1. Brain Injury and Seizures
SELF INTRODUCTION:
Name
Title
Say:
“This presentation is provided by the Epilepsy Foundation of Minnesota (EFM), 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. Not only do we work with those who have epilepsy or seizures, we also work with their families, friends, caregivers, teachers and or educators and the community (general public). We accomplish our mission by educating the community about epilepsy, connecting those affected by seizures to one another and creating opportunities for empowerment.”
| University Avenue West, Suite 300, St. Paul, MN |

2. Today’s Objectives
Talk about epilepsy and the correlation with brain injury
Identify the most common types of seizures and describe appropriate response
Learn useful resources
CHECK TO MAKE SURE EVERYONE HAS A COPY OF THE HANDOUT
REVIEW THE ABOVE STATEMENTS.
Optional, if applies: add: “At the end, we will show a video that will also cover first aid for seizures”.

3. Amanda Pike- Epilepsy Foundation of MN
A little bit about me
Amanda Pike- Epilepsy Foundation of MN

4. ABOUT US We serve Minnesota and Eastern North Dakota
Offices in St. Paul, Rochester, Duluth, St. Cloud, and Fargo
Funding Sources: used clothing, individual/corporate donations, special events and grants
The Epilepsy Foundation is the only organization in MN or ND that works exclusively with people affected by seizures.
The Epilepsy Foundation of Minnesota is one of 53 affiliates across the country - and part of the national Epilepsy Foundation.
The Epilepsy Foundation of Minnesota has been serving people in our community who are affected by epilepsy for more than 50 years.
Each year, we deliver more than $1M in programs that educate, connect and empower people to overcome the challenges created by epilepsy.
Proceeds from our Used Clothing Donation program help support our $1M program budget.
EFM is not a United Way Organization – although we do receive designated UW funds.
EFM does not receive ANY county, state or federal government funding.
| University Avenue West, Suite 300, St. Paul, MN |

5. PROGRAMS THAT EDUCATE Seizure Smart Communities
Seizure Recognition & Response Training
Seizure Smart Schools
Conferences & Workshops
We offer FREE educational programs to raise awareness about epilepsy and reduce the misconceptions that follow epilepsy. Programs are:
Seizure Smart Communities, founded in 2009, are communities that are educated about seizures through our trainings and workshops. There are currently 10 “Seizure Smart Communities:” Alexandria, Hibbing, Grand Forks, Duluth, Austin, Rochester, St. Cloud, Fargo, Moorhead and Willmar. Seizure Smart Community education impacts schools, key business leaders, media, senior centers, churches, police and fire departments, and more -- all in an effort to educate people about seizures. In 2011, Bemidji, Hutchinson, Fergus Falls and Owatonna will earn the “Seizure Smart Community” distinction.
Seizure Recognition & Response FREE training is offered for those that work and/or care for people affected by epilepsy: businesses, group homes, long-term care facilities, health professionals, and school staff. Participants learn about seizure recognition, first aid and can earn CEU credits for their training time.
Seizure Smart Schools FREE training provides in-classroom education to children to increase acceptance of kids living with seizures. We provide training to school nurses and administrative staff, parents and students to educate about seizures. Participants also get FREE classroom kits.
Regional Conferences. We gather medical experts, people living with seizures and caregivers twice annually for conferences to educate and connect people. Our summertime in Duluth and fall Twin Cities conferences draw over 1,000 people annually. In addition to these conferences, Understanding Epilepsy Workshops are offered across the state.
| University Avenue West, Suite 300, St. Paul, MN |

6. PROGRAMS THAT CONNECT Camp Oz Regional Events Shining Star Program
Information & Referral Program
Peer Groups & Online Communities
Camp OZ- for youth and teens between the ages of We partner with the YMCA and their Camp St. Croix, in Hudson, WI for Camp Oz. Camp Oz has operated for over 20 years! Fully staffed with Dr., Nurses, Pharmacists and camp counselors -- it’s a safe environment for kids with epilepsy to enjoy camping!! (Scholarships are available)
Many people with epilepsy feel isolated. Family events create a space for people to meet and connect with others living with seizures. Our next event in this area is planned for (Date) at the (location) at (time), if we can include you and your family, please visit with me afterwards.
Our “Shining Stars” program recognizes kids living with epilepsy. Shining Stars receive their own mail and special invites, plus free tickets to special events throughout the year. It’s another great opportunity to connect with other shining stars (or children with epilepsy) and families across Minnesota.
EFM offers FREE Information & Referral resources to the public. We want people with epilepsy to know that they are not alone, and we are here to help with resources, clinic information and educational materials. We have a wide range of videos, brochures and literature and a staff devoted to providing information.
Peer Groups are also offered at several locations across the state. If you are interested in peer group information, please see me after the presentation.
| University Avenue West, Suite 300, St. Paul, MN |

