Oct
20
2018

Leg Paralysis Can Be Treated

Several publications show that leg paralysis can be treated. This goes against the clinical experiences throughout the world. The common school of thought was that spinal cord injuries from a severe accident would lead to permanent damage. New research has proven that this is not so.

The publication to show that leg paralysis can be treated

On Sept. 24, 2018 the New England Journal of Medicine reported about several cases where completely paralyzed people were able to walk again with the help of a walker. A surgeon implanted a spinal cord stimulation device was under the skin of the abdominal wall. From there electrodes were going under the skin into the lower lumbar spine and upper sacral area close to the spinal cord. This allowed the muscles of the lower body half to receive the same nerve impulses that the muscles above the injury received. With extensive physiotherapy treatments the body was able to relearn the muscle contractions of the legs and feet.

Relearning how to walk

The next step was to relearn the steps of walking. There was a group of 14 patients with spinal cord injuries who had implantation of a spinal cord stimulation device. They were eventually able to walk again with a walker. The walker was necessary to stabilize their gait. One male took a chance and did not use a walker. He fractured his hip after a fall. But eventually he was making a full recovery and is able to walk now with a walker.

Details of a case of full leg paralysis

Kelly Thomas was driving in a car and lost control. The car ended up at a tree, severely deformed. She was unconscious for several weeks and needed treatment in the hospital. She was 19 and paralyzed from the chest down. Kelly is 24 now and she is able to walk again with the help of a walker. A surgeon had implanted a stimulation device in her abdominal wall with electrodes going to her lower back. The stimulator is passing on the signals coming down from the healthy spine. Electrical signals from the healthy spinal cord make their way to below the severed spinal cord. This though was only the first step.

The second step, a lengthy physiotherapy program

The second step was a lengthy physiotherapy program. All of the previous memories of learning to walk as a child are no longer there in a paralyzed person. The body has to relearn muscle contractions, coordination of muscles, moving of a foot or lower leg. Then all of these sub movements have to blend together into a smooth movement associated with walking. A walker helps to stabilize the gait. This link described more details regarding Kelly’s recovery and how hard she had to work on the physiotherapy part to finally achieve her walking. Leg paralysis can be treated.

Other studies showing people rising from wheelchairs

Here are two other studies that show how other people were able to rise from their wheelchairs.

2015 study

A 2015 study explains how the researchers were able to make one patient walk again. They used a recording of the brain currents (EEG) and pass that information on to below the spinal cord injury. This involved a lengthy learning procedure followed by many physiotherapy treatments. In the beginning it was important to have the patient suspended from the ceiling to prevent falls. Subsequently the patient could walk unsuspended.

2016 study

In a 2016 study eight patients were treated with the system described in the previous paper. Brain-machine interfaces recorded and transmitted the electrical brain activity to below the spinal cord injury. An intense 12-month physiotherapy program enabled the patient to regain her capability to walk. Only 50% of the participants were able to complete walking. There were some drawbacks of this procedure. Thoughts were interfering with brain wave recording. Also, a lack of focusing on the walking process could make it impossible for the person to walk.

Discussion re. leg paralysis can be treated

Walking again after a spinal paralysis is the dream of 1.275 million people with paralysis in the US.  Since these recent scientific findings one can truly say “leg paralysis can be treated”. There are about 8000 that would like to participate in a program, which Kelly Thomas has successfully completed. Her procedure seems to be the scientifically more robust program, although it is invasive considering that a surgeon has to implant the spinal cord stimulation device. The implanted device funnels the brain signals from above the severed spinal cord to below the injured cord. From there the electrical signals travel via the regular nerves into the muscles of the lower extremities. Extensive work with a physiotherapist is still necessary to complete the ability to walk again. For tissue defects, extracellular matrix treatment helps. For leg paralysis think spinal cord stimulation device implantation and physiotherapy treatments.

Leg Paralysis Can Be Treated

Leg Paralysis Can Be Treated

Conclusion

Lately great strides forward made it possible to help help people with paralysis enabling them to walk again. The most promising system is the one involving Kelly Thomas presented here. Briefly, following a serious car injury with a spinal cord crushing injury she received a spinal cord stimulation device. The stimulation device sends the electrical encoded muscle commands to below the scar of the spinal cord injury. The electrical impulses from above the spinal cord scar transmit smoothly to below the scar. The body does the rest.

Lots of physiotherapy

But the body needs a lot of coaxing to relearn the old body movements that connect with walking. A lot of that knowledge receded into the background following the spinal cord injury. However, extensive and prolonged physiotherapy treatments can achieve this. The Spinal Cord Injury Research Centers throughout the US have done a tremendous job researching this area. This resulted in new ways how to make paraplegic people walk again.

