1. Iron County School District
SEIZURES EPILEPSY
Iron County School District
HEALTH SERVICES
TRAINING MODULE
Welcome to the Washington County School District -
Health Services Training Module
This information is being made available to school personnel who
may be called on to assist students with seizures.

2. Definitions Types Triggers Emergencies Treatments Impact
SEIZURES - EPILEPSY
Definitions
Types
Triggers
Emergencies
Treatments
Impact
The following module will give you an overview of seizures. There are so many different kinds of seizures that neurologists are still updating how to classify them. We will explore the definitions, seizure types, seizure triggers, a seizure emergency, seizure treatments, and the impact they have on a child’s development and functioning.

3. DEFINITIONS A SEIZURE IS
A CHANGE IN
Sensation, awareness,
behavior, or involuntary
muscle activity
BROUGHT ABOUT BY
An electrical disturbance
in the brain
A neurological condition that affects the nervous system and makes people susceptible to seizures.
A SEIZURE IS
a change in sensation, awareness, behavior, or involuntary muscle activity brought about by an electrical disturbance in the brain.
Too many brain cells become excited simultaneously, causing a temporary communication problem between nerve cells.
EPILEPSY IS
A neurological condition that affects the nervous system and makes people susceptible to seizures.
While seizure disorders can be caused by injury, infection, lack of oxygen to the brain, poisoning, tumors, strokes or family tendencies, the majority of the time there is no known cause for epilepsy

4. NOT ALL SEIZURES INDICATE EPILEPSY
Non-epileptic seizures may be caused by:
High fever
Alcohol & drug withdrawal
Low blood sugar such
Imbalance of body fluids
Sudden loss of blood supply to the brain
Seizures may look scary but they are not painful.
Most seizures occur without warning.
Non-epileptic seizures may be caused by:
High fever
Alcohol & drug withdrawal
Low blood sugar such as in diabetes
Imbalance of body fluids, such as dehydration, and electrolyte imbalance
Sudden loss of blood supply to the brain, such as an abnormal heart rhythm or drop in blood pressure
Seizures may look scary but they are not painful.
Most seizures occur without warning

5. TYPES OF SEIZURES
There are many types of seizures
classified into two main types
GENERALIZED When the electrical disturbance involves the whole brain, the seizure is called generalized
PARTIAL When only part of the brain is affected, it is called partial
There are two main categories of seizures: Generalized and Partial. The difference between these types is in how they begin and the behaviors exhibited. Some children have just one type of seizure, others have two or more.
GENERALIZED:
When the electrical disturbance involves the whole brain, the seizure is called generalized.
PARTIAL:
When only part of the brain is affected, it is called partial

6. GENERALIZED SEIZURE TYPES
Involve electrical misfiring that affects the whole brain
TONIC-CLONIC SEIZURES MYOCLONIC SEIZURES ATONIC SEIZURES ABSENCE SEIZURES
GENERALIZED SEIZURE TYPES Involve electrical misfiring that affects the whole brain
You may be responsible for students experiencing several types of seizures including tonic-clonic seizures, myoclonic seizures, atonic seizures, and absence seizures.

7. TONIC-CLONIC SEIZURES
FIRST AID IS NECESSARY
Formally called grand mal seizures
Usually last 1-2 minutes
Stiffening of the limbs (tonic phase)
Loss of consciousness
Jerking movements (clonic phase)
Breathing may decrease or cease altogether,
Cyanosis (blue color) of the nail beds, lips and face
Breathing typically returns during the clonic phase,
but may be irregular.
Possible loss of bladder or bowel
Some people experience only the tonic phase or the
clonic phase; or a tonic-clonic pattern

8. ABSENCE SEIZURES NO FIRST AID NEEDED
Have been called petit mal seizures
Typically last seconds
Brief episodes of staring
Awareness and responsiveness are impaired
May occur occasionally OR 100 times a day
Can be mistaken for daydreaming
Do not realize they’ve had one but alert thereafter
Simple absence seizures only cause staring.
Complex absence seizures include changes in muscle activity such as blinking,
slight chewing movements, hand movements such as rubbing the fingers
together, and contraction or relaxation of the muscles.
NO FIRST AID NEEDED
They have been called petit mal seizures and
Typically last about 2-15 seconds.
They are brief episodes of staring in which
Awareness and responsiveness are impaired
They May occur only occasionally OR up to 100 times a day
‘They Can be mistaken for daydreaming and
People usually do not realize when they’ve had one
and are alert immediately there after
Simple absence seizures only cause staring.
Complex absence seizures include changes in muscle activity such as blinking,
slight chewing movements, hand movements such as rubbing the fingers together,
and contraction or relaxation of the muscles.

