Epilepsy.Epilepsy.

ByBy

Emily and Sarah.Emily and Sarah.

What is Epilepsy?What is Epilepsy?

• Epilepsy is a chronic disorder of the brain that affects Epilepsy is a chronic disorder of the brain that affects people in every country of the world. It is characterized by people in every country of the world. It is characterized by recurrent seizures - which are physical reactions to sudden, recurrent seizures - which are physical reactions to sudden, usually brief, excessive electrical discharges in a group of usually brief, excessive electrical discharges in a group of brain cells. Different parts of the brain can be the site of brain cells. Different parts of the brain can be the site of such discharges. (WHO, 2009)such discharges. (WHO, 2009)

• Seizures vary; they can be a few seconds or last Seizures vary; they can be a few seconds or last much longer, depending on how far the disruption much longer, depending on how far the disruption to the brain has spread. Seizures also depend on to the brain has spread. Seizures also depend on the part of the brain that is affected, whether it is the part of the brain that is affected, whether it is in just one part of the brain or in many (Johnson & in just one part of the brain or in many (Johnson & Parkinson, 2002). Parkinson, 2002).

Key FactsKey Facts

• Epilepsy is a chronic neurological disorder that affects Epilepsy is a chronic neurological disorder that affects people of all ages. people of all ages.

• Around 50 million people worldwide have epilepsy. Around 50 million people worldwide have epilepsy. • Nearly 90% of the people with epilepsy are found in Nearly 90% of the people with epilepsy are found in

developing regions. developing regions. • Epilepsy responds to treatment about 70% of the time, Epilepsy responds to treatment about 70% of the time,

yet about three fourths of affected people in developing yet about three fourths of affected people in developing countries do not get the treatment they need. countries do not get the treatment they need.

• People with epilepsy and their families can suffer from People with epilepsy and their families can suffer from stigma and discrimination in many parts of the world. stigma and discrimination in many parts of the world.

• (WHO, 2010)(WHO, 2010)

CausesCausesEpilepsy can be caused in a number of ways including;Epilepsy can be caused in a number of ways including;

• Accident of injury to the head.Accident of injury to the head.

• Infection to the brain – meningitis, encephalitis.Infection to the brain – meningitis, encephalitis.

• Tumours.Tumours.

• Brain not developing properly after birth.Brain not developing properly after birth.

• Drugs and alcohol.Drugs and alcohol.

• Birth difficulty, where the baby doesn’t receive enough oxygen.Birth difficulty, where the baby doesn’t receive enough oxygen.

• Abnormality development to the brain before birth.Abnormality development to the brain before birth.

• Hunger.Hunger.

• Fatigue.Fatigue.

• Some types of lighting. E.g. Flash of a video game (photosensitive epilepsy, most Some types of lighting. E.g. Flash of a video game (photosensitive epilepsy, most common).common).

• Changes in activity. Changes in activity.

• Stress.Stress.

• Nutritional deficiencies.Nutritional deficiencies.

• Excitement (Johnson & Parkinson, 2002., Jeavons & Aspinall, 1985., and World Health Excitement (Johnson & Parkinson, 2002., Jeavons & Aspinall, 1985., and World Health Organization, 2009). Organization, 2009).

  

Activity 1: Being the brainActivity 1: Being the brain

Signs and SymptomsSigns and Symptoms• Characteristics of seizures vary and depend on Characteristics of seizures vary and depend on

where in the brain the disturbance first starts, where in the brain the disturbance first starts, and how far it spreads. Temporary symptoms and how far it spreads. Temporary symptoms can occur, such as loss of awareness or can occur, such as loss of awareness or consciousness, and disturbances of consciousness, and disturbances of movement, sensation (including vision, movement, sensation (including vision, hearing and taste), mood or mental function.hearing and taste), mood or mental function.

• People with seizures tend to have more People with seizures tend to have more physical problems (such as fractures and physical problems (such as fractures and bruising), higher rates of other diseases or bruising), higher rates of other diseases or psychosocial issues. psychosocial issues.

(WHO, 2010)(WHO, 2010)

Types of Seizures.Types of Seizures.

There are many different types of seizures and they can be There are many different types of seizures and they can be categorised into two main groups, partial or generalised. Some of categorised into two main groups, partial or generalised. Some of the different types of seizures include:the different types of seizures include:

• Simple partial (Ability to hold onto consciousness).Simple partial (Ability to hold onto consciousness).

• Complex partial (Consciousness is damaged). Complex partial (Consciousness is damaged).

• Myoclonus (Part of the body jerks).Myoclonus (Part of the body jerks).

• Tonic (The body stiffens and falls without going into a spasm).Tonic (The body stiffens and falls without going into a spasm).

• Clonic (Body does not stiffen, but convulsions occur).Clonic (Body does not stiffen, but convulsions occur).

