Epilepsy PresentationEpilepsy Presentation

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By: Maureen MacKenzie By: Maureen MacKenzie Mohawk CollegeMohawk College

Instructors: Lynne Lafleur & Karen NagelInstructors: Lynne Lafleur & Karen Nagel

Due date: Week 9Due date: Week 9March 7, 2008 March 7, 2008

What is Epilepsy?What is Epilepsy?• Epilepsy is a seizure disorder resulting from sudden bursts Epilepsy is a seizure disorder resulting from sudden bursts

of electrical energy in the brain. These electrical of electrical energy in the brain. These electrical discharges produce seizures which vary from one person to discharges produce seizures which vary from one person to another in frequency and form. Sometimes the electrical another in frequency and form. Sometimes the electrical signal only reaches part of the brain where a part of the signal only reaches part of the brain where a part of the body, like an arm or a leg may move on its own. If the body, like an arm or a leg may move on its own. If the signal goes through all of the brain, the person may shake signal goes through all of the brain, the person may shake all over, fall and lose consciousness. all over, fall and lose consciousness.

• It is It is notnot a disease, psychological disorder or contagious a disease, psychological disorder or contagious..

• Please view the Video ‘ All about Epilepsy’Please view the Video ‘ All about Epilepsy’ http://www.epilepsyontario.org/allaboutep.wmvhttp://www.epilepsyontario.org/allaboutep.wmv

Epilepsy and GABA

A seizure occurs when the message delivery system becomes unbalanced. Under normal circumstances, the neurotransmitter GABA (gamma-aminobutryic acid) triggers signals. When there is not enough GABA, a person has a seizure because thereceiving neurons is flooded with signals.

IncidenceIncidence• Approximately 0.6% Approximately 0.6% Canadians Canadians have epilepsy.have epilepsy.• Each day in Each day in CanadaCanada, an average of 42 people learn , an average of 42 people learn

they have epilepsy.they have epilepsy.• Each year, 15,500 Each year, 15,500 CanadiansCanadians learn they have learn they have

epilepsy.epilepsy.• 60% of new patients are young children and senior 60% of new patients are young children and senior

citizens.citizens.• In In OntarioOntario, at least 120,000 and as many as 245,000 , at least 120,000 and as many as 245,000

people are living with a seizure disorder.people are living with a seizure disorder.• In In Hamilton-Wentworth and BurlingtonHamilton-Wentworth and Burlington about about

6,000 people have some form of epilepsy (1 person in 6,000 people have some form of epilepsy (1 person in every 100).every 100).

EtiologyEtiology

Identifiable Causes of Epilepsy in Children:Identifiable Causes of Epilepsy in Children:• Brain injury to the fetus during pregnancyBrain injury to the fetus during pregnancy• Birth trauma –lack of oxygenBirth trauma –lack of oxygen• Head trauma, e.g., car accidentHead trauma, e.g., car accident• Brain tumor and strokeBrain tumor and stroke• Infection e.g., meningitis Infection e.g., meningitis • Poisoning from substance abuse or Poisoning from substance abuse or

environmental contaminants, e.g., lead environmental contaminants, e.g., lead poisoning. poisoning.

CharacteristicsCharacteristicsThe characteristics and frequency of seizures varyThe characteristics and frequency of seizures varygreatly. greatly.

Some known characteristics are:Some known characteristics are:

• Uncontrolled movements such as shaking of arms or Uncontrolled movements such as shaking of arms or legslegs

• Loss of consciousness Loss of consciousness • FallingFalling• Staring into space (absences) – mostly in childrenStaring into space (absences) – mostly in children• Appearing dazed, confused, mumblingAppearing dazed, confused, mumbling

Types of SeizuresTypes of SeizuresThere are many different kinds of seizures. There are many different kinds of seizures. Two main types are: “partial” and “generalized”.Two main types are: “partial” and “generalized”.

