Epilepsy

1. Epilepsy Presented by Sarah Beggs and Jess Gardoll

2. What Is Epilepsy? Epilepsy is a sudden altered state of consciousness and bodily control due to abnormal electrical discharges within specific areas of the cortex. (brain) These attacks cause a seizure to occur and the seizure can occur for seconds or minutes depending on the severity of the disease.(Westwood, 2009)

3. Causes for Epilepsy Epilepsy is caused by many factors, here are just a few: • Sleep deprivation • Head injury • Intoxication-drugs and alcohol • Infection within the brain- meningitis, encephalitis • Brain chemistry • Hereditary causes • Prenatal injuries • Environmental causes • Nutritional deficiencies • Certain types of lighting • Strong emotion • Intense exercise • Stress • Hormonal changes • Missed Medication The Risk Factors • Babies are born with abnormal brain structure • Bleeding within the brain • Abnormal blood vessels in the brain • Serious injury due to lack of oxygen to the brain • Brain tumors • Stroke • Cerebral palsy • Mentally handicapped • Alzheimer’s disease-later in the illness

4. What is a Seizure? A seizure is a sudden burst of electrical activity within the brain and this affects how a person feels/acts. Seizures however, are not a disease they are symptom of many disorders from the brain. Some seizures go unnoticed whilst others are immobilize the individual. (Epilepsy, 2010)

5. Seizures-Beginning, Middle and End For many people who suffer from epilepsy they go through three stages whilst having a seizure. An individual may have a warning or early symptoms that prompt them for an attack it could be racing thoughts, dizziness, nausea or visual loss/burning. The middle of the seizure can take on many forms the symptoms may become more serious or it may stay similar. The end then brings the individual back to their normal state. This is called ‘postictal period’ and represents the recovery period of the brain readjusting after the attack. It may last from seconds to minutes or hours depending in the individual and what part of the brain was affected. (Epilepsy 2010)

6. Types of Seizures There are different types of seizures, but they can be separated into two major categories partial and generalised. Here are a few more: • Partial seizure • Generalised seizure • Absence Seizure-loss of facial expression and eye blinking. • Myoclonic Seizure- muscle jerks involving upper body. • Tonic Seizure-brief stiffening of whole body. • Atonic Seizure-brief loss of muscle control usually collapsing head first. (Epilepsy Action, 2008)

7. What to do if a Seizure Occurs • During the seizure there are safety precautions to prevent injury, you should place a small pillow under their head, loosen restrictive clothing and roll the person on side to prevent aspiration and ease from a standing or sitting position to the floor. • If the person is unconscious, make sure nothing is obstructing the nose or mouth. When you are watching an epileptic attack you should stay calm. • You shouldn’t place a finger or other object into the person’s mouth to protect or straighten the tongue-it is unnecessary and dangerous. • Don’t perform artificial respiration during a seizure, even if the person is turning blue. Most seizures are long over before brain damage begins. • Look for any identification, especially epilepsy bracelets or information cards. • You shouldn’t try to restrict the person because you may injure them or yourself. • If the person has vomited, you should roll the person on their side so that any fluid can easily flow out of the mouth. • Don’t give the person anything to eat or drink until they have fully recovered. • Don’t give the person medication until the seizure has stopped and he/she is completely awake. • Stay with the person until recovery is complete. • Try and maintain a patent airway, note the frequency, type, time, body parts involved and the length of the seizure. It is important to monitor vital signs and neurologic status. (Epilepsy Australia, 2010.)

8. Activity One-Memory Can you remember the order of what to do if a seizure occurs.

9. Epilepsy Risk Management People who have to live with epilepsy are more susceptible to other risks these include: • Injury-most common injuries occur due to individuals burning themselves in the kitchen or bathroom. • Driving- laws are in place for driving after a seizure, however if an individual has an attack whilst driving it can be catastrophic. • Swimming and Bathing- • Check for Hazards-leisure, work and home • Emergency Identification-some people choose to wear something to show they are suffering from epilepsy with small amount of information attached. (Epilepsy Australia 2010)

