards that and
education hasn’t been a viable option for particular? having confidence in my capabilities being
a number of reasons. Epilepsy Ireland may I felt that TFS gave me an opportunity to instilled through the course is something
have the solution if you’re looking for a excel, after having felt like I was amounting that would greatly benefit me.
stepping stone between second level and to nothing in every other aspect of my Have you any tips or advice for
further education or if you would like to education. I was confident that there
gain a qualification to assist you in preparing
someone considering Training for
would be people there who’d understand
for the world of work. Success as an option for them?
my difficulties, which would allow me to
Apply for your disability allowance months
Based on campus at the Institute of overcome them.
in advance if you plan on coming to the
Technology Sligo, Training For Success has Living away from home was an exciting course and aren’t receiving social welfare. I
had over 250 young people with epilepsy prospect. I came out to IT Sligo one day had to wait upwards of 11 months before
attend since its’ inception in 1998. Since for an interview and I was shown around I got my disability allowance. I have yet to
that year 85% of graduates have progressed the campus and talked about what I’d get receive my travel card or my medical card.
to employment or upskilled after they from taking part in the course. There was Fill out these forms and send them out
completed the programme. We have had something very unique about the chance I straight away and don’t be discouraged if
students from all 26 counties as the course was being given. I felt it would be wrong to they deny you at first.
is only available in Sligo. Indeed, TFS is the pass up on such an opportunity.
only course of its kind anywhere in Europe! The course co-ordinators and lecturers here
How are you finding the are fantastic and are always looking out
Students participate in a wide variety for ways to make the lives of the students
of activities including lectures, tutorials, experience including being
located within an Institute of easier. If the TFS Team sense that your head
presentations, assignments, portfolio is starting to drop, they’ll be there to look
development, project work, discussion Technology? for ways to make your college life easier and
groups, one to one supported training, Being in the IT Sligo is great. It’s a nice
ensure that you make it through the course.
goal-setting, peer learning, outdoor pursuits campus that offers a lot. There’s a great
and much more. All eligible students also library and a few good shops on campus. It’s
receive a MSLETB training allowance and an nice to be surrounded by so many people Recruiting NOW for
accommodation allowance. going about their things, as it provides an
September 2019
air of excitement.
We are now recruiting for the
I get all of my drinking water from the September 2019 intake onto our
college campus. It’s important to stay Training for Success course.
hydrated with the medication I’m on, so I
get about 5-7 litres of water free from the IT If you’d like to hear more about the
on a daily basis. course, please contact:
Honor Broderick (broderick.honor@
Have there been any unexpected itsligo.ie) or Maire Tansey (tansey.
or hidden benefits to the course? maire@itsligo.ie) or call 071 9155303.
This has been my first time living away
from home and the experience has been
invaluable. My family would have originally
come from the west of Ireland, so it feels like
I’m able to reconnect with the past by living
out here.
What do you hope to do after the
course?
I’m not sure what I’d like to do after the
course. I have thought about teaching
Who better to tell you about the course English as a foreign language and I have
than one of our current students, Joey also thought about going to university.
Finneran (20) from Dublin. Completing this course would give me
What were you doing before the the qualifications needed for university, so
course? having that option open to me would be In 2013 Training for Success won the Aontas
I was on a PLC course after I finished school, fantastic. STAR National Award for providing “an
but I never felt that I was going to be I have often thought about moving abroad, outstanding contribution to adult education.
L-R: David Gillick student, Paul Sharkey,
successful on that course. After that ended, to somewhere where the weather picks me Epilepsy Ireland, Maire Tansey course
I was doing nothing for five months, while up, rather than brings me down. Having the facilitator, Denise O’ Connell student, Honor
waiting on my disability allowance. experience of independent living gives me Broderick, course manager.
6
OVERCOMING MY EPILEPSY
I was chewing my chicken, when my A more lighthearted moment occurred
vision weakened, and rapidly began to when we tried to isolate the reason
circle. I begged my father for help. When behind my seizure. The doctor implied
he asked me what was wrong, I mumbled that I’d overdone it on drugs or alcohol.
something about a panic attack, as it felt His persistence on this suggestion still
like the quickest and most logical way to makes me laugh .At the time, I had this
explain whatever was happening. long, dirty, tangled hair stretching down
my back, and since I wasn’t a saint for
Ironically, my biggest challenge to date,
sleeping and eating, I looked far from my
my anxiety, was the last thing I referenced
best.
before an even bigger one emerged.
