Communication Breakdown: Case 03 By: Adrianne Peech & Savana Canary

Background Information A women brought in her 10-year- old son, Raymond. She says that he has been very aggressive and angry lately. She says his acting out has attributed to her divorce from his father. Last night, Raymond attended a party at his friends house. After the night filled with laser tag and little sleep, he started shaking and convulsing. He stopped though before his mom arrived, but she still brought him in to get checked out. Raymond doesn’t remember falling, but he does remember smelling a very foul odor right before he fell.

Patient’s Disease Based upon Raymond’s aggressiveness, anger, seizures, and smelling a nasty odor we believe him to be an epileptic (temporal lobe). His seizure could have been triggered due to his playing laser tag and seeing flashing bright lights. Also, his sleep deprivation after the party could have caused his seizure, and stress from his parents divorce. Some possible causes of his epilepsy are low oxygen during birth or a head injury. Other possibilities are a brain tumor or depression. We could be incorrect about him possibly having depression though because there isn’t a correlation between smelling something nasty and depression. Some limitations are not having many symptoms to go off of.

How We Diagnosed the Patient The tests we used in his diagnosis were an EEG test, a blood test, and a PET scan. What we could learn from the epilepsy EEG test (electroencephalogram test) is how the electrical signals move throughout the patient’s brain. This can identify epilepsy because it records how the patients brain processes information. https://www.youtube.com/watch?v=KXS268XsRic What could be learned from the blood test is a baseline to how bad their epilepsy is. Also, we can identify infections, allergies, and other abnormalities that could affect the choice of appropriate mediations. A blood test can identify epilepsy because it shows if there is even a starting point to how bad the disease could be. We can learn what part of the brain is causing the seizures with a PET scan. This can identify epilepsy because it shows which parts of the brain are activated when a seizure occurs.

Error in Communication The overactive firing of neurons in his temporal lobe causes the type of epilepsy that Raymond has . This causes him to have grand mal seizures. Before his seizures he experiences an aura where he smells the foul odor. The patient experiences the tonic and clonic phases of the grand mal seizures he has. During the tonic phase of his seizures he losses consciousness and his muscles suddenly contract and he falls. This phases usually lasts for 10-20 seconds. During the clonic phases his muscles go into rhythmic contracting. His convulsions usually last for less than two minutes.

Pediatrician A pediatrician is the patients regular doctor. They will see him or her when they start to notice epileptic symptoms such as mood disorders and seizures. The pediatrician’s key responsibility is referring them to the other caregivers more specifically related to his disease. These physicians also help make up care plans for the family.

Epileptologist Most patients who have epilepsy don’t have to see an epileptologist. However, in some cases people have severe seizures that are difficult for them to control, which requires them to seek further care. The main responsibility of an epileptologist is to diagnosis the severity of their condition through tests and scans. Also, they make recommendations to their patient’s treatment plan.

EEG Technician The EEG technician’s main responsibility will be performing tests, ensuring the patients comfort, and scanning results of the tests into the computer. They will also ask detailed questions before the tests - such as the patients diet, their sleep habits, and what medications they take.

Prognosis Currently there is no cure for epilepsy and it is a life- long disease. However, between 70-80 percent of people with epilepsy are able to control their symptoms with the right medication. Most people can live normal lives, and some can even eventually stop taking their medication. Some patients find it helpful to modify their diets. Alcohol avoidance is often recommended (however our patient is 10 so this won’t affect his life for a while). Getting enough sleep and relaxation can also help prevent epileptic attacks.

Treatment Some well-known treatment for epilepsy is drug therapy. It is the first treatment for epilepsy, but other therapies also exist. Some drugs that can treat epilepsy are: phenobarbital, clonazepam, and nitrazepine. Surgery is another option to help reduce the amount of seizures a patient has. Also, a vagus nerve stimulator can be implanted in the chest to help short-circuit seizure activity.

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