+ For Nurses Caring for People with Epilepsy American Epilepsy Society, 2013 Epilepsy 101 For Nurses.

+

For Nurses Caring for People with Epilepsy

American Epilepsy Society, 2013

Epilepsy 101 For Nurses

+Aims

This program has been developed to prepare professional nurses, in a variety of settings to:

Address overall information about epilepsy and seizures to help care for people with epilepsy in the general hospital and community settings

Introduces a level of learning for neurology nurses that are seeking additional information on specialty practices and care

+Overview Curriculum of Epilepsy 101

This program of study has 4 self-paced learning modules:

Basics of Epilepsy for Nurses Recognition and Care of Seizures and

Emergencies Overview of Treatment Options Patient Education and Self-Management

Approaches

There is an option for the participant to listen to audio synced to PowerPoint presentation, along with the option to download the modules in PDF format

+Objectives of Module One:

Upon completion of Module One-the participant will:

Describe the role of nursing in epilepsy careReview the common causes and consequences of seizuresDefine the spectrum of nursing care for people with epilepsy

+Nurse-Patient RelationshipPeople with epilepsy may come in

contact with nurses from diverse settings and with different educational backgrounds and expertise

The nurse-patient relationship may vary in relation to the setting and the patient’s needs

+Spectrum of Nursing Care – Epilepsy Specific Advanced practice nurses on neurology or epilepsy

units

Nurses providing direct patient care and education in a clinic setting or on epilepsy monitoring units

Research nurses and nurse researchers

Nurses in other acute care settings Neurology, medical and surgical units Emergency room nurses Intensive care units Operating and recovery room

+Spectrum of Nursing Care- Other Health NeedsPrimary care practices

Women’s health - gynecology, obstetrics

Wellness clinics – occupational, urgent care, pharmacy-based

+Spectrum of Nursing Care – Community/Independent LivingSchools, camps

Long-term care facilities- assisted living facilities, rehabilitation and nursing home facilities

Independent living programs

Group homes, day programs

Vocational programs

+Nursing Practice

The role of epilepsy nurses varies depending on practice setting- inpatient, outpatient, ICU

Core focus is the sameIdentifyingAssessingEducating

Understanding the impact the disorder has on function and quality of life

+Epilepsy Prevalence/Incidence 2.2 million Americans and > 65 million people

worldwide have epilepsy

300,000 have a first convulsion each year 120,000 under 18 years of age ~ 1 in 26 people will develop epilepsy during

their lifetime

150,000 new cases of epilepsy diagnosed each year

Highest incidence in young children and older adults

65-70% of new cases have no obvious cause

:

+Definitions

A seizure is: A symptom of a disturbance in the brain, Caused by abnormal electrical discharges in the brain.

Epilepsy means that: A person has had 2 or more seizures, separated

by at least 24 hours The seizures are unprovoked and not caused by

any known medical condition A person has a tendency to recurring seizures. The term seizure disorder is the same as epilepsy.

+Incidence of Epilepsy by Age

Hauser WA. Epilepsia. 1992;33:S6-S14.

+Causes of Epilepsy

Annegers JF. The epidemiology of epilepsy. In: Wyllie E, ed. The Treatment of Epilepsy: Principles and Practice. 2001:131-138

+Causes of Epilepsy by Age

Infancy and Childhood

- Birth injury

- Inborn errors of metabolism

- Congenital malformations

Childhood and Adolescence

- Idiopathic-Cryptogenic/genetic

- CNS infection

+Causes of Epilepsy by Age

Adolescence and Young Adult

- Head trauma

- Drug intoxication/withdrawal (acute sz)

Older Adult

- Stroke

- Brain tumor

- Acute metabolic disturbances (acute seizure)

+Post-Traumatic Epilepsy

Epilepsy arising as a result of head trauma

Head trauma may be subtle or severe

Extent & location of injury may increase likelihood of developing seizures 2 types of seizures -early/acute & delayed

onset

Early treatment with anti-epileptic drugs (AEDs) may not affect the development of seizures later on

+Epilepsy Risk Factors

Intellectual or other developmental disability

Cerebral PalsyAnoxia AutismStrokeMajor head trauma

CNS hemorrhage

CNS infection, neurocystercosis

Dementia

Brain tumor, tubers

Family history

Birth injury

+Seizure Triggers

Non-adherenceSleep deprivationStress (good or bad)Accident/injuryConcurrent illness (fever)Menses or hormonal changesAlcohol/drugsSpecific stimuli (photosensitivity, reflex

epilepsy)

+Mortality

Risk of death higher in people with epilepsy 10 years of life lost for people with known cause of

seizures 2 years of life lost for those with unknown cause of

seizures

Approximately 42,000 deaths are caused by epilepsy annually

Mortality rate associated with seizures lasting 30 minutes may be as high as 19% Vast majority of deaths occur in people with seizure

in the context of an acute brain insult, hypoxia, trauma, etc.

.

+Additional Causes of Death in Epilepsy Life-threatening injuries

Drowning

Status epilepticus

Sudden unexplained death in epilepsy (SUDEP)

Suicide

+Sudden Death in Epilepsy (SUDEP) SUDEP

applies to a sudden death in someone known to have epilepsy, in the absence of an obvious cause for the death

Numbers vary 1 in 10,000 of newly diagnosed 9 of 1,000 candidates for epilepsy surgery

A Spectrum of Severity

Uncomplicated epilepsy,Seizures controlled with

medication

Seizures not completely controlled by treatment;

Epilepsy lowers standard of living due to social, emotional, and educational problems

Seizures refractory to treatment; Epilepsy is disabling

due to frequent seizures and other problems

Increase risk of SUDEP