Brain surgery alleviates epilepsy in some children according to study>
Durham, N.C.? While modern
drugs have brought relief to many
youngsters who have epilepsy, about
20 percent of these children do not re
spond well to anticonvulsants For
some, surgical removal of an area of
the brain? usually the size of a
child's fist? is the answer.
"Surgery has a proven track re
cord for being a safe and effective
treatment for adults with epilepsy,"
said Dr. Darrell V. Lewis, associate
professor in the division of neurology
in the Department of Pediatrics at
Duke University Medical Center.
"In the last two decades, more phy
sicians have recognized that early
surgical treatment of children whose
seizures are not stopped by medica
tions will markedly improve the
child's ultimate social and intellec
tual development."
Lewis is with Duke's Center for the
Advanced Study of Epilepsy, which is
directed by Dr. James O. McNa
mara, professor of neurology The
center, which receives most of its re
ferrals from the Southeast, evaluates
20 to 30 children as potential candi
dates for surgery per year. Only 10 to
IS of them prove to have a localized
area of seizure onset that can be re
moved surgically.
Most types of epilepsy are geneti
cally inherited or appear following
head injury or stroke. The seizures,
which can occur as infrequently as
one or two per month or as often as
hundred per day, are caused by a
temporary dysfunction of the brain
due to excessive and abnormal dis
charges of its neurons.
Candidates for surgery must meet
several criteria. "Their condition
must be medically intractable," Le
wis said. "Their medical records
must show that, even with the best
anticonvulsants, they had no relief.
For these children, the medications
are just as much trouble as sei
zures."
The medications cause drowsiness,
coordination problems, irritability
and disturbance of sleep. Hie most
subtle? and sometimes the only
side effect, an interference of learn
ing and memory capacities, is not
easily detected by physicians, Lewis
said.
The seizures also must be the prin
cipal problem that prevents a child
from leading a productive life. Some
children may have overwhelming
problems in addition to epilepsy, and
surgery would be of no benefit, Lewis
said.
There are several types of sei
zures, but those who suffer from par
tial seizures are the best candidates
for surgery. Partial seizures, which
commonly have their onset in child
hood, begin in one area of the brain
and can spread to other areas.
"For example, a seizure beginning
in the visual cortex may spread to the
temporal lobe," Lewis said. "The
child may first see flashing lights and
then, lose conscious neas as more
areas of the brain become involved."
When areas of the brain controlling
motor functions are involved, the
child's body will become stiff. Partial
seizures sometimes lead to grand
mal convulsions.
Like other epileptic seizures, par
tial seizures often have no obvious le
sion, such as a tumor, to cause their
occurrence, Lewis said. But, with
testing, physicians often can pinpoint
the area of the brain where the sei
zure originates.
Using video-EEG monitoring
equipment throughout a one-to-two
week hospital stay, physicians can
monitor the child's brain activity as
well as make audio-video recordings
to determine the nature of the child's
seizures.
"We have to make sure we see all
of the seizure types of each patient,"
Lewis said. Different types of sei
zures may originate from different
sections of the brain.
An additional evaluation tool uaed
Is magnetic resonance imaging
(MRI), which is a sensitive brain
imaging technique brain scan that
can reveal abnormalities missed by
other tests.
Psychological tests to evaluate
memory, IQ and personality are also
given to help determine whether the
right or left hemispber is involved.
"These tests are also useful in pre
dicting how well the child will do af
ter surgery," he said. "Follow-up
testing is also done after surgery. We
often see small increases in IQ."
If the neurologist cannot determine
the area of the brain where seizures
begin, another test, depth electrodes
recordings, may be necessary. Elec
trodes are implanted in the brain for
as long as several weeks to record
brain activity during seizures. How
ever. this is a surgical procedure and
is not without some risk of complica
tions.
Once the area is defined, the physi
cian must evaluate the risks of sur
gery. "The affected area? most cotf)
monly it's the temporal lobe? is
removed only if no neurological prob
lem would result," Lewis said.
Surgery can yield dramatic re
suits. After temporal lobe surgery,"
two out of three patients can be
rendred seizure-free with most oth
ers experiencing a significant de
crease in the number of seizures.
The most important function of the
temporal lobes is memory, but the
child experiences little loss of mem
ory following surgery. f - ?.
"In fact, because the child no
longer hindered by seizures and med
ications can be reduced, his school"
work improves, and he makes better
social adjustments," he said. '
Home loan points may not win you many tax deductions
If you bought or refinanced your
home this year, you should be aware
of the rules surrounding the deducti
bility of certain costs incurred in the
process of financing house points.
According to the North Carolina
Association of CPAs, home mortgage
or equity loan points are genrally de
ductible, but there are some provi
sions that may force you to spread
the deduction over the life of the loan.
The term "point" is sometimes
used to describe certain charges paid
by a borrower. They are also called
loan origination fees, maximum loan
charges, or premium charges. If the
payment of any of these charges is
only for the use of money, it could be
deductible.
