Author: tucsonlifestyl

Richardson Home

Homeowner Nina Richardson photographed by Amy Haskell.
Homeowner Nina Richardson photographed by Amy Haskell.

Tree-riffic!

Holiday décor enlivens the Richardson home each year, with special help from a local floral designer.

WRITTEN BY DEBBY LARSEN | PHOTOS BY ROBIN STANCLIFF

Nina Richardson’s home portrays their personalities year-round, but this time of year it shines with holiday spirit. She and her husband David, a local anesthesiologist, purchased their place in the Catalina Foothills in 2011. As part of the renovation process, the Richardsons enlisted the expertise of interior designer and artist Kim Coffman of Fine Art Interiors. Her creativity is evident in the elegant décor — especially the formal living room, dining room and master suite.

The elegant formal dining room shimmers in tones of blue. Silver and glass ornaments and table décor complement the room’s ambience.
The elegant formal dining room shimmers in tones of blue.
Silver and glass ornaments and table décor complement the room’s ambience.
 The massive front entry door is framed with garlands of glass balls, ribbons and lights, flanked by toy soldiers. Design by Jacque Askren
The massive front entry door is framed with garlands of glass balls, ribbons and lights, flanked by toy soldiers.
Design by Jacque Askren
Bright red and chartreuse dominate this whimsical themed room, complete with Santa figure. Large-scale candy ornaments adorn this tree.
Bright red and chartreuse dominate this whimsical themed room, complete with Santa figure.
Large-scale candy ornaments adorn this tree.
A large flocked tree glimmers with garlands of brightly colored glass ornaments.
A large flocked tree glimmers with garlands of brightly colored glass ornaments.

“I have been working with Nina for more than four years,” Coffman notes, “and we just finished the complete remodel of the master bedroom. It really was a pleasure to work with Nina because she has a natural inclination toward design and attention to detail. She and I share a love of fabric, so when we were choosing textures for the custom bedding and headboard, we made sure the fabrics had a beautiful texture and aesthetic. It was amazing to see how perfectly Jacque Askren’s Christmas tree design works in the space.” Coffman also has worked with Askren and Nina in putting together vignettes throughout the home for other holidays, as well as everyday décor. Nina’s passion for creating lovely Christmas vignettes began with a prize she won at a Ballet Tucson fundraiser — a fully decorated tree donated by Askren & Sons, Inc. Nina met floral designer Jacque Askren when Jacque delivered the tree, and a friendship grew out of their shared appreciation for the traditions of the season. Every December, with Jacque’s help, the Richardsons’ home is filled with amazing theme trees and all types of décor — from the front entry to the back patio. Nina begins the process of creating her holiday scenes in November. For eight days, she unpacks the carefully categorized and labeled bins and starts her “labor of love.” This process is conveniently coordinated with her husband’s annual hunting trip to Vermont. When Jacque arrives, the duo gets to work adding or subtracting from last year’s collections. After a year in storage, some items need a bit of TLC. Nina’s favorite is a flocked tree she calls the “bubble gum tree” — a 10-footer that glistens with long garlands of glass balls. Jacque explains that when decorating voluminous trees, the use of large ornaments creates depth. “Sometimes when designing a new tree, a particularly beautiful ribbon will catch my eye and dictate a new theme.” On a tall tree, wide ribbons, tucked in and out of the branches, add movement around or down, and clusters of large bows, flowers or ornaments create pockets of interest.

The master bedroom suite shines with subtle tones of gold and taupe.
The master bedroom suite shines with subtle tones of gold and taupe.

In the master bedroom resides what Nina calls her “‘bling’ tree — lots of gold, shimmering ornaments of crowns and stars,” she says with a laugh.

The formal living room echoes the blue tone of the dining room, situated across the entry hall.
The formal living room echoes the blue tone of the dining room, situated across the entry hall.

