This document provides information about seizures and epilepsy. It defines what a seizure is, the different types of seizures including absence, tonic-clonic, simple partial and complex partial seizures. It discusses epilepsy as a neurological disorder characterized by recurrent seizures and covers common causes, prevalence, myths and facts. The document outlines appropriate first aid for different seizure types and signs that indicate a medical emergency. It also discusses potential learning impacts and provides tips for supporting students with epilepsy.
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Seizures
1.
2. Objectives
Recognize common seizure types and
their possible impact on students
Know appropriate first aid
Recognize when a seizure is a medical
emergency
Provide social and academic support
2
3. What is a Seizure?
A brief, excessive discharge of electrical
activity in the brain that alters one or
more of the following:
Movement
• There are more than 20 different
Sensation kinds of seizures.
• Seizure symptoms depend on
where in the brain the excessive
Behavior electrical activity occurs and how
much of the brain is affected during
Awareness the seizure.
• Seizures are temporary and
episodic.
3
4. What is Epilepsy?
Epilepsy is a chronic neurological
disorder characterized by a tendency
to have recurrent seizures
Epilepsy is also known as a “seizure
disorder”
Most seizures occur spontaneously
and unpredictably.
4
5. Epilepsy is More Common Than You Think
2.7 million Americans
315,000 students in the United States
More than 45,000 new cases are diagnosed
annually in children
1 in 100 people will develop epilepsy
1 in 10 people will have a seizure in their
lifetime
Epilepsy is more common than Cerebral
Palsy, Parkinson’s Disease and Multiple
Sclerosis combined
5
6. Did You Know That…
Most seizures are NOT medical emergencies
Students may NOT be aware they are having a
seizure and may NOT remember what happened
Epilepsy is NOT contagious
Epilepsy is NOT a form of mental illness
Students almost never die or have brain damage
during a seizure
A student can NOT swallow his/her tongue during a
seizure
You should never put anything in the mouth of a
person having a seizure.
6
7. Common Causes of Epilepsy
For seventy percent (70%) of people with epilepsy the
cause is unknown
For the remaining thirty percent (30%) common
identifiable causes include:
Brain trauma
Brain lesions (e.g. tumors)
Poisoning (lead)
Infections of the brain (e.g. meningitis, encephalitis,
measles)
Brain injury at birth
Abnormal brain development
Brain trauma is the major identified cause of epilepsy
in teens and adults.
7
8. Seizure Types
Generalized Seizures
Involve the whole brain
Common types include absence
and tonic-clonic
Symptoms may include
convulsions, staring, muscle
spasms and falls
Partial Seizures
Involve only part of the brain
Common types include simple
partial and complex partial
Symptoms relate to the part of
the brain affected
8
9. Seizure Types
Seizure symptoms in a specific person
are generally the same each time a
seizure occurs.
All about auras:
Some students will have a definite sign
that a seizure is about to happen. This
is called an aura.
An aura may include, but is not limited
to, an odd taste or smell, a feeling of
fear, a visual or auditory experience or
a tingling sensation.
In some cases an aura may allow the
student to prepare for the oncoming
seizure and warn others that a seizure
is about to occur.
9
10. Absence Seizures
Pause in activity with blank stare
Brief lapse of awareness
Possible chewing or blinking motion
Usually lasts 1 to 10 seconds
May occur many times a day
May be confused with:
Daydreaming
Lack of attention
ADD
10
11. Absence Seizures
Previously called “petit mal.”
Other symptoms may include eye fluttering, slight
head movement and some mouth movement.
As an absence seizure ends, a student will pick up
where he/she left off and resume normal activities.
No first aid is necessary for an absence seizure.
Absence seizures may occur in clusters which may
lead to a brief period of disorientation.
Recording seizure frequency using a seizure
observation record can help with identifying possible
seizure triggers.