7. PROGRAMS THAT EMPOWER Stroll for Epilepsy Creative Arts Advocacy
Volunteering
Youth Advisory Council
Winning Kid
Being ACTIVE is a great way to feel empowered.
The Stroll for Epilepsy is held each summer in August – a great opportunity to raise awareness about epilepsy and raise money to help fund our community programs. It’s empowering to see 100s of people walking to support people affected by epilepsy.
Our Creative Arts program showcases the talents of people living with seizures. It has three components: the Brainstorms Art Collection (visual arts), Epilogues Writing Collection (written poetry, essays and more) and Cadenzas (a performing arts program). Submissions from people with epilepsy are accepted throughout the year. You can view the Brainstorms collection on our website.
Advocacy is a great way to get involved! Join our grassroots network of advocates and help make a difference for people affected by epilepsy. Each year we go to the Minnesota State Capitol to raise awareness about epilepsy with our elected officials.
Volunteering is a great way to get involved. Let me know if you are interested in volunteering --- I’d love to talk with you! You can learn more about volunteer opportunities on our website.
Our Youth Advisory Council is a fairly new program designed to engage teens in our programs. The council allows for some service learning for teens as well as helping shape and structure our other youth programs.
| University Avenue West, Suite 300, St. Paul, MN |

8. Help us educate, connect and empower those impacted by epilepsy!
Make A Difference!
Help us educate, connect and empower those impacted by epilepsy!
- Visit us online at
- Participate in your employee giving campaign
(United Way, Community Health Charities or Combined Federal Campaign)
- Attend EFMN events
- Donate your used clothing
If you feel comfortable with the audience of your presentation you can discuss donation options and how to support EFMN
-online they can donate directly or see the events we have scheduled
To give through and employee giving program they must directly designate Epilepsy Foundation of Minnesota
If used clothing is an option in your area (Metro, St. Cloud, Southern MN) tell about pick up options and partnership with Savers we have. They can call the St. Paul/St. Cloud office or go online to schedule or find out what is accepted

9. 1 in how many people will have a seizure at some point in their life?
Review contents of slide.
Say:
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
SUDEP
Most people with epilepsy live a full life span however some people may die suddenly, without explanation. This is called SUDEP
SUDEP stands for Sudden Unexplained Death in Epilepsy
SUDEP is not well understood, although it is suspected , sometimes, to be related to hear rhythm problems during a seizure.
It occurs more often among people with convulsive seizures, especially generalized tonic-clonic
The incidence of SUDEP differs greatly depending upon the population studied
In general, the risk is small- 1 in 3,000 persons, for a person with poorly controlled seizures, especially generalized tonic clonic the risk is 1 in 100 persons
For more information go to ( National Epilepsy site put together by the SUDEP task force)

10. Epilepsy Facts… 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 26 people will develop epilepsy at some point in their lives
Over 60,000 people in MN & ND have epilepsy
Review contents of slide.
Say:
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
SUDEP
Most people with epilepsy live a full life span however some people may die suddenly, without explanation. This is called SUDEP
SUDEP stands for Sudden Unexplained Death in Epilepsy
SUDEP is not well understood, although it is suspected , sometimes, to be related to hear rhythm problems during a seizure.
It occurs more often among people with convulsive seizures, especially generalized tonic-clonic
The incidence of SUDEP differs greatly depending upon the population studied
In general, the risk is small- 1 in 3,000 persons, for a person with poorly controlled seizures, especially generalized tonic clonic the risk is 1 in 100 persons
For more information go to ( National Epilepsy site put together by the SUDEP task force)

