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Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved...

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Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student with epilepsy.
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Page 1: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Fact:The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student with epilepsy.

Page 2: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Today we will talk about:Today we will talk about:Seizure types.Epilepsy syndromes.Treatments.Common medications.Medication Side Effects.Epilepsy and the IEP.AccommodationsDiastat in school.Seizure plans.

Page 3: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Early Detection – Why?Early Detection – Why?

Page 4: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.
Page 5: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.
Page 6: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Generalized Tonic-ClonicGeneralized Tonic-Clonic

Also known as Grand-Mal.Begin w/stiffening of the limbs (tonic

phase).Followed by jerking of limbs and face

(clonic phase).In some cases will require Diastat.

Page 7: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Myoclonic SeizuresMyoclonic SeizuresRapid brief jerking movements.Typically occur on both sides of

the body.Often confused as clumsiness.Typically do not require first aid.

Page 8: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Atonic SeizuresAtonic Seizures

Also known as drop seizures.Causes abrupt loss of muscle tone.Often causes head and face injuries.Wearing of helmet recommended.Tough seizures to control.First aid needed if injury is caused.

Page 9: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Absence SeizuresAbsence SeizuresAlso know as petit-mal seizures or

“staring spells”Lapses of awareness the end abruptly.No warning and no after effect.More common in children than adults.Children can have 50-100+ per day.Affects school performance.

Page 10: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Simple Partial SeizuresSimple Partial SeizuresNo loss of consciousness.Involves one side of the brain.Sudden jerk.Sensory phenomena.No first aid required, should be logged

and timed.

Page 11: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Complex Partial SeizureComplex Partial SeizureInvolves one side of the brain.May have aura.Repeated movements i.e. lip smacking,

picking at clothes, fumbling.Unaware of environment/surroundings.May wander.Typically no first aid required, should

be logged and timed.

Page 12: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Gelastic EpilepsyGelastic Epilepsy“Gelastic” is greek for laughter.Pediatric – seizures can begin at any age,

often between 2-3 years of age.More often boys than girls.Laughter described as “empty” or “hollow”,

not pleasant.Can be followed by complex partial seizure.Often caused by small tumor in

hypothalamus.

Page 13: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Infantile SpasmsInfantile SpasmsTypically starts at 4-8 months of age.Most severe type of pediatric epilepsy.Seizures come in clusters/bending

forward, arms flare out. Prognosis poor.Stops by age 5, often goes to another

seizure type.Treatment – ACTH steroid injections.

Page 14: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Lennox-Gastaut SyndromeLennox-Gastaut SyndromeSevere form of childhood epilepsy.Multiple seizure types, i.e. atonic,

myoclonic, tonic, atypical absence.Most children have impaired

intellect.Can be caused from malformation of

brain, TBI, metabolic disorder.30-35% cause unknown.

Page 15: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Dravet SyndromeDravet SyndromeAlso called SMEI (severe

myoclonic epilpesy in infancy).Begins in first year of life with

frequent febrile seizures.Often causes status epilepticus.Hard to treat.Outcome poor.Caused by genetic defect.

Page 16: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Status EpilepticusStatus EpilepticusLife threatening condition where the

brain is in a constant state of seizures.Typically defined as constant state of

seizures for 30 minutes +.Any type of seizure disorder can cause

status epilepticus.Immediate medical attention needed!

Page 17: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Vagal Nerve Stimulator Vagal Nerve Stimulator (VNS)(VNS)Used in addition to AED’s.80% of implanted patients

experience fewer seizures.75% of patients are able to

reduce their AED’s.Improved seizure control w/o the

medication side effects.

Page 18: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Ketogenic DietKetogenic DietHigh fat/low carb diet.Helps control seizures in up to 2/3

of children with refractory epilepsy.Medical Treatment – must be

started under close medical supervision.

Calories restricted to 75% of daily requirement, 90% from fat.

Works well if followed properly.

Page 19: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Common Seizure MedsCommon Seizure Meds Banzel Carbatrol® Clonazepam Depakene® Depakote® Depakote ER® Diastat Dilantin® Felbatol® Felbamate Frisium Gabitril® Keppra® Keppra XR™ Klonopin Lamictal®

Lyrica Mysoline® Neurontin® Phenobarbital Phenytek® Primidone Sabril Tegretol® Tegretol XR® Tiagabine Topamax® Trileptal® Valproic Acid Vimpat Zarontin® Zonegran®

Page 20: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Possible Side EffectsPossible Side EffectsLethargyHair LossProcessing/Word finding issues.Dental/OralAnxious/irritableRashIQ Decline

Page 21: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.
Page 22: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Common Side EffectsCommon Side Effects

LethargyHair LossProcessing/Word finding issues.Dental/OralAnxious/irritableIQ DeclineRash

Page 23: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.
Page 24: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.
Page 25: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Switch GearsSwitch Gears

Page 26: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

OHI DefinitionOHI DefinitionOther health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—

(i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever,sickle cell anemia, and Tourette syndrome; and

(ii) Adversely affects a child's educational performance.

Source: ISBE Regulations & IDEA

Page 27: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Why does a student with Why does a student with epilepsy qualify for an IEP?epilepsy qualify for an IEP?

HR 1350 Sec. 602(3) states as follows:(i) With mental retardation, hearing impairments

speech or language impairments, visual impairmnts, serious emotional distrubance, orthopedic impairments, autism, traumatic brain injury, other health impairment, or specific learning disabilities and (ii) who, by reason thereof needs special education and related services.

Source: Federal IDEA Law

Page 28: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Suggested Suggested AccommodationsAccommodationsExtended Time for Tests/QuizzesReduced Homework AssignmentsReduced Spelling WordsTests/Quizzes taken in a quiet areaTests/Quizzes read out loudUse of a calculatorUse of a number lineGraphic organizerOutline of classroom NotesExtra set of books at home

Page 29: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

Seizure Medication Seizure Medication AdministrationAdministration

No nurse on site (this cannot affect placement)

ISBE Medication Regulations

Page 30: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

DiastatDiastatA program for administration of medication to students in schools must be developed and managed by a certified school nurse or registered nurse in accordance with the Recommended Guidelines for Medication Administration in Schools. Each school district must determine who (e.g. superintendent, principal) is responsible for administering medication in the absence of a certified school nurse or registered nurse. Pursuant to section 105 ILCS 5/10-22.21b of the School Code, teachers and other non-administrative employees cannot be required to administer medication, although they may volunteer to do so.

Source: ISBE Regulations - Medication

Page 31: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

DiastatDiastatThe Illinois Department of Professional Regulation (IDPR) issued a legal opinion which allows a school employee to stand in the place of a parent or guardian in administration of medication or supervision of self-medication in the school setting. School employees who do not hold a valid IDPR license must receive training in the correct procedure to be used to administer medication and/or provide a specific treatment. This does not prohibit any school employee from administering emergency assistance to a student.A certified school nurse or registered nurse must manage this medication administration program following the Recommended Guidelines for Medication Administration in Schools developed by the Illinois Department Human Services (IDHS) and the Illinois State Board of Education (ISBE), September 2000. A designated administer will be responsible for medication administration or supervision of self-medication when a nurse is not available. Teachers or other employees cannot be required to administer medication or supervise self-medication although they may volunteer to do so.

Source: ISBE/IDHS

Page 32: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

All seizures require a plan!All seizures require a plan!

Page 33: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.
Page 34: Fact: The school nurse plays a significant role in the life of a student with epilepsy. An involved nurse can positively impact the future of a student.

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