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Epilepsy

Purpose
• The purpose of this presentation is to introduce the information about Epilepsy.

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Contents
1. What is Epilepsy 2. Statistics 3. Types of Epilepsy 4. Causes 5. Symptoms 6. Treatments 7. Dos and Don’ts 8. Teaching Strategies 9. New Medical Discoveries 10. Adaptive/Assistive Technology 11. Driving Laws for Epilepsy 12. Resources 13. Quiz 14. References

Do you think you know?
Suppose you have a student with epilepsy in your classroom: 1. Can you tell when his or her epilepsy is coming?

2. Do you know how to handle it if it happens?

1. What is Epilepsy?

 Epilepsy is a persistent disorder of the nervous system.  It produces periodic or recurring seizures that affect a variety of mental and physical functions.  When a person has two or more unprovoked seizures, they are considered to have epilepsy.

2. Statistics about Epilepsy

According to the Centers for Disease Control and Prevention:
Epilepsy affects  65 million people worldwide  2.2 million Americans, including: --300,000 children under the age of 15, and --570,000 adults age 65 and above.  Epilepsy is the 4th most common neurological disorder in the U.S. after migraine, stroke, and Alzheimer’s disease.

 Epilepsy strikes mainly among the very young children and the very old adults.

 Returning veterans who have traumatic brain injury show an increased risk of developing epilepsy.  Many questions about seizures remain unanswered. Currently no sure cure exists for epilepsy.  Researchers are searching for answers by looking at new ways to treat epilepsy and determine its cause.

3. Major Types of Epilepsy
Types of Epilepsy Idiopathic (genetic causes) Generalized Epilepsy Partial Epilepsy - Childhood absence - Benign focal epilepsy of epilepsy childhood - Juvenile myoclonic epilepsy - Epilepsy with grand-mal seizures on awakening Others - West syndrome - Temporal lobe epilepsy - Lennox-Gastaut syndrome - Frontal lobe epilepsy - Others Others

Symptomatic (cause unknown) or cryptogenic (cause unknown)

Idiopathic Generalized Epilepsy
 In idiopathic generalized epilepsy, there is often, but not always, a family history of epilepsy. Idiopathic generalized epilepsy tends to appear during childhood or adolescence.  People with idiopathic generalized epilepsy have normal intelligence and the results of the neurological exam and MRI are usually normal.

Idiopathic Partial Epilepsy
 Idiopathic partial epilepsy begins in childhood (between ages 5 and 8) and may have a family history. It is also known as benign focal epilepsy of childhood (BFEC).  Idiopathic partial epilepsy is considered one of the mildest types of epilepsy. It is almost always outgrown by puberty and is never diagnosed in adults.

Symptomatic Generalized Epilepsy
 In addition to seizures, these patients often have other neurological problems, such as mental retardation or cerebral palsy.  Multiple types of seizures (generalized tonicclonic, tonic, myoclonic, tonic, atonic, and absence seizures) are common in these patients and can be difficult to control.

Symptomatic Partial Epilepsy
 Symptomatic partial (or focal) epilepsy is the most common type of epilepsy that begins in adulthood, but it does occur frequently in children.  Sometimes these brain abnormalities can be seen on MRI scans, but often they cannot be identified, despite repeated attempts, because they are microscopic.

4. Causes
• Genetic or hereditary • Congenital neurological conditions • Trauma with brain injury • Stroke • Brain tumors • Infections such as meningitis and encephalitis • Multiple sclerosis • Toxins, such as carbon monoxide and lead • Idiopathic (unknown or genetic)

5. Symptoms
An epileptic seizure usually lasts a few seconds to a few minutes. Symptoms you may see are:  Confusion  Wide open eyes that have a blank stare or are constantly blinking  Jerking of hands, legs, or face  Breathing that slows or stops

 Bluish lips, nail beds, and face if breathing is affected

 Stiff arms or legs  Strange or small constant movements, such as picking at clothes or lip smacking  Loss of consciousness

6. Treatments
• Drugs

• Surgery • Vagus Nerve Stimulation (VNS) • Special dietary program
 Epilepsy is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases. In some cases the implantation of a stimulator of the vagus nerve, or a special diet can be helpful.

7. DO and DON’T During an Epilepsy

What to do:
 Note the time.  Clear a space around the person.  Cushion the head (e.g. with a rolled up jacket).

 Loosen tight neckwear.
 Remove glasses if worn.
 Check to see if the person is carrying an ID or wearing an SOS Talisman or any Medic Alert jewelry, as this may give information about the seizure type and medication.

 Clear any frothy saliva from the mouth and check the airway.  Reassure the person during any period of confusion which may follow  As soon as the convulsions subside, turn the person onto his/her side into the recovery position to aid breathing.

What Not to Do
 DO NOT move the person while the seizure is in progress, unless he/she is in immediate danger (e.g. in a busy road, at the top of a flight of stairs, at the edge of water, or near a fire).

 DO NOT restrict movements.
 DO NOT attempt to lift the person up.

 DO NOT try to give anything by mouth.
 DO NOT interfere with the person in the period immediately after the seizure. Let them recover in peace and quiet, but stay with them until any confusion has passed.

 Do not hold or tie the person down.  Do not place anything in the person's mouth or try to force his teeth apart. The person is not in danger of swallowing his tongue.  Do not pour any liquid into the person's mouth or offer food or medicines until he is fully awake.