10. Treatment Epilepsy can be treated in many different means; once a diagnosis has been completed it is best to select the appropriate treatment for the individual. The objective of all treatments is to prevent seizures so that even though the individual has epilepsy they are still able to lead active lives. Treatment includes: • Medications-depends upon the type of seizure they experience. • Surgery-only in serious cases. • Vagus Nerve Stimulation Therapy-short bursts of electrical energy directed at the brain via vagus nerve. • Complementary Treatment- folk medicines, herbs and megavitamin therapy. • Ketogenic Diet- high in fats and low in carbohydrates. (Epilepsy Foundation 2008)

11. Impact of Epilepsy-Individual Epilepsy impacts individuals differently as depends on the type of epilepsy they have and how serious case they have as well. The fear of having a seizure is a major impact that affects individual’s lives, also ‘low self-esteem from a stigmatising disorder can rob the individual of their self-confidence and initiative to learn and try new things.’(Mittan, 2010. Epilepsy and Learning Disabilities Part 1) Epilepsy is not just a physical disorder but a disorder that affects how the individual learns; it limits the experiences that they are able to participate in. People with epilepsy also experience discrimination as people don’t understand what living with epilepsy is like and are afraid to interact or socialise with individuals as they feel they won’t know what to do if they have a seizure.(World Health Organisation 2009) Epilepsy can also affect how students perform with the classroom in particular they may have difficulty with concentration, memory, organisational skills and challenges in reading, spelling and maths. (Elliot, 2005. Epilepsy: Impact on the Life of the Child) People with epilepsy may also suffer from behavioural/emotional issues these include anxiety, depression, irritability, hyperactivity and aggression. This then impacts on their social inclusion which can reinforce their negative view about themselves and they become alienated.

12. Impact of Epilepsy-Family Not only does epilepsy impact on the individual it can also affect the lives of their families. The diagnosis of epilepsy in the family may make the parents focus on the child with epilepsy damaging their relationships with their other children. Also it impacts on the relationship between the siblings due to the psychological difficulties. (Hills, 2007. The psychological and social impact of epilepsy) It is common for parents and siblings to experience anxiety, guilt and feelings of helplessness. ‘Seizures have the potential to interrupt normal routines; this in turn can impact a family’s daily activities. However, as unsettling as a seizure itself may be, the inability to predict when they will occur may have an even more profound affect.’ (Growing up with Epilepsy 2006)

13. Implications-Teachers/Schools Teachers need to be informed by parents if their child has epilepsy, this is essential to ensure that the child has the best learning opportunities. The school also needs to be told if the child has epilepsy so that all teachers are aware. It is also suggested that the child be fully informed about their condition so that are able to better understand and cope with it effectively. (Westwood, 2009. What teachers need to know about students with disabilities?) It is important for the teacher/school to know what medication the student is on and how much dosage they require as they may have to give the medication if needed. Also any side effects that may be associated with the medication as this can alter the students’ behaviour and education. The school has to notify the parents if an attack has occurred at school and depending on the parents’ choice they may be sent home. Epilepsy can affect how a student will perform and interact at school. The child may seem to be day dreaming, not paying attention, not following instructions and not understanding. It is important to notice these signs as the child may be about to have an attack, or they have had one and are embarrassed to talk about it.

14. Activity Two-Myth or Fact • Epilepsy is rare-myth around 50 million people have epilepsy. • Epilepsy is contagious-myth epilepsy is not contagious. • Epilepsy can’t be cured-fact whilst there is treatment available it will only modify the condition it will not cure it. • Epilepsy is a sign of low intelligence-myth epilepsy is a physical condition. • Always call the ambulance-myth unless the seizure lasts more than 5 minutes, or is followed by a series of seizures you do not have to call the ambulance. • Epilepsy is a medical condition-fact epilepsy is caused by excessive discharges from the brain.