11
12. Generalized Tonic-Clonic
A sudden, hoarse cry
Loss of consciousness
A fall
Convulsions (stiffening of arms and legs followed by
rhythmic jerking)
Shallow breathing and drooling may occur
Possible loss of bowel or bladder control
Occasionally skin, nails, lips may turn blue
Generally lasts 1 to 3 minutes
Usually followed by confusion, headache, tiredness,
soreness, speech difficulty
12
13. Generalized Tonic-Clonic
Previously called a “grand mal” seizure.
This is the seizure most people think of when they hear the
word epilepsy.
Initially, the student loses consciousness and falls to the
ground.
As the diaphragm contracts, the student may produce a
loud cry.
Eyes may roll up or turn to the side.
The body usually becomes very rigid before convulsions
begin.
The student may bite his/her tongue during the seizure.
Several hours of rest may be needed after the seizure.
13
14. First Aid - Generalized Tonic-Clonic
Seizure
Stay calm and track time
Check for epilepsy or seizure disorder I.D. (bracelet,
necklace)
Protect student from possible hazards (chairs, tables,
sharp objects, etc.)
Turn student on his/her side
Cushion head
After the seizure, remain with the student until
awareness of surroundings is fully regained
Provide emotional support
Document seizure activity
14
15. First Aid - Generalized Tonic-Clonic
Seizure
Tracking time is important because a seizure lasting longer than 5
minutes will require an emergency intervention.
Reassure other students and explain what is happening if necessary.
Turning the student to one side keeps the tongue from blocking the
airway and allows saliva to drain from the mouth.
The palm of the hand or other soft object can be used to cushion the
head.
Be sure that any object cushioning the head is not covering the mouth or
nose and hampering breathing.
If necessary, remove eyeglasses and loosen tight neckwear.
To establish that student has regained full awareness of surroundings
after the seizure, ask simple questions like, “What is your name?”
IMPORTANT! - If your school district has emergency seizure protocols,
please explain them to the training participants now.
15
16. Dangerous First Aid!!!
DO NOT put anything in the student’s mouth
during a seizure
DO NOT hold down or restrain
DO NOT attempt to give oral medications,
food or drink during a seizure
It is physically impossible to swallow your tongue.
Inserting something in the student’s mouth during a seizure will
potentially break teeth, injure their jaw or block the airway.
Restraining or holding someone down during a convulsive seizure
can cause spraining or breaking of body parts.
16
17. When is a Seizure an Emergency?
First time seizure (no medical ID and no known history of
seizures)
Convulsive seizure lasting more than 5 minutes
Repeated seizures without regaining consciousness
More seizures than usual or change in type
Student is injured, has diabetes or is pregnant
Seizure occurs in water
Normal breathing does not resume
Parents request emergency evaluation
If the student is not breathing after the seizure, begin rescue
breathing until the ambulance arrives.
Follow seizure emergency definition and protocol as defined
by the healthcare provider in the seizure action plan
17
18. Simple Partial Seizures
Full awareness maintained
Rhythmic movements (isolated twitching of arms, face, legs)
Sensory symptoms (tingling, weakness, sounds, smells, tastes,
feeling of upset stomach, visual distortions)
Psychic symptoms (déjà vu, hallucinations, feeling of fear or
anxiety, or a feeling they can’t explain)
Usually lasts less than one minute
May be confused with: acting out, mystical experience,
psychosomatic illness
18
19. Simple Partial Seizures
A student remains conscious and responsive during a
simple partial seizure.
Typical symptoms may include ringing in ears, odd
smells, metallic taste, nausea, tingling, sweating,
dilation of pupils, emotional changes such as fear, joy
or anxiety, visual hallucinations and distortions of how
the student views his or her environment.
No particular first aid is needed other than emotional
support and reassurance.