8. Teaching Students with Epilepsy: Strategies
 Children with epilepsy often experience learning issues as a result of their seizures. These may include ongoing problems with motor skills or cognitive functions, as well as difficulty in acquiring new skills or knowledge due to a vulnerable working memory that results from the seizure disorder. The fact that  epilepsy is associated with such wide-ranging learning problems makes it critical that children With epilepsy have the appropriate supports at school in order to realize their potential.

The key to helping students with epilepsy reach their full potential in school and beyond is to provide them with opportunities that take into account their range of learning problems, including difficulties with speech and language, attention, and memory.

Strategy 1: Curriculum Adaptation
□ To help students with epilepsy bypass a vulnerable working memory, teachers can adapt some of their activities to focus less on retrieval of information and more on recognition tasks. In other words, students with memory problems can show their understanding of a concept by responding to questions or prompts that use the information they know.

 Example 1: Language Arts Use a graphic organizer, such as a web, to display the characters, plot, themes, and settings in a novel. Ask the student to fill in information as it’s being read, or have the student read while you log the information .

 Have the student use index cards to

make a timeline of key events in a story. Later, the student can use the index cards as triggers for recounting the plot.

Strategy 2: Thematic Teaching
□ Another strategy for helping students with
epilepsy is Thematic Teaching. Thematic teaching can expose the students to the new information as often as possible, engage them in learning the same concepts and skills many times throughout the day. This can be practiced with the cooperation of regular classroom teacher, individual tutorials, home reinforcement and interventions, and occupational therapies, all of which touch upon some of the same topics.

Strategy 3: Tutorial
□ One-on-one tutorials can support the regular curriculum by addressing the same themes and topics multiple times. However, tutorials can also provide the student with a more focused look at new concepts, as well as practice at the process of learning.

9. New Medical Discoveries
 Calcium and vitamin D improve bone density in patients taking antiepileptic drugs  Chronic epileptic seizure prevented by low-frequency repetitive transcranial magnetic stimulation (rTMS)

 50 years after valproate was first discovered, research published in the journal Neurobiology of Disease, reports how the drug works to block seizure progression.

 Gene that fosters synapse formation in the brain has Implications for language development, autism, epilepsy.
 Brain study uncovers vital clue in bid to beat epilepsy - role played by protein BDNF identified  Scientists have discovered two new genes linked to severe forms of childhood epilepsy, a breakthrough reached with new genetic technology, according to a study published in the journal Nature.  Antiepileptic Drug Use While Pregnant Impacts Early Child Development  2-Week Treatment Found To Prevent Epilepsy In Mice Gives Hope For Drug Development  A large scientific study has discovered new genes causing severe seizure disorders that begin in babies and early childhood. The finding will lead to new tests to diagnose these conditions and promises to lead to improved outcomes.

10. Adaptive/Assistive Technology
 Flicker-free monitors  Auto-Dial Feature in Telephones  Electronic Organizers  Picture Exchange Communication Systems

11. Driving Laws for Epilepsy
 Every state regulates driver's license eligibility of persons with certain medical conditions. The most common requirement for people with epilepsy is that they be seizure free for a specific period of time and submit a physician's evaluation of their ability to drive safely.  Another common requirement is the periodic submission of medical reports, in some states for a specified period of time and in others for as long as the person remains licensed.

12. Where can I get more information?
• Epilepsy Foundation 4351 Garden City Drive Landover , MD 20785-7223 Phone: 1- 800 - 332-1000 Web Address: http://http://www.epilepsyfoundation.org • American Epilepsy Society 342 North Main Street West Hartford , CT 06117-2507 Phone: 1- 860 - 586-7505 Web Address: http://www.aesnet.org

13. Quiz
1. When a person has two or more unprovoked seizures, they are considered to have epilepsy. a. True b. False 2. Diabetes is one of the causes of Epilepsy. a. True b. False 3. One of the symptoms of Epilepsy is insomnia. a. True b. False 4. When a student starts seizure, the teacher should call 911 right away and move the student out of the class. a. True b. False 5. Students with Epilepsy can benefit from Thematic Teaching. a. True b. False

14. References
"Epilepsy." FamilyDoctor.org . Information Page. (accessed November 27, 2013) http://familydoctor.org/online/famdocen/home/common/brain/disorders/21 4.printerview.html "Facts about Epilepsy." Epilepsy Institute . Information Page. (accessed November 27, 2013) http://www.epilepsyinstitute.org/facts/index.htm Marshall G. Letcher, Roy Sucholeiki, and Fran Hodgkins. “Epilepsy”, The Gale Encyclopedia of Neurological Disorders, Second Edition. Ed. Brigham Narins. Detroit: Gale, 2012. 2 vols.

” Teaching Students with Epilepsy: Strategies for Educators”. Growing up with Epilespy.Information Page. (accessed November 30, 2013) http://www2.massgeneral.org/childhoodepilepsy/pdf/strategies_for_educato rs.pdf

http://www.epilepsyfoundation.org/resources/DrivingLaws-by-State.cfm

http://evengrounds.com/blog/assistive-technologies-forpeople-with-epilepsy
http://www.medicalnewstoday.com/categories/epilepsy http://www.ninds.nih.gov/disorders/epilepsy/detail_epile psy.htm