Epilepsy Presentation :Epilepsy Presentation EDE26 By: Maureen MacKenzie Mohawk College Instructors: Lynne Lafleur & Karen Nagel Due date: Week 9 March 7, 2008


What is Epilepsy? :What is Epilepsy? Epilepsy is a seizure disorder resulting from sudden bursts of electrical energy in the brain. These electrical discharges produce seizures which vary from one person to another in frequency and form. Sometimes the electrical signal only reaches part of the brain where a part of the body, like an arm or a leg may move on its own. If the signal goes through all of the brain, the person may shake all over, fall and lose consciousness. It is not a disease, psychological disorder or contagious. Please view the Video ‘ All about Epilepsy’ http://www.epilepsyontario.org/allaboutep.wmv


Epilepsy and GABA :Epilepsy and GABA A seizure occurs when the message delivery system becomes unbalanced. Under normal circumstances, the neurotransmitter GABA (gamma-amino butryic acid) triggers signals. When there is not enough GABA, a person has a seizure because the receiving neurons is flooded with signals.


Incidence :Incidence Approximately 0.6% Canadians have epilepsy. Each day in Canada, an average of 42 people learn they have epilepsy. Each year, 15,500 Canadians learn they have epilepsy. 60% of new patients are young children and senior citizens. In Ontario, at least 120,000 and as many as 245,000 people are living with a seizure disorder. In Hamilton-Wentworth and Burlington about 6,000 people have some form of epilepsy (1 person in every 100).


Etiology :Etiology Identifiable Causes of Epilepsy in Children: Brain injury to the fetus during pregnancy Birth trauma –lack of oxygen Head trauma, e.g., car accident Brain tumor and stroke Infection e.g., meningitis Poisoning from substance abuse or environmental contaminants, e.g., lead poisoning.


Characteristics :Characteristics The characteristics and frequency of seizures vary greatly. Some known characteristics are: Uncontrolled movements such as shaking of arms or legs Loss of consciousness Falling Staring into space (absences) – mostly in children Appearing dazed, confused, mumbling


Types of Seizures :Types of Seizures There are many different kinds of seizures. Two main types are: “partial” and “generalized”. Simple partial seizure sudden jerky movements distortion in sight or smell sudden sense of fear, stomach discomfort, dizziness sensations above are called an “aura” Strategy: Reassure the person


Partial seizures continued… :Partial seizures continued… Complex partial seizure loses awareness appears dazed and confused random walking, mumbling, head turning and pulling at clothes person does not remember these behaviours after the seizure 2/3 of people have this type of seizure Strategy: do not restrain the person – stay with the person until he/she is out danger.


Generalized seizures :Generalized seizures Generalized seizures affect the whole body. They are generalized absence or tonic-clonic. Generalized absence seizure staring into space eyes may roll forward 5 to 15 second lapses of consciousness person does not recall this lapse occur in childhood and disappear in adolescence Strategy: Talk gently to the person, be comforting as it may take time for the person to become re-oriented.


Generalized seizures continued… :Generalized seizures continued… Tonic-clonic seizure (grand mal) occurs in two phases Tonic phase: loses consciousness and falls Clonic phase: muscles stiffen, body jerks and twitches bladder control may be lost consciousness returns slowly Strategy: Require First Aid Treatment plus immediate medical attention if the seizure lasts more than 5 minutes.


Incidence of Seizure Types :Incidence of Seizure Types Based on information from: Epilepsy - A Comprehensive Textbook, 1997


Management procedures/strategies :Management procedures/strategies Medication Management: Find the correct medication to take. Not all medications work the same for each person Take the medication as prescribed by the Doctor Never miss taking the medication plus always take it at the same time each day. Let the Doctor know if you feel ill, dizzy or start seeing double At school, know the child’s possible seizure triggers: not taking medications poor diet and eating habits and lack of sleep stress, excitement & emotional upset inactivity and boredom flashing lights, computer screens, television Know the possible side effects of the student’s medication: short term memory loss, fatigue, dizziness, depression, aggressive and anti-social behaviour. Know what to do when a seizure starts Learn what kind of a seizure your student has and know the proper strategy in assisting them through it. First Aid Treatment may be needed (see the next slide).