19
20. Complex Partial Seizures
Awareness impaired/inability to respond
Often begins with blank dazed stare
AUTOMATISMS (repetitive purposeless movements)
Clumsy or disoriented movements, aimless walking,
picking things up, nonsensical speech or lip smacking
Often lasts one to three minutes
Often followed by tiredness, headache or nausea
May become combative if restrained
May be confused with:
Drunkenness or drug abuse
Aggressive behavior
20
21. Complex Partial Seizures
Complex partial seizures typically involve automatic
behaviors (automatisms), including hand wringing,
picking at clothing, lip smacking and wandering.
An aura (actually a simple partial seizure) often precedes
a complex partial seizure.
Complex partial seizures usually begin before age 18
and are the most common seizure type in teens and
adults.
A complex partial seizure can progress to a generalized
tonic-clonic seizure.
21
22. First Aid - Complex Partial Seizure
Stay calm, reassure others
Track time
Check for medical I.D.
Do not restrain
Gently direct away from hazards
Don’t expect student to obey verbal instructions
Stay with student until fully alert and aware
If seizure lasts 5 minutes beyond what is routine for that
student or another seizure begins before full consciousness
is achieved, follow emergency protocol
If this is a first seizure, inform the school nurse or parent.
Restraint during a seizure can cause an aggressive
response – brain perceives unwanted restraint as an attack.
22
23. Seizure Triggers or Precipitants
Flashing lights and hyperventilation can trigger seizures in
some students with epilepsy
Factors that might increase the likelihood of a seizure in
students with epilepsy include:
Missed or late medication (#1 reason)
Stress/anxiety
Lack of sleep/fatigue
Hormonal changes
Illness
Alcohol or drug use
Drug interactions (from prescribed or over the counter medicines)
Overheating/overexertion
Poor diet/missed meals
23
24. Seizure Triggers or Precipitants
A student’s environment or activities may need to be
modified to reduce exposure to situations that trigger
seizures.
A school safety evaluation can help determine any
changes that need to be made.
Consider flashing lights in MOVIES, TELEVISION
and COMPUTERS, all of which can be seizure
triggers.
In many cases there is no identifiable trigger or
precipitating factor.
24
25. The Impact on Learning & Behavior
Seizures may cause short-term memory problems
After a seizure, coursework may have to be re-taught
Seizure activity, without obvious physical symptoms,
can still affect learning
Medications may cause drowsiness, inattention,
concentration difficulties and behavior changes
Students with epilepsy are more likely to suffer from
low self-esteem
School difficulties are not always epilepsy-related
25
26. Tips for Supporting Students with Epilepsy
Stay calm during seizure episodes
Be supportive
Have a copy of the child’s seizure action plan
Discuss seizure the action plan in the student’s IEP
Know child’s medications and their possible side effects
Encourage positive peer interaction
Your behavior during a seizure episode can make a substantial
difference in how students react and how the student with
seizures copes with his/her condition.
By reassuring other students that you know what to do and that
everything will be all right, they will remain calm during seizure
episodes.
26
27. Tips for Supporting Students with Epilepsy
Avoid overprotection and encourage independence
Include the student in as many activities as possible
Communicate with parents about child’s seizure activity, behavior
and learning problems
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 from the school nurse about how to
manage seizures in the classroom.
This document should include the student’s seizure type(s),
frequency of seizures, emergency contact information, basic first
aid and emergency response protocol.
27
28. Contact Information
Epilepsy Foundation
Information and Referral
(800) 332-1000
www.epilepsyfoundation.org
28
Notas do Editor
NOTES: Introduce yourself. Ask, “How many of you have experience with students or other people who have seizures? Would you be willing to briefly share your experience with the group?” Keep total sharing time to about two minutes. If implementing the optional certification process, notify participants that they will be tested on the training content.
NOTES: All materials presented in the PowerPoint slides are covered in the written materials in your handout packets. If implementing the certification process, review the following with training participants: At the conclusion of this training, you will be asked to take a brief learning assessment to help determine the effectiveness of the training. A certificate of participation will also be issued. Receipt of your certificate is not dependent on the results of your learning assessment.