The latest additions include nine-foot garlands, sporting oversized ornaments, to surround the large front doors. The entry hall chandelier is embellished with strands of LED lights, which hover over a large table display. Decorating is truly a family affair. The Richardsons’ two young daughters, Darya and Natalie, also get into the act by choosing their favorite color theme to coordinate with their bedrooms. Even Nina’s mother Mimi joins the fun. On the last tree, she sewed wide ribbons together to create a custom tree skirt. In the master bedroom resides what Nina calls her “‘bling’ tree — lots of gold, shimmering ornaments of crowns and stars,” she says with a laugh. The media room decorations are the most traditional, in reds and greens, complete with a life-sized figure of Santa. Here, whimsical figures seem to climb among the tree’s branches, with dozens of ornaments fashioned by Darya and Natalie. Giant red and white candies are placed among the chartreuse ribbons. The candy theme is repeated in the kitchen, with gingerbread house-style displays on both the center island and soffits. The collection started with just one house, and years later it has become a village. By the middle of December, each room gets a final nod of approval from Nina and Jacque for the Richardsons’ annual holiday event. “Let the party begin!” HG

Sources:
Askren & Sons Inc., askrenandsons.com
Fine Art Interiors, (520) 975-2947, www.fineartinteriors.com

Holiday Gift

Happenings Abound

(no grinches allowed)

Mark your calendar for these five, fun, festive celebrations of the holiday season! From sharing tea with characters from The Nutcracker, to listening to carols in a historic church, to experiencing a procession honoring the birth of Jesus, there is a wide variety of things to do.

DEC.8-26

Winterhaven Festival of Lights

Photos by Ray Brice

The Winterhaven Festival of Lights is one of the longest running holiday celebrations of its kind in the country! Held annually since 1949, it is visited by thousands of people from all over Southern Arizona. It’s hard to believe that nearly 70 years have passed since CB Richards purchased the first set of Christmas lights and donated them to the neighborhood. He was inspired to create the festival after visiting a similar display in Beverly Hills, California, in the 1930s. He purchased theadder may have sufficed 69 years ago, putting lights up in the mature Allepos now requires the assistance of  Aleppo pines (still thriving today) from a local nursery that was going out of business. They were planted at regular intervals throughout the neighborhood with electrical hook-ups near each tree. Every year, visitors and residents delight in the magic of seeing these elder Aleppos lit up by hundreds of twinkling lights. Although a simple lCOX Cable and Tucson Electric Power, now a proud sponsor of the event. “It’s pretty amazing,” says this year’s chairmen Mariel Hall, of the massive undertaking. Contrary to popular belief, the Winterhaven HOA does not require residents to put up lights. However, Hall says it’s hard not to, “You just get the fever.” Aside from bringing a little Christmas cheer to the Tucson community, the main focus is to raise funds and food for the Community Food Bank of Southern Arizona, a partnership that has been flourishing since the ’80s. In fact, the Winterhaven Festival of Lights is the largest fundraiser they have, and last year $23,820 was raised, along with 49,631 pounds of food! Visitors are welcome to experience the festival on foot or, for a more whimsical experience, reserve a hayride, party bike or trolley limo. There also is a drive-through night on Dec. 26. Donation stations are set up at all four entrances to the neighborhood — open 24 hours a day.

Gold StarsDEC. 8-26

69th Annual Winterhaven Festival of Lights

6-10 p.m. every day Admission free, but donations are encouraged.

For more information visit WinterhavenFestival.org

Winterhaven Hayrides call (520) 825-0208
Arizona Party Bikes call (844) 654-5544.
Trolley Limo call (520) 529-7400

DEC.2

18th Annual Sugar Plum Tea

Photo courtesy of Ballet Tucson
Taylor Noel Photography

This delightful annual tradition features live music and dance performances, shopping and scrumptious treats, all to benefit Ballet Tucson — our city’s only professional ballet company. Ballet Tucson’s Sugar Plum Tea will offer a dazzling array of delicious nibbles to accompany the tea and hot cocoa. Adult guests will have the opportunity to try to outbid one another during a silent auction for fabulous prizes, or enjoy shopping the Holiday Boutique for Christmas gifts and stocking stuffers. Live music of the season will be performed by pianist Jeff Haskell, vocalist Katherine Byrnes and harpist Christine Vivona. Characters from The Nutcracker will appear at the event, and Ballet Tucson’s dancers will perform selections from the well-know holiday classic. Proceeds benefit Ballet Tucson, which was established in 1986, and presents a full season of high-quality professional dance productions, with works ranging from historical classics through contemporary pieces, many created by the company’s own choreographers. TucsonLifestyle.com is a media partner.

