Epilepsy Guidance


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Epilepsy Know How

by Dr. N. R. Halder

Published in: Health & Medicine
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Epilepsy Guidance

  1. 1. Emergency tips for epilepsy AndGeneral Care for an Epileptic Individual
  2. 2. W h a t t o d o if s o m e o n e g e t s a c o n v u l s iv e s e iz u r e :Here are a few things you can do to help someone who is having a seizure ofany kind:Many seizure types-such as generalized absence seizures or complex partialseizures, which involve relatively brief episodes of unresponsiveness- don’t requireany specific first-aid measures.Tonic Clonic SeizureConvulsive seizure with loss of consciousness, muscle stiffening, falling, followedby jerking movements.
  3. 3. C h e c k f o r In ju r y•Make sure the victims mental state has returned to normal. Oneway to do this is to ask the person his or her name, the year, andyour location.•Look for any injury to the mouth and head.
  4. 4. W h a t T o D o I f S o m e o n e H a s A No n - C o n v u l s iv e S e iz u r e (staring blankly, confused, not responding, movements are purposeless)1. Stay with the person. Let the seizure take its course. Speakcalmly and explain to others what is happening.2. If the patient is standing or sitting when seizure begins, ease himor her to the floor to prevent fall.3. Move dangerous objects out of the way.4. D O N O T r e s t r a i n t h e p e r s o n .5. Gently guide the person away from danger or block access tohazards.6. After the seizure, talk reassuringly to the person.
  5. 5. C a llin g t h e A m b u la n c eMost seizures due to epilepsy are not medical emergencies. Theyend naturally after a minute or two. There is usually no need to callfor emergency help, unless, of course, the physician has advised it.H o w e v e r , a n a m b u la n c e s h o u ld b e c a lle dif : • Its the first seizure a person has ever had • Normal breathing does not start again after the shaking stops • There are injuries or the seizure happened in water • Other medical conditions, like diabetes, pregnancy or heart disease are involved • The seizure is prolonged (goes on for more than five minutes without any sign of stopping) • Another seizure starts soon after the first one • You are concerned that something else may be wrong
  6. 6. DOCUMENTATIONFacts that should be recorded when a seizure occurs include:1. Documentation and description of aura if reported by the patient2. Circumstances in which the seizure activity occurred3. Time of the onset of seizure activity4. Muscle groups involved (and whether unilateral or bilateral)5. Total length of seizure activity6. Vital signs7. Behavior after seizure8. Neurologic status in postictal period (weakness or inactivity of abody part, sleep, amnesia, confusion, or headache)9. Documentation and assessment of any injury anddocumentation that injury has been reported to the proper person
  7. 7. Safety and Seizures
  8. 8. Safety and Seizures•Accidents can happen at any time to anyone. People take risksevery day, but sometimes risks people with epilepsy have to dealwith can be different from those faced by others.•Safety precautions should be sensible and relevant to theparticular person involved, with a balance between risk andrestrictions.•With an awareness of potential risks and ways in which these canbe lessened, activities can be much safer and most people withepilepsy can live full and active lives.•Enjoy life as much as you can and dont restrict activities to a pointwhere your interests and fun are excluded.
  9. 9. E v a lu a t in g P e r s o n a l R is k•U n d e r s t a n d t h e t y p eo f s e i z u r e : If you have dropattacks or convulsions, you have anincreased risk of injury. Your risk isprobably lower if you have briefstaring episodes, or remain awakeand aware during seizures, or haveseizures only at night.•F a l l d u r i n g a s e i z u r e ?Loss of balance and fallingincreases the risk of fractures, cutsand bruises.•Frequency of seizures – someonewho has many seizures a day ismore at risk.
  10. 10. R is k s•Age – infants, children and older persons are more susceptible toinjuries and accidents•Medications – people on multiple medications or very high dosesmay suffer side effects such as drowsiness, double vision, poorcoordination•Participation in high risk activities – If the activity takes place atheights, near water, or near some other hazard, the risk of beinghurt during a seizure goes up also included are drinking alcohol,taking drugs•Any other physical or neurological problems
  11. 11. E v a lu a t in g P e r s o n a l R is kId e n t if y in g t h ew a r n in g s ig n so r t r ig g e r sIf you do, changingactivities to avoid thetrigger as much as youcan reduces the risk ofrelated injury.Keep anE p ile p s y d ia r y ,s o tha tfre q u e n c y o fs e iz u r e s c a n b eund e rs to o d .
  12. 12. S a f e t y T ip s -- D a ily L iv in gSome people with epilepsy will not need (or want) to make anyof these modifications to their lives. • Make sure everyone in the family knows what to expect when you have a seizure, knows correct seizure first aid and knows when it is (or isnt) necessary to call for emergency help. • Know first aid for choking. Make sure your family and friends do, too. • Help young children in your family learn what to do by having "seizure drills" that review first aid steps and how to call for help. • Avoid things which are known to increase the risk of a seizure -- for example, forgetting to take medication; not getting enough sleep; drinking a lot of alcohol. •
  13. 13. Common accidentsCommon accidents seen and ways to lessen the likelihood of accidents are listedbelow. It is important to remember this list is not exhaustive and somesuggestions are not relevant to all people with epilepsy.T o r e d u c e lik e lih o o d o f c u t s , b r u is e s a n d a b r a s io n s•Reduce clutter, sharp or jutting edges and corners.•Use a shower curtain rather than a glass screen. Also use a shower chair ifnecessary.•Reinforced glass doors are preferable or apply safety film to existing glass.•Use non-breakable crockery and cordless electrical appliances with automaticswitch off.•Minimise the use of knives by buying pre-sliced food when possible.• Prefer microwave cooking instead of Gas flame