Simple partial seizureSimple partial seizure sudden jerky movementssudden jerky movements distortion in sight or smelldistortion in sight or smell sudden sense of fear, stomach discomfort, dizziness sudden sense of fear, stomach discomfort, dizziness sensations above are called an “aura”sensations above are called an “aura” Strategy: Reassure the personStrategy: Reassure the person

Partial seizures continued…Partial seizures continued…

Complex partial seizureComplex partial seizure loses awarenessloses awareness appears dazed and confusedappears dazed and confused random walking, mumbling, head turning and random walking, mumbling, head turning and

pulling at clothespulling at clothes person does not remember these behaviours person does not remember these behaviours

after the seizureafter the seizure 2/3 of people have this type of seizure2/3 of people have this type of seizure Strategy: do not restrain the person – stay with Strategy: do not restrain the person – stay with

the person until he/she is out danger.the person until he/she is out danger.

Generalized seizuresGeneralized seizuresGeneralized seizures affect the whole body.Generalized seizures affect the whole body.They are generalized absence or tonic-clonic. They are generalized absence or tonic-clonic.

Generalized absence seizureGeneralized absence seizure staring into space staring into space eyes may roll forwardeyes may roll forward 5 to 15 second lapses of consciousness5 to 15 second lapses of consciousness person does not recall this lapseperson does not recall this lapse occur in childhood and disappear in adolescenceoccur in childhood and disappear in adolescence Strategy: Talk gently to the person, be comforting Strategy: Talk gently to the person, be comforting

as it may take time for the person to become re-as it may take time for the person to become re-oriented.oriented.

Generalized seizures continued…Generalized seizures continued…

Tonic-clonic seizure (grand mal)Tonic-clonic seizure (grand mal) occurs in two phasesoccurs in two phases TonicTonic phase: loses consciousness and falls phase: loses consciousness and falls ClonicClonic phase: muscles stiffen, body jerks and phase: muscles stiffen, body jerks and

twitchestwitches bladder control may be lostbladder control may be lost consciousness returns slowlyconsciousness returns slowly Strategy: Require First Aid Treatment plus Strategy: Require First Aid Treatment plus

immediate medical attention if the seizure lasts immediate medical attention if the seizure lasts more than 5 minutes. more than 5 minutes.

Incidence of Seizure Types

Based on information from:Epilepsy -A ComprehensiveTextbook,

1997

Management Management procedures/strategiesprocedures/strategies

Medication Management:Medication Management: Find the correct medication to take. Not all medications work the same for each Find the correct medication to take. Not all medications work the same for each

personperson Take the medication as prescribed by the DoctorTake the medication as prescribed by the Doctor Never miss taking the medication plus always take it at the same time each day.Never miss taking the medication plus always take it at the same time each day. Let the Doctor know if you feel ill, dizzy or start seeing doubleLet the Doctor know if you feel ill, dizzy or start seeing double

At school, know the child’s possible seizure triggers:At school, know the child’s possible seizure triggers: not taking medications not taking medications poor diet and eating habits and lack of sleeppoor diet and eating habits and lack of sleep stress, excitement & emotional upsetstress, excitement & emotional upset inactivity and boredominactivity and boredom flashing lights, computer screens, televisionflashing lights, computer screens, television Know the possible side effects of the student’s medication: short term memory loss, Know the possible side effects of the student’s medication: short term memory loss,

fatigue, dizziness, depression, aggressive and anti-social behaviour. fatigue, dizziness, depression, aggressive and anti-social behaviour.

Know what to do when a seizure startsKnow what to do when a seizure startsLearn what kind of a seizure your student has and know the proper strategy in assisting Learn what kind of a seizure your student has and know the proper strategy in assisting them through it. First Aid Treatment may be needed (see the next slide).them through it. First Aid Treatment may be needed (see the next slide).

