Myeshi Briley and Dr. William Allan Kritsonis

8/9/2019 Myeshi Briley and Dr. William Allan Kritsonis

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Epilepsy & Seizures

A HANDBOOK OF EFFECTIVESTRATEGIES FOR WORKING

WITH STUDENTS DIAGNOSED

WITH EPILEPSY

Myeshi BrileyGraduate Student - Final Project

Master Degree in Human Services

Concentration in OrganizationalManagement and Leadership

William Allan Kritsonis, PhD,

Major Professor

Graduate Student Project 2010



What Is the Difference Between

Epilepsy & Seizures? Epilepsy is a disorder characterized by

recurring seizures (also known as ³seizure

disorder´)

A seizure is a brief, temporary disturbance

A seizure is a symptom of epilepsy

in the electrical activity of the brain

Introduction



Who Has Epilepsy? About 2.3 million Americans have epilepsy

Roughly 181,000 new cases of seizures

and epilepsy occur each year

50% of people with epilepsy developseizures by the age of 25; however,anyone can get epilepsy at any time

Now there are as many people withepilepsy who are 60 or older as childrenaged 10 or younger



What Causes Epilepsy?

In about 70% of people with epilepsy, thecause is not known

In the remaining 30%, the most commoncauses are:

- Head trauma

- Infection of brain tissue

- Brain tumor and stroke

- Heredity- Lead poisoning

- Prenatal disturbance of brain

development



The Brain Is the Source of Epilepsy

All brain functions -- including feeling,

seeing, thinking, and moving muscles --

depend on electrical signals passed

between nerve cells in the brain

A seizure occurs when too many nerve

cells in the brain ³fire´ too quickly causing

an ³electrical storm´



What Happens During a Seizure? Generalized seizure

Involve the whole brain and loss of consciousness

Absence: characterized by brief loss of consciousness

Tonic-clonic: characterized by rhythmic jerking of muscles

Partial seizure

Involve only part of the brain; may or

may not include loss of consciousness Symptoms relate to the part of the brain

affected



How Is Epilepsy Diagnosed?

Clinical Assessment

Patient history

Tests (blood, EEG, CT, MRI or PET

scans)

Neurologic exam

ID of seizure type

Clinical evaluation

to look for causes



Symptoms That May Indicate a Seizure Disorder

Periods of blackout or confused memory

Occasional ³fainting spells´

Episodes of blank staring in children

Sudden falls for no apparent reason

Episodes of blinking or chewing at inappropriate

times

A convulsion, with or without fever

Clusters of swift jerking movements in babies



Seizure Triggers

Missed medication (#1 reason)

Stress/anxiety

Hormonal changes

Dehydration

Lack of sleep/extreme fatigue

Photosensitivity

Drug/alcohol use; drug interactions



Information:

How medicine gets to the brain, after

swallowing.

1. Goes to the stomach and intestine.

2. Passes into the blood stream.3 Goes to the liver.

4. Liver will process some of it then some

goes to the heart

then to the brain.

This process could take up to 8-10 hours.



A HANDBOOK OF EFFECTIVE STRATEGIES

FOR WORKING WITH STUDENTS DIAGNOSED

WITH EPILEPSY

IDENTIFICATION OF PROBLEM:

There is a limited amount of research

dealing with building successful strategies

for working with students that have been

diagnosed with epilepsy. This project will

contribute to the body of knowledge for helping those individuals responsible for

working with students with epilepsy.





WITH EPILEPSY WHAT THE LITERATURE SAYS?

Studies indicate there are 2.4 million Americans

diagnosed with epilepsy every year. There have been

about 51 million different cases worldwide diagnosed in2007. From this number over 350,000 young children in

the United States have been diagnosed with epilepsy

each year. These children will be attending our public and

private schools. About 92% of these children will have

difficulties in learning throughout their school aged years.

Most will experience difficulties with learning the basic lifeskills. Studies indicated there are 500 different genes

that could be linked to epilepsy. Epilepsy is a Greek word

meaning to seize up or attach. Epilepsy attacks the brain

at anytime and never is planned.




FOR WORKING WITH STUDENTS DIAGNOSE

WITH EPILEPSY

Based on the review of the literature

there appears to be a definite need

for a project dealing with effectivestrategies for working with students

that have been diagnosed with

epilepsy.





WITH EPILEPSY WHY IS THIS TOPIC IMPORTANT TO BE

STUDIED?

This project will contribute to thebody of knowledge for helping those

individuals responsible for working

with students who have been

diagnosed with epilepsy.





