One of the oldest Known conditions Epilepsy One of the oldest Known conditions

Alice Hanscomb Hanscomb Training & Consultancy

Facts about epilepsy 1 in 20 people will have a seizure in their life time At least 1 in 131 people have epilepsy in the UK with 75 new cases diagnosed daily 50 million world wide have epilepsy making it the most common serious neurological condition globally

Facts about epilepsy 80 per cent of the worlds population of people with epilepsy are in developing countries 90 per cent of people with epilepsy in developing countries are not receiving appropriate treatment

Facts about epilepsy Epilepsy is a physical condition It can affect anyone at any age without warning or apparent cause There are many different causes, about 30 different epileptic syndromes and over 38 different seizure types It can go into remission as suddenly as it started or last a life time

Facts about epilepsy Someone can have more than one type of seizure The seizure type(s) someone has can change with time or with drug treatment

What is epilepsy? Epilepsy can be defined as: A neurological condition causing the tendency for repeated seizures of primary cerebral origin

Physical Causes Head injury from accidents, brain trauma, stroke, brain parasites, infections or diseases (such as cerebral malaria), scars on the brain and brain tumours. In young children: head trauma and/or lack of oxygen during birth. Prolonged febrile convulsions. Brain malformations and/or ‘birthmarks’ on the brain cause seizures to start early in life or later on

Genetic causes Increasingly recognised that there are genetic causes for epilepsy Idiopathic epilepsy is thought to have a genetic causes Low seizure threshold can be inherited in a small number of cases

International League Against Epilepsy (ILAE) seizure classification Divided into focal and generalised seizures Important to get seizure type right as different treatments are appropriate for different seizure types

Focal seizures

Focal seizures Simple focal seizures Complex focal seizures No impairment of consciousness Complex focal seizures Consciousness effected to a lesser or greater extent

Generalised seizures

Then there are unclassifiable seizures…. Generalised seizures Secondarily generalised – focal onset Consciousness is lost in generalised seizures Seizure types include: TC, T, C, AT, MC, aA, A, Then there are unclassifiable seizures….

The most common seizure types: Tonic clonic Complex partial

Seizure management General guidelines Note the time Make the person safe Put something soft under their head TC: once seizure has stopped put the person on their side and clear the airway if necessary CP: speak reassuringly, calmly and quietly. Do not physically engage the person unless you need to for their safety Prevent others from crowding around and minimise embarrassment Stay with them until they are themselves again Call for medical help if: They have injured themselves or are having difficulty breathing If they have one seizure after another or the seizure lasts 2 mins longer than normal The tonic clonic seizure goes on for more than 5 mins It is the persons first seizure

Status Epilepticus In Tonic clonic seizures and in seizures where breathing is impaired status is a medical emergency In other seizure types status is easily misdiagnosed but is important to treat

Types of epilepsy Idiopathic – no structural cause, probably genetic Symptomatic – structural cause Cryptogenic – no structural cause found but one suspected

Some Possible Triggers Missed medication Lack of sleep Stress / boredom Irregular eating Over indulgence of alcohol Hormones Visual triggers (very rare)

Knowing that someone ‘has epilepsy’ tells you… nothing! Does the person have seizures or are they controlled? If they do, what sort of seizures? How often do they occur and is there a pattern? Do they want/need medication and if so, which? How is the person after their seizures? How would they like others to manage the seizure, if at all? How are they coping with their epilepsy?

Facts about epilepsy It is thought that the reason the human brain has the ability to have seizures is that way way back in our past … epilepsy was of evolutionary advantage

Facts about epilepsy At least two animals still have epilepsy for this reason: Mexican Waltzing Mouse Papio Papio baboon