Points are treated as prepaid inter
est are generally deducted over the
period of the loan unless they are in
curred on a loan to buy or improve
your principal residence. In this
case, points are deductible in the
year paid, provided r
1. The loan is secured by your
principal residence;
2. The charging of points is an es
tablished business practice in your
geographic area in which the loan is
made;
3. The points paid did not exceed
the number of points generally
charged in your area.
In order to get a deduction for
points, the loan document should
clearly establish that the points were
not paid for any specific services that
the lender performed in connection
with your account under the loan con
tract. Separate charges should be in
dicated on the loan agreement. In ad
dition, you should write a separate
check for the points. Don't have the
points paid out of the mortgage pro
ceeds as they may then become de
ductible over the term of the loan.
To determine the annual deduction
allowed for points spread over the
life of the loan, the IRS, as a matter
of "administrative convenience," al
lows most peopie to allocate the
points ratably That means you can
divide the total cost of the points by
the total number of periodic pay
ments due over the life of the loan.
That figure is then multiplied by the
number of payments made in the cur
rent year.
For example, in June of this year
you paid (3,600 in points that do not
meet the tests for full deductibility in
the current year. The term of the
loan is 30 years with payments made
monthly. That means for this year's
taxes, you may deduct $60 of the
point co6t. ($3,600 divided by 360 pay
ments times 6 payments made.)
Generally, points you pay in refi
nancing a mortgage, regardless of
how you arrange to pay them, are not
deductible in full in the year you pay
them unless they are paid in connec
tion with the purchase of or im
provement of a home. If, however,
you used only a portion of the loan on
borne improvements, then only a por
tion of the points is deductible.
For example: you took out a home
equity loan of $50,000 of which $25,000
was spent on home improvements
and 125,000 on consolidating other
debts. At the time of closing you paid
two points or $1,000. According to the
IRS, you may deduct only 50 percent
of the points this year with the other
half deducted over the life of the loan.
This is because only half of the loan
went for home improvements.
CPAs advise you to closely exam
ine when and how you paid any points
to determine their deductibility. If
you are not sure, consult your tax
professional.
Information on planting and keeping oriental gardens
ORIENTAL GARDENS
N.C. BOTANICAL GARDEN
As more and more Westerners visit
? the Orient, the serenity of Oriental
gardens becomes better known, say
experts at the N. C. Botanical Garden
at the University of North Carolina at
Chapel Hill
Japanese and Chinese gardens
have evolved into several styles or
schools over thousand of years.
Meanwhile, Western gardens have
recently gone beyond medicinal and
agricultural plantings.
Several .distinctive elements are
noticeable in Asiatic gardens. These
are tranquility, privacy, a visual link
between house and garden, the use of
specific materials and a sense of pro
portion.
The tranquility and privacy are
achieved by some sort of wall, some
times hidden behind plantings, often
evergreens severely pruned to give a
sense of line to one part of the garden
picture. An illusion of an idealized
natural environment is created on a
scale in proportion to humans, not
nature.
Oriental gardens should offer as
satisfying a picture looking from the
house as well as from within the gar
den itself.
Stepping stones can carry the eye
between the house and garden. An il
lusion of a path produced by moving
water or by raked river rocks or sand
simulating water in movement can
connect the house and garden.
Deciduous trees or shrubs can pro
vide a colorful accent at blooming
time or can add to the interesting line
and shape of bare branches in winter.
Pruning can take advantage of the
effect of snow lying on bare tree
branches
The whole concept of Oriental gar
dens is constructed with detailed
planning, so that each part is perfect
and artistic in itself and yet still fills
its place in the total design.
Bamboo, although it must be re
placed periodically, is used extensi
vely for walls, gates and other artis
tic structures.
Rocks are important in the garden
design. Large rocks can represent
mountains in the scaled-down natu
ral landscape. Others serve as step
ping stones or islands in a pool that
may represent a lake.
Smaller rocks, sometimes chosen
for their grain, or raked sand can
represent water in moFement. All
these are not just any rocks found
nearby, but especially chosen for
their size and shape. Works of art in
themselves, they represent specific
natural components of the entire pic
ture.
Zen gardens take the philosophy
further. Zen meditation is a disci
pline in which the mind is emptied of
the problems of daily life, creating an
incompleteness. Important to this
type of garden is the use of the imagi
nation on the part of the viewer. For
example, paths leading around par
tially seen curves.
Oriental gardens are the result of
much study and planning and are not
always compatible with the Western
attitude toward gardening. Eastern
thought attempts to show that hu
mans are the masters of nature.
Books are available in local librar
ies and bookships, some with imagi
nation-provoking photographs, for
North Carolina gardeners interested
Nominations sought for Ready awards
Raleigh? Nominations are now be
ing sought for the I.E. Ready Honor
ary Awards established to commem
orate the 25th anniversary of the
North Carolina Community College
System.
Legislation creating the commu
nity college system-now the third
largest in the nation with 58 cam
puses statewide-was ratified May 17,
1963.