9. MYOCLONIC SEIZURES NO FIRST AID NEEDED Lasts only a few seconds
Rapid, brief jerking (muscle contractions)
Usually occurs at the same time on both
sides of the body
Occasionally, they involve one arm or a foot
People usually think of them as sudden jerks
or clumsiness.
Myoclonic seizures require no first aid and last only a few seconds. Rapid, brief jerking usually occurs at the same time on both sides of the body. Occasionaly, they involve one arm or a foot. People usually think of them as sudden jerks or clumsiness.

10. ATONIC SEIZURES FIRST AID USUALLY NOT NEEDED
Also known as drop attacks
Produces an abrupt loss of muscle tone
The head drops
Loss of posture or sudden collapse
These seizures can result in injuries to the head and face
because they are so abrupt, occur without warning and the
people experiencing them fall with force. Protective head
gear is sometimes used.
ATONIC SEIZURE
FIRST AID is USUALLY NOT NEEDED
They are Also known as drop attacks
because they Produce an abrupt loss of muscle tone.
The head drops, and there is a
Loss of posture or sudden collapse
These seizures can result in injuries to the head and face because they are so abrupt, occur without warning and the people experiencing them fall with force. Protective headgear is sometimes used.

11. FIRST AID GENERALIZED TONIC-CLONIC SEIZURES
Keep calm and reassure other people who may be nearby.
Don't hold the person down or try to stop their movements.
Time the seizure with your watch.
Clear the area around the person of anything hard or sharp.
Loosen ties or anything around the neck that may make breathing difficult.
Remove glasses.
Put something flat and soft, like a folded jacket, under the head.
Turn the person gently onto one side. This will help keep the airway clear.
Do not try to force the mouth open with any hard implement or with fingers.
Don't attempt CPR except in the unlikely event that a person does not start
breathing again after the seizure has stopped.
Stay with the person until the seizure ends naturally.
Be friendly and reassuring as consciousness returns.
The person may be very sleepy after the seizure.
When giving FIRST AID for GENERALIZED TONIC-CLONIC SEIZURES
Keep calm and reassure other people who may be nearby.
Don't hold the person down or try to stop his movements.
Time the seizure with your watch.
Clear the area around the person of anything hard or sharp.
Loosen the ties or anything around the neck that may make breathing difficult.
Remove their glasses.
Put something flat and soft, like a folded jacket, under their head.
Turn him or her gently onto one side. This will help keep the airway clear.
Do not try to force the mouth open with any hard implement or with fingers. A person having a seizure CANNOT swallow their tongue. Efforts to hold the tongue down can injure their teeth or jaw.
Don't attempt CPR except in the unlikely event that a person does not start breathing again after the seizure has stopped.
Stay with the person until the seizure ends naturally.
Be friendly and reassuring as consciousness returns.
The person may be very sleepy after the seizure.

12. Electrical misfiring is limited to one part of the brain
PARTIAL SEIZURES
Electrical misfiring is limited to one part of the brain
SIMPLE PARTIAL SEIZURES
Awareness, memory and consciousness maintained
COMPLEX
PARTIAL SEIZURES
Awareness, memory and consciousness are impaired or lost
The impact of a partial seizure depends on where in the brain it begins and how it spreads.
Partial seizures can spread to cause a generalized type of seizure, discussed in the previous slides.
“The other main type of seizure classification is partial seizures.”
Partial seizures are the most common type of seizures experienced by people with epilepsy & are divided into
SIMPLE PARTIAL SEIZURES
Where the Awareness, memory and consciousness are maintained, AND
COMPLEX
PARTIAL SEIZURES
Where Awareness, memory and consciousness are impaired or lost
The impact of a partial seizure depends on where in the brain it begins and how it spreads.
Partial seizures can spread to cause a generalized type of seizure, discussed in the previous slides.