11. How many of you have seen a seizure before?
Review contents of slide.
Say:
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
SUDEP
Most people with epilepsy live a full life span however some people may die suddenly, without explanation. This is called SUDEP
SUDEP stands for Sudden Unexplained Death in Epilepsy
SUDEP is not well understood, although it is suspected , sometimes, to be related to hear rhythm problems during a seizure.
It occurs more often among people with convulsive seizures, especially generalized tonic-clonic
The incidence of SUDEP differs greatly depending upon the population studied
In general, the risk is small- 1 in 3,000 persons, for a person with poorly controlled seizures, especially generalized tonic clonic the risk is 1 in 100 persons
For more information go to ( National Epilepsy site put together by the SUDEP task force)

12. What is a seizure? Sudden electrical activity in the brain
Most seizures are either partial or generalized
Where the activity occurs in the brain will determine how the seizure will look
Review contents of slide.
Say:
“A seizure is an excess discharge of electrical impulses between brain neurons
The excess electrical energy (synchrony) may be generalized, that is, occurring throughout the whole brain, resulting in complete unconsciousness or . . .
It may be partial, that is, confined to one area of the brain, resulting in a state of impaired consciousness. There may be little memory of the actual seizure after the episode.
Whether a seizure is generalized or partial, and where the seizure activity occurs in the brain, determines what happens during a seizure, i.e., what it looks like, etc.” No seizure will probably look the same in two different people.”

13. Epilepsy is…
A neurological disorder of the brain characterized by the tendency to have recurring seizures
May also be called a Seizure Disorder
REVIEW THE CONTENTS OF THE SLIDE:
Say:
“Epilepsy is not a disease, it is a chronic disorder of the Central Nervous System. Epilepsy may also be called a “Seizure Disorder.
Two keys words here are neurological and recurring.
A Seizure is defined as a ‘finite’ event with a beginning and an end. A symptom of epilepsy – an occasional, excessive disorderly discharge of nerve tissue.
MAY ADD:
“Examples of seizures that are not diagnosed as epilepsy:
Diabetic seizures are seizures resulting from excessive insulin or low blood sugar and are a medical emergency.
Febrile seizures are seizures caused by high fevers in children.
Withdrawal seizures are seizures occurring when a person is undergoing withdrawal from alcohol and/or drugs.
Isolated seizure: One in every ten people has a seizure at sometime in their lives. It is an one-time event or nonrecurring event so it is not diagnosed as epilepsy, regardless of the cause.
Non-epileptic episodes (NEE's) or psychogenic seizures (PNE’s) are seizures which are not neurological in origin, but of psychological origin.”
Nonepileptic Seizures EFMN Standpoint:
- legitimate/real no matter what the reason
- they don't always need medication
- doesn't necessarily mean it's connected to abuse or mental health issues
- our goal is to maintain the respect and dignity of all people having seizures
- promote people having a good relationship with their medical team to determine needs 

14. Epilepsy and stroke
Number 1 cause of epilepsy in people older than 50.
Side effects of medicine can make the effects of the stroke a little worse.
Make sure you know about any other medications and if it is safe to mix with any epilepsy medications.
Seizures are most likely to result from strokes that directly affect cortex
Say:
“Another name for stroke is “brain attack.” During a stroke, blood flow to the brain is blocked. Stroke is the number one cause of epilepsy in people older than 50.
Many times, after someone has a stroke, parts of their body may be weaker. The person may think more slowly than they used to.
Sometimes, epilepsy medicine can make you feel tired. It can also make your thinking slower. So these side effects can make the effects of the stroke a little worse.
If someone has epilepsy and has had a stroke:
• Find out what stroke medications the person takes.
• Ask the doctor whether it’s safe to mix the stroke medications with the epilepsy medications.

15. Epilepsy and Brain Injury
Increased risk of developing epilepsy following a traumatic brain injury
May be treated with phenytoin to prevent seizures up to 1 month after
Veterans- Post traumatic epilepsy
Seizures are most likely to result from strokes that directly affect cortex
Say:
“Another name for stroke is “brain attack.” During a stroke, blood flow to the brain is blocked. Stroke is the number one cause of epilepsy in people older than 50.
Many times, after someone has a stroke, parts of their body may be weaker. The person may think more slowly than they used to.
Sometimes, epilepsy medicine can make you feel tired. It can also make your thinking slower. So these side effects can make the effects of the stroke a little worse.
If someone has epilepsy and has had a stroke:
• Find out what stroke medications the person takes.
• Ask the doctor whether it’s safe to mix the stroke medications with the epilepsy medications.

