EPILEPSY: DEFINITION,PREVENTION AND ROLE OFOCCUPATIONAL THERAPY MADE BY: SARA SHEIKH 4TH YEAR STUDENT (OCCUPATIONAL THERAPY) DOW UNIVERSITY OF HEALTH SCIENCES
WHAT IS EPILEPSY?Epilepsy is an assortment of different types of seizures originating from several mechanisms that have in common the sudden excessive discharge of cerebral neurons. It may result in:• Loss of consciousness• Atypical or Odd behavior• Distorted perceptions
CAUSES OF EPILEPSYEpilepsy has no definite cause. However, some risk factors can be given:• Premature infants• Brain infections (meningitis, encephalitis)• Infants with abnormal brain structures• Cerebral palsy• Hypoxia• Brain tumors• Stroke due to arterial blockage (Hemorrhage)• Drug abuse• Family history of epilepsy
POSSIBLE PREVENTIVE MEASURES• Educating would-be mothers about balanced diet, proper medications and hygiene.• Ensure immediate consultancy if an infant is suspected of hypoxia or is premature.• Educating the public about possible indications of brain tumors or stroke and ensure immediate diagnosis and treatment, if present.• Educating the public about side effects of drug abuse.
PROBLEMS DUE TO EPILEPSYAn epileptic patient encounters Emotional, Behavioral and Cognitive problems more than Physical.• Social withdrawal can occur in both children and adults due to fear of exposure.• Denial to the disease may occur.
• Mood disorders such as Depression, Aggression or Bipolar disorder may develop due to excessive brooding.• Personality changes such as Avoidance, Dependence or Antisocial behavior may also occur.
• Routine Management, Work Coping and Executive skills can be adversely affected, leaving the person at a loss as to his aim in life.• Memory disturbances can be very exhausting.• The epileptic person may face neglect from the family and friends, which may lower his/her self-esteem.• Postural deformities or contractures may develop in some cases.
ROLE OF OCCUPATIONAL THERAPYThe primary emphasis of occupational therapy is on Independent Living, be the client may living with the family or alone.For epileptics, Safety is of prime consideration.Occupational therapists are able to advise people on how to create a safe environment by helping them consider risks, safety equipment and helping them adapt the risky areas of the home.
Basic Safety Precautions• Instruct the patient and the family to place a card with the patient’s name, address and phone number of a relative in his/her pocket whenever he/she goes outside, so the contact may easily be established in case of a seizure.• A cell phone must be with the patient when he is outside, and essential phone numbers (any close relative, hospital emergency etc.) should be fed in. moreover, the family should be instructed to keep tabs on the epileptic person by calling time to time.• The family should be guided as to the maintenance of correct posture during seizure and to remain calm.
Adaptations for Kitchen• Use oven mitts and cook only on rear burners• If possible, use an electric stove, so there is no open flame• Cooking in a microwave is the safest option• Carpet the kitchen floor. This can provide cushioning in case of fall• Use plastic containers rather than glass when possible
Adaptations for Bathroom• Install a temperature controlling device. This will keep the patient from burning if a seizure occurs.• Carpet the floor rather than tiling for a soft fall in case of a seizure.• Do not lock the bathroom door.• Use a handheld shower or a bathroom seat instead of a tub.
Relaxation and Exercise• The occupational therapist can guide the epileptic person through a series of Relaxation techniques like Deep Breathing, Massage and Meditation. This will help the patient to reduce stress and divert the mind away from negative and fearful thoughts.• Light exercises may help the patient maintain fitness and prevent possible deformities.
Routine Management and OrganizationThe occupational therapist can help the epileptic person in setting and maintaining a routine by making use of Routine boards, Counseling and Graded tasks involving Organization and Routine.
VocationDiversional activities, Leisure activities will help to increase Coping Skills, Executive skills and reduce Depression or Aggressive behavior.Children will especially benefit a lot from these.
GroupsGroups of epileptic patients, or groups of patients with a variety of disorders will help the epileptic patients understand that they are not the only one suffering.It will help increase their Self Esteem and Socialization and will reduce Fear of Exposure.
PRECAUTIONARY MEASURES• Epileptic patients should not be alone while swimming or doing exercise.• They should be supervised at night. A person can supervise the patient or the patient can use alarms that are set off by seizures.• Medicine compliance should be regularly checked.