• Absence: (Staring and blinking occurs).Absence: (Staring and blinking occurs).

• Tonic-clonic: (The body goes stiff and falls and the seizure occurs). Tonic-clonic: (The body goes stiff and falls and the seizure occurs).

• Atonic: (The body falls lifelessly to the floor).Atonic: (The body falls lifelessly to the floor).

• Unclassified: (Does not follow symptoms of other types of seizures) Unclassified: (Does not follow symptoms of other types of seizures) (Johnson & Parkinson, 2002., and Devinsky, 1994).(Johnson & Parkinson, 2002., and Devinsky, 1994).

During a SeizureDuring a Seizure

• Stay calm and make sure the other students are calm. Stay calm and make sure the other students are calm.

• Turn the child onto their side.Turn the child onto their side.

• Move any harm from them.Move any harm from them.

• Take note of how long the seizure goes for.Take note of how long the seizure goes for.

• Don’t put anything in their mouth.Don’t put anything in their mouth.

• Reassure them that everything is ok.Reassure them that everything is ok.

• Make a note of what happened before, during and Make a note of what happened before, during and after the seizure. after the seizure.

• Fill out report on the child’s seizure (Johnson & Fill out report on the child’s seizure (Johnson & Parkinson, 2002).Parkinson, 2002).

After a SeizureAfter a Seizure

• Reassure them.Reassure them.

• Allow the student time to recover.Allow the student time to recover.

• Students motor, sensory and psychic symptoms Students motor, sensory and psychic symptoms may be affected.may be affected.

• Students may show signs of short term memory Students may show signs of short term memory loss.loss.

• Autonomic symptoms (e.g. lip smacking)Autonomic symptoms (e.g. lip smacking)

• Hallucinations may occur.Hallucinations may occur.

• Some students may need to go home while others Some students may need to go home while others

just need to sleep it off or time tojust need to sleep it off or time to recover.recover.

Treatment.Treatment.There are many different ways in which epilepsy can be treated, There are many different ways in which epilepsy can be treated,

the most effective method of treatment being to prevent the most effective method of treatment being to prevent triggers. However other treatment methods of people with triggers. However other treatment methods of people with epilepsy include: epilepsy include:

• Drugs/medicine (Antiepileptic drugs).Drugs/medicine (Antiepileptic drugs).• A diet with high amounts of fat, low carbohydrates A diet with high amounts of fat, low carbohydrates

and small amounts of protein (ketogenic diet).and small amounts of protein (ketogenic diet).• Behaviour therapy.Behaviour therapy.• Aromatherapy.Aromatherapy.• Acupuncture.Acupuncture.• Herbal treatment.Herbal treatment.• Surgery to remove the damaged part of the brain if Surgery to remove the damaged part of the brain if

possible (can be very dangerous) possible (can be very dangerous) • (Jeavons & Aspinall, 1985., Johnson & Parkinson, (Jeavons & Aspinall, 1985., Johnson & Parkinson,

2002., Devinsky, 1994., and World Health 2002., Devinsky, 1994., and World Health Organization, 2009).Organization, 2009).

Impact on the student and Impact on the student and family.family.Epilepsy often has a big impact on family life, not just the parents but the other Epilepsy often has a big impact on family life, not just the parents but the other

siblings too. However this does depend on the severity of the child’s epilepsy. If siblings too. However this does depend on the severity of the child’s epilepsy. If they only have minor seizures then it shouldn’t affect the family greatly they only have minor seizures then it shouldn’t affect the family greatly (Devinsky, 1994). However when a family has a child with epilepsy they may (Devinsky, 1994). However when a family has a child with epilepsy they may experience a number of feelings including: experience a number of feelings including:

• Concern for their child. Concern for their child. • That it is their fault. That it is their fault. • Worried. Worried. • Unsure of what to do because they have not been given an explanation. Unsure of what to do because they have not been given an explanation. • Experiencing denial. Experiencing denial. • Feeling anxious. Feeling anxious. • Scared to ask questions. Scared to ask questions. • Trouble accepting the diagnosis of the child. Trouble accepting the diagnosis of the child. • Shock. Shock. • Anger. Anger. • Grief. Grief. • Guilty and disappointment. Guilty and disappointment.

Impacts on fellow students.Impacts on fellow students.

Other students may feel:Other students may feel:• Anxious.Anxious.• Trouble accepting that someone in their Trouble accepting that someone in their

class/their friend has epilepsy.class/their friend has epilepsy.• Confusion.Confusion.• Scared, as they don’t understand. Scared, as they don’t understand. • Unsure (Johnson and Parkinson, 2002).Unsure (Johnson and Parkinson, 2002).

