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Epilepsy basic tutorial


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Epilepsy tutorial for presentation at staff meetings in years we have an epileptic student.

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Epilepsy basic tutorial

  1. 1. Epilepsy YVETTE JONNA-MOORE
  2. 2. Epilepsy (definition) DEFINITION OF EPILEPSY A physical condition that occurs when there is a sudden, brief change in how the brain works Physical changes are called epileptic seizures Epilepsy affects people in all nations and of all races
  3. 3. Seizure (definition) A sudden attack, spasm, or convulsion The act of taking a person by force Seizures can include Blackouts or periods of confused memory  Episodes of staring or unexplained unresponsiveness  Involuntary movement of arms and legs  Fainting spells with incontinence, then excessive fatigue  Odd sounds, distorted perceptions, or episodic feelings of unexplained fear 
  4. 4. Types of Seizures There are many types of seizures. A person may experience only one type, or more than one. The type of seizure that a person has depends on what part and how much of the brain is affected by electrical disturbance. •Generalized seizures affect both cerebral hemispheres (sides of the brain) from the beginning of the seizure. They can produce a loss of consciousness, either briefly or for a longer period of time, and are sub-categorized into several major types. Type Duration Absence (petit mal seizure) 2 to 15 seconds Generalized TonicClonic (grand mal) 1 to 2 minutes Symptoms Postictal Stare Amnesia for seizure Eyes events fluttering No confusion Automatism Promptly resumes (such as lip activity smacking, picking at clothes, fumbling) if prolonged A cry Fall Tonicity (rigidity) Clonicity (jerking) May have cyanosis Amnesia for seizure events Confusion Deep sleep
  5. 5. Types of Seizures Type Duration Symptoms Postictal Simple Partial 90 seconds No loss of consciousness. Sudden jerking sensory phenomena Possible transient weakness or loss of sensation Complex partial 1 to 2 minutes May have aura Automatisms (such as lip smacking, picking at clothes, fumbling) Unaware of environment May wander Amnesia for seizure events Mild to moderate confusion sleepy Partial seizures are the most common type of seizure experienced by people with epilepsy. In partial seizures the electrical disturbance is limited to a specific area of one cerebral hemisphere (side of the brain). Partial seizures are subdivided into simple partial seizures (in which consciousness is retained); and complex partial seizures (in which consciousness is impaired or lost).
  6. 6. Epilepsy Statistics  By 20 years of age, one percent of the population can be expected to have developed        epilepsy. Prevalence of active epilepsy (history / seizure or use of antiepileptic medicine within the past 5 years) is estimated as almost 3 million in the United States. Prevalence tends to increase with age. 45,000 children develop epilepsy every year. 326,000 school children through age 15 have epilepsy. More than 300,000 persons over the age of 65 have epilepsy. By 75 years of age, three percent of the population can be expected to have been diagnosed with epilepsy, and ten percent will have experienced some type of seizure. 70% of cases, no cause is apparent.
  7. 7. Epilepsy Statistics Special Populations  25.8 percent of children with mental        retardation 13 percent of children with cerebral palsy 50 percent of children with both disabilities 10 percent of Alzheimer patients 22 percent of stroke patients 8.7 percent of children of mothers with epilepsy 2.4 percent of children of fathers with epilepsy 33 percent of people who have had a single, unprovoked seizure Remission  70 percent of people with epilepsy can be expected to enter remission-defined as 5 or more years seizure free on medication.  35 percent of people with mental retardation, cerebral palsy, or other neurological condition will enter remission.  75 percent of people who are seizure free on medication for 2 to 5 years can be successfully withdrawn from medication.  10 percent of new patients fail to gain control of seizures despite optimal medical management.
