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Health Line
a day ago
- General
- Health Line
Side Effects of Amoxicillin
Amoxicillin may cause mild side effects, including stomach issues, headaches, and yeast infections. Less commonly, people may have more severe reactions like seizures. Amoxicillin is a penicillin antibiotic used to treat bacterial infections, including bronchitis, pneumonia, and infections of the ear, nose, throat, skin, and urinary tract. Though it can be highly effective in treating bacterial infections, it also comes with a list of potential side effects. Among the more common side effects of amoxicillin (Amoxil) are: diarrhea stomach upset headache abnormal taste sense skin rash vaginal yeast infection Less common side effects include: allergic reactions like itching or hives, swelling of the face, lips, or tongue breathing problems blistering, peeling, or loosening of the skin, including inside the mouth dizziness trouble sleeping seizures trouble passing urine, dark urine, or a decrease in the quantity of urine unusually weak or tired unusual bleeding or bruising yellowing of the eyes or skin Can you overdose? Taking more than your prescribed dose of amoxicillin is unlikely to cause harm, and treatment is not typically needed for an antibiotic overdose. While acute renal toxicity may occur, it is rare. According to an observation of 285 patients taking amoxicillin from 2014 to 2015, 10 people (18 percent) developed acute kidney issues related to the amoxicillin. It is important to note that this observation occurred in patients with severe infections who received IV amoxicillin at high doses. These patients were not receiving oral amoxicillin for more common infections. Diarrhea Diarrhea is loose, watery, and frequent stool. Diarrhea is considered chronic when you have had loose or frequent stools for more than 2 weeks. Drink plenty of fluids to avoid becoming dehydrated. Drinking milk or other fluids like water may be fine for mild diarrhea. For moderate and severe diarrhea, electrolyte solutions — available online and in drugstores — are usually best. Diarrhea is a common side effect of amoxicillin. All antibiotics kill off the normal bacteria in our guts, disrupting the gut and potentially leading to diarrhea. To treat diarrhea caused by amoxicillin, talk with a healthcare professional first to discuss the best first steps. Then, consider taking a supplement with probiotics, staying hydrated, and following the healthcare professional's recommendation. Diarrhea is typically considered a common side effect, but if you're becoming dehydrated or noticing streaks of blood in diarrhea, seek immediate medical attention. Stomach upset Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly. Almost everyone experiences abdominal pain at one time or another. Most of the time, it is not caused by a serious medical problem. Stomach discomfort or nausea is a common side effect of amoxicillin. Less common symptoms include abdominal pain and vomiting. Taking your dose of amoxicillin with a meal may help prevent this side effect. To cope with an upset stomach, eat bland, easy-to-digest foods like soups, crackers, and toast. Peppermint is thought to help upset stomach symptoms. You can take anti-nausea medication if necessary. If you experience severe, prolonged abdominal pain or see blood in your vomit or stool, seek immediate medical attention. Headache A headache is a pain or discomfort in the head, scalp, or neck. Tight, contracted shoulders, neck, scalp, and jaw muscles likely cause the most common headaches. Headaches are a common side effect of taking amoxicillin, and while less severe, are a frequent occurrence. Taking your dosages with food and drinking an adequate amount of water can help prevent headaches caused by amoxicillin. Headache and migraine medications, including Tylenol and Aleve, can help to relieve headaches caused by amoxicillin. Abnormal taste sense Antibiotics like amoxicillin can cause taste disturbances. Sometimes, a person may find foods taste metallic when taking amoxicillin. One possible reason is the medication can affect how well the body absorbs the mineral zinc. A zinc deficiency can cause a bad or metallic taste in the mouth. Other people may find they are more sensitive to sweet or salty tastes when taking amoxicillin. A person may also be dehydrated if they have a fever while taking antibiotics. A dry mouth can affect a person's taste sensations, too. Most of the time, these side effects go away when you stop taking amoxicillin. Drinking more water to stay hydrated can help. Talk with a healthcare professional if you're having difficulty eating anything because of taste. Skin rash Skin rashes when taking amoxicillin can be common. Sometimes, it's hard to tell if the rash is caused by an allergy. People may notice a skin rash after taking amoxicillin for several days. The rash may have small, flat, or raised discolored patches unevenly spaced on the skin. Sometimes, it's itchy, and it usually starts on the chest, stomach, or back. The rash from amoxicillin is different from an allergic reaction or hives. Hives are raised, itchy welts that usually pop up within hours after taking the medication. A person may also have symptoms such as trouble breathing or swallowing. If you have a true allergic reaction to amoxicillin, seek emergency medical attention if you are having problems breathing. If you take an antihistamine like diphenhydramine (Benadryl), it may help with the itching. Ask for a prescription for another antibiotic 'family' if you are truly allergic. The rash should go away after a few days if it isn't an allergy. Some people may find that an anti-itch cream helps. Vaginal yeast infection Amoxicillin works well because it can keep bacteria from growing. Unfortunately, sometimes that extends to 'healthy' bacteria that maintain pH balance in the vagina. As a result, a person's vaginal pH may become disturbed, where yeast can thrive, and a yeast infection can result. Signs of a yeast infection include itching, redness or other color changes, and cottage cheese-like discharge. Over-the-counter medications are available to treat yeast infections. If you aren't sure if it's a yeast infection or another infection type, you should talk with a healthcare professional. Less common side effects Allergic reactions Allergies are usually not the reason for an