1 Epilepsy & Seizures

2 Epilepsy is a disorder characterized by recurring seizures (also known as “seizure disorder”) A seizure is a brief, temporary disturbance in the electrical activity of the brain A seizure is a symptom of epilepsy

3 The Brain Is the Source of Epilepsy All brain functions -- including feeling, seeing, thinking, and moving muscles -- depend on electrical signals passed between nerve cells in the brain A seizure occurs when too many nerve cells in the brain “fire” too quickly causing an “electrical storm”

4 Who Has Epilepsy? Over 3 million Americans have epilepsy Roughly 181,000 new cases of seizures and epilepsy occur each year 50% of people with epilepsy develop seizures by the age of 25; however, anyone can get epilepsy at any time Now there are as many people with epilepsy who are 60 or older as children aged 10 or younger

5 What Causes Epilepsy? In about 70% of people with epilepsy, the cause is not known In the remaining 30%, the most common causes are: - Head trauma- Infectious diseases - Brain tumor and stroke- Heredity - Lead poisoning - Prenatal disturbance - Poor Nutrition of Brain Development

6 Symptoms That May Indicate Epilepsy Periods of blackout or confused memory Occasional “fainting spells” Episodes of blank staring in children Sudden falls for no apparent reason Episodes of blinking or chewing at inappropriate times A convulsion, with or without fever Clusters of swift jerking movements in babies

7 Seizure Types 22 Different kinds of seizures Seizures are divided into two broad categories: –Partial Seizures –Generalized Seizures

8 Partial Seizures Involves only part of the brain Begins with a discharge of neurons in just one part of the brain Symptoms relate to the part of the brain affected Person may experience an aura

9 Simple Partial Seizures May occur at any age. May be limited to uncontrolled body movements. May involve brief changes in how things look, sound, taste, or feel. Do not usually affect consciousness. Last about 30 seconds.

10 Complex Partial Seizures May occur at any age. Person completely unconscious; in a trance-like state Repeats certain aimless movements until seizure is over (lip-smacking, picking at clothes, etc). Seizure lasts about 1-3 minutes; very confused afterwards (This is occasionally mistaken for alcohol or drug intoxication).

11 Generalized Seizures Begins with a discharge neurons throughout the brain. Total loss of consciousness Most common are Absence and Tonic- Clonic

12 Absence Seizures –Formally called “petit mal.” –Hard to recognize; may be mistaken for daydreaming or inattentiveness. –Characterized by brief loss of consciousness Usually affects children Cause “blank spells” – staring, blinking, slight twitching, or fumbling 2-10 second lapses in consciousness May occur times per day if uncontrolled

13 Tonic-Clonic Seizures Sometimes called “Grand Mal”. Tonic – Stiffness Clonic – Jerking Movement Becomes unconscious; will fall if standing Involuntary crying out may occur Skin turns pale blue or white though person is still breathing Jerking movement of head, arms, and legs May drool, vomit and become incontinent Seizure usually last 1-3 minutes Very tired following seizure

14 Seizure Triggers Missed medication (#1 reason) Stress/anxiety/worry Lack of sleep/extreme fatigue Dehydration, illness, poor nutrition Hormonal changes, growth spurts Photosensitivity Drug/alcohol use; drug interactions General illness

15 Stay calm and track time (length of seizure) Do not restrain person, but help them avoid hazards –Move anything hard or sharp out of the way –If person appears agitated stay back but protect Check for epilepsy or seizure disorder ID Understand that verbal instructions may not be obeyed Stay until person is fully aware and help reorient them –Ask simple questions –Stay with them until fully aware –Reassure them Call ambulance if seizure lasts more than 5 minutes or if it is unknown whether the person has had prior seizures First Aid for Complex Partial Seizures

16 First Aid for Tonic-Clonic Seizures Stay calm and track time (length of seizure) Don’t move person –Move anything hard or sharp out of the way Do not restrain person –Remove glasses, jewelry if possible, loosen tight neckwear –Turn person on one side, position mouth to ground –Protect head, keep neck in proper alignment –Don’t put anything into the mouth Check for epilepsy or seizure disorder ID Understand that verbal instructions may not be obeyed Stay until person is fully aware and help reorient them –Reassure them Call ambulance if seizure lasts more than 5 minutes or if it is unknown whether the person has had prior seizures

17 Potentially Dangerous Responses to Seizure DO NOT Put anything in the person’s mouth Try to hold down or restrain the person Attempt to give oral antiseizure medication Keep the person on their back face up throughout convulsions

18 When to Call 911 or Emergency Medical Services The seizure lasts longer than 5 minutes Full consciousness is not regained within 30 minutes after the end of the seizure Another seizure begins before the person regains consciousness Also call if the person: –Has never had a seizure before –Is injured or pregnant –Has diabetes/other medical condition –Recovers slowly –Does not resume normal breathing –Had the seizure in water

19 Treatment Goals in Epilepsy Help person with epilepsy lead full and productive life –Epilepsy is what they have, not who they are Eliminate seizures without producing side effects

20 What Factors Influence Decision to Treat? Treatment may be appropriate Abnormal EEG Previous seizure Partial seizure Driver Other neurologic impairment/mood disorder Elderly Treatment may NOT be appropriate Single seizure No history Neurologically normal Young age Side effects

21 Types of Treatment Medication 1 st Generation medications 2 nd Generation medications Nonpharmacologic treatment Ketogenic diet Vagus nerve stimulation Surgery

22 Epilepsy and Mood Disorders Depression is The Most Common Mood Disorder In People With Epilepsy. In General 29% of People With Epilepsy Have A Major Depressive Disorder. 50% Of Those Who Are Depressed Are Not Diagnosed. People Diagnosed with Epilepsy Are Three Times More Likely To Commit Suicide Then The General Population. People With A History of Depression Have a 3 to 7 Times Higher Risk of Developing Epilepsy.

23 Causes of Depression Medications/Drug Interactions Lack of Understanding About Epilepsy/ Myths & Stigmas Social Acceptance Impact On Family, Relationships, Professional Life Acceptance of Having Epilepsy/ Person & Family

24 Effects Of Depression Increased Use of Alcohol or Drugs Behavior Changes Illness Suicide Increased Depression in Family

25 Epilepsy Foundation of Western Wisconsin 1812 Brackett Ave, Suite 5 Eau Claire, WI or Cover 22 counties in Western WI –Ashland, Barron, Buffalo, Burnett, Chippewa, Clark, Dunn, Douglas, Eau Claire, Iron, Jackson, Pierce, Pepin, Polk, Price, Rusk, Sawyer, St. Croix, Taylor, Trempealeau and Washburn

26 National and Community Resources The Epilepsy Foundation –Website: MedicAlert Foundation Social Security Administration Accreditation Council on Services for People with Disabilities State Offices –Vocational Rehabilitation –Protection and Advocacy –Aging Services