GENERALIZED: Tonic-clonic (grand mal) seizures are characterized by individual falling, body rigid with muscle jerks, shallow breathing, bluish skin, and loss of bladder/bowel control. Absence (petit mal) seizures are characterized by blank stares, rapid blinking, chewing-like motion. Atonic (drop attack) seizures are characterized by the individual falling or collapsing suddenly. Myclonic seizures are characterized by brief muscle jerks in all or part of the body. PARTIAL: Simple Partial seizures are characterized by jerking in one area of the body with no loss of awareness. Individual may feel sad, fearful, or angry, and may have nausea or funny feeling in stomach, or smell something odd. Complex Partial seizures are characterized by blank stares with random or no activity. Individual will be unaware and unresponsive. May pick at objects, and may run or appear afraid.
Absence:
abscence (petite mal) seizures produce momentry loss of awareness, sometimes accompanied by movements of face
blinking or arm movements. these seizures may be frequent and differ from daydreaming in that they interrupt ongoing
activity. the individual immediately returns to full awareness after one of these episodes.
Management :
Just make sure the individual is fully aware of his surroundings.
A TONIC SEIZURES:
Also called drop seizures. A sudden loss of muscle tone causes the individual to collaspse. Sometimes there is only a sudden drop of the head. A few seconds to a minute later there is a full return to conciousness. These seizures can cause injuries because of the fall.
Myclonic Seizures: These invovle a quick sudden jerk. They may be mild and affect one part of the body or severe enough to throw
an individual to the floor. they can occur singularly or in clusters. management the individual should be helped up examined for injury from the force of the fall reassured and allowed to rest until fully recovered.
PARTIAL SEIZURES.
Simple Partial seizures
Affects movement and sensation but not consciousness it may involve a jerking movements that affect one side
of the body and may progress to a generalized seizure partial seizures that affect the sensations may cause things
to look sound taste smell or feel different, may also cause stomach pain nausa or sudden fear or anger.
Management
Compfort and reassure the individual if he or she seems confused or frightened.
Complex partial seizures
Alters consciousness and the individual is not aware during the seizure the seizure may begin with a blank stare
chewing movements and repeated motions The individual may seem dazed and may perform various acts picking
up and putting down objects picking at clothes or trying to run away this type or seizure lasts for a few minutes and has no memory of the seizure.
Management
If the individual has an episode of this type and appears dazed and oblivious to his surroundings take his arm
gently (if he is away from his seat) speak to him calmly and guide him carefully back in to his seat do not
gran hold or speak loudly . if there is resistenance just make sure he is not in any jeopardy. Ignore the automatic
behavior if the individual remains seated but have him stay in the classroom until fully awareness returns always
help re-orient the individual if he seems confused after wards.
EMERGENCY MANAGEMENT
The average convulsive seizure in a individual who has epilepsy is Not a medical emergency.
seizures usually resolve themselves without problems . Immediate medical attention is not required unless.
An individual has a seizure and there is no known history of Epilepsy. Some other medical problem
might be causing the seizure and emergency treatment of that problem might be required.
Consciousness does not return after the seizure ends. with in fifteen to twenty minutes
A second seizure begins shortly after the first one without regaining consciousness in between.
> the seizure shows no sign in ending after five minutes.
If an individual hits his or her head with force during the seizure or just before it began. one or more of the following
signs also call for immediate medical attention
Difficulty in rousing after twenty minutes
vomiting
complaints of difficulty with vision
persistent headache aftesr a short rest period
Unconsciousness with failure to respond.
Dilation of the pupils of the eye or if the pupils are unequal in seize.
If a seizure occurs while swimming and there is a possiblity that the large amounts of water
has been ingested he /she should be checked by a doctor as soon as possible even if he seems fully
recovered.
SEIZURE RECOGNITION
A caregiver may notice that an individual is having frequent episodes of blank staring and unresponsiveness
both symptoms of a seizure disorder. Many individuals have been diagnoised and successfully treated because of an
alert caregiver or relative.
