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Epilepsy  

The  facts:    Epilepsy  is  defined  as  a  tendency  to  recurrent  seizures  of  the  Primary  Cerebral  Origin  and  is  

the  most  common  serious  neurological  condition  in  the  UK.  

In  the  UK  approximately  20%  of  the  population  have  seizures  at  some  point  in  their  life  with  the  highest  incidence  between  the  ages  of  20  –  60.    

National  statistics  show  that  1  in  130  of  the  UK’s  population  develop  epilepsy  with  1  in  every  280  children  under  the  age  of  16.  

Learning  Disabilities    • 30%  of  people  with  learning  disabilities  suffer  from  epilepsy    

• Cerebral  Palsy  50-­‐80  %  suffer  from  epilepsy  

• Autism,  30%  incidence  and  50%  with  sever  learning  disability    

Diagnosis  can  be  difficult  especially  when  the  person  has  a  learning  disability  and  the  seizures  can  be  more  frequent  and  prolonged  and  often  harder  to  control.  Such  seizures  are  also  harder  to  record  as  there  often  reported  as  behavioural  issues.      Side  effects  from  

treatment  occur  more  often  and  again  are  difficult  to  detect  and  treat.    

Causes  of  epilepsy:        There’s  evidence  that  the  following  may  be  contributing  factors  for  the  development  of  

epilepsy    

• Living  in  areas  of  high  social  deprivation        

• Infection  to  the  brain  

• Prenatal  development  abnormality      

• Damage  to  the  brain  following  an  accident  (scarring  of  the  brain)  

• Person  may  have  been  born  with  another  neurological  condition  which  may  develop  into  

epilepsy  thereafter.  

Other  possible  causes  are:  • Stoke,  tumour  or  birth  trauma    

• Prolonged  drug  and  alcohol  abuse      

• Encephalitis  (swelling  of  the  brain)    

• Meningitis    

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Categories  of  seizures    • Partial  –  symptoms,  sweating,  rapid  pulse,  muscular  movement          

• Complex  Partial  –  symptoms    

• Person  may  show  signs  that  they  have  taken  drugs  with  slurred  speech  and  showing  sign  

of  confusion  and  the  slapping  of  lips  and  may  stumble  to  the  ground  with  muscular  movement.  May  bite  lips  or  cheeks    

• Breathing  may  be  interrupted    

• Often  blue-­‐ish  discoloration  of  the  skin    

• Possible  incontinence    

• Partial  with  Secondary  Generalisation  –  combination  of  simple  and  complex  partial  

seizures  often  known  as  Tonic  Clonic    

Management  of  epilepsy      What  do  when  you  witness  an  epileptic  seizure?  

• Do  not  restrain  the  person,  however  do  remove  any  object  obstacles  and  guide  the  person  away  from  danger  

• Give  plenty  of  reassurance  and  calm  the  person  down,  this  will  help  with  their  orientation    

• Remain  with  the  person  whilst  they  recover,  report  the  seizure  together  with  any  injuries  

Overview    • The  person  will  not  remember  the  seizure    

• The  complete  brain  is  effected  and  there  may  be  “seizure    warnings  or  auras”  muscular  

movements  before    a  full  seizure  occurs      

• Person  may  lose  consciousness    

• Seizures  may  be  brief  or  prolonged    

Generalised  Seizures    • Absence:  last  only  a  few  seconds.  The  person  may  stare  blankly  and  flutter  their  eye  

lashes  and  nod  their  head  

• Myoclonic:  Sudden  movement  of  limbs  often  whilst  walking  and  will  fall  

• Altonic  :  Sudden  collapse  with  quick  recovery    

• Tonic:  falls  if  walking  and  limbs  stiffen  

• Clonic:  Movement  of  limbs  without  prior  stiffening    

• Tonic  Clonic  :  Will  fall,  cry  out,  rapid  movements,  skin  discolouration,  laboured  breathing,  may  bite  their  lips  or  cheeks  and  seizure  may  be  prolonged    

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When  to  call  an  Ambulance  999  • If  the  Tonic  Clonic  seizure  lasts  for  more  than  2  minutes  longer  than  usual    

• Lasts  more  than  5  minutes    

• Repeated  Tonic  Clonic  seizures    

• Difficulty  with  breathing    

• Person  sustains  a  serious  injury    

• Persons  first  ever  seizure    

Post  Seizure  Recovery    • Put  the  person  in  the  recovery  position    

• Do  not  forcefully  straighten  limbs    

• The  persons  condition  should  stabilize  following  a  “normal”  timed  seizure  within  a  few  

minutes    

• Report  and  observe    

Triggers  of  Seizures  • Missed  medication  

• Stress  

• Infection  with  raised  temperature    

• Boredom  

• Sleep  deprivation    

• Alcohol  

• Menstruation        

• Bright  light  /  camera  flashing    

Recoding  and  observation  procedures    • Name  and  address  (if  applicable)  

• Date,  time  and  location    

• Details  of  when  last  medication  was  taken  

• What  medication  are  they  taking    

• Had  the  person  taken  alcohol  or  illegal  drugs    

• Any  prior  warnings,  change  in  behaviour  and  skin  colour    

• Record  body  movement  and  breathing    

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• Length  of  seizure    

• Was  the  seizure  singular  or  multiple    

• Level  of  consciousness  during  seizure    

• Behaviour  after  seizure  

• Injuries  (describe)  

• Incontinence  (if  any)  

• Timescale  of  full  recovery  

• Did  the  person  remain  confused    

• Unaccompanied  seizure      

• Failing  to  take  anti  epilepsy  medication    

Behaviour  Changes  can  happen  following  a  seizure  which  include:  • Paranoia    

• Management  challenges  of  people  with  learning  disabilities    

• Aggression    

• Embarrassment,    

• Low  self-­‐esteem  

• Frustration  

Living  with  Epilepsy  Some  people  are  unable  to  undertake  various  activities  and  bring  on  various  emotions.    

• May  be  driving  restrictions  ,  depending  on  severity    

• Effects  social  life    

• Low  self-­‐esteem    

• Breakdown  of  relationships    

• Career  development  may  be  restricted    

• Independence  may  be  taken    

• Sporting  activities  may  be  reduced  

Disability  Discrimination  Act  (DDA)  This  act  covers  anyone  with  epilepsy