OT 537

1. DIAGNOSTIC INFORMATION
AND THE ROLE OF
OCCUPATIONAL THERAPY
EPILEPSY and SEIZURES
Stephanie Lancaster, MS, OTR/L, ATP, CAPS UTHSC – OT 537

2. What is epilepsy?
Epilepsy is not a specific disease but rather a
tendency to have recurrent seizures over a period
of time.
UTHSC – OT 537
Have you witnessed a seizure?

3. Epilepsy: Facts & Figures
 Incidence: ~150,000 new cases are diagnosed in the
U.S. annually (48:100,000).
 More common in young children and older adults
 Prevalence: there are ~2.2 million people in the U.S.
with epilepsy (4th most common neurological
condition diagnosed in the world)
 Seen in men > women
 Diagnosed more often in people with lower
socioeconomic status
Resource: http://www.epilepsy.com
UTHSC – OT 537

4. Types of Seizures
 Seizures have many forms, including:
 Simple (staring) vs. complex (staring + involuntary movement)
 Typical (no outside awareness during sz) vs. atypical (partial awareness)
 Absence (petit mal)
 Atonic (drop seizures)
 Tonic-clonic (pattern of jerking then stiffening)
 Myoclonic (brief shock-like jerks of a muscle or muscle group)
 Symptoms range from mild  severe.
 Seizures are classified according to the individual’s
appearance or behavior during the seizure, and the pattern of
electrical activity in the brain, as measured by a test called an
electroencephalogram (EEG).
UTHSC – OT 537

5. Living with a Seizure Disorder

7. CAUSES OF SEIZURES
Epilepsy has no definite cause. Some risk factors include:
 Prematurity
• Brain infection (meningitis, encephalitis)
• Abnormal brain structure
• Cerebral palsy
• Hypoxia
• Brain tumor
• Stroke due to arterial blockage (hemorrhage)
• Drug abuse
• Family history of epilepsy
Resource: http://www.uptodate.com/contents/treatment-of-seizures-in-children-beyond-the-basics
UTHSC – OT 537

8. Triggers of Seizure Activity

9. ESSENTIAL KNOWLEDGE FOR THE O.T.
when a patient has a seizure
Addressing
CLIENT
SAFETY
• Assist client to the floor.
• Place something under his head.
• Turn him to his side.
• TIME THE SEIZURE
• Wait it out.
Do not
restrain Shunt?
UTHSC – OT 537
Resource: http://www.uptodate.com/contents/treatment-of-seizures-in-children-beyond-the-basics#H16

10. ESSENTIAL KNOWLEDGE FOR THE O.T.
when a patient has a seizure
 If seizure lasts >5 minutes
 If client is seriously injured during the seizure
 Breathing difficulty or skin that appears blue in color
 If another seizure occurs immediately after the first
 If client cannot be aroused after the seizure
 If no prior history of seizures
When to call for help:
UTHSC – OT 537

11. THE ROLE OF O.T. IN INTERVENTION
Assess risks in
client’s
routine/environm
ent
Support client in
adjusting/plannin
g to reduce risks
Recommend
safety
equipment/home
modification
UTHSC – OT 537
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12. General Recommendations
 People at high risk for seizures should use protective gear when biking,
skating, or skateboarding and avoid these activities around traffic.
 Activities at heights (climbing onto counter to get something, climbing a
ladder, etc.) should be avoided.
 Careful monitoring/supervision is necessary for water-based activities such
as bathing or swimming.
 Performing activities like cooking and showering while seated is
recommended.
 Advise those around you about the risk of seizure if they are not already
aware (ex. - medical i.d. bracelet).
 Adequate sleep is advised as is strict adherence to medication routines.
 Driving restrictions vary from state-to-state but should be considered.
 Patients should be advised that some seizure medications have the potential
to cause birth defects.
UTHSC – OT 537

13. Recommended Adaptations for the Kitchen
 Use oven mitts (not towels or oven pads) to
transfer hot items.
 When cooking on the stove, only use rear burners,
and turn all pot handles towards the back or side of
the stove.
 If possible, use an electric stove instead of gas to
avoid an open flame.
 Cooking in a microwave is the safest option.
 Consider carpeting the kitchen floor to provide
cushioning in case of fall.
 Use plastic containers rather than glass when
possible.
 Have a phone nearby.
UTHSC – OT 537

14. Recommended Adaptations for the Bathroom
 Install a temperature
controlling device.
 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.
UTHSC – OT 537

15.  B E Y O N D T H E B A S I C S O F S E I Z U R E C A R E -
H T T P : / / W W W . U P T O D A T E . C O M / C O N T E N T S /
T R E A T M E N T - O F - S E I Z U R E S - I N - C H I L D R E N -
B E Y O N D - T H E - B A S I C S
 E P I L E P S Y F O U N D A T I O N : S E I Z U R E S 1 0 1 -
H T T P : / / W W W . E P I L E P S Y . C O M / L E A R N / E P I L
E P S Y - 1 0 1 / W H A T - S E I Z U R E
 C D C R E S O U R C E S : T Y P E S O F S E I Z U R E S A N D
S E I Z U R E F I R S T A I D -
H T T P S : / / W W W . C D C . G O V / E P I L E P S Y / B A S I C S
/ T Y P E S - O F - S E I Z U R E S . H T M
Recommended Resources
UTHSC – OT 537