Myshe's final ppt.

Epilepsy & SeizuresA HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING

WITH STUDENTS DIAGNOSED WITH EPILEPSY

Myeshi BrileyGraduate Student - Final Project

Master Degree in Human Services Concentration in Organizational Management 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 “seizure 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 develop seizures by the age of 25; however, anyone can get epilepsy at any time

• Now there are as many people with epilepsy who are 60 or older as children aged 10 or younger

What Causes Epilepsy?

• In about 70% of people with epilepsy, the cause is not known

• In the remaining 30%, the most common causes 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 “fire” too quickly causing an “electrical 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 “fainting 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.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED 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 in 2007. 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 life skills. 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.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH EPILEPSY

• Based on the review of the literature there appears to be a definite need for a project dealing with effective strategies for working with students that have been diagnosed with epilepsy.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH EPILEPSY

• WHY IS THIS TOPIC IMPORTANT TO BE STUDIED?

• This project will contribute to the body of knowledge for helping those individuals responsible for working with students who have been diagnosed with epilepsy.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED 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.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH 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 students that have been diagnosed with epilepsy.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED 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 with epilepsy?

• 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?

A HANDBOOK OF EFFECTIVE STRATEGIES 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 persons working with students that have been diagnosed with epilepsy. This project utilize primarily historical and descriptive research methods.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH EPILEPSY

• Findings for RQ1:

• Are there basic needs of children with epilepsy?

Safety NeedsMedication Needs Environment NeedsEmotional NeedsDiet Needs ( Ketogenic Diet )Knowing rights and laws in place.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH EPILEPSY

Findings for RQ2 :

• Are there appropriate responses to an epileptic seizure?

Stay calm and track time.Do not restrain person. Avoid hazards.Protect there head.Turn person on one side, position mouth to ground.Talk to the person, many times they can hear you.Call 911 if last longer than 5 minutes.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH EPILEPSY • Finding for RQ3:

• Are there strategies for working more effectively with parents whose children have been diagnosed with epilepsy?

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.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH EPILEPSY • Findings for RQ4:

• Are there strategies for working more effectively with the school system in regards for advocating students with epilepsy?

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.

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH EPILEPSY

• Findings for RQ5:

• Are children with epilepsy placed in special education classes more frequently than regular education students?

Educational Treatment : More than 50% of epilepsy students 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

A HANDBOOK OF EFFECTIVE STRATEGIES FOR WORKING WITH STUDENTS DIAGNOSED WITH EPILEPSY

• Findings for RQ6:

• Are there strategies for parents to more effectively work with their child pertaining to life skills?

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 them avoid

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 may not

be obeyed• Stay until person is fully aware and help

reorient them• Call ambulance if seizure lasts more than 5

minutes or if it is unknown whether the person has had prior seizures

Potential Dangerous Responses to a Seizure

DO NOT• Put anything in the person’s mouth• Try to hold down or restrain the person• Attempt to give oral anti-seizure

medication• Keep the person on their

back face up throughoutconvulsion

When to Call 911 or Emergency Medical Services

• A convulsive seizure occurs in a person not known to have seizures or lasts more than 5 minutes

• A complex partial seizure lasts more than 5 minutes BEYOND its usual duration for the individual

• Another seizure begins before the person regains consciousness

• Also call if the person:• Is injured or pregnant• Has diabetes/other medical condition • Recovers slowly• Does not resume normal breathing

The MainTreatment 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 Effects Rash Clumsiness Drowsiness Irritability Nausea

Side effects may be related to dose

Care must be taken in discontinuing drug due to risk of seizure recurrence

Warning Signs of Possible

Serious Side Effects 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 influencing 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 childhood epilepsy, 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

“…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.”

• “Epilepsy doesn’t have to rule our lives -- as long as we have people who will listen to us, believe us, and give us honest answers.”

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 are followed.

