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Seizure Recognition & First Aid
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Objectives o Recognize common seizure types and
their possible impact on individuals
o Know appropriate first aid
o Recognize when a seizure is a medical emergency
o Provide social and academic support
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What is a Seizure? A brief, excessive discharge of electrical activity in the brain that alters one or more of the following: o Movement o Sensation o Behavior o Awareness
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What is Epilepsy?
o Epilepsy is a chronic neurological disorder characterized by a tendency to have recurrent seizures
o Epilepsy is also known as a “seizure disorder”
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Famous People with Epilepsy
n Julius Caesar n Napoleon Bonaparte n Charles Dickens n Agatha Christie n Truman Capote n Vincent Van Gogh n Beethoven n Isaac Newton n Richard Burton n Danny Glover n Neil Young
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Did You Know That… o Most seizures are NOT medical emergencies o People may NOT be aware they are having a
seizure and may NOT remember what happened
o Epilepsy is NOT contagious o Epilepsy is NOT a form of mental illness o Epilepsy is NOT a form of mental retardation o People almost never die or have brain damage
during a seizure o A person CAN NOT swallow his/her tongue
during a seizure
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Did You Know That… o Epilepsy can develop at ANY age o 20% of cases develop before the age of five o 50% of cases develop before the age of
twenty-five o Epilepsy currently affects about 300,000 senior
citizens nation wide o By the age of twenty, 1% of the population can
be expected to develop epilepsy o By the age of 75, 3% of the population can be
expected to have been diagnosed with epilepsy and 10% will have experienced some type of seizure
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Epilepsy is More Common Than You Think
o Epilepsy & seizures affect over 3 million Americans of all ages
o 315,000 students in the United States o More than 45,000 new cases are diagnosed annually in
children o Approximately 200,000 new cases of seizures & epilepsy
occur each year o 1 in 26 people will develop epilepsy o 1 in 10 people will have a seizure in their lifetime o Epilepsy is more common than Cerebral Palsy,
Parkinson’s Disease and Multiple Sclerosis combined
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Common Causes of Epilepsy
o For seventy percent (70%) of people with epilepsy the cause is unknown
o For the remaining thirty percent (30%) common identifiable causes include: n Brain Trauma n Brain lesions (e.g. tumors) n Poisoning (lead) n Infections of the brain (e.g. meningitis, encephalitis) n Brain Injury at birth n Abnormal brain development
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Seizure Types o Generalized Seizures
n Involve the whole brain n Common types include absence & tonic-clonic n Symptoms may include convulsion, staring, muscle spasms and falls
o Partial Seizures n Involve only part of the brain n Common types include simple partial
and complex partial n Symptoms relate to the part of the brain affected
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Absence Seizures o Pause in activity with blank stare o Brief lapse of awareness o Possible blinking or chewing motion o Usually lasts 1 to 10 seconds o May occur many times a day o May be confused with:
n Day dreaming n Lack of attention n ADD
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Generalized Tonic-Clonic o A sudden, hoarse cry o Loss of consciousness o A fall o Convulsions (stiffening of arms & legs followed
by rhythmic jerking) o Possible loss of bowel or bladder control o Occasionally skin, nails or lips may turn blue o Generally lasts 1 to 3 minutes o Usually followed by confusion, headache,
tiredness, soreness, speech difficulty
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First Aid – Generalized Tonic-Clonic Seizure o Stay calm and track time o Check for epilepsy/seizure disorder ID (bracelet
or necklace) o Protect the person from possible hazards
(chairs, tables, sharp objects, etc.) o Turn person on his/her side o Cushion the head o After the seizure, remain with the person until
awareness of surroundings is fully regained o Provide emotional support o Document seizure activity
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Dangerous First Aid
o DO NOT put anything in the person’s mouth during a seizure
o DO NOT hold the person down or restrain them during the seizure
o DO NOT attempt to give oral medications, food or drink during a seizure
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When is a Seizure an Emergency?