15. The Curriculum The curriculum may need to be adjusted to suit the child with epilepsy to ensure their educational needs and social needs are being filled. It is important that teachers don’t exclude children with epilepsy from classroom activities as this will influence the other children in the class. Inclusion within the school plays a vital part to assist with children’s self esteem and confidence. The teacher does need to assess the environment and the risk level that he/she may be exposing the child with epilepsy to and what to do in an emergency situation, it may be necessary that a teachers aid be requested for help for some activities. (Epilepsy Australia, 2010)

16. Issues/Concerns Raised by Teachers Teachers need to be prepared in their classroom if they have a child with epilepsy, they should be looking for early warning signs to show if a seizure is about to occur. One on the major problems for children with epilepsy is that the teacher will think the child is day dreaming or not paying attention in class, when really this is one of the symptoms before an attack is going to occur. (Epilepsy Action Australia, 2008) Here are some other concerns that teachers had when having children with epilepsy in their classroom: • What to do if a seizure occurs? • When or how often will a seizure occur? • How will it affect the learning of the child with epilepsy? • How will it affect the other children in the class? • Who could be asked to help within the classroom? • Will alternate furniture need to be considered in the classroom layout? • Duty of Care-Being met by school and teacher • Will the child be able to participate in activities?

17. Integration within the Classroom Due to epilepsy being a dysfunction within the brain different teaching strategies may need to be applied within the classroom to ensure the needs of all children are being met. Teachers can use many approaches for children with epilepsy, so that they welcomed and comfortable within the classroom whilst still participating actively. • Assign them a buddy or helper so that if any work is missed or misunderstood they have someone to help them. Also useful for self esteem and relationship building. • Provide clear instructions. • Routine for daily school life. • Provide information in a range of ways e. Visual, verbal, technological and handouts. • Offer additional support to the child.

18. Reference List • Elliot, I. (2005). Epilepsy: Impact on the Life of the Child. Epilepsia, vol.2, page. 249-252. Retrieved from www.epilepsy.com/articles. Retrieved 1st November 2010 • Epilepsy Australia. (2010) Epilepsy. Retrieved from www.epilepsyaustralia.net/default. Retrieved 1st November 2010 • Epilepsy Action Australia. (2008) Epilepsy. Retrieved from www.epilepsy.org.au/interacting-with-epilepsy. Retrieved 1st November 2010. • Epilepsy. (2010) Epilepsy the facts. Retrieved from www.epilepsy.com/101/treat101_whatnow. Retrieved 6th November 2010 • Epilepsy Foundation. (2010) Epilepsy Treatment. Retrieved from www.epilepsyfoundation.org/answerplace/medical/treatment. Retrieved 1st November 2010. • General Hospital Corporation. (2006) Growing up with Epilepsy. Retrieved from www.massgeneral.org/childhoodepilepsy/child/family_life. Retrieved 6th November 2010 • Health Information Publication. (2010)What causes epilepsy? Retrieved from www.ehealthmd.com/library/epilepsy. Retrieved 1st November 2010 • Hills, M. (2007). The psychological and social impact of epilepsy. Journal of Neurology Asia; vol. 12 page. 10-12. Retrieved from http://neurologyasia.org/articles/2007. Retrieved 6th November 2010. • Mittan, R. (2010). Epilepsy and Learning Disabilities Part 1: Diagnosing and Solving School Learning Disabilities in Epilepsy. Exceptional Parent, vol. 40, n.8, page. 33-35. Retrieved from Education Research Complete database. Retrieved 1st November 2010. • Westwood, P. (2009) What teachers need to know about students with disabilities? Vic: ACER Press, pages 55-57. Retrieved 6th November 2010. • World Health Organisation. (2009) Epilepsy. Retrieved from www.who.int/mediacentre/factsheets. Retrieved 1st November 2010. • Activity 2-http://epilepsyclassroom.com/lessons/grades_5_8.aspx • Activity3- www.epilepsytoronto.org/famouspeople.php

19. Activity Three-Guess Who Number one • Born in Belgium in 1878. • He is known for applying bright paint very thickly in swirls/dashes. • He only sold one painting in his lifetime. • His works include: potato eaters, sunflowers and starry night. • He cut off his ear in distraught after a fight with one of his friends. Vincent Van Gogh Number two • Born 1958 • Singer, songwriter and actor • He has been known under the unpronounceable symbol of love • Wrote s song about his condition called ‘The Sacrifice of Victor.’ Prince Number three • Born 1769 Corsica France • Emperor of France • Known as one of the greatest military commanders of all time, and he conquered much of Europe • The Arc de Triomphe, centrepiece of Paris were built in commemorate of his victories. Napoleon Number Four • Born 1924 • Russian Marxist revolutionary • Led the revolution in October in 1917 • He was a persuasive orator, political scientist, developed philosophical ideals of Marxism. Vladimir Lenin