This issue of the stroke newsletter highlights one of the important complications of stroke – post-stroke epilepsy; notes the excellent progress that is being made in the development and provision of evidence-based stroke service in the Pennine Acute Hospitals and the north east sector of Greater Manchester in general, and because of this, we would soon be starting three international stroke trials in the new NMGH Acute Stroke Unit (stroke research). Finally, we pay special tribute to our dedicated founder secretary, Sister Brenda Gibbons, whose visionary leadership and negotiation skills contributed immensely to the development of stroke service in NMGH. Please visit our interactive website at www.strokenewsletter.co.uk and post your views on any aspect of stroke to views@strokenewsletter.co.uk. You can also read other people’s views on the notice-board and visit other stroke web-sites through our extensive links. Do also help yourself to information leaflets on various aspects of stroke now available in our Stroke Information Racks on all Pennine Acute Hospitals Trust sites at Rochdale, Bury, Oldham and North Manchester.

Stroke is common. No age is exempt. It can occur in the first year of life, in the later stages of life, and at any age in between. The causes or risk factors of stroke vary with age, and with gender. Stroke is preventable. Many patients and relatives do not recognize the symptoms of stroke and do not realize that seeking treatment is urgent. We can reduce the chance of a stroke by dealing with the common causes of stroke, such as smoking, excessive alcohol, poor diet, obesity, physical inactivity, high blood pressure, diabetes (high blood sugar), high cholesterol and heart disease such as irregular heart rhythm.

Stroke Awareness - Stroke is an acute medical emergency and all patients require urgent admission to hospital (Acute Stroke Unit).

A Free Stop Smoking Service is now available to members of staff of North Manchester General Hospital, their family and friends who wish to stop smoking, by the Manchester Stop Smoking Service (0161 2055998). For staff or their families/friends in Oldham please call 0161 621 5937, and for those in Bury or Rochdale please call 01706 708000.

A small proportion (2%) of people may have a seizure at the time they have a stroke or soon after (onset seizures). More commonly, the risk of seizures is higher long after having a stroke (up to 5% in the first year following a stroke). Around half of those who have a seizure following a stroke go on to develop epilepsy – by having further seizures. Someone who has had a stroke is 20 times more likely to have a seizure than someone of the same age who has not had a stroke. A seizure can be compared to an electrical short circuit in the brain. The brain sends and receives millions of electrical messages to and from the rest of the body. These messages are passed along nerves, in a similar way to electric currents passing along a wire. Stroke damages the nerves or the insulating material surrounding the nerve core, thereby causing the electrical signals to short circuit. There are two main types of seizures: generalized seizures which involve the whole of the brain, and partial seizures which involve only part of the brain (more common following a stroke). The symptoms or manifestations of epilepsy following a stroke take many forms depending on the area of the brain which has been damaged by the stroke, and whether the electrical short circuit remains confined to that area or spreads throughout the brain. When the short circuit is confined to one area, you may have a ‘focal’ seizure, which often manifests itself as jerking movements of the part of your body affected by the stroke. Whatever your symptoms, you will remain conscious during a focal seizure. Sometimes the electrical short circuit spreads throughout the brain and a generalised seizure – one affecting your whole body – occurs. In this case consciousness may be impaired or lost temporarily. However, not every episode of shaking, jerking, or loss of consciousness is caused by epilepsy. It is important that you see a doctor, who may do various tests to confirm the diagnosis and treat you accordingly. Even if you have had only a single seizure you must notify the DVLA. You must also stop driving until they decide whether it is safe for you to do so again. If you witness a seizure, protect the person from injury by removing any sharp or hard objects nearby and cushioning their head; do not move them unless they are in danger; loosen any tight clothing from around their neck; turn them on to their side to avoid inhalation of vomit and to keep their airways clear; do not force anything in to their mouth to keep them from biting their tongue; do not give them anything to drink after the seizure has stopped; if they have a second seizure immediately after the first, call the doctor or the ambulance; try to remember as much detail as possible to tell the doctor. For more information contact: British Epilepsy Association – tel:0113 210 8800; helpline:0808 800 5050; www.epilepsy.org.uk; National Society for Epilepsy – tel:01494 601 300; helpline:01494 601 400; www.epilepsynse.org.uk .

An article in The Daily Telegraph (Wednesday, November 30, 2005; page 3) reported that a pilot study to investigate whether damaged nerves could be repaired by one’s own stem cells would be undertaken in the UK. This could have important implications for the treatment of stroke and spinal cord injuries. CLOTS, COSSACS & CHHIPS research trials to start in NMGH acute stroke unit.

The 15th European Stroke Conference will be held 16 – 19 May 2006 in Brussels, Belgium – www.eurostroke.org for more information.

North Manchester Stroke Club- Next Event-
Thurs 26 Jan 06; 7-9pm;
tel.0161681 5305 (Marion Sharkey).

National Service Framework - Stroke (Department of Health) April 2001, www.doh.gov.uk/nsf/olderpeople.htm

• Stroke Helpline (for patients discharged from NMGH)
  telephone 0161 720 2709
  
• Stroke Association
  telephone 0161 745 9222; www.stroke.org.uk
  
• Different Strokes
  telephone 0161 655 4245; www.differentstrokes.co.uk
  
• TIA / Stroke Clinic
  North Manchester General Hospital-contact Dr U Ahmed (details below)

Dr U Ahmed (Editor)

• Telephone 0161 720 2790
• FAX 0161 720 2613
• E-mail usman.ahmed@pat.nhs.uk
• Previous issues: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Tuesday 31 January 2006 12.30 – 1.30 PM,
Stroke Rehabilitation Unit (Homewood) Seminar Room, North Manchester General Hospital, Crumpsall, Manchester.

ALL WELCOME