Transcript A seizure

Epilepsy & Seizures
1


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
2
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”
3
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
4
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
- Brain tumor and stroke
- Lead poisoning
- Poor Nutrition
- Infectious diseases
- Heredity
- Prenatal disturbance
of Brain
Development
5
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
6
Seizure Types
• 22 Different kinds of seizures
• Seizures are divided into two broad categories:
– Partial Seizures
– Generalized Seizures
7
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
8
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.
9
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).
10
Generalized Seizures
• Begins with a
discharge neurons
throughout the brain.
• Total loss of
consciousness
• Most common are
Absence and TonicClonic
11
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 10-250 times
per day if uncontrolled
12
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
13
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
14
First Aid for Complex Partial Seizures
• 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
15
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
16
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
17
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
18
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
19
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
20
Types of Treatment

Medication



Nonpharmacologic treatment



1st Generation medications
2nd Generation medications
Ketogenic diet
Vagus nerve stimulation
Surgery
21
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.
22
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
23
Effects Of Depression
•
•
•
•
•
Increased Use of Alcohol or Drugs
Behavior Changes
Illness
Suicide
Increased Depression in Family
24
Epilepsy Foundation
of Western Wisconsin
• 1812 Brackett Ave, Suite 5
Eau Claire, WI 54701
• 1-800-924-2105 or 715-834-4455
• www.epilepsywesternwi.org
• 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
25
National and Community
Resources
• The Epilepsy Foundation
– Website: www.epilepsywesternwi.org
• MedicAlert Foundation
• Social Security Administration
• Accreditation Council on Services for People with
Disabilities
• State Offices
– Vocational Rehabilitation
– Protection and Advocacy
– Aging Services
26