13. SIMPLE PARTIAL SEIZURES
Last about 90 seconds, while aware of their surroundings, with memory and consciousness retained
MOTOR SEIZURES: Affect movement, usually on one side of the body
SENSORY SEIZURES: Sensations may cause things to look, sound, taste, smell, or feel different.
AUTONOMIC SEIZURES: Cause changes in the part of the nervous system that automatically controls bodily functions.
PSYCHIC SEIZURES: Change how people think, feel or experience things.
SIMPLE PARTIAL SEIZURES
Last about 90 seconds, while the person is aware of their surroundings and memory and consciousness are retained. It is remarkably different for each person depending on the part of the brain affected.
MOTOR SEIZURES: Affect movement, usually on one side of the body and May cause jerking movements that start in the fingers, toes, or other parts of the body, eventually affecting the whole of one side.
With SENSORY SEIZURES: Sensations may cause things to look, sound, taste, smell, or feel different.
AUTONOMIC SEIZURES:
Cause changes in the part of the nervous system that automatically controls bodily functions, such as Upset stomach, discomfort in the head, chest, changes in heart rate, breathing, sweating or goose bumps.
PSYCHIC SEIZURES: Change how people think, feel or experience things. They may have problems with memory, garbled speech, inability to find the right word, trouble understanding spoken or written language. They may suddenly feel emotions like fear, anger, depression, or happiness with no outside reason, or a feeling like “I’ve been through this before” or This is new to me” even though the setting is really familiar.

14. COMPLEX PARTIAL SEIZURES
Last about 1 – 2 minutes, alters awareness, memory and consciousness, and
is different for each person depending on the part of the brain affected.
Often starts with a blank stare and inability
to interact normally with other people and
no control of bodily movements, speech, or actions
Eyes may be open
Make mechanical
movements
Chewing
Repeated movements
Pick at clothes
Picks objects up & put
down
Freezing in place
Daydreaming
Mumbles, repeat words
Laugh, scream or cry
May run and appear afraid
Struggles or flails if restrained
Remains frightened &
confused afterward
COMLEX PARTIAL SEIZURES
Last about 1 – 2 minutes, alters awareness, memory and consciousness, and
is different for each person depending on the part of the brain affected.
This seizure often starts with a blank stare and an Inability to interact normally with other people, with no control of bodily movements, speech, or actions.
You may observe that their eyes are open, and they are ,making mechanical movements but there is nobody home.
Chewing, various repeated movements, picking at clothes, picking up objects and then putting them down, or they may seem dazed and freeze in
As if daydreaming
They may mumble, repeat words, laugh, scream or cry.
They may run and appear afraid, struggle or flail if restrained, remaining frightened & confused after the seizure. .
Some may mumble, repeat words or phrases, laugh, scream or cry, try to take clothes off, may run and appear afraid
May struggle or flail if restrained & may remain frightened and confused afterward.

15. SEIZURE TRIGGERS
Certain things can trigger seizures in people with epilepsy, and include;
Flashing or bright lights
Lack of sleep
Stress
Overstimulation
Fever
Certain medications,
Heavy alcohol use
Hyperventilation
Nutritional deficiencies
Menstrual cycle
Certain things can trigger seizures in people with epilepsy, and include;
Flashing or bright lights
Lack of sleep
Stress
Overstimulation such as
(staring at a computer screen or
playing video games for too long)
With Fever
Certain medications,
heavy alcohol use, or
With Hyperventilation
Nutritional deficiencies or
Menstrual cycle