Ed Flores Photography

Gold StarsDEC. 2

18th Annual Sugar Plum Tea

1 p.m. Tucson Marriott University Park Hotel Tickets:
$75 per person

For more information call 903-1445 or visit
https://ballettucson.org.

DEC.15

24th Annual Parade of Lights & Festival

Downtown Tucson’s premier holiday event — the Parade of Lights & Festival — brings together Tucsonans from all walks of life to celebrate not just the spirit of the winter season but also the unique culture of our community. Mark the date on your calendar, Saturday, Dec. 15, and make plans for a festive evening for the entire family. The grand scale procession will weave throughout an illuminated and decorated downtown, and you can expect to see a cavalcade of colorful floats, Folklórico dancers adorned with brilliant lights, marching mariachis and … parading pups! The parade is adjacent to Jacome Plaza, where a fabulous festival will be held. You’ll enjoy live entertainment as well as a smorgasbord of foods from local vendors. And … be ready for some Snow!! The parade — presented by Carondelet Health Network and Downtown Tucson Partnership — starts at the intersection of Church Avenue and Alameda Street. For additional information go to downtowntucson.org.

Gold StarsDEC. 15

24th Annual Parade of Lights & Festival

Saturday Time: 6:30 p.m.

Parade Start: Church Avenue and Alameda Street
Cost: free

DEC.14

Las Posadas

Students from Carrillo K-5 Magnet School invite Tucsonans to participate in Las Posadas, an event featuring music, dance, food and fun, which begins at 5 p.m. on Dec. 14. Las Posadas (translated in English as “the inns”) is a nine-day Mexican Christmas tradition based on the Biblical journey of Mary and Joseph and their search of a safe place, or “inn,” to stay before the birth of Jesus. The Carrillo event was started in 1936 by teacher Marguerite Collier, who brought the custom to the school to instill pride of culture in the children of Mexican heritage. Today, the school children join in an after-school program to practice songs, learn the meanings of the characters they play, and even help create props for the procession. From 20 to 40 children usually participate, with “roles” ranging from peasants, “the knocker boy” (who knocks on doors) and pink, blue and white angels. Las Posadas begins at the school, where music, food and folklórico dancing are enjoyed. The children then lead the procession through the streets near the school DEC. Las Posadas 14 (blocked off by TPD for safety), where several “white angels” carry a nativity scene (La Nacimiento). The “knocker boy” will approach several homes, asking “if there is room at the inn.” When they finally reach the fifth, representing the inn at Bethlehem, the nativity scene is placed, and the procession returns to the school for more multi-cultural songs and a distribution of candy. In some years, nearly 300 Tucsonans are part of the procession! This is the 82nd time Carrillo K-5 Magnet School has staged Las Posadas. No TUSD funds are used in staging. It is self-funded by teachers and parents who volunteer to help; the school also holds fundraisers specifically to defray costs. Teachers, parents and support staff members help to decorate, sell food, get ready and clean up following the visit. Proceeds from food sales will go toward next year’s procession. The children also will perform Las Posadas at Presidio San Agustín as part of their Luminaria Nights event on Dec. 8, which runs from 4 to 7:30 p.m.

Photos courtesy of Carrillo K-5 Magnet School.

Gold StarsDEC. 14

Las Posadas

5 p.m.; procession begins at 7 p.m.
Carrillo K-5 Magnet School
4405 S. Main Ave.

Admission is free, food is sold

DEC.11-13

Patronato Christmas at San Xavier

Photos courtesy of Tucson Arizona Boys Chorus

Alandmark setting, two choruses that are renowned for their talent, and a repertoire that is guaranteed to provide comfort and joy add up to a series of concerts that even angels would stop to hear. For Julian Ackerley, director of the Tucson Arizona Boys Chorus, one of the choirs that participates in this remarkable concert, it has been a more than two-decade commitment. “We’re going into our 22nd year of doing it, and it has evolved into a really good format,” he observes. “The Tucson Arizona Boys Chorus is integral in the centuries-old tradition of liturgical music using men and boys’ voices. We do a lot of shared repertoire with the Sons of Orpheus, and then both groups are highlighted with individual music.” Four works that will be performed by the boys chorus this year during these concerts at Mission San Xavier del Bac are, “He Is Born,” by Barry Talley, “Candlelight Carol” by John Rutter, “Hark The Herald/Praise His Holy Name (Gospel Style)” by Keith Hampton, and “Carol of the Bells” by Mykola Leontovich. The concert is a fundraiser for the Patronato San Xavier, which works to conserve the mission, construction of which began in 1756. “The historic nature of the building makes it an incredible environment, and the acoustics are very favorable to the music,” notes Ackerley. “But just looking around at all the icons and the statuary, and being amongst that in a packed house seven times during the week is a very special thing for an 11 or 12 year old to experience. I tell the boys about the history of the mission and we take a little tour of it so that every year they know they aren’t just going to sing in some church. I think that they really value the longevity of the building and its significance in Arizona culture.” TL