It took some convincing, but he eventually
According to my father, I fell out of my
got past that possibility.
chair, but he caught me before I hit the
ground. A stranger then assisted him in From there, the doctor pointed out that
laying me flat on the floor, and provided one in twenty people will have a one
his jacket as a pillow. off seizure in their life. So, unless I had
a repeat experience, then no accurate
It’s unlikely I’ll ever know who he is, or
Kevin O’Connell, a 19 year old diagnosis could be made. Following a
that he’ll ever see this, but I extend my
journalism student, will document his night of cautionary observation, I was sent
gratitude. I know that if brains were
epilepsy story in a series of articles for home to play the waiting game. Anxiety’s
switched, I’d have frozen.
Epilepsy News. In this piece, he talks favourite game. However, that is irrelevant,
Once down, I started to shake, violently. my gripes with the Irish health system are
about his first seizure.
As I type this, it’s like my bones feel the for another blog.
Epilepsy hung over me, like a cloud of ghosts of those violent tremors. There
depression. For so long, I was ashamed of were several ugly side effects, such as
my condition. That was until I slayed the saliva and leftover pieces of chicken racing
stigma, and popped the cloud, letting
The only positive
from my mouth. In the few conversations
the truth of my epilepsy sprinkle over my I’ve allowed to occur about the seizures, from my first seizure is that
life. In this series of articles, I will share this those are all the details I can bear to hear. it changed my perspective
truth, starting with my very first seizure.
I woke on a stretcher, feeling groggy, and on family.
The seizure occurred on December 15th, being guided towards an ambulance by a
2017. Over a year before I was officially paramedic. Behind her was the winter sky,
diagnosed as having epilepsy. It was a dark as ever. Like her, it was beautiful, and The only positive from my first seizure is
Thursday, and I spent the day at school, it all felt like a dream, until my father came that it changed my perspective on family.
being my awkward self, and suffering into sight, with a relieved, but horrified Before, thanks to teenage moodiness
through what already felt like an endless look on his face. and a messy past, I categorized them as
fifth year. Physically, I felt fine, so once compulsory friends rather than family.
He would have no issues with
school concluded, I decided to go for food However, the looks on my parents faces,
remembering this experience. It had been
with my father at a well known petrol and the breathless presence of my siblings
burned into his brain. Every last second
station/food court. at the hospital, reacquainted me with the
of it.
This is where my memory becomes meaning of family.
I repeatedly vomited at the hospital, from
slightly fuzzy. I remember moments, but With all that in mind, I went home, sat
a combination of the seizure itself, and the
not in concrete fashion. It feels like I was down against the wall, and sarcastically
obviously chaotic ambulance ride. Once
already floating out of consciousness, and welcomed epilepsy into my life. However,
over the initial shock, I thought “must have
just didn’t notice. no amount of sarcasm, worry, or hiding
been some dodgy chicken.”
I remember being in the car, and being could have prepared me for the epilepsy
It didn’t take long the doctor to mention journey set to follow.
asked to check if any traffic was coming
the words “seizure”. I instantly thought
from my side. The usual anxiousness and Kevin will continue to write about his
of the stigma, of those freaks who can’t
self-consciousness were present, as I epilepsy experience in the next issue of
watch television or handle strong lights.
ordered my chicken-roll from the hot food Epilepsy News and you can also follow
Those who live an unliveable life and
counter. Most of all, I remember those last his blog on kevinskick.wordpress.com.
are an absolute burden on absolutely
few moments, before I passed out, before
everybody. As if anxiety didn’t bring
my life changed forever.
enough of a stigma and weight.
7
THE ROLE OF NEUROSCIENCE IN TREATING EPILEPSY
The brain is a complex organ with 100 therefore directly related to this clinical
billion brain cells and 0.15 quadrillion measurement.
connections, or synapses, between Using these approaches my group aims
those brain cells. Remarkably, the to carry out research that addresses
circuits of brain cells which produce fundamental questions about epilepsy
a seizure in the whole brain can be but also has the capacity to translate
studied at a much more basic level. For findings into the clinic and ultimately
example, brain cells, or neurons, can be improve the treatment of people with
grown in a petri dish and are capable epilepsy.