16. Possible Causes of Epilepsy
Head Trauma
Brain tumor and stroke
Infection and maternal injury
Some forms are genetic
Briefly describe the causes (etiology) of epilepsy. (Review the content of the slide)
Say:
“Anything that can damage brain tissue can cause epilepsy.
“Some of the known causes include:
Problems during brain development prior to birth such as abnormal brain development, certain drugs, and infections.
Problems during birth such as injury to the brain during birth.
Problems in early infancy such as infections: meningitis, encephalitis, and brain abscesses.
Inherited diseases such as phenylketonuria (PKU), tuberous sclerosis, and neurofibromatosis (the growth of tumors or cysts).
Brain trauma (penetrating brain injury is more likely to cause seizures), Strokes, Hemorrhage, or bleeding in or around the brain.”
GENETICS:
People with first degree relatives (parents or siblings) who have epilepsy are at an increased risk of developing seizures themselves.
Anything beyond 1st degree relatives are at the same risk as a brain injury or prior brain infection would be at.
It may be necessary to clarify the role of heredity in epilepsy. To address this issue say the following:
“Each of you has a unique brain and nervous system. At some point, if your body is under enough stress, you will have a seizure. The amount of stress it takes to cause your brain to have a seizure is called your seizure threshold. This seizure threshold is partly hereditary. So, if a person has epilepsy that is not the result of a specific injury, this person may simply have a low seizure threshold…and their children may be a bit more likely to have epilepsy too.”

17. In 70% of the epilepsy cases – there is no known cause
Read slide
Say:
“Those who have been diagnosed with epilepsy but the cause is unknown or cannot be determined are referred to as having idiopathic epilepsy.
The cause may be unknown because:
Damage to the brain is too small to detect
Too much time has passed to link one specific event to why they are currently having seizures.
We just don’t have the technology right now to pinpoint exactly what is causing the seizures.”

18. Possible Seizure Triggers
Assess the environment
Failure to take medications
Lack of sleep
Stress / Anxiety
Dehydration
Photosensitivity – strobe lights
Menstrual cycle / hormonal changes
Say: “All triggers do not apply to all people. Some presumed triggers have not been "proven" to be triggers.”
Review points on slide, may also add:
“Non-compliance with medical instructions resulting in low blood levels is the most common trigger.
Lack of proper sleep and rest, high stress, and dehydration are not good for anyone, let alone anyone with seizures. A seizure is more likely to occur when your body is most vulnerable.
Always consult your physician about the use of other, non-epileptic medications. (OTC medications, herbal supplements).
Hormonal changes for example when kids go through puberty and when women go through menopause.
Photosensitivity – Any sudden change in light. Whether it be TV in the dark, video games, strobe lights, etc.”
only effects around 2% of those with epilepsy

19. Seizure Classification
Partial Seizures (focal)
Involves only part of brain
Simple & complex forms
Symptoms relate to the part of brain effected
Generalized Seizures
Involves whole brain
Convulsions, staring, muscle spasms, and falls
Most common are absence & tonic-clonic
Say:
“There are over 20 different types of seizures. These four are the seizures people are most likely to see.
In 1989 the CDC changed the names of seizures types from what were commonly known as petit mal and grand mal to what they are today
This change was made to make the names more specific so you will have a better, more detailed handle on dealing with the seizure.
Absence used to be called “petit mal” seizures. Tonic clonic is the new term used for “grand mal” seizures.”