adverse reaction to a drug. In fact, allergic reactions are an uncommon occurrence. Though it may seem like an allergic reaction, it is really a nonallergic adverse reaction. Mild allergic reactions include itching and hives. They aren't too worrisome on their own but should be observed in case symptoms worsen. Antihistamines and hydrocortisone can treat mild symptoms. Swelling of the face, lips, or tongue and shortness of breath are signs of a severe allergic reaction. If you experience a severe allergic reaction, seek medical attention immediately. If an allergic reaction occurs, monitor the spreading of the rash or discoloration. Amoxicillin can cause delayed allergic reactions even after you've stopped taking it. Breathing problems Breathing difficulty involves a sensation of difficult or uncomfortable breathing or a feeling of not getting enough air. In some circumstances, a small degree of breathing difficulty may be normal. Severe nasal congestion is one example. Another example is strenuous exercise, especially when you do not exercise regularly. If you have difficulty breathing, you could be experiencing an allergic reaction to amoxicillin. If you're experiencing mild breathing problems, you can try to ease breathing by doing the following: Breathe through pursed lips, slowing breathing and allowing for deeper breaths. Perform activities at a comfortable pace; avoid rushing. Try not to hold your breath. If you are allergic to amoxicillin or penicillin, inform your healthcare professional so you can be prescribed another medication to prevent this reaction. If breathing becomes increasingly difficult, contact your healthcare professional right away. If you have difficulty breathing and swelling of your lips, face, mouth, or throat, call 911 or go to the emergency room. Blisters and other skin problems Blisters are small, raised lesions where fluid has collected under the skin. They may be caused by an allergic reaction, burns, frostbite, or by excessive friction or trauma to the skin. Blisters may also be a symptom of a systemic illness or of a specific skin disorder. This side effect is somewhat rare but serious when it does occur. If you experience discoloration, blistering, peeling, or loosening of the skin after taking amoxicillin, contact your healthcare professional immediately. Home treatments may be used to manage mild, non-itching rashes that are not severe. Treatment includes antihistamines or hydrocortisone, oatmeal baths, and drinking lots of water. However, if skin starts blistering, peeling, or loosening, seek medical attention immediately. Do not take amoxicillin if you're allergic to penicillin to prevent severe skin irritations. Dizziness Dizziness occurs when you feel lightheaded and unsteady, or you experience a loss of balance or vertigo (a feeling that you or the room is spinning or moving). Most causes of dizziness are not serious and either quickly get better on their own or are easily treated. Tell your healthcare professional about the medications you are currently taking before they prescribe amoxicillin. To prevent dizziness, avoid drinking alcohol when on amoxicillin. Avoid driving until you know how amoxicillin will affect you. If you get dizzy, sit down for a moment and see if it passes. If you lie down, keep your head elevated with a pillow. Dizziness may be a symptom of anemia or an allergic reaction. A severe allergic reaction could be present if dizziness is combined with symptoms like shortness of breath or swelling of the lips, face, or tongue. Seek immediate medical attention. Trouble sleeping Sleeping difficulty, called insomnia, can involve difficulty falling asleep when you first go to bed at night, waking up too early in the morning, and waking up often during the night. Everyone has an occasional sleepless night, and this is not a problem for most people. However, as many as 25 percent of Americans a year experience acute insomnia, and insomnia is a chronic problem for many people. Seizures A seizure is a sudden change in behavior characterized by changes in sensory perception (sense of feeling) or motor activity (movement) due to an abnormal firing of nerve cells in the brain. Epilepsy is a condition characterized by recurrent seizures that may include repetitive muscle jerking called convulsions. If you are experiencing this side effect, contact your healthcare professional as soon as possible. Dark urine Normal urine is often a pale or straw-yellow color. When urine strays from this color, it is considered abnormal. Abnormally colored urine may be cloudy, dark, or blood-tinged. Any changes in urine color or the presence of an abnormal urine color that cannot be linked to the consumption of a food or drug should be reported to your healthcare professional. This is particularly important if it happens for longer than a day or two or if you have repeated episodes. Dark urine can be caused by amoxicillin due to changes in blood, liver, and/or kidney function. Renal toxicity is rare, but when it does occur, it can be serious. Those at risk for kidney complications, in particular, should not use amoxicillin to prevent this side effect and potential kidney damage. Your healthcare professional can prescribe another type of antibiotic. If you are prescribed amoxicillin, make sure to only take the prescribed dose within the time suggested by your healthcare professional. It's also important to drink the recommended requirement of water. Dark urine is a severe side effect of amoxicillin. If you experience changes in your urine, talk to your healthcare professional. Difficulty urinating Painful urination describes any pain, discomfort, or burning sensation during urination. Pain during urination is a fairly common problem. A urinary tract infection most often causes it. Amoxicillin may cause crystals to form in the urine. These crystals are directly tied to amoxicillin and look very different than crystals otherwise commonly found in urine. It can also happen in rare cases where the kidney is negatively impacted. To prevent this, never take more than your prescribed dose and drink plenty of water. If you're experiencing slight discomfort when you urinate, drink water and reduce the amount of protein in your diet. Painful urination can also indicate renal failure or damage. Contact your healthcare professional right away if you experience this. Unusual bleeding or