WITH EPILEPSY WHAT I HOPE TO ACHIVE IN

STUDYING THIS TOPIC:

My objective is to research and create a

handbook of effective strategies for working with students who been

diagnosed with epilepsy. These strategies

will also help the students to be more

successful in everyday life skills.




FOR WORKING WITH STUDENTS DIAGNOSEDWITH EPILEPSY

PURPOSE OF THE RESEARCH

STATEMENT:

The purpose of my research is to

document and recommend the essential

strategies that should be included in a

handbook for those working with studentsthat have been diagnosed with epilepsy.





WITH EPILEPSY

RESEARCH QUESTIONS :

The following questions guided this project:

1. Are there basic needs of children with epilepsy?

2. Are there appropriate responses to an epileptic seizure?

3. Are there strategies for working more effectively with

parents whose children have been diagnosed with epilepsy?

4. Are there strategies for working more effectively with the

school system in regard for advocating students withepilepsy?

5. Are children with epilepsy placed in special education

classes more frequently than regular education students?

6. Are there strategies for parents to work more effectively

with their child pertaining to life skills?




FOR WORKING WITH STUDENTS

DIAGNOSED WITH EPILEPSY

METHODOLOGY The researcher did an extensive review of

the literature on the topic of working with

students diagnosed with epilepsy. Based

on the review of the literature, a handbook

was developed to help those personsworking with students that have been

diagnosed with epilepsy. This project

utilize primarily historical and descriptive

research methods.





WITH EPILEPSY

Findings for RQ1:

Are there basic need s of chil dren w ith

e pil e psy?

Safety Needs

Medication NeedsEnvironment Needs

Emotional Needs

Diet Needs ( Ketogenic Diet )

Knowing rights and laws in place.





WITH EPILEPSY

Findings for RQ2 :

Are there a ppr opr i at e responses to an

e pil e ptic seizu re?

Stay calm and track time.Do not restrain person.

Avoid hazards.Protect there head.Turn person on one side, position mouth toground.Talk to the person, many times they canhear you.Call 911 if last longer than 5 minutes.





WITH EPILEPSY Finding for RQ3:

Are there st rat eg i es for w ork i ng

more eff ectiv ely w ith parents

w hose chil dren hav e been

d i agnosed w ith e pil e psy?

Understanding of the modification that is needed for that child.

Don¶t limit your knowledge.

Ask parents for all information that has been provided to them

about there child.

Updating information / status on the children with weekly

updates.

Clear communication with availability to learn.

Always take reassessment of treatment plan.





WITH EPILEPSY Findings for RQ4:

Are there st rat eg i es for w ork i ng

more eff ectiv ely w ith the school

syst em i n regard s for ad voc ati ng

stu dents w ith e pil e psy?

Learn the policy /practices for that school

system.

Secondary affects missing school.

Have meeting to enrich knowledge with

school system .

Know your school board.

Find local support groups that will help you

advocate to school.





WITH EPILEPSY

Findings for RQ5:

Are chil dren w ith e pil e psy pl ac ed i n

speci al ed uc ation cl asses more

f req u ently than reg ul ar ed uc ation

stu dents?

Educational Treatment : More than 50% of epilepsystudents day is spent in a separate class with a

special education teacher receiving instruction .

(Study by: Educational Assessment in Pediatric

Epilepsy. )

Section 504 Legal Issue





WITH EPILEPSY

Findings for RQ6:

Are there st rat eg i es for parents to more

eff ectiv ely w ork w ith thei r chil d

per t ai ni ng to lif e sk ills?

Motivation and encouragement to know they are not

along.

Positive parenting skills for stress reduction.

Life skills groups.

Control your reaction.

Get more involved in the day to day task.



SOME EFFECTIVE STRATEGIES FOR

WORKING WITH STUDENTS

DIAGNOSED WITH EPILEPSY



First Aid for Seizures

Stay calm and track time

Do not restrain person, but help themavoid hazards Protect head, remove glasses, loosen tight neckwear

Move anything hard or sharp out of the way Turn person on one side, position mouth to ground

Check for epilepsy or seizure disorder ID

Understand that verbal instructions maynot be obeyed

Stay until person is fully aware and helpreorient them

Call ambulance if seizure lasts more than5 minutes or if it is unknown whether theperson has had prior seizures



Potential Dangerous Responses

to a SeizureDO NOT

Put anything in the person¶s mouth

Try to hold down or restrain the person

Attempt to give oral anti-seizuremedication

Keep the person on their

back face up throughout

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When to Call 911 or Emergency

Medical Services

A convulsive seizure occurs in a personnot known to have seizures or lasts morethan 5 minutes

A complex partial seizure lasts more than

5 minutes BEYOND its usual duration for the individual

Another seizure begins before the personregains consciousness

Also call if the person: Is injured or pregnant

Has diabetes/other medical condition

Recovers slowly

Does not resume normal breathing



The Main

Treatment Goals in Epilepsy

Help the person with epilepsy to lead a full

and productive life.