20. Simple Partial Seizures
Uncontrollable shaking movements of hand, arm or legs
Sensory Seizures – may see flashing lights in peripheral vision, hear bells ringing, etc.
Seizure usually lasts between 1 and 2 minutes – no impairment of consciousness
May be considered an aura
No immediate action is needed other than reassurance and emotional support
A medical evaluation is recommended
Say:
“Simple partial seizures may display in two different ways: An uncontrollable movement or a distorted sense.
Displayed as an uncontrollable movements the seizure is:
Characterized by jerking, which may begin in one extremity or area of the body.
It cannot be voluntarily stopped, however the individual is aware of what is happening.
Sometimes, the jerking may spread to become a convulsive seizure.
The Sensory type of simple partial seizure may not be as obvious to an onlooker.
The individual experiences a distorted sense of environment, may smell or hear things that are not there, may feel unexplained fear, sadness, anger or joy or may have nausea and a general "funny" feeling in the stomach.
May also be an aura or a warning sign for a more intense seizure. Not everyone experiences these.

21. Complex Partial Seizures
Most common seizure type
Unaware of surroundings and unable to respond
Repetitive, purposeless movements such as lip smacking, hand wringing, or wandering - actions seem unusual
Seizure usually lasts approximately three minutes
Review contents of slide
May add:
“Complex partial seizures are frequently misinterpreted as drunkenness, intoxication, being on drugs, mental illness or disorderly conduct.
The individual may appear to be conscious but state is altered and is unable to communicate appropriately but may recognize something as basic as his or her name, if called.
The person may experience confusion, fear or some other emotion at the onset of the seizure. There is not likely to be any memory of what has occurred during the seizure unless it was extremely brief (a few seconds).
Partial seizures may generalize and become generalized tonic clonic (GTC) seizures in persons who have a diagnosis of "partial seizures secondarily generalized".

22. Appropriate Response – Complex Partial
Stay calm
Track time
Do not restrain
Gently direct away from hazards
Remain with the individual until they have gained full awareness
Review contents of slide
May add:
“The seizure is usually over in a few minutes and the individual gradually returns to full awareness.
The appropriate response is to:
Speak calmly and reassuringly to the individual and others around. You set the tone.
Approach individual from behind and gently guide by shoulders away from hazards.
Offer to help/assist during post ictal phase.
Individual will probably have a headache, be confused, and may be tired.”

23. Absence Seizures (formerly petit mal)
Usual onset between 4 and 12 years of age
Characterized by brief staring – can be confused with “daydreaming”
Starts and ends abruptly - can happen several times a day
Quickly returns to complete awareness
Appropriate response includes documentation
Say:
“Absence (pronounced ab-saw-ence), formerly known as petit mal, is a generalized seizure resulting in brief periods of complete unconsciousness.
It is characterized by a blank stare which begins and ends abruptly, lasting only a few seconds and is most common in children and can happen several times a day.
It may be accompanied by some rapid eye blinking and chewing movements or a facial 'twitch'.
The individual experiencing an absence seizure is completely unaware of what is happening during the seizure, but quickly returns to full awareness once it has stopped.”

24. Generalized Tonic Clonic (formerly grand mal)
NOT the most common type
Completely unconscious – loss of control
Characterized by a sudden fall
May cry out or make some types of noise
Onset of uncontrolled jerking or shaking of muscles
May have irregular breathing
Lasts 5 minutes or less
Review contents of slide
May add:
“The generalized tonic clonic seizure, formerly known as the Grand Mal is the convulsive seizure most people associate with epilepsy.
The individual may let out a sudden cry, which is the sound of air being expelled from the lungs, fall rigidly followed by rhythmic muscle jerks, shallow breathing or temporarily suspended breathing.
The individual may also have bluish skin, and possible loss of bladder or bowel control.
The time the actual convulsing lasts is the time which is considered in determining whether to call an ambulance or not
Once the normal breathing has resumed and the convulsing has stopped, the individual is in a recovering state, post ictal phase.
There is a gradual return to full awareness which may take as much as an hour.

25. Appropriate Response – Generalized Tonic Clonic
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.
Review contents of slide.
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.

26. Appropriate Response – Generalized Tonic Clonic
Remain with them until they have gained full awareness
If seizure lasts more than 5 minutes, call EMS
Recovery period– post ictal state
Review contents of slide.
May add:
It is common for a person having such a seizure to bite his/her tongue or lips, however it is dangerous and inappropriate to put anything into the person's mouth as greater damage can result such as broken teeth.
The post ictal state is the state of recovery following the convulsion or actual seizure and is considered a distinct part of the seizure. This may involve a period of confusion and/or fatigue. Individuals may need time to rest or clean up before returning to an activity. This does not apply to all people.
You may also add (Optional):
Do not give the individual anything to eat or drink until they have gained full awareness.
Do not give artificial respiration unless breathing is absent after muscle jerks subside, or unless water has been inhaled.