bruising Bleeding under the skin can occur from broken blood vessels that form tiny pinpoint red or discolored dots (called petechiae). Blood can also collect under the tissue in larger flat areas (called purpura) or in a very large bruised area (called an ecchymosis). Amoxicillin can increase the risk of bleeding. If you're experiencing either unusual bleeding or bruising, see a healthcare professional immediately. Internal bleeding may be occurring, which could lead to bleeding in the digestive system or, in rare cases, the brain. To prevent this, tell your healthcare professional if you're on anticoagulants or blood thinners before you start taking amoxicillin. If you experience this side effect of amoxicillin, it's considered a rare but serious side effect. Seek medical attention as soon as possible. Yellowing of the eyes or skin Jaundice is a yellow color in the skin, mucous membranes, or eyes. The yellow pigment is from bilirubin, a byproduct of old red blood cells. If you've ever had a bruise, you may have noticed that the skin went through a series of color changes as it healed. When you saw yellow in the bruise, you were seeing bilirubin. Amoxicillin can also cause this effect and liver damage or injury. The liver injury can even occur after amoxicillin doses have stopped. It is more likely to happen when taking amoxicillin with clavulanate. Recognizing early symptoms such as fatigue, poor appetite, and vomiting can help prevent jaundice from worsening. Talk with your healthcare professional if you experience any of these symptoms. Before taking amoxicillin, tell your healthcare professional if you have or have ever had liver damage. When is it an emergency? Taking an extra dose of amoxicillin will not typically cause harm, but there are certain symptoms to look out for that merit immediate medical attention. You should call 911 or the poison control helpline at 800-222-1222 if you experience any of the following symptoms after taking more than your prescribed dose of amoxicillin: stomach pain vomiting bloody or cloudy urine difficulty urinating decreased urination confusion How long do side effects last after taking amoxicillin? Amoxicillin's side effects typically resolve when treatment is stopped. However, the exact length of their duration depends on the side effects. Antibiotic-associated diarrhea may occur for a few hours for up to 2 months after antibiotic intake. Probiotic therapy may help to treat it. Vaginal yeast infections typically resolve after treatment with an antifungal medication, done over the course of 1 to 7 days. Sense of taste tends to return to normal when treatment is stopped. Skin rashes usually begin on the fifth day of taking the drug and last for a week or less. Mild allergic reactions typically stop upon discontinuation of use and treatment with antihistamines and hydrocortisone. Takeaway Amoxicillin is a commonly prescribed antibiotic in the penicillin family used to treat a range of bacterial infections. Side effects of amoxicillin are typically mild and include gastrointestinal issues like upset stomach and diarrhea, as well as headache, rash, abnormal taste, and vaginal yeast infections. Less common side effects like allergic reactions, breathing problems, and seizures have also been recorded.
Yahoo
3 days ago
- General
- Yahoo
Kansas Supreme Court splits on constitutionality of drug-dog search at Wichita traffic stop
Kansas Supreme Court Justice Caleb Stegall, second from left back row, wrote the majority opinion in a case questioning constitutionality of admitting evidence found by Wichita police after deploying a drug-sniffing dog. Justice Eric Rosen, from row left, wrote the dissenting opinion in the case raising questions about Fourth Amendment rights in searches and seizures. (Kansas Reflector screen capture from Supreme Court photograph) TOPEKA — Wichita police officers Donald Bailey and Shawn Isham were watching a suspected drug house in 2020 when Gina Wilson parked a vehicle in the driveway, entered the residence, reappeared a few minutes later and drove away. The officers followed Wilson before pulling her over on Greenfield Street, allegedly for twice failing to properly use a turn signal. Wilson denied committing the traffic infractions, but informed officers she didn't have a valid driver's license. What happened next as Wilson stood on the curb with police officers was closely examined by the Sedgwick County District Court, Kansas Court of Appeals and Kansas Supreme Court. In the end, Wilson lost her bid to exclude evidence of a drug offense and the state's highest court exposed a disagreement regarding constitutional rights of individuals subjected to searches and seizures by law enforcement. On Friday, the Supreme Court's majority opinion from Justice Caleb Stegall affirmed the officers' compliance with the Fourth Amendment in terms of constitutionally conducting the traffic stop and deploying Oden, a drug-sniffing dog, to examine the exterior of Wilson's vehicle. Wilson had refused to consent to a search of her vehicle. However, the canine alerted to presence of illicit drugs. A subsequent examination of the car's interior by Wichita officers led to discovery of a packet of oxycodone pills. Stegall concluded that because Wilson had no legal ability to drive the car away at conclusion of the traffic-related portion of the stop, officers didn't overstep their authority by nominally extending the encounter to allow for the dog sniff. Four minutes elapsed between when the officers completed her traffic citation and the time Oden alerted to presence of drugs. 'Even though she was not under arrest, Wilson argues that because she was not free to leave during these four minutes, she was unconstitutionally seized as an extension of the traffic stop,' Stegall said in the opinion. 'As such, she concludes that the search of the car was also unconstitutional and therefore the evidence gained from the unconstitutional search must be excluded.' Stegall's majority opinion argued Wilson's suspended license created an unusual circumstance enabling officers to deploy the K-9 around her legally parked car that no one was attempting to move. 'Oden's alert provided probable cause, which allowed the officers to perform a warrantless search of the car … and the pills were properly admitted into evidence,' Stegall's opinion said. 