First Aid for Tonic-Clonic Seizure :First Aid for Tonic-Clonic Seizure Keep calm- seizures usually only last a few minutes and do not require medical attention*. Protect from injury – ease the person to the floor, move away any objects, protect the person’s head with a pillow or rolled up coat. Loosen any tight neckwear. Do not restrain the person. Do not insert anything into the person’s mouth. After the seizure, roll the person on to their side. Be reassuring – talk calmly to the person. *If a seizure lasts longer than 5 minutes, seek Medical Attention.


A child’s view…. :A child’s view….


Classroom Strategies for Educational Assistant :Classroom Strategies for Educational Assistant Ask the teacher to have an informal discussion with the class about epilepsy, letting them know ‘epilepsy’ is not contagious or a disease and using appropriate terms ‘tonic clonic’ or ‘absence’. Have the student sit at the front of the class to avoid any distractions. Watch for any flashing lights in the class, e.g.; ceilings lights that need to be replaced. Establish a “buddy” system to help the student catch up on any missed work. Repeat instructions to assist the student from work he/she missed due to “absence” seizures. Use physical prompts to help keep the student oriented. Limit time on the computer or when watching school videos. Make the student’s day as normal as possible -do not be overprotective. Ensure the student stays in the playground or classroom where he/she can be seen. After a seizure, give the student a chance to rest or re-focus before starting on another task.


Make my day as normal as possible- do not be overprotective! :Make my day as normal as possible- do not be overprotective!


Resources :Resources Epilepsy Ontario provides the following services: Information, counselling and referral services. Education and advocacy services for children and adults living with seizure disorders and for their families. Resource Centre for borrowing books, videos, medical journals at www.epilepsyontario.org. Address of Local agencies; e.g. Hamilton has a new agency at 182 East 6th Street - with many resources such as pamphlets, CD’s; e.g. “Children living with Epilepsy”, booklets, newsletters, etc. Summerfest Summer Camp at Camp Couchiching for children living with epilepsy, ages 6-15. Up-to-date links: to support groups, to the latest medical information.


Support for children living with Epilepsy :Support for children living with Epilepsy Pediatric neurologists help assist the families with finding the right medication for their child along with support and counselling. School alert program for teachers and schools with videos, pamphlets and in-depth first aid training. “Kids on the Block” puppet troupe for elementary schools – full size puppets program to enlighten children about epilepsy awareness. School personal work in partnership with the parents. Informal and formal meetings with various school board personal to assist the teachers and educational assistants in understanding the needs of the child. Support Group: Seizure Disorder of Greater Hamilton 905-522-8487- Conduct self-help/support groups-provide quarterly newsletters-provide presentations to schools. All about Epilepsy – a great animated video for ages 8 and up http://www.aboutkidshealth.ca/JustForKids/epilepsy.aspx


Treatment Centre :Treatment Centre McMaster University Medical Centre Regional Epilepsy Clinic Neurology Department 1200 Main St W, Hamilton, ON L8N 3Z5 905-521-2100 Children and Adults More Treatment Centres http://www.epilepsy.ca See Treatment Centres


Facts :Facts March is Epilepsy Awareness Month – Lavender Ribbon Campaign Why Lavender? Lavender is associated with isolation which is one of the many challenges facing people with epilepsy. A child living with epilepsy can have over 25 seizures a day and take 15 pills a day. Surgery is used only when other medical avenues have been pursued. Epilepsy comes from a Greek word ‘epilambanein’ which means to seize or attack. The Greek’s believed seizures were caused by demons, and regarded them as a supernatural phenomenon. Epilepsy Ontario has been serving Ontario for 52 years.


Bibliography :Bibliography Epilepsy & Your Child – Parent’s Information Booklet, Novartis Pharmaceuticals Canada Inc., Dorval, Quebec Epilepsy – Answer to Your Questions Brochure, Epilepsy Canada, Montreal, Quebec World Health Organization (WHO), Fact Sheet http://www.who.int/mediacentre/factsheets Epilepsy Canada, Living with Epilepsy, http://www.epilepsyfoundationorg. Epilepsy Ontario, Facts about Epilepsy http://www.epilepsyontario.org Seizure Disorder of Greater Hamilton, Pamphlets, brochures, booklets. CD on Children Living with Epilepsy, Epilepsy Ontario, Thornhill, Ontario Causes of Epilepsy in Childhood Fact Sheet, http://www.epilepsy.com/info/family_kids ACKNOWLEDGEMENT: Thank you to Patricia Kloet of the New Epilepsy-Seizure Disorder of Greater Hamilton Agency for the resource package.