27. Call 911 if the person… Is injured Has diabetes Is pregnant
Does not resume normal breathing
Has a 1st time seizure
Has a seizure in water
Say:
“If the person has a seizure ID bracelet, or if the history of seizures is known, an ambulance is not necessary unless it meets these following conditions: (review slide)”.

28. VIDEO Review contents of slide. May add:
It is common for a person having such a seizure to bite his/her tongue or lips, however it is dangerous and inappropriate to put anything into the person's mouth as greater damage can result such as broken teeth.
The post ictal state is the state of recovery following the convulsion or actual seizure and is considered a distinct part of the seizure. This may involve a period of confusion and/or fatigue. Individuals may need time to rest or clean up before returning to an activity. This does not apply to all people.
You may also add (Optional):
Do not give the individual anything to eat or drink until they have gained full awareness.
Do not give artificial respiration unless breathing is absent after muscle jerks subside, or unless water has been inhaled.

29. Treatment Options Medication Brain Surgery Diet VNS 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 an implant called the Vagus Nerve Stimulator (VNS).

30. Goals of Epilepsy Care
Eliminate seizures with no side effects; alternatively
Reduce the number
Decrease the severity
Minimize side effects
Optimize quality of life

31. Medications Medications are most often the first line of treatment:
Approximately 60% of people achieve seizure control after the 1st year
15% achieve control at a later date
25% continue to have seizures despite treatment
Refer participants to the Medicines for Epilepsy brochure.
Review contents of slide:
Things you may include:
Goals of meds is best seizure control with the least amount of side effects.
Hope for mono therapy to be successful, one medication, but often times takes multiple medications, poly therapy, to gain control.

32. Common Side Effects of Medication
Lethargy
Weight gain / weight loss
Cognitive, concentration, memory difficulties
Hyperactivity
Emotional and/or behavioral changes
Say:
“Even despite excellent care, as with any medication, some individuals may experience side effects of their epilepsy medications. These may include but are not limited to: (Review contents of slide).
Optional, depending on audience, may add:
“Occasionally, the patient must have 'blood levels' of medications checked to ensure consistency and ensure that the medication in the blood is at a level high enough to be effective and not so high as to cause toxic side effects.
Some over-the-counter medications, and prescribed medications, can seriously interact with medications for epilepsy.
Ask your pharmacist before using other medications and over-the-counter drugs about the safety of taking them with epilepsy medications.
Be aware of changes in mood, behavior, physical appearance, and even personality as AED’s are quite strong.
Side effects increase if going through a med change or a dosage change.”

33. Brain Surgery Options Lobectomy Corpus Callosotomy Partial Seizures
Hope for result of seizure free
Corpus Callosotomy
Generalized Seizures
Never seizure free, less frequent/ intense seizures
Say:
“Sometimes, medication may not work for some individuals with epilepsy, and a variety of surgery options may be available. Not everyone is a candidate for brain surgery and it should be discussed with their doctor.
A lobectomy is where one small section of tissue can be removed to cure or stop seizures. This is usually only performed on people who have seizures originating from the same location on the brain. With low medication, many people have been seizure free from this surgery, within the first year. And, for some, seizure free without medication.
A Corpus Callosotomy has been performed on some people with epilepsy who have seizures which spread to involve the whole brain. Most commonly used in people with atonic (or drop) seizures. It is usually used to reduce to isolate the seizure to one part of the brain. Much recovery needed for this type of surgery and full seizure control is rare.