'Therefore, officers do not run afoul of the Fourth Amendment's protections by performing a dog sniff of any vehicle that is legally parked in public.' The dissent by Justice Eric Rosen, which was joined by Chief Justice Marla Luckert and Justice Melissa Standridge, said the drug evidence should have been suppressed because prolonging a traffic stop to complete the drug sniff without reasonable suspicion violated the Fourth Amendment. Rosen held the Wichita officers seized Wilson and the vehicle, extended the traffic stop, deployed Oden and discovered an envelope containing 30 oxycodone capsules in the car's console. Rosen expressed frustration the majority opinion 'pronounces some new legal rules for which it provides no supporting authority.' He challenged the majority's declaration that a vehicle directed to the side of the road during a traffic stop shouldn't be characterized as seized by law enforcement. 'The majority likens this car to any car that was voluntarily parked in a public place,' Rosen wrote. 'From here, the majority announces that officers can perform a dog sniff on any car legally parked in public.' In 2022, Wilson was convicted of driving while suspended and illegal possession of opiates. She unsuccessfully argued in district court for suppression of drug evidence while alleging the officers impermissibly extended scope of the traffic stop to create a window for deployment of the K-9 unit. The Court of Appeals sided with the district court in 2023 after concluding there was 'no evidence that the dog sniff meaningfully extended the duration of the original stop.' The divided Supreme Court affirmed Wilson's constitutional rights weren't violated.
Yahoo
3 days ago
- General
- Yahoo
Kansas Supreme Court splits on constitutionality of drug-dog search at Wichita traffic stop
Kansas Supreme Court Justice Caleb Stegall, second from left back row, wrote the majority opinion in a case questioning constitutionality of admitting evidence found by Wichita police after deploying a drug-sniffing dog. Justice Eric Rosen, from row left, wrote the dissenting opinion in the case raising questions about Fourth Amendment rights in searches and seizures. (Kansas Reflector screen capture from Supreme Court photograph) TOPEKA — Wichita police officers Donald Bailey and Shawn Isham were watching a suspected drug house in 2020 when Gina Wilson parked a vehicle in the driveway, entered the residence, reappeared a few minutes later and drove away. The officers followed Wilson before pulling her over on Greenfield Street, allegedly for twice failing to properly use a turn signal. Wilson denied committing the traffic infractions, but informed officers she didn't have a valid driver's license. What happened next as Wilson stood on the curb with police officers was closely examined by the Sedgwick County District Court, Kansas Court of Appeals and Kansas Supreme Court. In the end, Wilson lost her bid to exclude evidence of a drug offense and the state's highest court exposed a disagreement regarding constitutional rights of individuals subjected to searches and seizures by law enforcement. On Friday, the Supreme Court's majority opinion from Justice Caleb Stegall affirmed the officers' compliance with the Fourth Amendment in terms of constitutionally conducting the traffic stop and deploying Oden, a drug-sniffing dog, to examine the exterior of Wilson's vehicle. Wilson had refused to consent to a search of her vehicle. However, the canine alerted to presence of illicit drugs. A subsequent examination of the car's interior by Wichita officers led to discovery of a packet of oxycodone pills. Stegall concluded that because Wilson had no legal ability to drive the car away at conclusion of the traffic-related portion of the stop, officers didn't overstep their authority by nominally extending the encounter to allow for the dog sniff. Four minutes elapsed between when the officers completed her traffic citation and the time Oden alerted to presence of drugs. 'Even though she was not under arrest, Wilson argues that because she was not free to leave during these four minutes, she was unconstitutionally seized as an extension of the traffic stop,' Stegall said in the opinion. 'As such, she concludes that the search of the car was also unconstitutional and therefore the evidence gained from the unconstitutional search must be excluded.' Stegall's majority opinion argued Wilson's suspended license created an unusual circumstance enabling officers to deploy the K-9 around her legally parked car that no one was attempting to move. 'Oden's alert provided probable cause, which allowed the officers to perform a warrantless search of the car … and the pills were properly admitted into evidence,' Stegall's opinion said. 'Therefore, officers do not run afoul of the Fourth Amendment's protections by performing a dog sniff of any vehicle that is legally parked in public.' The dissent by Justice Eric Rosen, which was joined by Chief Justice Marla Luckert and Justice Melissa Standridge, said the drug evidence should have been suppressed because prolonging a traffic stop to complete the drug sniff without reasonable suspicion violated the Fourth Amendment. Rosen held the Wichita officers seized Wilson and the vehicle, extended the traffic stop, deployed Oden and discovered an envelope containing 30 oxycodone capsules in the car's console. Rosen expressed frustration the majority opinion 'pronounces some new legal rules for which it provides no supporting authority.' He challenged the majority's declaration that a vehicle directed to the side of the road during a traffic stop shouldn't be characterized as seized by law enforcement. 'The majority likens this car to any car that was voluntarily parked in a public place,' Rosen wrote. 'From here, the majority announces that officers can perform a dog sniff on any car legally parked in public.' In 2022, Wilson was convicted of driving while suspended and illegal possession of opiates. She unsuccessfully argued in district court for suppression of drug evidence while alleging the officers impermissibly extended scope of the traffic stop to create a window for deployment of the K-9 unit. The Court of Appeals sided with the district court in 2023 after concluding there was 'no evidence that the dog sniff meaningfully extended the duration of the original stop.' The divided Supreme Court affirmed Wilson's constitutional rights weren't violated.