of forming connections between
themselves that are similar to those An example of this type of work is
connections in the intact brain. This as follows. Within the brain there
cell model can be used to study seizure is a molecule which acts to help
activity in the lab and is an important neurons communicate with each
Mark Cunningham is the recently tool to assess potential anticonvulsant other. The molecule, glutamate, is a
appointed Ellen Mayston Bates features of new drugs. Similarly, thin neurotransmitter and when released
Professor of Neurophysiology of slices (0.5-1 mm) of brain tissue can be from the endings of one neuron it acts
Epilepsy at Trinity College Dublin. prepared and kept alive in such a way on another neuron to excite it. This
In this piece, he explains the that the electrical activity of seizures excitation causes neurons to generate
importance of neuroscience in generated by these intact brain tissue electrical signals or spikes and too much
treating epilepsy. sections can be examined. The type glutamate can cause uncontrollable
‘Electricity is life but electricity is an invisible of seizure activity seen in these slices electrical spiking. If unchecked
fist punching up your spine, knocking your relates directly to seizure observed in these spiking neurons can produce
brains right out of your skull.’ the intact brain and we can also study the electrical storms that underlie
Ray Robinson this using animal models of epilepsy. seizure generation. Normally, levels of
A variety of models of epilepsy are glutamate are tightly regulated in the
The quote above captures the main
available for scientists to study. These brain however in certain conditions
theme from Ray Robinson’s debut
range from models in which chemical glutamate levels can become very
novel ‘Electricity’ – an evocative and
agents, termed proconvulsants, are high. This frequently occurs around
unsentimental description of living
administered to the animal which brain tumours particularly in the case
with epilepsy. Through the narrator and
then goes on to exhibit spontaneous of low grade gliomas. Patients with
protagonist, Lily O’Connor, the reader
seizures. Other models include where this form of brain tumour experience
is given an insight into Lily’s attempts
genetic manipulations associated with epileptic seizures and it is thought that
to deal with her difficult to control
epilepsy have been made. We also their seizures are due to an excess of
seizures as they impact on her life. Lily’s
work with models of brain tumours or glutamate. We work with slices of live
complex wider existence is soothed by
traumatic brain injury, both conditions human brain tissue obtained during
a romantic liaison with an electrician – a
in which epilepsy is commonly seen. an operation to remove this type of
girl with abnormal electrical discharges
brain tumour and we have been using
rescued by an electrician? How do we study epilepsy? As neurophysiology to record seizures in
Can studying the abnormal electrical mentioned above, seizures arise from these human brain slices and study
discharges associated with epilepsy alterations in how brain cells generate the role that glutamate is playing. Our
provide insights that might provide electrical activity and communicate work suggests that currently available
better treatments for those living with as networks. In order to eavesdrop drugs, which target a particular type of
epilepsy? This question is central to on this electrical activity we use an glutamate receptor, may be better at
the research that my laboratory at approach called neurophysiology. limiting seizures associated with brain
Trinity College Dublin hopes to address. Neurophysiology is the study of the tumours than other drugs presently
Despite there being more than 30 functions of the nervous system. used.
different types of seizures, all share the This technique is directed towards
unravelling the question of operation As captured in the quote at the
fact that underlying the seizure is a
of individual neurons, connections start of this article electricity plays a
‘misfiring’ of brain cells. This is due to
between neurons, interactions between fundamental role in epilepsy. I aim to
alterations in how these cells generate
groups of neuron and the emergent carry out research which shines a light
electrical activity and communicate
network features that arise from all on the abnormal electrical discharges
between each other. These electrical
these levels of function. All of the which give rise to the epilepsy. In doing
and chemical disturbances give rise
afore mentioned levels give rise to so I hope to provide answers about how
to a disorganisation of the electrical
patterns of electrical activity which epilepsy occurs but more importantly
signals between large numbers of brain
can be recorded by electrodes placed use this knowledge to improve how the
cells producing an electrical storm in
on the scalp – commonly known as condition can be treated for the benefit
the brain. Such uncontrolled electrical
the electroencephalogram or EEG. The and wellbeing of patients, their carers
storms cause a change in awareness,
activity we study in the laboratory is and families.
movement or sensation – a seizure.
8
NEW DISEASE MODEL SHEDS LIGHT ON
MITOCHONDRIAL EPILEPSY number two types of brain cell. Diseased tissue had fewer
inhibitory brain cells (those that reduce overall brain activity)
and also fewer astrocytes- crucial support cells which regulate,
amongst other things, the levels of the chemicals which brain
cells use to communicate with each other.
Previous studies showed that experimentally reducing
mitochondrial function in otherwise healthy tissue was not
enough to trigger seizures on its own. So, Mark’s team realised
that some of the changes seen in the post-mortem tissue must
also be an important part of the disease.