• 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

National and Community Resources

• Epilepsy FoundationThe 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 in society; 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

National and Community Resources

• Canine Assistants ProgramCanine 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/

National and Community Resources

• Epilepsy Foundation www.epilepsyfoundation.org

• The Epilepsy Project www.epilepsy.com

• Citizens United for Research in Epilepsy www.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

National and Community Resources

• Educational Assessment in Pediatric Epilepsy. http://www.slideshare.net/rhepadmin/epilepsy-assessment

National and Community Resources

• 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

RELATED REFERENCES AND SOURCES

• Austin JK, McBride AB, Davis HW. Parental attitude and adjustment to childhood epilepsy. Nurs Res. 1984 Mar–Apr;33(2):92–96. [PubMed]

• Austin JK, McDermott N. Parental attitude and coping behaviors in families of children with epilepsy. J Neurosci Nurs. 1988 Jun;20(3):174–179. [PubMed]

• Beran RG, Flanagan PL. Examination of the problems confronting those with epilepsy. Clin Exp Neurol. 1985;21:183–188. [PubMed]

•  

RELATED REFERENCES AND SOURCES

• Beran RG, Read T. A survey of doctors in Sydney, Australia: perspectives and practices regarding epilepsy and those affected by it. Epilepsia. 1983 Feb;24(1):79–104. [PubMed]

• Beran RG, Read T. Patient perspectives of epilepsy. Clin Exp Neurol. 1981;17:59–69. [PubMed]

• Chaplin JE, Yepez Lasso R, Shorvon SD, Floyd M. National general practice study of epilepsy: the social and psychological effects of a recent diagnosis of epilepsy. BMJ. 1992 May 30;304(6839):1416–1418. [PubMed]

RELATED REFERENCES AND SOURCES

• Critchley EM, Mitchell JD. Explanation and management of neurological disability. Br Med J (Clin Res Ed). 1987 May 9;294(6581):1203–1205. [PubMed

• Danesi MA. Patient perspectives on epilepsy in a developing country. Epilepsia. 1984 Apr;25(2):184–190. [PubMed]

• Elwes RD, Marshall J, Beattie A, Newman PK. Epilepsy and employment. A community based survey in an area of high unemployment. J Neurol Neurosurg Psychiatry. 1991 Mar;54(3):200–203. [PubMed]

RELATED REFERENCES AND SOURCES

• Gallhofer B. Epilepsy and its prejudice. Teachers' knowledge and opinions: are they a response to psychopathological phenomena? Psychopathology. 1984;17(4):187–212. [PubMed]

• Goodridge DM, Shorvon SD. Epileptic seizures in a population of 6000. II: Treatment and prognosis. Br Med J (Clin Res Ed). 1983 Sep 3;287(6393):645–647. [PubMed]

• GORDON N, RUSSELL S. The problem of unemployment among epileptics. J Ment Sci. 1958 Jan;104(434):103–114. [PubMed]

RELATED REFERENCES AND SOURCES

• Hopkins A, Scambler G. How doctors deal with epilepsy. Lancet. 1977 Jan 22;

• Jacoby A. Epilepsy and the quality of everyday life. Findings from a study of people with well-controlled epilepsy. Soc Sci Med. 1992 Mar;34(6):657–666. [PubMed]

• Jones AL. Medical audit of the care of patients with epilepsy in one group practice. J R Coll Gen Pract. 1980 Jul;30(216):396–400. [PubMed]

• Levin R, Banks S, Berg B. Psychosocial dimensions of epilepsy: a review of the literature. Epilepsia. 1988 Nov–Dec;29(6):805–816. [PubMed]

RELATED REFERENCES AND SOURCES

• McCluggage JR, Ramsey HC, Irwin WG, Dowds MF. Anticonvulsant therapy in a general practice population in Northern Ireland. J R Coll Gen Pract. 1984 Jan;34(258):24–31. [PubMed]

• POND DA, BIDWELL BH. A survey of epilepsy in fourteen general practices. II. Social and psychological aspects. Epilepsia. 1960 Apr;1:285–299. [PubMed

• Ryan R, Kempner K, Emlen AC. The stigma of epilepsy as a self-concept. Epilepsia. 1980 Aug;21(4):433–444. [PubMed]

RELATED REFERENCES AND SOURCES

• Thompson PJ, Oxley J. Socioeconomic accompaniments of severe epilepsy. Epilepsia. 1988;29 Suppl 1:S9–18. [PubMed]

• Turnbull DM, Howel D, Rawlins MD, Chadwick DW. Which drug for the adult epileptic patient: phenytoin or valproate? Br Med J (Clin Res Ed). 1985 Mar 16;290(6471):815–819. [PubMed]

• Wall M, Buchanan N, Baird-Lambert JA. The management of epilepsy: patients' perceptions and expectations. Med J Aust. 1987 May 4;146(9):473–476. [PubMed]

Thank You,Myeshi Briley