First Aid for Tonic-Clonic SeizureFirst Aid for Tonic-Clonic Seizure Keep calm- seizures usually only last a few minutes and do Keep calm- seizures usually only last a few minutes and do

not require medical attention*.not require medical attention*. Protect from injury – ease the person to the floor, move Protect from injury – ease the person to the floor, move

away any objects, protect the person’s head with a pillow or away any objects, protect the person’s head with a pillow or rolled up coat. Loosen any tight neckwear.rolled up coat. Loosen any tight neckwear.

Do not restrain the person.Do not restrain the person. Do not insert anything into the person’s mouth.Do not insert anything into the person’s mouth. After the seizure, roll the person on to their side.After the seizure, roll the person on to their side. Be reassuring – talk calmly to the person.Be reassuring – talk calmly to the person.

**If a seizure lasts If a seizure lasts longer than 5 minuteslonger than 5 minutes, seek , seek Medical Attention.Medical Attention.

A child’s view….

Classroom Strategies for Classroom Strategies for Educational Assistant Educational Assistant

• Ask the teacher to have an informal discussion with the class about epilepsy, Ask the teacher to have an informal discussion with the class about epilepsy, letting them know ‘epilepsy’ is not contagious or a disease and using letting them know ‘epilepsy’ is not contagious or a disease and using appropriate terms ‘tonic clonic’ or ‘absence’.appropriate terms ‘tonic clonic’ or ‘absence’.

• Have the student sit at the front of the class to avoid any distractions.Have the student sit at the front of the class to avoid any distractions.• Watch for any flashing lights in the class, e.g.; ceilings lights that need to be Watch for any flashing lights in the class, e.g.; ceilings lights that need to be

replaced.replaced.• Establish a “buddy” system to help the student catch up on any missed work.Establish a “buddy” system to help the student catch up on any missed work.• Repeat instructions to assist the student from work he/she missed due to Repeat instructions to assist the student from work he/she missed due to

“absence” seizures.“absence” seizures.• Use physical prompts to help keep the student oriented.Use physical prompts to help keep the student oriented.• Limit time on the computer or when watching school videos. Limit time on the computer or when watching school videos. • Make the student’s day as normal as possible -do not be overprotective.Make the student’s day as normal as possible -do not be overprotective.• Ensure the student stays in the playground or classroom where he/she can be Ensure the student stays in the playground or classroom where he/she can be

seen. seen. • After a seizure, give the student a chance to rest or re-focus before starting After a seizure, give the student a chance to rest or re-focus before starting

on another task.on another task.

Make my day as normal as possible- do not be overprotective!

Resources Resources Epilepsy OntarioEpilepsy Ontario provides the following services: provides the following services:

1.1. Information, counselling and referral services.Information, counselling and referral services.2.2. Education and advocacy services for children and adults living with Education and advocacy services for children and adults living with

seizure disorders and for their families. seizure disorders and for their families. 3.3. Resource Centre for borrowing books, videos, medical journals at Resource Centre for borrowing books, videos, medical journals at

www.epilepsyontario.orgwww.epilepsyontario.org..4.4. Address of Local agencies; e.g. Hamilton has a new agency at 182 Address of Local agencies; e.g. Hamilton has a new agency at 182

East 6East 6thth Street - with many resources such as pamphlets, CD’s; e.g. Street - with many resources such as pamphlets, CD’s; e.g. “Children living with Epilepsy”, booklets, newsletters, etc. “Children living with Epilepsy”, booklets, newsletters, etc.

5.5. Summerfest Summer Camp at Camp Couchiching for children living Summerfest Summer Camp at Camp Couchiching for children living with epilepsy, ages 6-15.with epilepsy, ages 6-15.

6.6. Up-to-date links: to support groups, to the latest medical Up-to-date links: to support groups, to the latest medical information.information.

Support for children living with Support for children living with EpilepsyEpilepsy

Pediatric neurologists help assist the families with finding the right Pediatric neurologists help assist the families with finding the right medication for their child along with support and counselling. medication for their child along with support and counselling.