Sep
07
2018

Two Proteins Responsible For Getting Epilepsy

Epilepsy is sometimes difficult to control, but research has now identified two proteins responsible for getting epilepsy. According to the researchers this finding has the potential of turning our current knowledge about epilepsy upside down.

How the brain works and seizures originate

The brain is an accumulation of a myriad of nerve cells that are connected with an equal number of nerve fibers.

The communication from one end of the brain to the other end occurs via electrical signals. They have their origin in the nerve cells and travel through the nerve fibers at an astonishingly fast rate.

The nerve cells of the brain also have a connection to the muscles, organs and skin. This is achieved with the help of nerve fibers. They travel through the spinal cord and peripheral nerves to reach the end organs. Again the transmission of these communication signals are through electrical impulses. Usually these signals are perfectly balanced by inhibitory nerve cells, whose job it is in the spinal cord and throughout the brain to keep these electrical signals under control.

Unfortunately some people are not so lucky. They have a “low seizure threshold” and a fever or stress can trigger a seizure or epilepsy. This is a state of the brain where activated parts are overruling the inhibitory parts and an epileptic seizure or partial seizure results. In the case of a grand mal seizure the person may be unconscious for a brief period of time while the muscles have shaking spells. It may start with involuntary muscle twitching around the eyes, the patient becomes unconscious and may fall down onto the ground. The patient may bite the tongue, stop breathing, shake arms, then the trunk muscles and finally both legs. Around 1 in 100 people get epilepsy, and it is mostly children and people above the age of 65 who get it.

New research regarding two proteins responsible for getting epilepsy

Rochelle Hines led a team of neuroscientists from the University of Nevada, Las Vegas in this research. They investigated two proteins involved in inhibiting the central nervous system. In the past it was thought that an overstimulation of nerve cells would have caused electrical overstimulation of the central nervous system causing epilepsy. Now this new research showed that it is two proteins that are missing. Normally these proteins suppress the electrical nerve activity that leads to epilepsy.

First of all, gephyrin is a protein that regulates GABA receptors. GABA is a brain hormone that calms the brain. Another protein, called collybistin is a regulator of the localization of gephyrin.

Different approach to study epilepsy will find better medications

Rochelle Hines and her team found two key proteins, gephyrin and another protein, the alpha-2 subunit of the GABA receptor. They found that they have to interact with each other in order to calm the brain. If this does not occur, seizures (epilepsy) can occur. The emphasis of this research was on finding ways to stimulate the inhibition of the GABA receptor system. In the past the emphasis was to generally calm down the entire brain with medications. This caused a lot of side effects because the traditional anti-seizure medications do not target a specific area of the brain. Now scientists can work with the two key inhibitory proteins, gephyrin and the alpha-2 subunit of the GABA receptor. At this point a new medication is not yet available, but certainly when the development of it is complete, it will be more specific and have fewer side effects.

Some citations from the lead researcher, Rochelle Hines

“Regulating this ‘compartment’ of proteins in the brain that controls cell signalling may lead to better therapies for stopping or preventing seizures. If we can better understand the activity of the brain pattern, we can understand how it might go wrong in a disorder like epilepsy, where brain activity becomes uncontrolled. And if we can understand what is important for this control, we can come up with better strategies for treating and improving the quality of life for people with epileptic seizures and maybe other types of disorders as well, such as anxiety or sleep disorders.”

It is interesting to me that seizures and anxiety maybe the same process in the brain. While with anxiety the brain is irritated, it is still controlled. In contrast in the case of epilepsy the control of the GABA system is gone and the brain excitation is uncontrolled. Medication that will increase the proteins gephyrin and the alpha-2 subunit of the GABA receptor is badly needed.

Two Proteins Responsible For Getting Epilepsy

Two Proteins Responsible For Getting Epilepsy

Conclusion

Epilepsy and seizure disorders appear to now be due to a lack of inhibition in the central nervous system. Two proteins that work on the inhibitory GABA receptors hold the key. They are gephyrin and the alpha-2 subunit of the GABA receptor. There are mouse strains that are deficient for these proteins, and they come down with epilepsy. The human brain has the same proteins that are necessary to inhibit the brain. In anxiety disorders it seems like there is a mild loss of these inhibitory proteins. In contrast with epilepsy the deficiency of these hormones is more severe. Researchers are now concentrating on developing new drugs or modifying existing drugs to stimulate the production of these inhibitory proteins. The hope is that these medications will have fewer side effects, because they will be more receptor specific.

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