To test this, they took small pieces of healthy brain tissue from
rats and used drugs to block the activity of astrocytes – one of
the cell types lost in the post-mortem tissue – at the same time
A new blog called ‘Epilepsy in English’ from academics at as blocking mitochondrial function. This made the pieces of
FutureNeuro aims to present epilepsy research papers in brain tissue start to generate seizures. Further analysis showed
plain English so that they are accessible to everyone. In that the previously healthy tissue also began to look like tissue
the first of a series of articles Dr. Gareth Morris discusses with mitochondrial epilepsy. This means that the team were
mitochondrial epilepsy and a recent study by Prof Mark able to create the first disease model of mitochondrial epilepsy.
Cunnigham’s team on the subject. This is a massively valuable research tool to try to find new
treatments.
Our brains are hungry beasts
With the model created, Mark’s team then used a variety
There are around 86 billion (yes, billion) electrically active of common anti-epileptic drugs, to see if they could stop
cells in the average human brain. Each one of these cells can mitochondrial seizures. Just like the real condition, the seizures
connect to multiple others, adding up to something like 10 in this model did not respond to most drugs. But – promisingly
trillion (yes, trillion) intricate electrical connections in the brain. – they were stopped by one drug, sodium pentobarbital.
And this doesn’t even take into account numerous non- This is interesting because sodium pentobarbital effectively
electrical cells which carry out vital processes like mediating compensates for the lost inhibitory brain cells, by mimicking
the levels of critical brain chemicals and providing structural the action of a chemical called GABA which is normally
support. All of these biological processes use up energy and so, released from inhibitory cells.
unsurprisingly, the energy bills in the brain start to add up.
This finding gave the team another clue about mitochondrial
But where does this energy come from? epilepsy. In a healthy brain, GABA can be made from a
Each of the cells in the brain (and also in the rest of the body) chemical called glutamine. Usually this glutamine is produced
has its own built-in batteries known as mitochondria. The main by astrocytes but, as the team already showed, astrocytes are
function of these tiny structures is to take energetic nutrients damaged in mitochondrial epilepsy. In a final experiment,
and convert them into a form that the cells can use. The useful Mark’s team added glutamine to their mitochondrial epilepsy
energy currency in the cell is a molecule called ATP and it is at model. They showed that replenishing the lost glutamine
the heart of all biological processes that require energy. means that the brain is able to restore GABA and stop seizure
And if it fails? activity at the same time.
Now, as with any biological process, there is a potential for This research paper is very exciting for mitochondrial epilepsy.
mitochondria to stop functioning properly. It is estimated that Not only does it provide us a new disease model that we can
about 1 in 4000 people have mitochondrial disease. Of these use to better understand the disease, it also suggests new
people, about a quarter will have ‘mitochondrial epilepsy’, treatments which might work in the condition.
where their condition leads to seizures. Mitochondrial epilepsy Indeed, Prof Cunningham told us: ‘’We believe this work
is notoriously difficult to treat and, on top of that, we don’t provides important insights into the mechanisms which
really know exactly how problems in the mitochondria can underlie mitochondrial epilepsy and provides future avenues
cause seizures in some people and not in others. for developing novel treatments for this condition. We
What do we know about mitochondrial epilepsy? are currently examining how available treatment may be
Not very much! In fact, because we know so little about re-purposed to treat this form of epilepsy based on the
mitochondrial epilepsy, we don’t even have a disease model – mechanistic underpinnings we have discovered.‘
a way to mimic the disease in an experimental setting so that We do have to be cautious at this point. Just because a drug or
we can test new drugs. a treatment works in a disease model, it does not mean that it
What does the new research show? will work in real mitochondrial epilepsy. This paper provides a
They began by looking at post-mortem human brain tissue very strong beginning for further research into mitochondrial
from people who had mitochondrial disease. This gave epilepsy with the hope that one day these treatments could be
them a few clues about how the condition could lead to used in the clinic.
epilepsy. Along with the expected decrease in the activity of For more articles log onto epilepsyinenglish.wordpress.com.
mitochondria, they also observed specific reductions in the
9
EPILEPSY AND EXERCISE
a check list to remind ourselves and It is important to have both types of
most importantly remain safe with our training in a program but remember
exercise. the most important thing is that you’re
• Stay well-hydrated and eat keeping yourself safe.
something light before exercising. Getting Started
• Remember, don’t continue exercising The key is to start small and set
if you feel faint, lightheaded or measureable and attainable goals.
nauseous.