Globe and Mail
5 days ago
- Health
- Globe and Mail
The drastic brain procedure that gave a baby a fighting chance
On a February morning last year, Prakash Muthusami peered at a panel of display screens as he carefully snaked a tiny catheter into the delicate blood vessels of a baby's brain. About two hours had passed since Maryam Fatima's mother kissed her 11-week-old daughter goodbye, tucking a Quran into her pink hospital blankets. Those blankets were now replaced with a blue surgical drape and Maryam was intubated and unconscious, paralyzed under deep anesthesia. Not even an eyelid flickered as electrical storms in her brain caused seizure after seizure. Those seizures were what brought her into Dr. Muthusami's procedure room at Toronto's Hospital for Sick Children in the first place. Maryam had her first seizure within minutes of being born and they never stopped coming – sometimes every minute. On her worst days, Maryam suffered hundreds of seizures, so many she couldn't eat or gasp in a breath. Four weeks after her birth, it looked as though Maryam was unlikely to survive. But on this winter morning, Dr. Muthusami and his team were determined to give her a chance. In many ways, it was a typical workday for Dr. Muthusami, a neurointerventionist who has performed intricate brain procedures on some 2,000 patients in the last 13 years. Some were even smaller than Maryam, whose body was so tiny it could fit onto just the headrest of the procedure table. At under six pounds, she was no bigger than a pet rabbit. But Dr. Muthusami was about to try something that no Canadian doctor had ever done before; in fact, it had only been attempted a few times worldwide. With his catheters finally in position, Dr. Muthusami was ready; he filled a syringe and slowly pushed the plunger, injecting its contents into Maryam's brain. When Maryam was born, her mother Muzna Nafees had a kind of maternal urge to put her baby back inside her body. There, she felt her daughter had been safe; now she was exposed to the dangers and uncertainties of life. Maryam was a firstborn for Ms. Nafees and her husband, Shahban Beg. Ms. Nafees was working for an e-rickshaw manufacturing factory in Lucknow, India when her boss introduced her to his younger brother, a gentle and patient man of few words. 'He was very adamant that we should get together,' she laughs. The couple married in January, 2019, and later moved to Toronto, where Ms. Nafees quickly landed an accounting job and Mr. Beg found work at a jewelry auction company. In 2023, they decided to try for a baby; Mr. Beg, one of six brothers, was delighted to have a girl. Ms. Nafees was doing laundry when her water broke. Maryam was born the next day on Dec. 3, 2023, delivered by Caesarean section at Mount Sinai Hospital, just a ten-minute walk from her family's basement apartment in downtown Toronto, which they share with three other newcomers from India. After meeting mom and dad, Maryam was whisked away to be checked and cleaned while Ms. Nafees rested in the recovery room. For the first hour of their new life as parents, everything was normal. But then, one of the nurses came in with unsettling news. 'She told me that the doctors are seeing her, she is okay,' Ms. Nafees recalls. 'But we saw some kind of twitching in her right arm and right leg.' It was a seizure. Maryam was transferred to the neonatal intensive care unit (NICU), where she continued having seizure after seizure. After a battery of tests, a brain MRI revealed the problem. If the MRI scan were a piece of art rather than a medical image, the two halves of Maryam's brain could have been rendered by entirely different artists. Her right brain hemisphere was like a pencil sketch, a work of realism; the brain folds looked clear and sharply defined, with the grey and white matter separated by distinct borders. Her left brain hemisphere, however, was an abstract watercolour. The brain ridges looked puffy and haphazard, with the grey and white matter blurring together, as though too much water in the brush had caused the paint to bleed. The left hemisphere of Maryam's brain was also noticeably bigger. She was transferred to SickKids, where doctors diagnosed Maryam with hemimegalencephaly (HME), a rare birth defect where one side of the brain is abnormally large. The brain hemisphere's function is so disturbed, and the neurons so disordered, that it is effectively capable of only one thing: causing seizures. Further scans and genetic testing revealed that Maryam also had tuberous sclerosis complex (TSC), a disorder that can cause benign tumours – or 'tubers' – to grow in various organs, including the heart and brain. The next two weeks were a fog of worry and exhaustion. Ms. Nafees was herself hospitalized during this time for symptoms of pre-eclampsia and she and her husband would shuffle between her hospital and Maryam's, watching in helpless despair as their baby was trapped inside a never-ending circuit of electrical misfire. 'The seizures came in a row, in clusters, every minute, every two minutes,' Ms. Nafees says. 'It's a very helpless feeling. She is in pain and you can do nothing. Just watch.' On Christmas Eve, 2023, doctors called a family meeting. Maryam's seizures could not be controlled with medication, they explained, and surgical options weren't possible for a baby of her age and size. Her chances at survival were bleak. 'They thought that it was stressing her body, her health, too much. She was suffering a lot,' Ms. Nafees recalls, tears dripping down her cheek. 