Health and Social CareEpilepsy – Seizures

Aims and ObjectivesThis session will focus on what

epileptic seizures It will look types of seizures It will also cover what can happen

during a seizureYou will demonstrate your

understanding in an end of session assessment

IntroductionEpilepsy is a common neurological

condition that affects about 1 person in every 200

Epilepsy is a tendency to have recurrent seizures that originate in the brain

Effects of SeizuresA seizure can cause changes in a

person's:Body movementsAwarenessEmotionsSenses (e.g. taste, smell, vision, or

hearing)

Seizures and EpilepsyA person can have more than one

type of seizureTypes of seizure can change Over time With drug treatment

Fear and PrejudiceEpilepsy is sometimes feared and

a great deal of misunderstanding and prejudice surrounds the condition

If a person's seizures are controlled then epilepsy should not stop them from leading a full life

Types of EpilepsyThere are many different causesAround 30 different epileptic

syndromesOver 38 different seizure types Epilepsy can go into remission as

suddenly as it started Or it can stay with a person

forever

Categories of SeizureThere are 3 broad categories:Primary generalised seizuresPartial seizuresSecondary generalised seizures

Types of EpilepsySeizure types:Simple partial seizureComplex partial seizureAbsence seizureTonic, atonic and myoclonic

seizuresTonic clonic (major convulsive)

seizure

Status EpilepticusStatus epilepticus is a condition in

which seizures persist for 30 minutes or more

It can occur with all types of seizure, but with tonic clonic seizures it is a medical emergency requiring immediate medical treatment

Effects of SeizuresSeizures cause temporary

disturbances of brain functions (e.g. motor control, responsiveness and recall) which typically last from seconds to a few minutes

Seizures may be followed by a period of confusion or sensory impairment that can persist for several hours

Primary Generalised Seizures

The whole brain is affected by the disruption to its usual activity and consciousness is lost

Seizures in this category include:AbsencesTonic-clonicTonic and atonic seizures, or drop

attacksMyoclonic

Primary Generalised Seizures

AbsencesThe person looks blank for a few

seconds and may not respond when spoken to or realise they have had a seizure

This type of seizure can happen repeatedly and can be mistaken for daydreaming

Primary Generalised Seizures

Tonic-clonicThe person stiffens, loses

consciousness, convulses and may fall

Incontinence may occur

Primary Generalised Seizures

Tonic and atonic seizures, or drop attacks

The person may stiffen and fall heavily or lose muscle tone and crumple to the ground

Primary Generalised Seizures

MyoclonicRhythmic, shock-like muscle jerks

that can affect the whole body and can be strong enough to throw the person to the ground

Partial SeizuresOnly part of the brain is affected

and consciousness may be altered but not lost

Seizures in this category include: Simple partial seizureComplex partial seizures

Partial SeizuresSimple partial seizureThe person may experience

unusual sensations and/or movement in one part of the body (e.g. tingling or twitching)

Partial SeizuresComplex partial seizuresAwareness is disturbed or lost and

the person may experience unusual feelings

They may be unaware of their surroundings and unable to respond when spoken to and their behaviour may appear strange

Secondary Generalised Seizures

The disruption starts in one part of the brain and spreads to the whole brain

Understanding Seizures If a persons’ seizures are active

(70% of people are seizure free) you need to understand:

Their type of seizure Their seizure frequency Their seizure pattern

Understanding SeizuresSeizure pattern (examples)Only whilst asleep?Only on wakening?Only on going to sleep?At a particular time of day?And so on . . .

Understanding SeizuresSeizure pattern (continued) Is there a specific “trigger” for

their seizures (e.g. tiredness) Do they get a warning (aura) that

their seizure is about to happen?

Seizures and RisksThere will be substantial risks if

the person is having “unpredictable” (no warning, no pattern, no “trigger”) seizures

Special Note It is possible to have more than

one type of seizure

SleepSome people with epilepsy find

that certain situations can have an effect on their seizures:

For example being tired or having a disturbed sleep pattern

Photosensitive EpilepsySome people have photosensitive

epilepsyThis means their seizures are

triggered by flashing lights or by certain geometric shapes and patterns

Special warnings:TVStrip lighting

Photosensitive EpilepsyThis is relatively rare and affects

around 3-5% of people with epilepsy

People who have photosensitive epilepsy are most likely to react to lights which flicker between five and thirty times per second (5-30 Hertz)

End of Session Assessment

Testing your knowledge. . . . . . .

Before the handout

ReferencesRichards, J. (1999) – Complete A –

Z Health & Social Care Handbook. London. Hodder & Stoughton.

Waugh, A., Grant, A. (2002) – Anatomy and Physiology in Health and Illness. Edinburgh. Churchill Livingstone.

Epilepsy Research Foundation (www.erf.org.uk)