Remember, research states that 30
• Don’t overexert yourself – know your
minutes of physical activity most days
limits and be kind to yourself.
of the week is enough. Why not look at
• If heat or becoming overheated is a
breaking this into 2 x 15 minute blocks
trigger for you, avoid studios which
per day when starting off or even 3
can increase this and exercise in an
blocks of 10 minutes? Try something
air-conditioned gym or at a cooler
simple like a walk around your block.
time of day.
Another way to get moving more is
• Let family or friends know your
to just make your daily activities more
walking, jogging route or exercise
active. Jog up your stairs every time you
location before you leave, and how
climb them. Park in the spot furthest
long you will be out.
Mark O’Reilly is Managing Director from the supermarket entrance or get
• Consider carrying a mobile phone,
of FitVision, a Corporate Wellbeing off the bus a stop or two from home.
which many of us do now.
Partner to some of Ireland and the From there, increase your activity level
• Consider wearing a medical alert
UK’s biggest organisations. Mark is every week slightly and ensure it is
bracelet or pendant, so people can
a former professional soccer player manageable for your current lifestyle.
easily identify you have epilepsy.
with Bohemians here in Ireland and Aim to build sustainable habits, so opt
also with Parramatta FC in Sydney, Can I do things like HIIT (High for small increases which over time lead
Australia along with taking part Intensity Interval Training) or to a big change.
regularly in Triathlons and Ironman Resistance Training?
events. He is an experienced First of all, intensity is relative to the
Should I exercise if I’m tired?
Executive Coach, Personal Trainer, This is a common question. The best
individual. For some, walking a mile
Strength and Conditioning Coach, advice here would be to do some self-
may be high intensity, but for others
Nutrition Coach and Physical assessment. The first step is to figure
that is just a warmup. So, it’s important
Therapist and would like to share out why you are tired. Ask yourself the
that you do not compare yourself to
some ways in which you can use following questions;
someone else, rather listen to your
exercise to help with your epilepsy. body and what intensity is right for you. • Did you not sleep well the night
Mark had epilepsy up until the age Higher intensity exercise is very helpful before?
of 11 and he only began getting to improve fitness, increase muscle, • Are you doing too much at the
involved in sports at a later age due to and help hormone balance. It also can minute and need some downtime?
his condition. This article offers some be done in a shorter amount of time • Has your nutrition been off its regular
tips on how you can start and most which generally can be very appealing pattern and could this be impacting
importantly be safe while improving to us all. High intensity exercise is brief your energy?
your health. and intense. This generally comes • Are you dehydrated and not drinking
Epilepsy and Exercise in the form of interval-based cardio, enough fluids on a regular basis?
Exercise is good for everyone as we bodyweight resistance training or lifting All of these things can make us tired
know, but there can be a stigma weights. and need to be assessed, maybe resting
around exercise and epilepsy. People With low intensity exercise, this means and focusing on fixing those problem
with epilepsy get the same health working out for a longer length of time areas can be a better use of your time
benefits from exercise as individuals at a rate that doesn’t stress the body as that day. I hope this information can
without epilepsy; increased stamina and much. Think of taking a walk, yoga or a help you in developing that regular
strength, weight and fat loss, improved leisurely bike ride, I would recommend amount of activity needed to energise
mood, reduced stress, better sleep, 1-2 sessions of low intensity work per both body and mind.
lower risk of illness- the list goes on and week. Also remember just adding in For further exercise tips and routines
on. Before I offer some advice on how more steps through your day has plenty check out www.FitVision.ie.
to get started let’s look at a few key of health benefits so use your lunch
points to consider in the build up to See also Epilepsy Ireland’s exercise
break to up the total steps for the day,
embarking on your new fitness regime. section on our website : https://www.
especially now coming into spring and
epilepsy.ie/content/sport
Some of the following you will certainly summer.