NOTES: There are more than 20 different kinds of seizures. Seizure symptoms depend on where in the brain the excessive electrical activity occurs and how much of the brain is affected during the seizure. Seizures are temporary and episodic .
NOTES: Most seizures occur spontaneously and unpredictably.
NOTES: Before reviewing the next overhead, say: There are many prevalent misconceptions about epilepsy. Here are some of the facts you should know.
NOTES: You should never put anything in the mouth of a person having a seizure.
NOTES: Brain trauma is the major identified cause of epilepsy in teens and adults.
NOTES: Seizure symptoms in a specific person are generally the same each time a seizure occurs. All about auras: Some students will have a definite sign that a seizure is about to happen. This is called an aura . An aura may include, but is not limited to, an odd taste or smell, a feeling of fear, a visual or auditory experience or a tingling sensation. In some cases an aura may allow the student to prepare for the oncoming seizure and warn others that a seizure is about to occur.
NOTES: Seizure symptoms in a specific person are generally the same each time a seizure occurs. All about auras: Some students will have a definite sign that a seizure is about to happen. This is called an aura . An aura may include, but is not limited to, an odd taste or smell, a feeling of fear, a visual or auditory experience or a tingling sensation. In some cases an aura may allow the student to prepare for the oncoming seizure and warn others that a seizure is about to occur.
NOTES: Previously called “petit mal.” Other symptoms may include eye fluttering, slight head movement and some mouth movement. As an absence seizure ends, a student will pick up where he/she left off and resume normal activities. No first aid is necessary for an absence seizure. Absence seizures may occur in clusters which may lead to a brief period of disorientation. Recording seizure frequency using a seizure observation record can help with identifying possible seizure triggers.
NOTES: Previously called “petit mal.” Other symptoms may include eye fluttering, slight head movement and some mouth movement. As an absence seizure ends, a student will pick up where he/she left off and resume normal activities. No first aid is necessary for an absence seizure. Absence seizures may occur in clusters which may lead to a brief period of disorientation. Recording seizure frequency using a seizure observation record can help with identifying possible seizure triggers.
NOTES: Previously called a “grand mal” seizure. This is the seizure most people think of when they hear the word epilepsy. Initially, the student loses consciousness and falls to the ground. As the diaphragm contracts, the student may produce a loud cry. Eyes may roll up or turn to the side. The body usually becomes very rigid before convulsions begin. The student may bite his/her tongue during the seizure. Several hours of rest may be needed after the seizure.
NOTES: Previously called a “grand mal” seizure. This is the seizure most people think of when they hear the word epilepsy. Initially, the student loses consciousness and falls to the ground. As the diaphragm contracts, the student may produce a loud cry. Eyes may roll up or turn to the side. The body usually becomes very rigid before convulsions begin. The student may bite his/her tongue during the seizure. Several hours of rest may be needed after the seizure.
NOTES: Tracking time is important because a seizure lasting longer than 5 minutes will require an emergency intervention. Reassure other students and explain what is happening if necessary. Turning the student to one side keeps the tongue from blocking the airway and allows saliva to drain from the mouth. The palm of the hand or other soft object can be used to cushion the head. Be sure that any object cushioning the head is not covering the mouth or nose and hampering breathing. If necessary, remove eyeglasses and loosen tight neckwear. To establish that student has regained full awareness of surroundings after the seizure, ask simple questions like, “What is your name?” IMPORTANT! - If your school district has emergency seizure protocols, please explain them to the training participants now.
NOTES: Tracking time is important because a seizure lasting longer than 5 minutes will require an emergency intervention. Reassure other students and explain what is happening if necessary. Turning the student to one side keeps the tongue from blocking the airway and allows saliva to drain from the mouth. The palm of the hand or other soft object can be used to cushion the head. Be sure that any object cushioning the head is not covering the mouth or nose and hampering breathing. If necessary, remove eyeglasses and loosen tight neckwear. To establish that student has regained full awareness of surroundings after the seizure, ask simple questions like, “What is your name?” IMPORTANT! - If your school district has emergency seizure protocols, please explain them to the training participants now.