Gold StarsDEC. 11-13

Patronato Christmas at San Xavier

6 pm and 8 pm
Mission San Xavier del Bac

For tickets or more information call
407-6130 or visit
www.patronatosanxavier.org/Christmas-concerts.

Festive Feasts

Celebrate the holidays in style with these special dining events at resorts around town.

The holiday menu at El Conquistador Tucson features slow-roasted leg of lamb. OPPOSITE: El Conquistador’s festive desserts include a holiday Yule log and Christmas sugar cookies.

For some folks, the holidays just aren’t the same without days of prep and hours in the kitchen. For the rest of us, there are several simpler options if you and the family prefer to let someone else do the work. Your go-to special-occasion spots around town also are offering traditional, as well as innovative, fare for the holiday season. Here’s a look at some of the menu selections at local resorts.

El Conquistador Tucson, A Hilton Resort

On the northwest side, El Conquistador Tucson also will tempt Tucsonans and tourists with a special holiday brunch on Christmas Day. There’s a reason locals have long counted on this particular spot for holiday celebrations — when a resort dedicates a whole ballroom to brunch, you know they mean business. Expect seasonal dishes, along with the Southwestern-inspired fare of Executive Chef Jan Osipowicz. This year’s signature offerings will include a slow-roasted leg of lamb with rosemary and garlic, sea salt-crusted prime rib, and baked salmon en croute. Holiday goodies such as spiced chocolate yule log will be in good company among the myriad other desserts and treats that the resort’s pastry crew bakes for this brunch. To keep the holiday spirit going after feasting, head to the resort’s lobby to marvel at a life-sized gingerbread house, which is open to the public. This is the fourth year El Conquistador has unveiled this specially crafted creation for the holiday season, bringing new meaning to “sweet digs!” 10000 N. Oracle Rd., (520) 544-5000, hiltonelconquistador.com

Loews Ventana Canyon

Loews will continue a longstanding tradition of bringing cheer to locals and visitors alike with a lineup of festivities, including free community events for all ages, and special fare in the resort’s restaurants. For the entire month of December, visit the resort on Fridays and Saturdays for their three-course afternoon Holiday Tea. If not already part of your family’s traditions, expect to add it after leisurely sipping tea or champagne, and nibbling on scones, finger sandwiches, and special holiday pastries. In addition, Executive Chef Ken Harvey of the Flying V Bar & Grill goes all out to create special dinner menus for both Christmas Eve and Christmas Day, while the Canyon Café puts out quite a spread for Christmas brunch. 7000 N. Resort Dr., (520) 299-2020, loewshotels.com/ventana-canyon

At PY Steakhouse, house-brined and smoked Kurobuta Ham is a seasonal specialty, with creative sides including grilled pineapple.

PY Steakhouse

PY Steakhouse may be best known for their perfectly aged, prime cut meat and fresh seafood, but they also take great pride in their seasonally inspired menus. And for December, Executive Chef Ryan Clark incorporates pumpkin in his dishes, using those locally harvested from Tucson’s Pivot Produce. Chef Clark works his magic with this Chef’s Seasonal Selections menu, taking the familiar squash to new heights with courses of roasted pumpkin bisque, seared scallops served with pumpkin risotto and pepitas, and finishing off with pumpkin fluffernutter for dessert (made with pumpkin-peanut mousse, whipped marshmallow, and bread crumbs). On Christmas Eve and Christmas Day, in addition to their regular menu service, PY Steakhouse will offer a few more holiday-inspired specials. First is an herb-salt-rubbed prime rib roast with rosemary jus and cream horseradish, accompanied by mashed potatoes and butter-roasted baby carrots. Also available will be house-brined and smoked Japanese kurobuta ham with grilled pineapple jam and a fresh-juiced cherry reduction, alongside butter whipped potatoes and winter vegetables. 5655 W. Valencia Rd., (520) 324-9350, casinodelsol.com

The Westin La Paloma Resort & Spa

The special menu for The Westin La Paloma’s Azul Restaurant includes spicerubbed sterling salmon (above) and heirloom squash bisque served in roasted acorn squash.