The most common signs of possible seizure activity is
Brief staring spells (5-10 seconds.) in which the individual does not respond to direct attempts to gain
his or her attention, periods of confusion, head dropping, sudden loss of muscle tone, episodes of rapid blinking,
inappropriate movements of the mouth face accompanied by blank expressions,aimless dazed behavior including walking or repative movements, involventary jerking of an arm or leg.
Observing single instance of any of the above actions is no proof an individual has a seizure
disorder other things could cause it.
Seizure prevention
Antiepileptic Medications
Many indivduals with epilepsy gain control of their seizure with regualar use of seizure preventing medicines
these medicines These medicines have to be taken daily at the same time indicated by the doctor.
Successful treatment depends on keeping a steady level of medication in thepersons blood at all times
so it is important that the dosages not be missed or given late. The medicines should be given according to the
doctors instructions.
Although the side affections of an antiepleptic drug are generally mild unusal fatizure Lethargy clumminess
nausa, or other signs of ill health in the individual with epilepsy should be reported promptly.
Vagus Nerve Stimulator implant
The Fda approved the Vns implant in 1997 orginially, the implant met with some resistence from physicians and individuals. However as more became known about the procedure and its successes more individuals (children
and adults) are having the devise implanted as away to control seizures. All caregivers should be well versed in
careing for the indivduals
Thirty thousand implants have been performed in the united States. since 1997 much success has been noted in the in the medical journals including the treatment for depression parkinsons disease andAlzheimers .
PERFORMANCE
Most idviduals with epilepsy test in the average I. Q. range. However research studies have shown that a number of individuals with epilepsy achieve at a lower level than test scores would predict.There are several reasons why this may happen.
The medicines preventing seizures may be affecting the abiltity to learn. Phenobarbitol sometimes ha this affect certain other drugs do as well. A changed in medicine might help.
Unrecognized seizure activity in the brain may be interfering with attention. Difficulty paying attention is a frequent problem for children with epilepsy. Especially boys. Anxiety over the possiblity of of having a seizure may be affecting
attention as well.
Some underlying condition in the brain may interfere with learning and memory or the way the brain handles the information . These problems may show up in math reading and tasks involving memory.
Missing school can ususally be remedied through tutoring and remedial work. The other problems are subtler and may
require to identify and over come . Testing by a Neuropsychologist. knowledgeable about epilepsy can help determine
if the difficulties a child is having are due to some specific learning disbility. Once difficulties are identified special education techinques may help the youngester over come the problem.
Behavior
The average child with epilepsy will not have behavior problems. and will respond to appropriate discipline in the classroom in the same manner as all other children.
When a child with epilepsy do have problems behavior problems there are several factors. may be the cause.
The seizure activity itself the medication, the child's own anxiety and low self esteem. or parental over protection
or indulgence are all factors that produce behavior problems.
AVOIDING OVER PROTECTION
Well meaning adults tend to protect children with epilepsy from life itself.
Parents may limit a child's participation in the usual childhood activities. because of fear that a seizure will occur
during the activities or that exertion will somehow tringger.
seizure
This is unfortunate for several reasons . First vigorous physical activity is not generally associated with a great number
of seizures: in fact studies suggest fewer seizures will occur when the average person is active.
Secondly the individual is excluded from experiences that would help him develop social skills and self confidence.
The sense of being diferent of being unable to join others are doing encourage dependence and keeps him socially
immature.
The outside experiences offers the individual with epilepsy a unique opportunity to break the pattern of over protection
and isolation where ever possible he should be incouraged to take part in all activities. Careful supervision is needed
when a individual with seizures takes swimming or gym. With appropriate safeguards these activities can be safely undertaken.
Common Seizure Triggers
Missed doses of antiepilepsy medication ( too little medication)
Antiepilepsy medication toxicity ( too much medication)
Lack of Sleep
Abuse of Alcohol and other drugs
Fever colds infections or other illnesses
Blinking and flashing lights geometric patterns (photosensitivity)
Menstrual cycle hormonal changes or imbalances
for instance at puberty or during menopause
Low blood surgar
Deficiency of Vitiamin B6, Sodium, Calcium or Magnesium
Sudden streess such as being started which may cause hyperventilation
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