'It would be better if we allow nature to take its course.' Three weeks after she was born, Maryam was moved into a private hospital room as a palliative patient. Her doctors couldn't say how long she might survive, or even whether her remaining time could be measured in hours, days or weeks. They laid out one possible scenario: When Maryam's nasogastric feeding tube was removed, she would struggle to feed. Her oxygen levels would drop, her heart rate would slow. She would get sleepy and sluggish and eventually die. Maryam was disconnected from her medical supports. All they could do now was wait. If Maryam had been bigger, older and less fragile, there was, in fact, an option for bringing her seizures under control. In 1928, American physician Walter Dandy, one of the pioneers of neurology, published a report detailing his radical idea for treating incurable brain tumours: removing the diseased half of the brain. The surgery, now known as a hemispherectomy, was ultimately abandoned as a viable treatment for brain tumours. But a decade later, it was attempted on a 16-year-old girl at Toronto General Hospital. The girl had suffered a brain injury as a newborn, which left her with epilepsy as well as paralysis on the left side of her body. Kenneth George McKenzie, Canada's first neurosurgeon, decided to remove her right brain hemisphere; while her paralysis didn't improve, her 'fits ceased completely,' according to a 1939 article. Doctors who examined her afterwards were impressed by her 'striking' physical well-being and mental alertness. And while she lost some forms of sensation on one side, she had good movement in her major joints. Throughout the 1950s, 'anatomic hemispherectomies' were increasingly used to treat drug-resistant epilepsy, but over time it became clear that a significant proportion of patients were suffering delayed surgical complications, sometimes resulting in death. The procedure has since been refined to be safer and less invasive. Today, minimal brain tissue is removed and rather than removing the dysfunctional hemisphere, it's simply disconnected from the healthy side of the brain – a 'functional' hemispherectomy. 'It still survives,' says SickKids neurosurgeon James Rutka. 'But it's offline.' Since 1987, Dr. Rutka and his colleagues at SickKids have done hemispherectomies on at least 28 children with HME. But what kind of future can a child have when half of their brain goes dark? To answer the question, Dr. Rutka pulls up photos of a former patient, who had a functional hemispherectomy when he was six. In one picture, the boy is downhill skiing; in another, he's giving a thumbs up while scuba diving. Later photographs show a tanned and muscular young man, gripping a tow rope while wakeboarding. The boy is now a university graduate. 'You can have an amazing outcome,' Dr. Rutka says. 'It's called the plasticity of the human brain. The younger you are, the more likely the other parts of the brain are able to take over the damaged areas – or parts of the brain that might be missing.' Dr. Rutka has now done hemispherectomies on patients as young as two months old but the risks are often unacceptably high for babies under one. The biggest danger is blood loss, he explains. A baby's reserve is so small, that even a small bleed can prove fatal. Ideally, a baby should weigh at least seven to 10 kilograms before undergoing a hemispherectomy, Dr. Rutka says. In the NICU, Maryam was barely a month old and weighed less than three kilograms. Before Maryam was transitioned into palliative care, her parents asked about functional hemispherectomy, which Mr. Beg had come across in his own research. But they were told that Maryam was too small to undergo the surgery, and doctors weren't sure she'd survive to the point where she would qualify, according to Ms. Nafees. When Maryam was disconnected from her medical supports, her seizures continued, as everyone expected. But then something remarkable happened. She started drinking from a bottle. Her temperature stayed normal, as did her vital signs. She was breathing, moving, looking alert. Maryam was, in a word, alive. Ms. Nafees could tell that some hospital staff were surprised, but she was not. In the weeks since giving birth to Maryam, she had come to understand something fundamental about her daughter: She was strong. 'Maryam proved to everyone, against all odds, that she was going to fight for her life,' says Ivanna Yau, a nurse practitioner with SickKids' epilepsy team. 'This was not the end for her.' Clearly, not intervening was no longer an option, Ms. Yau says; a new plan was formed. Maryam's parents would manage her seizures at home until she was big and strong enough for brain surgery. Ms. Yau – who Ms. Nafees calls a 'sister, life changer, saviour' – joined Maryam's medical team and stayed in constant communication with her parents, helping them manage her seizures and medications. But about a month after going home, Maryam woke up one day and started immediately seizing. The seizures continued nearly every minute for eight hours, at which point she began turning blue. Ms. Nafees rushed Maryam to the emergency room at SickKids. There, in the epilepsy monitoring unit, she was having near-continuous seizures, between 30 and 40 an hour. A patient with drug-resistant epilepsy is defined as someone who fails on two good medications, Ms. Yau says. Maryam was on six medications, in addition to regular boluses of 'rescue medications' reserved for emergency situations, and still she kept seizing. 'It was really heartbreaking,' Ms. Yau says. 'You're in a profession that you want to help, but you feel like nothing is helping ... You're trying to give them hope, and yet you're also suffering alongside with them.' Ms. Yau says a turning point was when Maryam's seizures started affecting the other side of her body, suggested her healthy brain hemisphere was now being affected and therefore at risk. Her breathing was also under threat, prompting increasingly urgent discussions about whether Maryam needed intensive care. Time was running out. Ms. Yau started asking around, searching for options. If Maryam was still too small for a functional hemispherectomy, what else could they do? That's when someone pointed her towards some papers published out of Children's National Hospital in Washington, D.C. One paper, published in the Journal of NeuroInterventional Surgery, described three babies with drug-resistant seizures caused by HME, Maryam's exact condition. The youngest baby was only 13 days old. Their doctors had taken a radical approach for stopping their seizures, with thrilling results – all three were now seizure free. One patient hadn't had a seizure in four years. It was a glimmer of hope. It was also a hard sell. 