know already but it is no harm to have
10LEARNING TO BREATHE AGAIN
heat and sometimes after even I think my problems with epilepsy have
catching my reflection in a mirror. My improved over time after surgery but
daytime seizures completely stopped, as soon as I got the hang of breathing
but nocturnal seizures became more lightly through my nose during the day,
of a problem. I did find after-effects the next nocturnal seizure I had was so
such as strong paranoia began to fade much better. I didn’t have that copper
out, but some of the effects I noticed taste in my mouth and was able to get
the next day apart from a bad memory up out of bed. Even if I get that feeling
were a throbbing headache, a dry taste of a panic attack coming on, I still find
in my mouth so that anything I ate that as long as I keep my mouth shut
tasted of copper. I won’t have one, but it’s had such a
I’d stopped having daytime seizures, positive effect on my nocturnal seizures
but I sometimes felt an aura come on that sometimes I have to look at the
as if I was going to have one. When I sleep pattern on my phone to decide
was out for lunch one day, I picked out whether I’ve had one or not. There have
my reflection in a shop window and been times during the day when I get
got that frightening feeling of déjà vu that aura that used to come on before
that I remember having just before I had a seizure. Now I naturally start to
a seizure usually starts. It didn’t turn concentrate on breathing in and out
Epilepsy Ireland member Jenny through my nose and the feeling goes
into a seizure, but it was so long since
Snook (33) discusses an alternative away.
I’d had that feeling I remember how
treatment that helped her anxiety
scared I was. My heartbeat sped up and The first thing my neurologist said
and epilepsy, which is known as ‘The
I started to feel like I couldn’t breathe when I told him was: “Do you know
Buteyko Breathing Method’.
before it turned into a panic attack. I how important it is to breathe through
Epilepsy first became a problem know how many people think they’re your nose?’ If I start to feel like I’m
when I was 13 and started having having a heart attack when this feeling going to have a panic attack, I know if
small complex partial seizures. It was comes on. I remember a big crowd I breathe in and out through my nose,
something I was able to handle until standing around me on Henry St and I might feel out of breath, but it never
I finished college when postictal someone coming out of Clarke’s Shoes goes to my head. I’ve also stopped
psychosis became a problem. This with a pillow for my head. having seizures completely and think
continued for about 3 or 4 days there are always safe, natural methods
After that I was afraid to go out for
after I had a seizure. Some of the that help, it’s just up to the person to
lunch when I was in work but found
effects included insomnia, paranoia, research them and try them out.
out how helpful it was to breathe
thinking that people were constantly
through a paper bag when my Although Lamictal is still something
talking about me and hearing voices.
heartbeat sped up. I began to read I take for epilepsy that I’d never leave
Sometimes I even ended up in hospital
online that lightly breathing in and out the house without having. I think it’s
after a panic attack. My medical
through your nose (Buteyko Breathing also worth trying alternative treatments
team in Beaumont Hospital believed
Method) so that you don’t breathe in like the Buteyko Breathing Method but
neurosurgery might be able to help
too much oxygen, also helped when I only staying on it if it works well for
me.
felt a panic attack coming on. you. After all everybody’s epilepsy is
Five years after surgery, I am now unique.
working in a permanent job for the Buteyko Breathing Method
first time as content executive for After reading a book called “Anxiety
a management software company Free: Stop Worrying and Quieten Your Epilepsy Ireland would like to
in Dublin, giving me the chance to Mind (Featuring the Buteyko Breathing highlight that over-breathing or
research and write my own pieces. I Method)”, by Patrick McKeown, I tried hyperventilation can trigger some
had the choice to work from home or the technique of only ever breathing seizures for certain individuals.
the office, as long as articles are written through my nose. Apart from anxiety Everyone’s epilepsy is unique and
on time. This really helped when I made a link between taking in deep before you consider any alternative
epilepsy was more of an issue. It’s still breaths through my mouth and treatments such as the above please
great to know I have the choice but it’s disrupted sleep. contact your GP.
even better to know it’s not a problem I I made the link between holding
have to worry about anymore. my breath in my sleep and then
over-breathing through my mouth
Life after surgery afterwards, to my daytime sleepiness,
Neurosurgery helped a lot with the
problems with memory and
amount of seizures I used to have
concentration, headaches and dry
during the day. Usually from tiredness,
mouth.
11JOE SCHMIDT SUPPORTS SEIZURE AWARENESS CAMPAIGN
FOR INTERNATIONAL EPILEPSY DAY among the Irish public over the past
five years. There are over 40,000 people
International Epilepsy Day (February with epilepsy in Ireland, so it is vital
11th) was one of the most high profile that we all know the basics of how
days in recent years with widespread to respond to a seizure if ever called
coverage. Epilepsy Ireland used the upon.”
day to focus on seizure awareness with
Ireland Rugby Coach, Joe Schmidt Epilepsy Research Explained Event
supporting this year’s campaign. Meanwhile, Epilepsy Ireland and
FutureNeuro were pleased to recently
Epilpesy Ireland CEO Peter Murphy co-host a Public Seminar to mark
said: “We were delighted to have Joe International Epilepsy Day. The seminar
Schmidt again supporting the need was for people with epilepsy, their
for greater seizure awareness through families & carers and highlighted the
the T.E.A.M. campaign. Joe’s association latest developments in epilepsy research
with Epilepsy Ireland has been a major in Ireland and internationally. A selection
factor in improving seizure awareness of presentations from the event can be
watched via this link: https://goo.gl/
This image of Joe Schmidt was shared by
thousands of people on social media to
xnKqjn.
mark International Epilepsy Day.
