Epilepsy Basics Definition Epilepsy vs. Seizures Statistics Causes

Seizure Classification Treatments Medications Surgical Interventions Dietary Non-Epileptic Events Emergencies

Status EpilepticusClusters

Seizure First Aid Personal Care and Safety Mobility

Seizure: An episode of pathological, hyperactive, hypersynchronous brain activity, expressed as abnormal motor, sensory, or psychologic behavior.

Seizure Disorder: A chronic brain disorder characterized by recurrent unprovoked seizures.

Nothing, they are the same thing.

Single Seizure: 9%Recurrent Seizures: 0.5%

0%

5%

10%

15%

20%

25%

30%

5 10 15 20 25 30 35 40 45 50+

years

0%

20%

40%

60%

80%

100%

0 to 4 5 to

14

15 to

24

25 to

44

45 to

64

65+

other

Degen.

CVD

brain tumor

trauma

infection

Devel.

Clinical observation+

EEG findings

Partial seizure Generalized seizure

More common in adults than childrenInvolves a focal area of the brain at onsetA warning (aura) often precedes the seizureMay or may not be associated with an alteration of

consciousnessUsually symptomatic

Visual hallucinationAuditory hallucinationTactile sensationMotor sensationAutonomic sensation

Pause in activity with a blank stareMay have an inability to talkMay have hand or arm posturingEye deviationMay appear apprehensiveMay turn in a circleMay run away - random

Partial seizures

Simple partial Complex partial

Consciousness preserved Impaired consciousness

Patient may pause, or slow down.Aware of seizureAble to comprehend and speakDuration: variablePost ictal phase: may feel tired

Usually begin with an aura.Alteration of consciousness.May exhibit automatisms:

Lip smackingHand posturingPick at clothing or reach out without purposeMove about in a purposeless manner

Duration: usually 2 – 3 minutesPost ictal phase is variable in length.

ConfusedFrightenedCombative or angrySleepy or may become hyperactiveAmnestic for the event

Partial Seizure

Simple partial seizure

Complex partial seizures

Secondary Generalization

Occur in 20 – 40%More common in childrenGenetic cause suspected with mostThey begin without warningAlways associated with an alteration of consciousness

Generalized tonic clonic or clonicAbsence or Atypical Absence MyoclonicTonicAtonic

Abrupt onsetLoss of consciousnessStiffening of the extremitiesDecreased ability to breathRhythmic jerkingDuration: 1 – 3 minutes (usually)

Often associated with tongue biting, and loss of bowel or bladder control

Post ictal phaseConfusionSleepy may sleep 30 minutes to 4 hours

Brief loss of consciousness (10 – 20 seconds)Blank stareNo post ictal period associatedMay have subtle twitching (myoclonic movements)May have simple automatisms

Generally look like a fast tonic seizure or startlePatient will often fall to the groundBrief – lasting only a few secondsUsually occur in clustersNo post ictal phase

Patient often yell at the onsetArms are up, and extended to the front or side.Head drops, and legs may become stiffPatient may drop abruptly.Duration usually 1 minute or lessOften poor respiratory effortPost ictal phase is variable

Sudden loss of muscle toneFall to the groundNo warningDuration: a few seconds

InsomniaConstipationFebrile illnessesExcessive ExcitementExcessive StressMedication changes

MedicationsSurgeryDietary

Valproate SodiumLamotriginePhenytoinCarbamazepinePhenobarbital

LamotriginePhenytoinCarbamazepinePhenobarbital

PhenobarbitalDilantinTopamaxLevetiracetam

Vagal Nerve StimulatorTemporal lobectomyCorpus CallosotomySubpial transection

Ketogenic DietAtkins Diet(Low carbohydrate)?

SyncopeCardiac arrhythmiaBreath holding spellPanic attacksMovement disorderHypoglycemic episodes

Esophageal refluxSleep disorderBenign nocturnal jerksPsychogenic episodesMensestrauma

DOStay CalmProtect from injuryMove surrounding

objects awayPosition on floor or soft

surface

DOProtect airwayPlace head on pillowLoosen clothingPlace on left side

Do not panic!Do not try to stop the seizureDo not place objects in mouthDo not try to restraint them

Any first time seizure

When it compromises respiration

When it has lasted

>5 minutes

>2 seizures in 10 minutes

Associated with trauma

In a Wheelchair, Stroller or BusDo not try to remove them from this Position

The seat provides support.Moving the person puts you and the client at risk of injury.You may provide extra padding, move footrests or take steps

to protect limbs from injury.Always continue to monitor airway

-Loosen but do not unfasten seat belts-They may need to be taken out of the chair after the seizure

At workAt home

Around the HousePad corners, rounded cornersCarpet with extra padding underneathNo top bunks Low bed or mattress on the floorPlace guards around fireplace or woo stovesMonitor in the bedroom

Bathroom:Supervise showerDo not lock doorsKeep water levels low in tubSet lower temperature on water

heaterDoors opening outwards

instead of inwards

KitchenUse Plastic containers/dishesUse microwave instead of stove as much as possibleSupervision with knives or sharp objects

In the workplace:have a place to restkeep extra set of clothestake regular breaks to

avoid fatigueavoid flashing lightsspecial safety around

machinery