NOTES: It is physically impossible to swallow your tongue. Inserting something in the student’s mouth during a seizure will potentially break teeth, injure their jaw or block the airway. Restraining or holding someone down during a convulsive seizure can cause spraining or breaking of body parts.
NOTES: If the student is not breathing after the seizure, begin rescue breathing until the ambulance arrives.
NOTES: A student remains conscious and responsive during a simple partial seizure. Typical symptoms may include ringing in ears, odd smells, metallic taste, nausea, tingling, sweating, dilation of pupils, emotional changes such as fear, joy or anxiety, visual hallucinations and distortions of how the student views his or her environment. No particular first aid is needed other than emotional support and reassurance.
NOTES: A student remains conscious and responsive during a simple partial seizure. Typical symptoms may include ringing in ears, odd smells, metallic taste, nausea, tingling, sweating, dilation of pupils, emotional changes such as fear, joy or anxiety, visual hallucinations and distortions of how the student views his or her environment. No particular first aid is needed other than emotional support and reassurance.
NOTES: Complex partial seizures typically involve automatic behaviors (automatisms) , including hand wringing, picking at clothing, lip smacking and wandering. An aura (actually a simple partial seizure) often precedes a complex partial seizure. Complex partial seizures usually begin before age 18 and are the most common seizure type in teens and adults. A complex partial seizure can progress to a generalized tonic-clonic seizure.
NOTES: Complex partial seizures typically involve automatic behaviors (automatisms) , including hand wringing, picking at clothing, lip smacking and wandering. An aura (actually a simple partial seizure) often precedes a complex partial seizure. Complex partial seizures usually begin before age 18 and are the most common seizure type in teens and adults. A complex partial seizure can progress to a generalized tonic-clonic seizure.
NOTES: If this is a first seizure, inform the school nurse or parent. Restraint during a seizure can cause an aggressive response – brain perceives unwanted restraint as an attack. Before reviewing the next overhead: Sometimes a specific seizure trigger is discovered. Avoiding that activity may decrease the frequency of seizures. Here is a list of possible seizure triggers.
NOTES: A student’s environment or activities may need to be modified to reduce exposure to situations that trigger seizures. A school safety evaluation can help determine any changes that need to be made. Consider flashing lights in MOVIES, TELEVISION and COMPUTERS, all of which can be seizure triggers. In many cases there is no identifiable trigger or precipitating factor. Before reviewing the next overhead: When teaching students with epilepsy, there are several important things to keep in mind.
NOTES: A student’s environment or activities may need to be modified to reduce exposure to situations that trigger seizures. A school safety evaluation can help determine any changes that need to be made. Consider flashing lights in MOVIES, TELEVISION and COMPUTERS, all of which can be seizure triggers. In many cases there is no identifiable trigger or precipitating factor. Before reviewing the next overhead: When teaching students with epilepsy, there are several important things to keep in mind.
NOTES:
NOTES: Your behavior during a seizure episode can make a substantial difference in how students react and how the student with seizures copes with his/her condition. By reassuring other students that you know what to do and that everything will be all right, they will remain calm during seizure episodes.
NOTES: 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 from the school nurse about how to manage seizures in the classroom. This document should include the student’s seizure type(s), frequency of seizures, emergency contact information, basic first aid and emergency response protocol. BEFORE PLAYING THE DVD SAY: We are going to watch a DVD that reviews some of what we’ve learned thus far in the training and shows footage of actual seizures. PLAY DVD HERE
NOTES: If you need contact information for your local affiliate or would like additional information about epilepsy, please call this number or visit the Epilepsy Foundation website. Ask participants to take a few minutes to complete the Learning Assessment and a Participant Satisfaction Survey . When participants are finished, review the correct answers for the learning assessment. If implementing the certification process provide a Certificate of Participation to each participant.