  8. 8. Genetics and Causes While some types of epilepsy tend to run in families, there is not a strong genetic factor Other factors that seem to be involved in inheritance:   Age when epilepsy begins Gender of parent with epilepsy Causes of Epilepsy       Congenital brain defects Metabolic diseases that children may be born with Serious brain injury Brain and CNS tumors or lesions Brain and CNS infections, including meningitis & encephalitis Degenerative diseases
  9. 9. Seizure Triggers and Warning Signs Warning Signs:   Physical Sensory Triggers  Vary greatly depending on type of epilepsy   Internal External
  10. 10. Treatment for Epilepsy Seizure First Aid Medical Treatment  Doctor  Medication  Neurologist referral  Ketogenic diet  Vagus nerve stimulation  Stay calm, keep onlookers away  Prevent injury- make sure nothing is in    Brain surgery     reach that could harm victim if struck Pay attention to the length of the seizure Make the person as comfortable as possible-do not hold the person down. Do not put anything in the person's mouth Do not give the person water, pills, or food until fully alert If the seizure continues for longer than five minutes, call 911 Be sensitive and supportive, and ask others to do the same
  11. 11. Famous People with Epilepsy  Vladimir Lenin- Politician  Florence Griffith Joyner- Athlete  Fyodor Dostoyevsky- Author  Prince- Musician  Neil Young- Musician  Bud Abbot (Actor- Abbott and Costello)  Danny Glover- Actor  Retrospective Diagnosis:     Napoleon I Socrates Julius Caesar Joan of Arc
  12. 12. Can Movies or Video Games Trigger Seizures?  Physiological symptoms occurring during video games may trigger seizures in children with epilepsy, such as stress, fatigue, or hyperventilation.  About 3% of children may be photosensitive. Flashing lights, flickering, or certain color sequences can trigger seizures.  Most epileptic children should be able to watch movies, television, and play games with no problems.  Recently, there have been several reported seizures by audience members at screenings of the recent film “127 Hours”, starring James Franco. It is speculated that these were a result cinematography effects and stress.
  13. 13. Children with Epilepsy  About 400,000 children in • Most children who have the U.S. have epilepsy.  In 70% - 80% of children, epilepsy is completely controllable with medication. epilepsy will outgrow the condition. • Most children with epilepsy are perfectly healthy and normal in other ways.
  14. 14. Logistical Impacts of Epilepsy  “He has a non-life. He cannot work or drive, cannot afford health insurance, cannot afford to see a neurologist. He gets very depressed about all this, and there is no way he or we can fix it. Something needs to be done. He is only 23 and he feels his life is over” (Epilepsy Foundation of Michigan, 2008).  Employment    Only 27% of adult survey respondents work full-time 38% unemployed Mean annual income for full-time workers: $39,690 (U.S. average was $52,703)  Lack of Transportation   Difficulty getting to work, social isolation, and dependence on others 17% rated this as the hardest thing about living with Epilepsy
  15. 15. Physical/Mental Impact of Epilepsy  “The uncertainty of normal living… I never know when a seizure is going to hit and hope like heck someone knows what to do should I have one while in their company” (Epilepsy Foundation of Michigan, 2008).  Seizures   41% of survey respondents said that seizures limited quality of life “a lot” 42% have at least 1 per month, 11% have them daily  Memory & Cognitive Problems   Epilepsy can affect learning, development, and memory 80% of children experienced learning problems  Physical Health  Injuries (24%), sleeping problems, weight gain, fatigue, shakiness  Medication Problems  May not work, or may have disruptive side effects (over 50%)  Health Care Access and Cost  Cost of—and access to—testing, surgery, medication and other treatment
  16. 16. Psychosocial Impact of Epilepsy  “I am always afraid of being in a social situation because I never know if I am going to have some type of seizure. I often feel alone and depressed” (Epilepsy Foundation of Michigan, 2008). • Social Challenges-per survey response o o o o o o • Social isolation- 48% report loneliness Restrictions /limitation Dependence on others 26 experienced clinical depression in last year 26% suffer from anxiety disorder 48% report low self-esteem Public Misperceptions 11% of adult s with epilepsy received incorrect seizure first aid from someone in the past year, while 40% of children with epilepsy reported being mistreated or left out because of epilepsy.