34. Medical Device Options
Say:
The Vagus Nerve Stimulator (VNS) is a transmitter that is placed under the skin on the left side of the chest, and has an electrode that is connected to the Vagus Nerve.
This transmitter sends electrical impulses to the brain, interrupting seizure activity. The transmitter is controlled by the doctor and a computer, and is programmed to turn on at varied intervals. A common interval may be 30 seconds of impulses every 5 minutes.
The VNS is also issued with a magnet, which may allow the person with epilepsy or others around the individual to turn on the transmitter.
This is done by passing a magnet across the transmitter. (this procedure to turn on may vary).
The most common side effect of a VNS is a sore throat.
The goal here is to prevent or interrupt seizure activity.
Approved in 1997

35. Special Diets Ketogenic Diet
Burns fat instead of glucose (fasting induced)
Gets 80% of calories from fat
Gets 20% from carbohydrates and proteins
Must be strictly managed and maintained daily
1/3 become seizure free or almost seizure free
1/3 improve but still have some seizures
1/3 do not respond or find it too hard to comply
Review contents of slide
May add:
“ Is a high fat, low protein, low carb diet. Usually one to four units. When making eggs, 1 unit egg, 4 units butter.
Very hard to comply with.
Burns fat instead of glucose.
It is believed that the diet mimics fasting or starvation by keeping the ketones in the body raised and that may result in reduced frequency of seizures or no seizures at all.
Not a long term fix. Average time span spent on this diet is 2-4 years.
It is a very controversial diet, because it is very high in saturated fat, and not healthy.
However, is has been a successful alternative treatment for some children with epilepsy.

36. Special Diets Modified Atkins Diet Low Glycemic Index Treatment
No fluid or calorie restriction, no protein restriction
Foods not weighed and measured, carbohydrates monitored
Not fast induced
Low Glycemic Index Treatment
Glycemic Index: how high that food raises your blood glucose
Easier to maintain - based more on portion control
Increase of carbohydrates with a low Glycemic Index
Review slide content.
The following 2 diets are modifications to the Ketogenic diet, they stem off of the Keto diet principles
MAD:
Ketones still remain high and seizures under control.
Fats strongly encouraged, no restrictions on proteins
Started outside the hospital, without a fast.
Foods can be eaten more freely in restaurants and outside of the home.
“Modified” Atkins as it allows for less carbs than traditional Atkins and more fat intake.
Results: About 2/3 had a 50% reduction in seizures after 6 months. Many were also able to reduce medications.
LGIT:
Focuses on those with intractable epilepsy.
Much more user friendly
Monitors not only the total carbs consumed daily, but focuses on carbs that have a low Glycemic Index.
Allowed for increased intake of carbs –40-60 grams per day.
Foods not weighed out by grams, more on portion size.
Calories from fat are 60% versus 80% with the keto diet.

37. Possible Impact of Epilepsy
Depression, Anger, Anxiety, Fear
Cognitive Problems
Developmental Delays
Relationships
Financial Costs
School/Employment
Driving
Recreational Activities
Emotional Difficulties:
Say:
There are many reports of people with seizures also dealing with emotions such as anger, depression, fear, and anxiety. Some of these feelings may be a result of underestimation of abilities, too much restriction and over protection.
For most people they don’t have a reason for their seizures and that makes it a bit more difficult to understand and deal with why this is happening. These feelings may also be due to the lack of social awareness of this disorder and the feelings and judgments that are projected from society.
a typical seizure lasts just a minute or two, but wondering/worrying about when the next one will occur can consume much more time
Cognitive/Learning Problems:
Some may be due to irregularities in brain function.
More common in those with the more intense seizures.
Also may be caused by medications

38. The Epilepsy Foundation of Minnesota leads the fight to stop seizures, find a cure and overcome the challenges created by epilepsy.
Share contact information, statewide services and #.
May also add:
EFM 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.
EFM 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.
The Epilepsy Foundation of MN is an affiliate of a National Epilepsy Foundation, this is their webpage. Our national office’s webpage is a great resource, where you can buy video’s, 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
| University Avenue West, Suite 300, St. Paul, MN |

39. Resources www.efmn.org Seizure Action Plans
Seizure Observation Records
First Aid posters
Share contact information, statewide services and #.
May also add:
EFM 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.
EFM 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.
The Epilepsy Foundation of MN is an affiliate of a National Epilepsy Foundation, this is their webpage. Our national office’s webpage is a great resource, where you can buy video’s, 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
| University Avenue West, Suite 300, St. Paul, MN |

40. Questions??
EFMN Information and Referral