School alert program for teachers and schools with videos, School alert program for teachers and schools with videos, pamphlets and in-depth first aid training.pamphlets and in-depth first aid training.

““Kids on the Block” puppet troupe for elementary schools – full Kids on the Block” puppet troupe for elementary schools – full size puppets program to enlighten children about epilepsy size puppets program to enlighten children about epilepsy awareness. awareness.

School personal work in partnership with the parents. Informal School personal work in partnership with the parents. Informal and formal meetings with various school board personal to assist and formal meetings with various school board personal to assist the teachers and educational assistants in understanding the the teachers and educational assistants in understanding the needs of the child. needs of the child.

Support Group: Seizure Disorder of Greater Hamilton Support Group: Seizure Disorder of Greater Hamilton 905-522-8487- Conduct self-help/support groups-provide quarterly 905-522-8487- Conduct self-help/support groups-provide quarterly

newsletters-provide presentations to schools.newsletters-provide presentations to schools. All about Epilepsy – a great animated video for ages 8 and upAll about Epilepsy – a great animated video for ages 8 and up http://www.aboutkidshealth.ca/JustForKids/epilepsy.aspxhttp://www.aboutkidshealth.ca/JustForKids/epilepsy.aspx

Treatment CentreTreatment Centre

McMaster University Medical McMaster University Medical CentreCentreRegional Epilepsy ClinicRegional Epilepsy ClinicNeurology DepartmentNeurology Department1200 Main St W, 1200 Main St W, Hamilton, ON L8N 3Z5Hamilton, ON L8N 3Z5905-521-2100905-521-2100Children and AdultsChildren and Adults

More Treatment Centres More Treatment Centres http://www.epilepsy.cahttp://www.epilepsy.ca See Treatment CentresSee Treatment Centres

FactsFacts• MarchMarch is Epilepsy Awareness Month – is Epilepsy Awareness Month – Lavender Ribbon Lavender Ribbon

CampaignCampaign• Why Lavender? Lavender is associated with isolation which Why Lavender? Lavender is associated with isolation which

is one of the many challenges facing people with epilepsy.is one of the many challenges facing people with epilepsy.• A child living with epilepsy can have over 25 seizures a day A child living with epilepsy can have over 25 seizures a day

and take 15 pills a day.and take 15 pills a day.• Surgery is used only when other medical avenues have Surgery is used only when other medical avenues have

been pursued. been pursued. • Epilepsy comes from a Greek word ‘epilambanein’ which Epilepsy comes from a Greek word ‘epilambanein’ which

means to seize or attack. The Greek’s believed seizures means to seize or attack. The Greek’s believed seizures were caused by demons, and regarded them as a were caused by demons, and regarded them as a supernatural phenomenon. supernatural phenomenon.

• Epilepsy Ontario has been serving Ontario for 52 years.Epilepsy Ontario has been serving Ontario for 52 years.

BibliographyEpilepsy & Your Child – Parent’s Information Booklet, Novartis Pharmaceuticals Canada Inc., Dorval, Quebec

Epilepsy – Answer to Your Questions Brochure, Epilepsy Canada, Montreal, Quebec

World Health Organization (WHO), Fact Sheet http://www.who.int/mediacentre/factsheets

Epilepsy Canada, Living with Epilepsy, http://www.epilepsyfoundationorg.

Epilepsy Ontario, Facts about Epilepsyhttp://www.epilepsyontario.org

Seizure Disorder of Greater Hamilton, Pamphlets, brochures, booklets.

CD on Children Living with Epilepsy, Epilepsy Ontario, Thornhill, Ontario

Causes of Epilepsy in Childhood Fact Sheet, http://www.epilepsy.com/info/family_kids

ACKNOWLEDGEMENT: Thank you to Patricia Kloet of the New Epilepsy-Seizure Disorder of Greater Hamilton Agency for the resource package.