Epilepsy Ireland Patron Rick O’Shea told his Political activist Sile Ni Dhubhghaill spoke Asia Enterprises were kind enough to drop
epilepsy story on twitter. about her epilepsy in the Irish Independent. sweet treats into the Epilepsy Ireland office
to mark the day.
In Brussels, Irish MEP Brian Hayes brought together his colleagues for Over 200 people attended Epilepsy Research Explained in the Royal
a seminar on epilepsy. College of Surgeons in Ireland.
Online highlights Other media highlights
Epilepsy Ireland Facebook posts reached 100,000 people An interview with rugby player BJ Botha about his son’s
from February 1st to February 12th. epilepsy was featured in the Irish Times.
Over 72,000 impressions on February 11th on Twitter and The Pat Kenny Show on Newstalk featured a special report
#EpilepsyDay was the most talked about topics on the same on epilepsy which featured an interview with Colin Doherty,
social media platform. Lorraine Lally and Donna Kennedy.
Famous Irish people such as Cian Healy, Minister Finian International Epilepsy Day also enjoyed widespread regional
McGrath and Gerry Adams tweeted their support for coverage through many media outlets (The Kerryman,
#EpilepsyDay. Evening Echo, The Connaught Tribune etc).
12FUNDRAISING
Lunch with Joe Vhi Women’s Mini Marathon Cape Challenge
Former Munster and South African Rugby
The VHI Women’s Mini Marathon, takes player BJ Botha pictured (left) during the
place this June bank holiday weekend in Cape Challenge in South Africa. BJ Botha is
Dublin and is the largest Women’s event of raising funds for Epilepsy Ireland.
its kind in the world. To get involved please
contact Luke Meany on 01-4557500 or Volunteers needed!
Epilepsy Ireland’s annual fundraising email lmeany@epilepy.ie. Epilepsy Ireland are looking for
lunch will be held on May 9th 2019 in Fire volunteers in the Cavan area to
Restaurant Dawson St. take up a church gate collection
The event will involve a drinks reception, on 20th & 21st April. Please
followed by a 3 course lunch. We will then contact Barbara on 01-4557500.
be having a panel discussion where we will
chat with Irish rugby coach Joe Schmidt
and World Cup winner, and former Cork Marathon
Munster rugby player BJ Botha. Tables are The 2019 Cork City Marathon,
now sold out. If you or your organisation Half Marathon & Team Relay will
would like to donate a prize for the event take place on Sunday 2nd June.
please contact Luke Meany on 01-4557500 Entry is now open. Log onto
or email lmeany@epilepy.ie. www.epilepsy.ie/content/get-
involved for more details.
PURPLE DAY
Landmark Buildings around Ireland turn Purple in Support around the country to ‘turn purple’ to raise awareness of epilepsy
of Epilepsy Awareness on March 26th. Almost 40 well known Irish buildings showed
Epilepsy Ireland with the support of Joe Schmidt promoted their support for the cause including the Convention Centre ,
Purple Day this year by encouraging buildings and businesses UCC and Kilkenny Castle.
Joe Schmidt shows his support for Purple Day. The Convention Centre goes Purple for epilepsy awareness.