  17. 17. Education and Epilepsy What issues might you see in a classroom? Problems in the Classroom:  underachievement in Reading, Language and Arithmetic   16% below grade level in Reading, 50% below grade level in general knowledge 9% have I.Q.s below 70 (3x the general pop.) attention problems  delayed or impaired motor skills  impairment of self-concept  behavior issues  social rejection from peers 
  18. 18. Education and Epilepsy Why are these issues occurring?  Seizure-prevention medications  sleepiness & lack of energy  Seizures   interfere with attention and could affect memory anxiety & fear over when the next seizure will come  Underlying brain conditions / Neurological impairment   can affect learning, memory, and processing might be seen in Math, Reading, and memorization  Missed class time / Frequent seizures  falling behind in assignments, assessments, and instruction
  19. 19. Education and Epilepsy  Students with Epilepsy are entitled to services under IDEA if the impairment adversely affects their educational performance.  The right to be taught in a regular classroom, and to be included in social and other activities.    Establish the existence of a disability Get a detailed picture of how it affects the student functionally, developmentally and academically Document the student’s special needs
  20. 20. Education and Epilepsy Some Accommodations, Modifications & Services:            A special class aide (A) Extra time for assignments (A) Monitor medication & seizures (A) Specially designed furniture (A) Replace fluorescent lighting with full spectrum lighting (A) Private area to rest or recover after a seizure (A) Separate programs in physical and/or music education (M) Education for teachers and school nurses (S) An education program for other students (S) Physical/occupational therapy (S) Counseling for social impairments/struggles (S)
  21. 21. Education and Epilepsy Interview counselor re: student with epilepsy o o o o o o o o Student was originally in special education classes, but now attends all general education classes. Student seizures uncontrolled with medication. Student experiences up to 15 seizures a day. Student receives all “G” grades in classes, has parapro, and is currently repeating 7 th grade. Seizures have increased, and district demanded that she wear a helmet. Typical procedure- teachers call office when seizing, continue with class. Student is transported to office afterward sometimes in wheelchair, have had to call 911 on occasion. When not seizing, is typically sleeping in class (due to medications, recovery, and exhaustion). Teachers try unsuccessfully to wake- no learning accomplished.
  22. 22. Education and Epilepsy Concerns         Counselor (also a former special education teacher) feels general ed classroom is inappropriate placement, but parents wanted minimal services. Teachers concerned student will stop breathing, and that they are not trained in CPR. Teachers unsure of expectations and workload for student. Has received many phone calls from concerned parents regarding the stress the other students experience. Counselor feels more appropriate placement would be a program such as Wing Lake. Counselor has concerns for student’s future. Counselor feels student’s cognitive ability may have significantly dropped in last few years due to increased seizure activity. Student to be evaluated at end of school year- counselor feels she should be recertified and returned to special education. Counselor expressed concerns about the severity and prevalence of symptoms, as well as parental attitude, and has wondered whether she should call Children’s Protective Services.
  23. 23. References o (n.d.). Education of Kids with Epilepsy. Retrieved from o o o o o o o /info/family_kids_education (n.d.). Seizure First Aid. Retrieved from (n.d.). Video Games and Epilepsy. Retrieved from family kids video Epilepsy Foundation (n.d.) Epilepsy and Seizure Statistics. Retrieved from Epilepsy Foundation (n.d.). About Epilepsy & Seizures. Retrieved from http://www.epilepsy Epilepsy Foundation (n.d.). Helping Children Understand. Retrieved from Epilepsy Foundation (n.d.). Types of Seizures. Retrieved from Epilepsy Foundation of Michigan (n.d.). About Epilepsy. Retrieved from
  24. 24. References o Epilepsy Foundation of Michigan (2008). 2008 Epilepsy Needs Assessment Survey: Key o o o o Findings. Retrieved from AssessmentSummary.pdf Hartenburg, J. (personal communication, March 22, 2011) National Dissemination Center for Children with Disabilities (2010). Epilepsy. Retrieved from VanAirsdale,S.T. (2011, January 4). 127 Hours' Causes Fainting, Vomiting, Seizures. Huffington Post. Retrieved from Wikimedia Foundation (2011). List of people with epilepsy. Retrieved from
  25. 25. Epilepsy (Handout)  Teaching students about seizures:       What you just saw was a seizure Your friend's brain did not work properly and sent mixed up messages to the rest of his body Having seizures is part of a health condition called “epilepsy” Epilepsy is not a disease and it can't be caught Your friend takes medicine to prevent seizures, but sometimes one happens anyway Seizures stop by themselves, but you should know how to keep your friend safe while it’s happening  When you see someone having a seizure:           Stay calm Prevent injury Notice the length Make them comfortable Keep onlookers away Do not hold the person down Do not put something in their mouth Do not give water/pills/food Call 911 (if longer than 5 min.) Be sensitive & supportive