Another time-honored Tucson tradition for sumptuous meals, La Paloma’s fine dining restaurant Azul offers a special holiday dinner menu this year. Among other tried-and-true seasonal dishes, look for Executive Chef Russel Michel’s artful Southwest-infused offerings with that extra festive twist. Year-round, Azul’s menu reflects the seasons, highlighting locally sourced ingredients. For December, Chef Michel puts a spotlight on one of his very favorite flavors with an aromatic heirloom squash bisque served in roasted acorn squash bowls. Another special entrée is sterling salmon dusted with a house-made 12-spice adobo rub, served with an herb and pomegranate pico de gallo. Keeping it all well-balanced, a special dessert also will be available — a caramel spiced-pear cheesecake trifle. 3800 E. Sunrise Dr., (520) 742-6000, westinlapalomaresort.com

Hacienda del Sol Guest Ranch Resort

Head to this picturesque and historic spot in the heart of the Catalina Foothills to dine in style. Every year, Hacienda del Sol’s indulgent Christmas Day Buffet features an array of seasonal favorites and traditional fare. Choose from stations ready to serve up roast turkey with stuffing and thyme-andgarlic gravy, prime rib, or country ham. Dive into a seafood display or a variety of savory salads and sides like minted green beans, roasted beets with orange and horseradish, and cinnamon-cayenne sweet potatoes. With so many options, it may be difficult to leave room for dessert, but make the effort! Of course, there will be fresh donuts, cheesecake and fruit tarts, but to get into the season indulge in gingerbread mousse, figgy pudding, and chocolate cupcakes with peppermint buttercream. 5501 N. Hacienda del Sol Rd., (520) 529-3500, haciendadelsol.com TL

Bacon-wrapped pork loin (above) and salmon en croute are holiday specials at Hacienda del Sol Guest Ranch Resort.

Get In On the Outs!

Debby Larsen
Debby Larsen on a recent garden photo shoot.
Photo by Thomas Veneklasen.

Dive into spring, with an issue filled with reasons why we love being outdoors in Tucson! Our cover story is an award-winning pool and patio remodel by Elizabeth Pryzgoda-Montgomery. The new light and bright look pleased not only the homeowners, but contest judges as well. See the results, starting on page 18. Another contest winner involved a complete pool and patio renovation by landscape designer Allen Denomy. His task was to create elements to block an unwanted view, along with making the outdoor living areas more functional and aesthetically pleasing. Turn to page 30 for the reveal. Two local firms, Pro Remodeling, and Pools By Design, collaborated on a project to replace a worn-out pool with a new one and build a cozy, wellappointed pool house. This picture-perfect makeover was a win-win for all. Check it out for yourself, beginning on page 24. Elsewhere in this issue, visit the kitchen of Wendy Gauthier of Chef Chic, who shares a favorite recipe for mini chicken pot pies on page 14. One afternoon, we visited Yume Gardens to photograph the result of a Japanese floral arranging class led by guest Ikebbana specialist Ping Wei. Marvel at a few of the participants’ designs on page 34. We have more beautiful flowers for you on page 32 — orchids — which may not be as hard to grow as you think! Debby Larsen on a recent garden photo shoot.

In Health

Seizures — What you must know.

By Anne Kellog

Seizures can be caused by something as simple as becoming dehydrated, and do not always indicate epilepsy. However, they always can be dangerous … even life threatening. We spoke with two neurologists on the subject, one of whom shares her experience of experiencing seizures as a result of a metabolic epilepsy disorder.

“A seizure  indicates abnormal brain wave activity,” according to Mateja de Leonni Stanonik Spindler, M.D, M.A., Ph.D., of Vita Medica Institute. “I liken it to a sort of ‘electrical earthquake’ in the brain,” she says. “That description speaks to what it’s like for patients with these electrical discharges.”