The State Board of Community Col
leges will present the awards to indi
viduals who have contributed signifi
cantly to the system's growth and
development. I.E. Ready, who died
in March, was among the principal
authors of the system's founding leg
islation and served as its first direc
tor for almost eight years.
Nominations should be submitted
no later than Feb. I, 1988, to Helen
Dowdy, Department of Community
Colleges board liaison, at 200 W.
Jones St., Raleigh, NC 27603-1337. To
obtain an official nomination form,
call Dowdy at 733-7051, extension 730.
Winners will be selected by a spe
cial awards committee of system
trustees, institution presidents,
board members and DCC officials
appointed by John A. Forlines Jr.,
board chairman. The honorees will
be recognized at an awards cere
mony in Raleigh May 17, 1988, as part
of the silver anniversary celebration.
Employees of the community col
lege system are excluded from nomi
nation.
During its 25-year history, North
Carolina's community college sys
tem has earned a national reputation
for its emphasis on vocational and
technical training and its commit
ment to meeting business and indus
try's needs for skilled workers.
Free financial aid calendars available
"FREE FINANCIAL AID PLAN
NING CALENDAR AVAILABLE"
Students in need of funding for the
current and next academic terms
were urged to order a free financial
aid planning calendar from The
Scholarship Bank. This vital planner
includes critical aid deadlines, ad
dresses and phone numbers of aid
sources and tips on applying for aid.
According to the director, Steve
Danz, over 500 million dollars is
available in private aid to college stu
dents, and in many cases can cover
up to twenty-five percent of a stu
dent's annual college costs. These
funds are contributed by corpora
tions, trade, civic and non-profit
foundations. They are normally
awarded on non-traditional basis',
such as academic standing, college
major, geographic preferences, and
even on a student's willingness to un
dertake a special research project or
enter a contest. Parental factors
such as union, employer or military
affiliation is also considered by some
donors.
The Scholarship Bank works with
financial aids offices throughout the
US to distribute information on the
over 5,000 sources. Interested stu
dents may receive a computer-gener
ated print-out of up to 65 sources of
private financial aid that they appear
specifically qualified to receive.
According to the director, many
sources are renewable annually and
have an average value in excess of
$1,000.00.
Students interested in receiving the
free aid calendar and information on
the scholarship programs should
send a stamped, business-sized self
addressed envelope to The Schol
arship Bank, 4626 N. Grand, Covina,
CA. 91724.
in creating aspects of Oriental gar
dens.
| For Farm Bureau Members
Lewis B. Evans
AGENCY MANAGER
Pat Ward Jeff L. Smith
AGENT AGENT
426-5636 426-7401
Church Street Ext.
Hertford, N.C.
SUGGEST TO YOUR ROOFER
THAT HE FIND THE LEAK BEFORE
? MAKING THE REPAIR.
> AMAZING HOW MUCH TIME
AND MONEV THIS WILL SAVE!
GORDON SHEET METAL
ELIZABETH CITY 315 S. ROAD ST. 335-5404
LOOKING FOR
that special
gift on your
Christmas
List?
A GIFT
SUBSCRIPTION
to
The Perquimans
Weekly
? Rates ?
'10.00- Perq. Co.
Residents
'1 1.00 Outside of
Perq. Co
Clip and Mail
with check today
to The Perquimans
Weekly.
r*
Just fill in Name &
Address Below with
check attached to:
The Perquimans
Weekly
P. 0. Box 277
Hertford
Name
Address
? Last Chance For 99' Installation ?
TIME IS RUNNING OUT!!!
Our Special Installation Offer May End At Any Momentl
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P.O. Box *30 Mwiton, N.C
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'Available In Cabla tarwlcaahla Araas Only.
1987- 88
WINTER
Schedule
NonCredit ADULT INTEREST Courses
COURSE BEGINS ENDS OAY(S) TIME LOCATION INSTRUCTOR FEE
ABE/GED Prep. 12-1 2-25 UTH. 7-10 Vocational Cntr. K. Ansink Free
Bible 12-1 2-23 Tues. 1-3 Senior Center W. Martin $20
Bible 12-3 2-25 Thur. 1-3 Senior Center W.Martin $20
Bible 12-4 2-26 Fri. 11-1 Senior Center W.Martin $20
Computer Understanding 12-1 2-23 Tues. 7-10 Vocational Cntr. TBA $15
Sewing U-30 2-22 Mon. 10-1 Wynn Fork E. Hurdle $20
S?wing 12-1 2-23 Tues. 7-10 Vocational Cntr. L Hurdle $20
Typing ? 12-1 2-23 Tues. 7-10 Vocational Cntr. TBA $15
Upholstery 11-30 2-23 Mon.A 9-124 Parker's Garage 0. Toler $15
Tues. 1-4
Perquimans County ? Gladys Hall - 426-5263
Registration will bo during the first two weeks at the beginning
of the class period tor the above general interest (non-credit)
courses. Registration is on a first-come, first served basis.
Persons 65 years of age and over may enroll at no charge
tor tuition. Social Security numbers wilt be needed.
College
of
The Albemarle
k/t Equal Opportunlty/AflHmMfv Action Institution