16. Lightheaded & Numbness
AURAS
Partial seizures sometimes have an aura, a warning sign that a seizure is going to occur.
Tingling
Dizziness
Headache
Fear or Panic
Upset Stomach
Distorted Vision
Racing Thoughts
Strange Feelings
Distorted Emotions
Weird Smell or Taste
Lightheaded & Numbness
Auras usually occur seconds
to minutes before a seizure
Physical sensations that can
occur as auras
Partial seizures sometimes have an Aura which is a warning sign that a seizure is going to occur. Auras usually occur seconds to minutes before a seizure however some individuals may have periods of warning lasting a day or longer.
Physical sensations that can occur as auras include: tingling, dizziness, headache, fear or panic, upset stomach, distorted vision, racing thoughts, strange feelings, distorted emotions, a weird smell or taste, lightheadedness and numbness. Sometimes the warning or aura is not followed by any other symptoms. It may be considered a simple partial seizure by the doctor.
Sometimes the warning or aura is not
followed by any other symptom

17. AFTER A SEIZURE
May be sleepy or confused for a few minutes or even an hour or more
May not remember the seizure or what happened immediately before the event
May be alert and ready to resume whatever they were doing before the seizure happened
Most seizures last only a few seconds or minutes.
After a seizure the person may be sleepy or confused for a few minutes or even an hour or more.
They may not remember the seizure or what happened immediately before the event, or
They may be alert and ready to resume whatever they were doing before the seizure happened.

18. Call emergency medical services (911) if :
SEIZURE EMERGENCIES
Seizure lasts over 5 minutes
Seizures occur close together with
no recovery between seizures
Injury occurs
Difficulty breathing-blue coloration
Illness after seizure
Suspect ingestion of poisons or medications
Or other abnormalities
Call 911 emergency
medical services if
Call emergency medical services (911) if :
The seizure lasts long time, over 5 minutes in the school setting or when seizures occur close together and the person does not recover between seizures. A long-lasting convulsive seizure (called "tonic-clonic status epilepticus") is a medical emergency. If not stopped within about 30 minutes, it may cause permanent injury or death
If There is a head injury or any other serious injury
If they have Difficulty breathing or a blue coloration present
If they are ill after the seizure
If You suspect ingestion of poisons or medications
Or other abnormalities

19. SEIZURE TREATMENT If drugs don’t work or child has a lot of medication
side effects
other
treatments
are
considered
MEDICATION
DIET CHANGE
MEDICATION: Childhood epilepsy is usually treated with seizure-preventing medicines, most often taken at home. If drugs don’t work, or there are a lot of side effects other measures may be taken:
SURGERY can be done where the seizure-producing areas of the brain are removed or there is a severing of the connection between the two sides of the brain.
DIETARY CHANGES can be made: A high fat, low carbohydrate diet causes the body to burn fat instead of glucose (sugar) for fuel resulting in a reduction or prevention of seizures.
VAGUS NERVE STIMULATOR: An Electrical stimulation of the vagus nerve in the neck can reduce seizures through a battery operated implantable device placed under the skin, about the size of a silver dollar.
VAGUS NERVE
STIMULATOR
SURGERY

20. Learning/Academic issues
May have deficits in
Attention
Concentration
Memory
Organizational skills
Academic achievement
May have fatigue
from seizures
People with epilepsy usually are not intellectually challenged, however there is a greater risk for learning problems and underachievement.
They may have deficits in areas related to thinking and learning such as attention, concentration, memory, organizational skills and academic achievement.
They may experience fatigue from the seizures and the side effects of medication which can contribute to learning problems.
At greater risk for learning problems and underachievement
And side effects
from medication

21. Emotional & behavioral issues
Higher risk for
anxiety
depression
irritability
hyperactivity
frustration
aggression & rage
shame
embarrassment
Emotional and behavioral issues may surface
They are at hgher risk
for anxiety
depression, irritability,
hyperactivity, frustration,
aggression, rage,
shame and embarrassment.
Stigma of epilepsy and insensitivity of others can be stressors.
Teasing and bullying can decrease self esteem and inhibit normal social development.
Concern for a child’s safety may restrict participation in recreational activities, increasing the child’s sense of isolation.

22. To the needs of students with Seizures Let us be sensitive
It is important that we be sensitive to the needs of students with seizures.

23. This concludes the Health Services training module
Please follow the instructions below to complete a short quiz:
Make a copy of the test for this module then
answer the questions.
You can also make a copy of this power point to
assist you with the test.
3. Check the answers.
4. Send a copy of your answers to the school nurse.
Thank you for taking the time to learn how to assist students with Seizures
Iron County School District Health Services