Seizures can vary greatly in their degree and causation. Some are barely noticeable, while others are dramatic to witness.

Dr. de Leonni notes, “The general public should understand that seizures are far more common than we are led to believe, and that the least common type we see are the stereotypical grand mal seizures (with violent muscle contractions and sometimes unconsciousness).”

Some patients develop seizures in infancy — in most cases because of an epilepsy disorder — but even people who never have had a seizure in their lives can have one.

Symptoms

Imagine you’re at Wildcat football game on a hot, sunny day, and perhaps you have consumed several beers while tailgating. You’re having a terrific time but suddenly you feel a little peculiar, start convulsing and drop to the ground. What happened? You’ve never had a seizure before, so what gives?

In many cases, a seizure can be a one-time thing or multiple seizures can occur even in a nonepileptic patient due to a combination of triggering factors.

“On a biochemical level, usually we discover there’s an imbalance between the sodium and potassium ions in the brain cells, which cause electrical abnormality between nerve cells,” Dr. de Leonni states. “Certain medications, for example, can disturb the balance of sodium, potassium, and sometimes calcium in the brain, which can bring on a seizure.

“Let’s say you get very dehydrated and don’t sleep well that night, or maybe had an infection going on — that’s a perfect storm to bring on a grand mal seizure. Those who have consistent seizures have epilepsy or an epileptic disorder, for which they often are genetically predisposed.”

An epileptic seizure can be presaged by an “aura,” or perceptual disturbance such as flashes of light or an unpleasant smell. These auras often give the patient enough warning that he has time to avoid injury.

I will ask the patient to keep a diary that includes their sleep patterns, daily diet, stress levels and any seizure activity.” — Mateja de Leonni StanonikSpindler, M.D., M.A., Ph.D.

Diagnosing the Cause of the Seizures

Dr. de Leonni gathers information as part of taking a patient history. Photo by Chris Richards

Job one for the neurologist is to help the patient reduce or even stop the seizures altogether, if possible. The neurologist will take a patient history, do a full physical workup, and perform an electroencephalogram (or EEG), to look at the brain’s electrical activity. “There are definitive signs in the brain waves that indicate to the neurologist that a seizure has occurred, or is about to occur,” Dr. de Leonni explains. “We always perform imaging tests as well, such as magnetic resonance imaging (MRI), to look at the brain’s anatomy and check for structural anomalies or scarring from a stroke or injury.”

Depending on the severity and frequency of the patient’s seizures, the neurologist may have the patient wear an EEG monitor for several days at home, or he’ll be put in the hospital and observed 24 hours a day for several days. In that way, a certain course of medication can be tried and the EEG closely monitored to see how he responds. In a patient with an epilepsy disorder who has many disruptive seizures, it may require trying several different types of medications before an optimal match is found,

“I will ask the patient to keep a diary that includes their sleep patterns, daily diet, stress levels and any seizure activity,” Dr. de Leonni notes. “Sleep, or lack thereof, is extremely important in seizure patients, so I always address sleep issues, as well as any coexisting mood disorders (i.e., anxiety or depression).

“I also check the patient history for any type of heart issues, such as any history of arrhythmia or atrial fibrillation. The heart and the brain are connected electrically, and when atrial fibrillation or arrhythmias occur in the heart, a seizure can be brought on, and vice versa. When seizures occur, the incidence of heart arrhythmias — particularly ventricular arrhythmias, the most dangerous ones — is higher, and death can be imminent.”

Seizures in Infants and Children

“Seizures that start in babies and small children — unless caused by high fever or other trigger — usually indicate they’ll have epilepsy in adulthood,” Dr. de Leonni contends. “Sometimes the child can outgrow it.

“It is believed that in some cases the area of the brain causing the childhood seizures has its etiology in abnormal development of the brain, either in utero or shortly after birth. Those areas can serve as  focal points for abnormal brain wave activity. With imaging techniques such as functional MRI, we’re better able to detect those areas and, in some cases, surgical excision of those areas can be curative. Epileptic surgery is a fairly new and very much evolving field.