  14. 14. T o p r e v e n t d r o w n in g•Never swim alone & avoid water sports•Ensure that the water is not too hot.•Wear an approved life jacket for wateractivities, including boating and fishing.•Showers pose less of a risk than a bath. Ifyou only have a bath, use a hand-heldshower attachment.•Do not shower or bathe whilst alone in thehouse if possible.•Shower at a time when seizures are lesslikely to happen.•Preferably have outward opening doors,sliding doors, half doors or doors that areeasily removable fitted to the bathrooms.•Keep bathroom doors unlocked.•Turn the taps off before getting into thebath.
  15. 15. T o m in im is e s e r io u s in ju r ie s•Avoid high-risk activities like using aladder, rock climbing without a harness orflying foxes.•Wear helmets when riding a bicycle,scooter, horse, or when roller-blading orskateboarding.•Choose a low bed and avoid sleeping ona top bunk.•Stand well back from the road or platformedge when waiting for a bus or train.•Bathroom floors may be less hazardous ifrubber-backed mats are used.•Avoid living in accommodation withstairs.
  16. 16. S u f f o c a t io n•Try to sleep without a pillow or use a firm porous pillow.•Choose a low wide bed that has a firm mattress with a tightlyfitted sheet.•An alarm may help alert parents or carers to seizures at nighteg. baby monitor or intercom.
  17. 17. A v o id in g a c c id e n t a l o v e r d o s e o f a n t ie p ile p t ic m e d ic a t io n•All medications should be lockedaway out of reach of children and notbe left in pockets and handbags.•If a dose of medication is missed,the next dose should be taken asnormal. Do not double the dose.•Discuss possible reactions with yourdoctor before taking any otherprescribed medications or over thecounter medications.•Consult the doctor before alteringthe prescribed medication regime.• Mark tablet foils for dates & months,using a marker pen (ease of dosingschedule)
  18. 18. S e iz u r e s d u r in g s le e p•Many families are concerned with thesafety of their loved ones while theyare asleep. This is of particular concernto parents of young children who haveseizures and families of people livingalone.•Family or parents should not stayawake watching for seizures. Everyoneneeds sleep, and this practice createstiredness and dysfunction in the wholehousehold.•Place a baby monitor in the childsbedroom so parents can hear anyabnormal noises
  19. 19. In K it c h e n s …•Use a microwave oven rather than a stove.•If using a stove, use back burners.•Serve hot liquids or food onto plates at the stoverather than carrying them to the table.•Do not carry boiling water.•If possible, cook when someone else is home.•Use cups with lids.•Sit down to do tasks when possible.•Place sharp utensils downwards in thedishwasher.•Wear rubber gloves if washing glass or usingsharp utensils.•Keep frequently used items within easy reach toavoid having to climb up to high cupboards.•Keep electrical appliances away from sinks.
  20. 20. W o r k p la c e S a f e t yWhen working around machinery, check for safety guards.Try to keep consistent work hours so you dont have to go a long time withoutsleep.If you are sensitive to flashing lights, try to limit your exposure. Look away ifyou can. Use dark glasses. Some people think blue lenses work best.Does stress make your seizures worse? Is your job a very stressful one? If so,look at ways to reduce stress on the job.Depending on your job and demands of the work site, consider wearingprotective clothing if you have frequent seizures.Keep a small pillow tucked away in a drawer so a co-worker (who knows whereit is and what to do with it) can place it under your head if you have ageneralized tonic clonic (grand mal) seizure.Keep a change of clothes at work in case your clothes get soiled during aseizure.
  21. 21. T r a n s p o r t a t io n S a f e t yAvoid driving a car unless you have a valid license and are nothaving seizures.Always wear a seat belt and insist your passengers do, too.Stand well back from the road when waiting for a bus and from theplatform edge when taking the subway or train.To avoid wandering during a seizure, take a friend along when youtravel.If you have frequent seizures, the safety of taking a taxi cabinstead of public transportation may be worth the extra cost.
  22. 22. C h ild r e n s S a f e t yA monitor in the childs bedroom may alert you to the sound of a typicalseizure.Avoid top bunks. A lower bunk, a regular bed, a futon or even amattress on the floor is a safer place to sleep for a child with seizures.Choking is a risk for any child, especially if the child has frequentseizures and other disabilities. Children sometimes retain food in theirmouths and its a good idea to check if this is a problem.Put a list of first aid steps in a place where its easy to find Write downthe phone number where you or a relative can be reached include thedoctors number and the one for the emergency squad on the samesheet.
  23. 23. M e d ic a l Id e n t if ic a t io nThere are a number of reasons why werecommend wearing a medical ID bracelet ifseizures are not fully controlled. Some of theseinclude:•Many members of public do not know the correctfirst aid for a seizure.•Incorrect first aid such as putting something insomeones mouth or restraining them can causeinjury to either party.•A large number of people would call anambulance if they witnessed a seizure.•This is not always necessary and can prove aninconvenience for the person with epilepsy, mainlydue to long waits in casualty and ambulance bills.•Some seizures may present as if the person isintoxicated or on drugs.
  24. 24. S a f e t y T ip s -- D a ily L iv in g • Try using a pillbox to help you remember your medicines. Store all medicines safely away from children. • Wear a medical identification bracelet or card. • If you have an aura (warning) before a seizure, lie down on your side on a carpeted or other soft surface. • Carry a small portable phone or beeper in case you have to call for help and cannot get to a regular phone. • If your seizures are very frequent and sudden, consider wearing a helmet or other protective clothing, such as knee or elbow pads, at least when youre at home alone.