Eliminate seizures without producing side

effects.

Work with the body and brain daily to keep

the memorization part of the brain focused.



Types of Treatment

Medication

Surgery

Non-pharmacologic treatment Ketogenic diet

Vagus nerve stimulation

Lifestyle modifications



Tolerating Medications

Most Common Side

Eff ects

Rash

Clumsiness

Drowsiness

Irritability

Nausea

Side effects may berelated to dose

Care must be taken in

discontinuing drug due to

risk of seizure recurrence

War ning Signs of Possible

Serious Side Eff ects

Prolonged fever

Rash, nausea/vomiting

Severe sore throat Mouth ulcers

Easy bruising

Pinpoint bleeding

Weakness

Fatigue

Swollen glands

Lack of appetite

Abdominal pain



Surgery

Factors inf luencing decision

Likelihood seizures are due to epilepsy

Likelihood surgery will help

Ability to identify focus of seizures Other treatments attempted

Benefits vs. risks



Ketogenic Diet

Based on finding that starvation -- which

burns fat for energy -- has an antiepileptic

effect

Used primarily to treat severe childhoodepilepsy, has been effective in some

adults & adolescents

High fat, low carbohydrate

and protein intake

Usually started in hospital

Requires strong family commitment



Effect of Epilepsy on Students

³«I just need to remember that things

happen for a reason, and that we will cope

with whatever comes our way. It is okay

not to like it. Seizures aren¶t fun and can

be very scary.´

³Epilepsy doesn¶t have to rule our lives --

as long as we have people who will listen

to us, believe us, and give us honestanswers.´



Recommendations:

Find a local support group.

Keep an on going journal of every event.

Be as informed as possible. It helps with

health care professionals. Stay positive with the person.

Make sure medication is not missed.

Work closely with the care giver.

Make sure the student safety tips arefollowed.

Help with proper diet and sleep.

Let the student know you are not along in

this issue.



Recommendations:

Making work /study modifications.

Help with social and team building skills.

Understanding that things change.

Control your reaction. Know your rights.

Understanding 504 legal issue.

Make time line for reassessments of

treatment plan.



National and Community Resources

The Epilepsy Foundation

Local affiliates

Website: www.epilepsyfoundation.org

Medic Alert Foundation

Social Security Administration

Accreditation Council on Services for People with

Disabilities

US Dept of Education

State Offices

Vocational Rehabilitation Protection and Advocacy

Division of Developmental Disabilities




Epilepsy Foundation

The Epilepsy Foundation works to ensure that

people with seizures are able to participate in all

life experiences; to improve how people with

epilepsy are perceived, accepted, and valued insociety; and to promote research for a cure. Find a

local chapter near you.

4351 Garden City Drive

Landover, MD 20785

1-800-EFA-1000

http://www.epilepsyfoundation.org

Understanding Seizures and Epilepsy

Closed Captioned 1-888-886-Epilepsy




Canine Assistants Program

Canine Assistants is a non-profit

organization that provides service dogs for

children and adults with physical

disabilities or other special needs,

including epilepsy.

http://www.canineassistants.org/




Epilepsy Foundation

www.epilepsyfoundation.org

The Epilepsy Project www.epilepsy.com

Citizens United for Research in Epilepsywww.cureepilepsy.org

American Academy of Neurology

www.aan.com

Child Neurology Society

www.childneurologysociety.org

American Epilepsy Society

www.aesnet.org

Centers for Disease Control and

Prevention www.cdc.gov




Educational Assessment in Pediatric

Epilepsy.

http://www.slideshare.net/rhepadmin/epile

psy-assessment




National Institutes of Health www.nih.gov

NINDS - National Institute of Neurological

Disorders and Stroke

http://www.ninds.hih.gov Epilepsia http://www.epilepsia.com

Living Well With Epilepsy II - A Report of

the 2000 National Conference on Public

Health and Epilepsy

http://cdc.gov/nccdphp/epilepsy/index.htm

ClinicalTrials.gov www.clinicaltrials.gov

Antiepileptic Drug Pregnancy Registry

www.aedpregnancyregistry.org



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Thank You,

Myeshi Briley

Myeshi Briley and Dr. William Allan Kritsonis

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