“In babies who die of Sudden Infant Death Syndrome, we believe that at least half, if not the majority, actually are caused by a heart rhythm abnormality that then translates into a brain wave abnormality as well.”

Seizures in Older Adults

As one ages, shrinking of the brain is inevitable — it’s a normal part of aging. However, many seniors also suffer from chronic conditions like high blood pressure, diabetes, or high cholesterol. “That predisposes you to have hundreds or possibly thousands of transient ischemic attacks (TIAs), or mini-strokes, over time,” says Dr. de Leonni. “These TIAs leave scars in the brain that serve as foci for seizures. I have many older patients who are on medications for some or all of these ailments. There may come a time when they’ve become dehydrated, are running a fever or are stressed, and boom, they can have a seizure.

“If the patient is someone who already has had a stroke or TIAs, the likelihood of their having a seizure can be higher than 80 percent. If the patient is someone without these risk factors for stroke (such as high cholesterol, diabetes, hypertension, obesity), the percentage is probably lower.” 

Treatment

To perform an electroencephalogram (EEG), electrodes must be placed in specific locations on the scalp so brain wave activity can be monitored.

If a patient is diagnosed with epilepsy, the number and severity of their seizures, combined with test results, will dictate the medication the neurologist may choose. In the majority of those with epilepsy disorders, their seizures can be brought under control with medication and they go on to live relatively normal lives. Dr. de Leonni notes that some epilepsy disorders are typified by “intractable” seizures, meaning that medications do not bring the condition under control. In these cases, neurosurgery may be the answer, especially if the epilepsy only affects one side of the brain, such as in refractory partial epilepsy. A surgeon can remove the area of the brain that’s responsible for the seizures.

In those patients without epilepsy, a seizure can be a one-time thing, caused by specific triggering factors, such as our example of the football fan. These incidents can occur more than once.

Seizure triggers can include:

• Jet lag, sleep deprivation

• Electrolyte disturbance (usually caused by dehydration)

• Withdrawal from overuse of alcohol. Other illicit drugs also can produce seizures, such as cocaine, heroin and even marijuana, if it is ingested in toxic levels

• Some prescription meds will lower the seizure threshold, for example Tramadol (a pain management medication) and certain antibiotics to which the patient is sensitive.

• Specific foods can trigger seizures in individuals who are sensitive to them, such as honey, carbohydrates and artificial sweeteners.

Magnetic resonance imaging (MRI) allows the neurologist to look for structural abnormalities in the brain.

• Certain metabolic issues such as liver or kidney problems

• Any infection that produces high fevers

• Flashing lights — even the slight fluctuations in fluorescent lights

• For women, the changing blood levels of estrogen and progesterone right around their periods

• A drop in blood sugar below 70, and especially below 50

• Excess caffeine

In addition to medications and trigger avoidance, neurologists have a number of other less conventional methods in their arsenal to help prevent seizures, even in those with epilepsy disorder.

“We’ve discovered, especially with kids, that a ketogenic diet is very helpful in helping to abate epilepsy,” observes Dr. de Leonni. “We also counsel our adult patients that carbs can make seizures worse. High-protein diets can help even in very severe genetic seizure disorders.

“The Academy of Neurology and the FDA have approved medical marijuana as a treatment in intractable epilepsy. And we’ve even been incorporating aromatherapy with our patients. These are multifaceted and complicated issues, and they require all of our efforts to help reduce seizure incidence.”

Seizures: A First-Person Account

Louann Carnahan, D.O., is a board-certified neurologist and a fellowship-trained Epileptologist treating adult patients at the Center for Neurosciences.

Here, she shares her experience with seizures related to a unique clinical syndrome called Myoclonic Epilepsy with Ragged Red Fibers.

had my first generalized convulsive seizure when I was 17 years old, during a high school calculus test, in a classroom full of students and everything!

What is it like to have a seizure? Some people, like myself, have no warning, it’s just boom — I lost consciousness.” — Louann Carnahan, D.O.

“I took the seizure in stride, and went about my business, not too concerned about having another. The second one occurred nine months after the first while I was on a plane going to Indonesia. We were over the ocean when it struck. I was with my brother, and because he knew my history he got on the phone back home, and they got hold of a neurologist. By the time we landed in Japan, my family had arranged for a doctor to meet the plane. I spoke with a young doctor for a quick assessment, and my home neurologist already had shipped my medicine to Indonesia, so it was there when we finally arrived.