'We're talking about something drastic,' Ms. Yau says. 'We're causing a stroke.' When open surgery isn't an option, doctors do have another trick for reaching inside the brain. As a medical student in Pondicherry, India, Prakash Muthusami was enthralled by doctors who practiced interventional radiology – a specialty that treats diseases using imaging technologies, like X-ray and MRI, to guide catheters inserted into the patient's blood vessels. It was a kind of medical magic that felt out of reach, almost mystical. But when Dr. Muthusami's friend suffered an aortic dissection, he watched as interventional radiologists fixed this life-threatening condition using just a pinhole opening at the top of his leg. 'That, to me, was so fascinating.' Dr. Muthusami wound up specializing in pediatric neurointervention, treating strokes, aneurysms and blood-vessel abnormalities in the brain without ever cutting open a child's skull. Imagine, for a moment, that the brain is an underground pool inside a rocky cavern. One way of reaching the pool is by drilling through the rock – traditional brain surgery. Another is neurointervention; by mapping the underground tributary system that feeds into the pool, you find one of the connected waterways and travel along until you reach the cavern. 'We use blood vessels as conduits,' Dr. Muthusami says. 'Much like ships and boats sail up rivers and streams, we use catheters and wires.' Recent years have seen neurointerventional approaches increasingly used for childhood diseases, sometimes in game-changing ways. In the past, treating retinoblastoma – the most common form of eye cancer in babies – often meant surgically removing the eye. Nowadays, neurointerventionists can thread a microcatheter into the artery of the baby's eye, delivering a tiny but precise dose of chemotherapy. 'This is an area where technology moves very, very fast,' Dr. Muthusami says. 'There are diseases that yesterday could not be treated. But today, there's the technology and ability.' A few years ago at SickKids, which Dr. Muthusami joined in 2013, he was in a meeting with neurology colleagues when someone flagged some papers published by a medical team in Washington, D.C. They described an audacious new approach for treating babies with drug-resistant seizures caused by HME: an 'endovascular embolic hemispherectomy.' These newborns were too small to undergo open brain surgery, so their doctors devised a workaround. Using catheters and neurointerventional techniques, they intentionally triggered a series of strokes. In other words, they couldn't disconnect the faulty brain hemisphere, so they killed it. Dr. Muthusami was intrigued but cautious. 'We discussed it, nodded around the table, and then moved on,' he says. 'It's so novel that you don't want to introduce something like that unless ... we are backed up against the wall.' That moment arrived in February, 2024, when he learned about Maryam. Dr. Rutka and Ms. Yau both approached him about Maryam's case, explaining how she had run out of options. Would he consider attempting an endovascular hemispherectomy, like the one described in the study out of Washington? 'I think I was silent for a few seconds,' Dr. Muthusami says. Those seconds contained a jumble of questions. Was he ready for something like this? Was his team? What if something went wrong and Maryam wound up in a worse state? He called an old friend and mentor for advice: Was he crazy to consider this? 'It was very counterintuitive to our entire lifelong training,' he says. 'We protect the brain. But here, we are actually going in and causing many strokes.' On the other hand, what was the cost of not trying? Maryam's seizures were becoming life-threatening and he had the team and resources required to take a chance on a risky and novel procedure. And the longer they waited to stop her seizures, the longer her brain was prevented from developing normally, putting Maryam at ever-greater risk of profound disabilities. By morning, he knew his decision. 'This was the only way we could give her a fighting chance.' But the ultimate decision lay with Maryam's parents, and the medical team could see how daunting this idea might be to them, Ms. Yau says. This was a procedure that had never been done before at SickKids, or anywhere in Canada. They would be intentionally damaging parts of her brain. And the risks were stark; a small 'misadventure' with the guide wire could tear an artery, or the strokes could trigger dangerous brain swelling. Death was a possibility. Furthermore, the procedure wasn't even expected to cure Maryam's seizures – just quiet them down to buy her time until she's ready for open brain surgery. Her parents deliberated for a day and a half, but there wasn't much debate. 'We did not have any options other than saying yes,' Ms. Nafees says. 