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Learning Objectives

We will be covering:

What epilepsy is

Who gets epilepsy

Some causes of epilepsy

How epilepsy is diagnosed

How epilepsy is treated

Risks of epilepsy

What you need to do to manage different types of seizures

Recognise when a seizure is a emergency situation

When to call for an ambulance

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What is epilepsy?

Epilepsy is a neurological condition. This means it is a condition that affects the brain and/or nerves

If someone is diagnosed with epilepsy, it means that they have had at least one unprovoked epileptic seizure, and they have a high risk of having more in the future.

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What is an epileptic seizure?

Electrical activity is happening in our brain all the time.

A seizure happens when there is a sudden burst of intense electrical activity in the brain. This is often referred to as epileptic activity.

The epileptic activity causes a temporary disruption to the way the brain normally works, so the brain’s messages become mixed up.

The result is an epileptic seizure

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What happens during an epileptic seizure?

How the seizure affects a person depends on the area(s) of the brain affected by the epileptic activity.

Some people lose consciousness during a seizure but others do not
Some people experience strange sensations
Some people have parts of their body twitch or jerk
Some people fall to the floor and convulse (shake)

Seizures usually last between a few seconds a several minutes.

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What are the different types of seizures?

Tonic-clonic

2 Phases, Tonic and Clonic. During the tonic phase the person loses consciousness, their body goes stiff and they fall to the floor. During the clonic phase, their limbs jerk, and they may lose control of their bladder or bowels.

Tonic

Muscles stiffen and if they are not lying down, they might fall down. They may turn blue and stop breathing, this is because their chest muscles stiffen.

Atonic

Also called drop attacked. The person loses all muscle tone and drops heavily to the floor. Often very brief. However, falls can result in injury, often to face, nose or head.

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What are the different types of seizures?

Myoclonic

The persons muscles jerk. Usually, just one or both arms. Sometimes the persons head or whole body can jerk. The jerking can be very mild, like a twitch, or it can be very forceful.

Absence

The person is unconscious for a few seconds. They will stop doing whatever they were doing before it started, but will not fall. They don’t know what is happening and cant be brought out of it.

Focal

Focal seizures can cause lots of different symptoms and each person will have their own individual experience and symptoms. Seizures usually occur in focal part of the brain. This area of the brain controls emotion and memory function.

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Who has epilepsy?

In the UK, there are around 600,000 people with epilepsy – That’s around 1 in every 103.

There are around 51,500 children aged 16 year and under with Epilepsy - That’s around 1 in every 240.

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What causes epilepsy

Possible causes include:

Brain damage
A head injury
A stroke
An infection such as meningitis

However, for many people, doctors do not know the cause of the epilepsy.

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How is epilepsy diagnosed?

Anyone can be diagnosed with epilepsy at any age.

An epilepsy specialist will make a diagnosis based mainly on their symptoms. To help the specialist make a diagnosis, eyewitness accounts, records or videos of what happens when someone has a suspected seizure can be very useful.

The epilepsy specialist may do some tests at hospital, but none of these tests prove whether someone has epilepsy or not, but may give useful information on the type and/or cause of seizure

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How is epilepsy treated?

Some people have their seizures stopped by medicine or other treatment.

Epilepsy is usually treated with medicines. These do not cure epilepsy, but try to stop seizures from happening.

For some people, their seizures cannot be controlled, despite taking medicine or using other treatments.

About 7 in 10 children with epilepsy can be successfully treated with medication.

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Risks of epilepsy

Most of the time, children and young people recover perfectly well after a seizure.

However, seizures do put people at risk of accidents. Many of these risks can be prevented or reduced. For example, by making sure that any ponds in the school grounds are securely fenced off.

A small number of people are at risk of dying because of their epilepsy. Death may be caused by seizure itself or an accident caused by the seizure.

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SUDEP

In some cases, there’s no clear reason why a person with epilepsy has died. This is called sudden unexpected death in epilepsy (SUDEP)

It is estimated to happen to 1 in every 1000 people with epilepsy.

There is no way of predicting who will be affected by SUDEP, but some people are at a higher risk than others. The more seizures a person has, the higher the risk.

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Managing seizures

If you work in a school environment, you might be with or near a pupil when they have a seizure. You will need to know how to help them, both during and after the seizure.

General Guidance First aid for most seizures is simple. The main thing is to keep calm and keep the person safe from injury.

You also need to know when an ambulance needs to be called.

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General Guidance

First aid for most seizures is simple. The main thing is to keep calm and keep the person safe from injury.

More detailed information about managing an individuals seizures will be in their healthcare plan.

You also need to know when an ambulance needs to be called.

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Emergency Situations

Call an ambulance if:

You know it is a person’s first seizure, or
The seizure for more than five minutes, or
One seizure follows another, without the person gaining consciousness in between, or
The person is injured during the seizure, or
You believe the person needs urgent medical attention

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Emergency Situations: Longer then usual

Sometimes a seizure can develop into status epilepticus. A person has status epilepticus when:

A single seizure lasts for 30 minutes or more
They have repeated seizures over a period of 30 minutes without recovering fully between
Any type of seizure can develop into status epilepticus
If a pupil has been prescribed emergency medication, this should be administered by a named and trained person.

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Emergency Situations: Emergency Medication

Some pupils with epilepsy have a history of long lasting or repeated seizures. They have prescribed emergency medication.

This medication can be given by a trained person, if a seizure or repeated seizure lasts longer then usual for them. It can stop a seizure from progressing to status epilepticus.

Emergency medication is usually given after a seizure has lasted more than 5 minutes or a set amount of seizures in a set time.

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Emergency Situations: Emergency Medication (Cont)

If a pupil’s seizures continue after they have been given emergency medicine, an ambulance needs to be called.

The healthcare plan will have detailed instructions from the health professional on how and when to give the rescue medication.

The headteacher has responsibility for making sure that there are enough named, trained members of staff available to administer rescue medication, if it is needed.

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Any questions?

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Resources

Adapted from Epilepsy Action – Epilepsy Awareness for Schools (https://learn.epilepsy.org.uk/courses/epilepsy-for-school-staff/) and Manging seizures. (https://learn.epilepsy.org.uk/lessons/s03-managing-seizures/)

Epilepsy Action (https://www.epilepsy.org.uk/) has a range of online courses and learning resources to help you understand more about epilepsy. This includes videos, case studies and assessments to test your knowledge.