Dr. Louann Carnahan points out an area of interest on a brain scan. Photo by Kris Hanning

“The cause of my seizures is a bit more complicated than traditional epilepsy. It’s part of a syndrome of mitochondrial disorders — a systemic disorder that can affect multiple parts of the body. It is called Myoclonic Epilepsy with Ragged Red Fibers, or MERRF syndrome. Ragged Red Fibers pertains to the microscopic muscle cell appearance, and it causes weakness and nervous system issues that started to affect me a few years later when I was beginning medical school.

“A doctor asked me later if I’d ever had any jerks or twitches in my arms, and I’d actually had them all the time since I was 14. That is textbook for my kind of epilepsy, and those were myoclonic seizures, which is a common presentation.

“What is it like to have a seizure? Some people, like myself, have no warning, it’s just boom — I lost consciousness. My classmates and, later, the people on the plane, witnessed my stiffening and convulsions. Seizures by their classical definition, are very short — a couple of minutes or less on average.

“Relatively speaking, I’m very lucky that I’ve had only three seizures in my life. My third one occurred during medical school the morning of an exam! I woke up on the floor, and discovered I was on the phone with my classmate. He knew I was in the habit of sleeping in, so he had called to make sure I made it to the test. I was confused and had a huge headache, I’d bitten the inside of my mouth pretty badly, and all I could think was, “I’ve got to get to that test! I did end up passing it….

“So I ended up back in the neurologist’s office in a new city. He was the first physician to put together that my epilepsy syndrome was consistent with the myoclonic type.

“I got on the proper medication, have had no further arm jerks or generalized convulsions, and I’ve passed my 12-year anniversary of being seizure-free.

“The Center for Neuroscience treats both children and adults, but I am an adult neurologist. Treatments are the same for kids and adults, and seizure activity is the same in terms of the electrical storm in the brain … it’s the same pathophysiology.

“The majority of patients, 65-70 percent, can be controlled with medication if they take it as prescribed, and follow up with their doctor. I’d say successful treatment relies half on medical treatment and half on self care of the patient. Many times, the struggle is the patient being noncompliant. In my own situation, the seizure I had in medical school led me to realize how very disruptive my epilepsy was. I couldn’t drive for six months, and I hated that. So, I finally complied, and took my meds.

“Symptomatic management and treatment of epilepsy is largely the same as it has been: medications and Vagus nerve stimulation.

Deep Brain Stimulation modulation recently has been approved in the U.S.; it was approved in Europe going on 10 years, but wasn’t FDA approved. They had Deep Brain Stimulation for intractable movement disorders such as Parkinson’s, but the approval never crossed over to the area of epilepsy. Experts are still learning the correct amount of stimulation for epilepsy, so this is still on the horizon for generalized use.

“Quite honestly, I’ve never looked on the epilepsy part of my condition as a disability. I just take my pill and forget about it.

“Statistically speaking, the majority of patients who are controlled go on to live normal lives.

“There are triggers that can cause a breakthrough seizure, such as sleep deprivation, stress (the top two triggers), illness or running out of meds. Lifestyle management is important.

“The seizures were what sparked my interest in neurology. I already had an interest in becoming a doctor and thought I wanted to become a surgeon, but during my med student rotations when I got to neurology I loved it!

“The other side of my condition, the Ragged Red Fibers, started manifesting early in medical school, and that causes a visible, physical disability from muscle weakness. I’ve had to use electric mobility aids. When I started my clinical rotations, my legs were too weak to walk the entire distances. It has been a challenge, and I’ve been fortunate that my advisors and co-workers have been willing to work with me to develop accommodations for my muscle weakness, such as electric scooters. I was introduced to people who understand, because I chose the field of neurology.

“My goal is that my patients return to normal life, that they’re seizure-free, able to drive and work where they wish. Understanding, education and awareness are key for patients being treated for epilepsy. When dealing with patients who won’t take their medication, I’ll ask them, ‘How much do you want to live confidently? What is it worth to you?’”

Editor’s Note:
This article is by no means meant to be an exhaustive study on, or medical advice for, seizures and epilepsy.
Readers always should obtain medical help immediately if they suffer a seizure
. 

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