'Because we can't see her like this.' Dr. Muthusami and his team started by using MRI scans to create a 'map' of Maryam's left brain hemisphere. Then, over several days, they devised a strategy for taking it down. They needed to avoid triggering one big stroke, which would increase the risk of brain swelling. So instead, they planned a sequence of mini strokes; think of the careful, stepwise demolition of a building, with dynamite planted in different wings across the building to avoid triggering one massive collapse. Maryam's endovascular hemispherectomy ultimately took place over four procedures, each separated by about a week. Each time, Dr. Muthusami would stroke out a different brain territory, until eventually they all came together to span the entire brain hemisphere. The night before Maryam's first procedure, Ms. Nafees stayed at the hospital overnight at her daughter's bedside, as she regularly did. It was a sleepless night, with Maryam's oxygen levels fluctuating constantly and her seizures firing non-stop. Perhaps the busyness held Ms. Nafees together; she reflects now that a still, quiet moment with her daughter in the dark that night could have invited in the fears that threatened to break her. At 8 a.m. on Feb. 20, Ms. Nafees sent Maryam off with a kiss and the Quran that had been given to the family by SickKids' religious care team. Then she and Mr. Beg settled into the waiting room, where they sat and prayed. Throughout the entire procedure, Maryam's seizures continued. She wasn't moving because of the anesthesia but the electrical activity in her brain was picked up by the EEG electrodes on her scalp. Not too long after Dr. Muthusami deployed his first salvo of microbeads, one of his colleagues from the epilepsy team announced what they were seeing on Maryam's EEG readouts. 'We were watching those seizures die away,' Dr. Muthusami says. 'When we were targeting an area, the seizures from that area would go away.' It was working. About four hours after Maryam was wheeled into the angiography suite, the room filled with the lapping of ocean waves, the sound effect layered into the opening bars of Champagne Supernova, the 90s Oasis hit. How many special people change? How many lives are living strange? It's the song Dr. Muthusami likes to play when wrapping up a major procedure, though he can't exactly explain why. And before parting ways, he and his team – which on this day included a second neurointerventionist, radiology fellows, technologists, nurses, epileptologists and anesthesiologists – often turn to each other to shake hands or high five. From there, Dr. Muthusami's first stop was the family waiting room. 'He told me that everything went very well,' Ms. Nafees says, her voice quavering as she recalls the moment. 'And she was very strong, like a rock.' Maryam wasn't out of the woods yet, though. After a procedure like this, there are worries of a bleed or brain swelling, which could require emergency surgery to remove a piece of the skull. One of the first 13 babies to undergo this procedure in Washington, D.C. died afterwards from complications, according to a recent paper. Maryam was taken to the ICU for close monitoring. But everything was fine. And when Ms. Nafees saw her daughter's first seizure after the procedure, she noticed an immediate difference; her limbs were no longer curling and the twitching was now mainly restricted to her face. 'Her EEG pattern really changed,' says Ms. Yau, who was on vacation at the time but received play-by-play updates from her team. 'There were a lot of shouts of joy, screaming even. We were all ecstatic.' Maryam's second procedure unfolded just as smoothly, as did her third and fourth. By the time she was discharged from SickKids on April 17th – a date that Ms. Nafees considers to be her daughter's true homecoming – she was down to just one or two seizures per day. The plan was to bring Maryam back for a functional hemispherectomy in about six months, but then something surprising occurred. Over the summer, while visiting family in India, Maryam was playing at her grandmother's house when her eye started twitching, just for a few seconds. To date, this remains Maryam's last seizure. Her doctors now believe she may never need brain surgery. 'That exceeded our expectations,' Dr. Muthusami says. It's impossible to say what lies ahead. Maryam is still taking seizure medications and her tuberous sclerosis could always present new problems down the road. At 18 months, Maryam has yet to crawl or walk and is noticeably weaker on one side, giving her a slightly lopsided grin. But the living half of her brain is already taking over. Today, Maryam is a happy toddler who loves spicy food, clapping along to The Wheels on the Bus, and smiling at her grandmother during one of their daily video chats. When her dad absentmindedly puts down his phone, his daughter's tiny hand will dart out to gleefully snatch it. Ms. Nafees is a woman of steadfast beliefs – in God, in fate. She believes it was Maryam's destiny to be born in Toronto, where she had access to not just a specialist like Dr. Muthusami, but the constellation of medical expertise required to pull off such an extraordinary procedure. But her greatest belief, from the moment she laid eyes on her little babu, has always been in Maryam. 'Whatever she wants to do, I think she will do,' she says. 'It was she who fought for herself.'
Emirates 24/7
5 days ago
- Health
- Emirates 24/7
A New Compound Capable of Halting the Progression of Epilepsy Has Been Synthesized
Scientists from Southern Federal University (SFU) and Volgograd State Medical University have synthesized a new compound capable of halting the progression of epilepsy and reducing the frequency of seizures. This was announced by the university's press service. "Researchers from Southern Federal University and Volgograd State Medical University have developed a promising compound that could become an effective treatment for epilepsy. The scientists synthesized a new compound based on benzimidazole derivatives – a class of substances known for their neuroprotective activity. Laboratory tests confirmed that the new molecule not only reduces the frequency of seizures but also protects neurons from damage," the statement said. It was noted that unlike many existing drugs, the new compound does not cause severe side effects or trigger a deterioration in condition after therapy is discontinued. "To assess the effectiveness of the compound, an experimental model was developed: using electrodes attached to the heads of laboratory animals, researchers induced controlled epileptic seizures similar to severe forms of the condition in humans," SFU added. Follow Emirates 24|7 on Google News.
