Seizure Recognition & Response SELF INTRODUCTION: Name Title Say: “This presentation is provided by the Epilepsy Foundation of Minnesota (EFMN), a local non-profit organization that serves the entire state of Minnesota and Eastern North Dakota. The Epilepsy Foundation of Minnesota is an affiliate of the National Epilepsy Foundation. The Epilepsy Foundation of Minnesota (EFMN) leads the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures and save lives. Objectives: Identify the most common types of seizures Define epilepsy and describe possible causes of disorder Describe appropriate response to seizures Discuss available treatment options efmn.org

Epilepsy is not… efmn.org

Epilepsy is… A neurological disorder of the brain characterized by the tendency to have reoccurring seizures. May also be called a seizure disorder. efmn.org

efmn.org Approximately 2.2 million Americans have epilepsy Epilepsy is the most common neurological condition in children and the fourth most common in adults after Alzheimer’s, stroke and migraines Approximately 1 in 10 people will have a seizure in their lifetime and 1 in 26 people will develop epilepsy Over 60,000 people in our service area The largest groups of people affected with epilepsy are children under 18. In schools, there is approximately one child in every other classroom with seizures. The second largest group affected are seniors over the age of 60. Epilepsy is as prevalent as Multiple Sclerosis, Parkinson’s disease and Cerebral Palsy combined. Our statistics are from the Institute of Medicine March 2012 efmn.org

What happens in the brain during a seizure? efmn.org

What causes epilepsy? efmn.org

Possible Seizure Triggers Failure to take medications Lack of sleep Stress and/or anxiety Dehydration Photosensitivity – strobe lights Menstrual cycle and/or hormonal changes Environmental efmn.org

Seizure Classification Focal Onset Seizures (partial) Involves only part of brain May or may not have change in awareness Symptoms relate to the part of brain affected Generalized Seizures Involves whole brain Convulsions, staring, muscle spasms and falls Most common are absence & tonic-clonic efmn.org

Simple Partial Seizures (focal seizures without change in awareness) Uncontrollable shaking movements Sensory seizures No impairment of consciousness May be considered an aura No immediate action is needed other than reassurance and emotional support efmn.org

Complex Partial Seizures (focal seizures with change in awareness) Most common seizure type Unaware of surroundings and unable to respond Repetitive, purposeless movement efmn.org

Appropriate Response: Complex Partial Seizure Stay calm Track time Do not restrain Gently direct away from hazards Remain with the individual until they have gained full awareness efmn.org

Absence Seizures (formerly petit mal) Characterized by brief staring Starts and ends abruptly Quickly returns to complete awareness Appropriate response includes documentation efmn.org

Generalized Tonic-Clonic (formerly grand mal) Not the most common seizure type Completely unconscious; loss of control May cry out or make noise May have irregular breathing Lasts 5 minutes or less efmn.org

Turn on side to prevent choking * Track time Stay calm Protect their head Turn on side to prevent choking * Track time Check for Seizure Disorder ID Move objects out of the way * Do NOT put anything in the person’s mouth. May add: put something soft, like a pillow, jacket or place your hands underneath their head loosen tight clothing and remove eyeglasses do not restrain the person as that may cause damage to muscles, ligaments or bones clear the area of objects which could injure the person during a seizure. efmn.org

Appropriate Response: Generalized Tonic-Clonic Remain with person until they have regained full awareness If seizure lasts more than 5 minutes, call 911 Recovery period – postictal state (not included in timing of the seizure) efmn.org

Call 911 if the person… Is injured Has diabetes or is pregnant Does not resume normal breathing or breathing stops Has a first-time seizure Has a seizure in water Situation escalates efmn.org

Also call 911 if: STATUS EPILEPTICUS There is more than 5 minutes of continuous seizure activity OR Two or more consecutive seizures (cluster) without complete recovery Say: “A seizure is also an emergency if the person goes into Status: Status is defined as – Read slide A seizure which lasts five minutes or more may be dangerous. Likewise, repeated seizures which appear to be out of control are a sign of something wrong, or an indication the patient needs additional medical assessment. Because a person having a convulsive seizure is either experiencing very impaired breathing, or not breathing at all, a prolonged seizure can result in brain damage and/or death. It is important to emphasize the need to call 911 or an ambulance if a generalized tonic clonic seizure lasts five minutes or more, or if seizures are clustered or repeated. A thorough medical examination is appropriate after a first generalized tonic clonic seizure or a seizure not typical for that individual.” efmn.org