It is important to ensure that all students are aware It is important to ensure that all students are aware of what might happen and feel comfortable in of what might happen and feel comfortable in performing helpful roles during and after a performing helpful roles during and after a siezure.siezure.

Implications for Teachers and Implications for Teachers and Schools.Schools.The impact of epilepsy on the individual greatly depends on the type The impact of epilepsy on the individual greatly depends on the type

of epilepsy and the severity. This factor may also determine of epilepsy and the severity. This factor may also determine whether they can attend a mainstream school or a special whether they can attend a mainstream school or a special education school (Devinsky, 1994). Epilepsy can affect how the education school (Devinsky, 1994). Epilepsy can affect how the student performs in the classroom. At times the child may seem student performs in the classroom. At times the child may seem like they are not paying attention, they may not seem to like they are not paying attention, they may not seem to understand, or they may not be able to follow instructions. There understand, or they may not be able to follow instructions. There are also times when people with epilepsy can’t do work or exams, are also times when people with epilepsy can’t do work or exams, or adjustments need to be made so that they are able to. These or adjustments need to be made so that they are able to. These times includes:times includes:

• After a severe seizure. After a severe seizure. • If their well-being or mood has been affected.If their well-being or mood has been affected.• Exam arrangements such as rest time, extra time, etc.Exam arrangements such as rest time, extra time, etc.• Trouble focusing on a test for more than a short period of time Trouble focusing on a test for more than a short period of time

(Johnson & Parkinson, 2002).(Johnson & Parkinson, 2002).• Trouble reading, due to visual information not being processed Trouble reading, due to visual information not being processed

properly in the brain (Devinsky, 1994). properly in the brain (Devinsky, 1994).

Implications for teachers and Implications for teachers and schools.schools.Although teachers need to involve students with epilepsy into Although teachers need to involve students with epilepsy into

the classroom, there are some activities that aren’t the classroom, there are some activities that aren’t recommended for them without medical consent, these recommended for them without medical consent, these activities include:activities include:

• Jet skiing.Jet skiing.• Swimming for some children with epilepsy (or adopt a Swimming for some children with epilepsy (or adopt a

buddy system so the child always has someone with them).buddy system so the child always has someone with them).• Labs for science are also considered dangerous, so Labs for science are also considered dangerous, so

adjustments and precautions need to be made to ensure adjustments and precautions need to be made to ensure the child is not at risk. Some children who have severe the child is not at risk. Some children who have severe epilepsy that is unpredictable may not be able to access epilepsy that is unpredictable may not be able to access labs as it is exposing them to a high level of danger labs as it is exposing them to a high level of danger (Jeavons & Aspinall, 1985., Johnson & Parkinson, 2002., and (Jeavons & Aspinall, 1985., Johnson & Parkinson, 2002., and Devinsky, 1994).Devinsky, 1994).

CurriculumCurriculum

Children with epilepsy should be encouraged to have a go at Children with epilepsy should be encouraged to have a go at all subjects in the curriculum and work in a normal all subjects in the curriculum and work in a normal classroom with the other students. However the curriculum classroom with the other students. However the curriculum may need to be adjusted to suit the child’s needs and style may need to be adjusted to suit the child’s needs and style of learning. Teacher’s need to make sure they don’t of learning. Teacher’s need to make sure they don’t exclude the child from the activities that other children in exclude the child from the activities that other children in the class do, such as sport and excursions. the class do, such as sport and excursions.

However the teacher should take note of the child’s epilepsy However the teacher should take note of the child’s epilepsy and look at the environment, what to expect, the risk level, and look at the environment, what to expect, the risk level, severity of the epilepsy and how to cope if they have any severity of the epilepsy and how to cope if they have any doubt of including a child in an activity. They may also seek doubt of including a child in an activity. They may also seek assistance from an aid in the classroom (Johnson & assistance from an aid in the classroom (Johnson & Parkinson, 2002 Parkinson, 2002

Activity 2: VideoActivity 2: Video

• http://www.youtube.com/watch?http://www.youtube.com/watch?v=_lntbtyQ7Wg&feature=relatedv=_lntbtyQ7Wg&feature=related

This video looks at how epilepsy This video looks at how epilepsy impacts on a students life and their impacts on a students life and their family. It highlights some of the more family. It highlights some of the more severe forms of epilepsy.severe forms of epilepsy.

Useful Websites.Useful Websites.

• Epilepsy Advocate:Epilepsy Advocate:– http://www.epilepsyadvocate.com/http://www.epilepsyadvocate.com/

• Epilepsy Classroom:Epilepsy Classroom:– http://www.epilepsyclassroom.com/http://www.epilepsyclassroom.com/

• Epilepsy for Kids:Epilepsy for Kids:– http://www.epilepsy.org.uk/kids/http://www.epilepsy.org.uk/kids/