o First time seizure (no medical ID and no known history of seizures)
o Convulsive seizure lasting more than 5 minutes o Repeated seizures without regaining
consciousness o More seizures than usual or change in type o Person is injured, has diabetes or is pregnant o Seizure occurs in water o Normal breathing does not resume o Person requests emergency evaluation
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Simple Partial Seizures n Full awareness maintained n Rhythmic movements (isolated twitching of
arms, face, legs) n Sensory symptoms (tingling, weakness, sounds,
smells, tastes, feeling of upset stomach, visual distortions)
n Psychic symptoms (déjà vu, hallucinations, feelings of fear of anxiety, or a feeling they cannot explain)
n Usually lasts less than one minute n May be confused with: acting out, mystical
experiences or psychosomatic illness
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Complex Partial Seizures o Awareness is impaired/Inability to respond o Often begins with blank dazed stare o AUTOMATISMS (repetitive purposeless movements) o Clumsy or disoriented movements, aimless walking,
picking things up, nonsensical speech or lip smacking o Often lasts one to three minutes o Often followed by tiredness, headache or nausea o Person may become combative if restrained o May be confused with:
n Drunkenness or drug abuse n Aggressive behavior n Mental illness
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First Aid- Complex Partial Seizure o Stay calm and reassure others o Track time o Check for medical ID o Do Not Restrain o Gently guide/direct away from hazards o Do NOT expect the person to obey verbal
instructions o Stay with the person until fully alert and aware o If seizure lasts 5 minutes beyond what is routine
for that person or if another seizure begins before full consciousness is regained, follow emergency protocol
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Seizure Triggers or Precipitants o Flashing lights and hyperventilation can trigger
seizures in some individuals with epilepsy o Factors that might increase the likelihood of a seizure in
someone with epilepsy include: n Missed or late medication (#1 reason) n Stress/anxiety n Lack of sleep/fatigue n Hormonal changes n Illness n Alcohol or drug use n Drug interactions n Overheating/overexertion n Poor diet/missed meals
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Impact on Learning & Behavior n Seizures may cause short-term memory
problems n Seizure activity, even without physical
symptoms, may affect learning/memory n Anti-Seizure medications may cause
drowsiness, inattention, concentration difficulties and behavior changes
n People with epilepsy may be more likely to suffer from low self-esteem and/or mood disorders
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Available Treatments o Anti-seizure medications
n Currently we have more than 20 medications to help control seizures
n Medications do not CURE epilepsy, rather they help prevent or control seizure activity
n Medication side-effects vary by the individual
n Not all medications work for all types of seizures
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Vagus Nerve Stimulator o Device implanted just under the skin in the
chest with wires that attach to the vagus nerve in the neck
o Delivers intermittent electrical stimulation to the vagus nerve in the neck that relays impulses to widespread areas of the brain
o Used primarily to treat partial seizures when medication is not effective
o Use of special magnet to activate the device may help student prevent or reduce the severity of an oncoming seizure
o Individual may still require antiseizure medication
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Available Treatments o Epilepsy Surgery
n Brain surgery to remove the small part of the brain where seizures begin or to interrupt the spread of electrical energy in the brain
n Not everyone is a candidate for surgery o Ketogenic Diet
n Used primarily in children n Diet includes a very high fat content, no sugar
and low carbohydrate and protein intake n It is a medical treatment NOT a fad diet
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Diazepam Rectal Gel o Used in acute or emergency situations to
stop a seizure that will not stop on its own
o Approved by FDA for use by parents and non-medical caregivers
o State/school district regulations often govern use in schools
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Tips for Supporting a Person with Epilepsy o Stay calm during a seizure episode o Be supportive o Talk openly about epilepsy with the
person and learn about their individual experiences
o Avoid overprotection and encourage independence
o Practice seizure recognition & first aid
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Additional Tips and Topics o Include the individual in as many activities as
possible o Communicate with parents about child’s seizure
activity, behavior and learning problems o Help to reduce the stigma that is wrongly
associated with epilepsy by learning more about this disorder
o Become an advocate
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Convulsive Seizure in a Wheelchair o Do not remove from wheelchair unless
absolutely necessary o Secure wheelchair to prevent movement o Fasten seatbelt (loosely) to prevent student
from falling from wheelchair o Protect and support head o Ensure breathing is unobstructed and allow
secretions to flow from mouth o Pad wheelchair to prevent injuries to limbs o Follow relevant seizure first aid protocol
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Convulsive Seizure on a School Bus o Safely pull over and stop bus o Place student on his/her side across the
seat facing away from the seat back (or in aisle if necessary)
o Follow standard seizure first aid protocol until seizure abates and child regains consciousness
o Continue to destination or follow school policy
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Convulsive Seizure in the Water o Support head so that both the mouth
and nose are always above the water
o Remove the student from the water as soon as it can be done safely
o If the student is not breathing, begin rescue breathing
o Always transport the student to the emergency room even if he/she appears fully recovered
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Resources o Epilepsy Foundation Louisiana
n 225-298-5499/1-800-960-0587 n www.epilepsylouisiana.org
o Epilepsy Foundation (National) n www.epilepsy.com