Rescue Medications Used in emergency situations to stop a seizure that will not stop on its own State/school district regulations often govern use in school There are various emergency medications available It can be administered a few different ways rectal buccal nasal Here is a list of some emergency medications Diazapam- Valium, Diastat Lorazepam- Ativan Clonazepam- Klonopin Midazolam-Versed efmn.org

Treatment Options Medication Brain surgery Medical Devices Diet Social and psychological support Say: “There are many treatment options available for people with seizures. Sometimes, people can be controlled and seizure free with medications. Some may be candidates for surgery, special diets or medical devices. efmn.org

Medications Often the first line of treatment Approximately 75% of people achieve seizure control. There are over 30 anti-seizure medications. efmn.org

Common Medication Side Effects Lethargy Weight gain and/or weight loss Cognitive, concentration, memory difficulties Hyperactivity Emotional and/or behavioral changes May go away after first several weeks efmn.org

Brain Surgery Options efmn.org Lobectomy Partial seizures Hope for result of seizure-free Corpus Callosotomy Generalized seizures Never seizure free, less frequent/intense seizures Visualase MRI-guided laser ablation of tumors and tubers Minimally invasive efmn.org

Medical Device Options efmn.org

Medical Device Options RNS (NeuroPace) Responsive Neurostimulator System Need to know localization of epileptic brain tissue Remote monitor efmn.org

Special Diets There are various diets that may used in conjunction with other epilepsy therapies. efmn.org

Seizure Assist Dogs Help people during and after and a seizure Trained for a variety of assistance tasks May wear a backpack with helpful information efmn.org

Medical Cannabis- 4 Steps Receive certification from physician Enroll in registry program After registry verification, eligible to receive at distribution facilities Patients must agree to continue treatment and provide ongoing reports efmn.org

Social and Psychological Support Up to 50-60% of patients with epilepsy have various mood disorders, including depression and anxiety. Important to include treatment options that treat the whole person efmn.org

Safety Issues with Epilepsy At home and work Seizure alert monitors SUDEP (Sudden Unexpected Death in Epilepsy) efmn.org

Possible Impact of Epilepsy Financial constraints Personal and work relationships Driving and transportation Learning and school performance efmn.org

Seizure first aid at your fingertips. 1 in 10 people will have a seizure in their lifetime. Download “SEIZURE FIRST AIDE” Your behavior during a seizure episode can make a substantial difference in how students react and how the students with seizures copes with the situation By reassuring other students that you know what to do and that everything will be alright, they will remain calm during seizure episodes. Promptly address teasing behaviors and help educate other students about epilepsy Each teacher should receive a seizure action plan or some type of detailed instructions about how to manage seizures in the classroom Show Seizure Action Plan and explain the document should include the student’s seizure type, frequency of seizures, emergency contact information, basic first aid and emergency response protocol efmn.org

The Epilepsy Foundation of Minnesota envisions a world where people with seizures realize their full potential. Epilepsy-Foundation Minnesota @EpilepsyMN efmn.org | 800.779.0777 Share contact information, statewide services and 1-800 #. May also add: EFMN offers in classroom school presentations in an effort to reduce the stigma associated with seizures. Sharing with kids about what seizures are, and how they can help, has increased the self esteem and confidence of children living with epilepsy. EFMN offers a week-long residential camp, each year, 3rd week in June for children and teens with epilepsy. Camp Oz. Doctors and nurses are on staff 24 hours a day. Children get to participate in all camp activities, including swimming and high ropes. We have a webpage, where we announce all the events and upcoming programs that we offer and that contains resources and educational materials. Sign up for our blog for updates and exclusive content. The Epilepsy Foundation of MN is an affiliate of a National Epilepsy Foundation, this is their webpage, where you can buy videos, books and other brochures. SHOW VIDEO Conclusion: epilepsy is a comprehensive disorder and taking the time to understand and gain knowledge on this will help those affected by seizures