13REGIONAL EVENTS
Carmelite Community Centre, 56
REGIONAL OFFICES KERRY Aungier Street, Dublin 2 NORTH EAST
10.30am – 1.30pm
Cork 16/04/2019 Commencing Wednesday May 1st 21/05/2019
Tel: 021 – 4274774 Kerry: Family Morning for 6 Wednesday mornings Monaghan; Seminar for
Niamh Jones, Loretta Kennedy Venue: TBC Teachers and SNAs
njones@epilepsy.ie 10.30am-1pm 23/05/2019 Glencarn Hotel, Monaghan
lkennedy@epilepsy.ie Support, Information & Toolkit 6.00 – 9.00pm
28/05/2019 Group for People recently
East For more information or to
Tralee: Support Group for diagnosed with Epilepsy or
Tel: 01 - 4557500 register please contact Mary at
Parents of children with Parents of Children recently
Edel Curran, Carina Fitzgerald the Dundalk office
epilepsy diagnosed with Epilepsy –
ecurran@epilepsy.ie The Manor West Hotel, Tralee 23/05/2019
cfitzgerald@epilepsy.ie Morning Group
10am. Thursday May 23rd 2019 at Navan: Parents Buccal
North-East Carmelite Community Centre, 56 Midazolam information session
Killarney: Support group for
Tel: 042 - 9337585 Aungier Street, Dublin 2. Navan Education Centre, Navan,
people with epilepsy
Mary Baker 10am – 1pm Co. Meath
KDYS centre Killarney
mbaker@epilepsy.ie For more information or to 10.00 – 1.00
Wednesday 10th April
Midlands register please contact Carina For more information or to
Wednesday 8th May
Tel 057 9346790 or Edel on 01-4557500 or email register please contact Mary at
Wednesday 12th June
Cliona Molloy cfitzgerald@epilepsy.ie the Dundalk office
10.30am
cmolloy@epilepsy.ie
20/05/2019 NORTH WEST
South-East
Tel: 0567789904
Tralee: Information Evening for MID WEST
Teachers and School Staff 09/04/2019
Miriam Gray
The Education centre, IT Tralee 11/04/2019 Sligo Outreach Service
mgray@epilepsy.ie
4.30pm Limerick: Nurse Talk for women Sligo Office
Mid-West with Epilepsy
Tel: 061 - 313773 Tralee: Outreach Appointments 10.30 - 12.30
Limerick Education Centre By Appointment only contact
Veronica Bon available each Monday at Kerry
6pm - 9pm Agnes
vbon@epilepsy.ie university hospital or in Tralee
Further information please 02/05/2019 21/05/2019
Kerry
contact Kathryn Parents information Session Sligo: Information Session
Tel: 064 6630301
and Buccal Midazolam for Parents, Families & Carers.
Kathryn Foley
WEST Demonstration Administration of Buccal
kfoley@epilepsy.ie
Clare Education Centre Midazolam
West
Tel: 091-587640 09/04/2019 22/05/2019 St Michaels Family Life Centre,
Edel Killarney Galway Epilepsy Nurse Limerick: Parents Inner-wise Church Hill, Sligo
ekillarney@epilepsy.ie Presentation Session 6.30pm to 8pm.
Maldron Hotel, Oranmore, Galway Radisson Hotel Limerick Please call Agnes to confirm your
North-West 11am - 1pm attendance:
Tel: 074 9168725
CORK 29/05/2019
Agnes Mooney DUBLIN Letterkenny: Hospital Outreach
amooney@epilepsy.ie
29/05/2019 Service
08/04/2019 Cork: Support Group for Out Patients, Scally House
Dublin: Support, Information Parents of Children with Letterkenny
SOUTH EAST & Toolkit Group for People Epilepsy Agnes will be available to meet
recently diagnosed with Bishopstown GAA Club with you at The Neurology Clinic
02/05/2019 Epilepsy or Parents of Children 7.30pm
Wexford: Epilepsy Awareness recently diagnosed with
presentations Epilepsy 22/05/2019
Maldron Hotel Wexford Carmelite Community Centre, 56 Cork: National Epilepsy Week Epilepsy
Information Stand
Ireland
2pm - 3pm - For Professionals: Aungier Street, Dublin 2
“On Epilepsy management with 6pm – 9pm Cork University Hospital
the focus on recognising and
responding to Seizures”
24/04/2019
Arklow: Outreach Service
10am - 4pm
National
2.30pm - 4.30pm - For People with
Epilepsy: “Epilepsy and Seizures”
Health Centre, Castle PARK, MIDLANDS Conference
Arklow, Co. Wicklow
Guest Speaker: Cora Flynn By appointment only contact 24/05/2019 SAVE THE DATE
Advance Nurse Practitioner for St Carina Portlaoise: Information Stand
Vincent’s Hospital Dublin Saturday 28th
Portlaoise Hospital
01/05/2019 10am - 2pm September in the
21/05/2019 Dublin: STEPS (Support and
Waterford Information Stand Radisson Blu Hotel,
Training in Epilepsy Self- Little Island, Cork.
University Hospital Waterford Management) for People
10am - 3pm with Epilepsy for 6 Wednesday More details to follow in
Mornings Summer issue.
14You can also read
