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EPILEPSY. Brenda Willis Regional Manager South West Region. Introduction. Epilepsy Society is the largest epilepsy charity in the UK Founded in 1892 Today: Research, Out Patients Clinics, Assessment Centre, Care Services, Training, Information Services and Awareness Raising. - PowerPoint PPT Presentation
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EPILEPSY
Brenda Willis
Regional ManagerSouth West Region
Introduction
• Epilepsy Society is the largest epilepsy charity in the UK
• Founded in 1892
• Today: Research, Out Patients Clinics, Assessment Centre, Care Services, Training, Information Services and Awareness Raising
What is Epilepsy?
• A neurological condition where there is a tendency for people to have repeated seizures that start in the brain
• Symptom of underlying cause
• There are more that 40 types of epileptic seizures
• Up to 70% of people with epilepsy can have their epilepsy controlled by prescribed medication
Epilepsy in the UK – the facts
• 1 in 20 people will have a single seizure during their lifetime
• 1 in 50 people will develop epilepsy• Highest incidence in children and elderly• 75 people a day are newly diagnosed as having
epilepsy (that’s 27,400 per year)• More than 1 in 100 people have epilepsy at any one
time – more than half a million people….
Figures from Joint Epilepsy Council
What causes epilepsy?
• Structural damagetumour, scarring, lesions, stroke, drug or
alcohol abuse, birth trauma, brain parasites• Infection
Meniningitis, Encephalitis• Inherited causes
Seizure threshold, tuberous sclerosis, neurofibromatosis
• Unknown
What are epileptic seizures?
Brief events caused by disturbances of brain
activity that cause a change in the persons– Awareness– Behaviour– Emotion– Feelings– Movement
Different areas of the brain
They communicate with each other through small electrical impulses
PROBLEM SOLVING PERCEPTION
EYES
MEMORY
EARS
SENSATION
LEGS
ARMS
What is epilepsy? Usual activity
A B Epilepsy
A B
Seizures happen when…
• …a message is not switched off after it has been passed on
• disturbed activity causes a change in the way the brain is working = a seizure
Are all seizures the same..?
– Focal Seizures
• Affect part of the brain
• Consciousness
intact/impaired
– Generalised Seizures
• Affect all of the brain
• Consciousness is lost
Day One Training 10
Focal seizures
• Simple Focal (also known as simple partial)Déjà vu, pins & needles, fear, twitching, warnings, auras
• Complex Focal (also known as complex partial)Automatisms- lip smacking, chewing, screaming, posturing
Secondarily generalised• When seizure activity spreads to affect all of the brain
Generalised seizures
• Tonic Clonic - stiffening & jerking
• Absence - brief lapse in awareness
• Myoclonic - muscle jerk
• Tonic - stiffening of muscles
• Atonic - loss of muscle tone
Video Clips
007 Graham simple partial seizure.wmv
011 Terry complex partial seizure.wmv
014 Lloyd complex partial seizure.wmv
018 Priya - secondarily generalised seizure.wmv
032 Calum - atypical absences.wmv
034 Calum - myoclonic seizure.wmv
How to manage non-convulsive seizure
• If the person becomes confused, wanders around or behaves oddly– Stay calm– Do not restrain but gently guide away from danger– Reassure, stay with them until fully recovered
• If the person falls and recovers, with or without confusion– Reassure, check for injury and stay with them until fully
recovered
How to manage a convulsive seizure
During the seizure– Stay calm– Note the time– Stop others from crowding around– Put something soft under the person’s head– Don’t move them (unless in danger)– Don’t restrain the person– Don’t put anything in their mouth– Minimise embarrassment
After the seizure stops
– Roll them into the recovery position and check their breathing
– Stay with them, giving reassurance, until they have recovered fully
• A - Move the patient's nearest arm, as though they are stopping
traffic;
• B - Lift the patient's furthest knee, and bring their furthest hand to the
near side of their face;
• C - Using the patient's knee as a lever, pull them onto your knees
• D - Adjust the patient's position, as shown
The Recovery Position
This information is provided by St John’s Ambulance on their website www.halifax.sja.org.uk
When should you call an ambulance -
• If the person– stops breathing– was injured during the seizure– does not recover well– asks you to call an ambulance
• “Status Epilepticus”– When a seizure does not stop by itself or– When one seizure follows another without time to
recover in between
With tonic clonic seizures “status” is a medical emergency
Patient journey
• Funny turns• Collapses
• Go to GP or A&E• Referred to Neurologist
Seizures that are not epilepsy
• Heart conditions• Fainting (syncope)• Low blood sugar (hypoglycaemia)• Febrile convulsions (high temperature) • Psychological problems (dissociative)• Panic attacks
Investigations for Diagnosis• History & Witness statement• Electroencephalogram (EEG) • Magnetic Resonance Imaging (MRI)
• Blood test• Electrocardiogram (ECG) • Ambulatory EEG • Video Telemetry• Computerised Tomography (CT or CAT)
Day One Training 21
Epilepsy Awareness
Patient journey (2)• Eye witness accounts
of seizures
• Tests trying to ruling things out ECG
• EEG, MRI
• Diagnosis of epilepsy
Seizure control or limitation
Anti Epileptic Drugs
Vagal Nerve Stimulation
Surgery
Triggers for seizures
• Forgotten medication• Incorrect medication• “Recreational” drugs• Alcohol • Tiredness • Sleep deprivation• Stress• Unusual excitement• Boredom
• Illness • High temperature• Hormonal changes• Flashing lights• Patterns • Sounds
• OR OCCUR WITHOUT TRIGGERS
Epilepsy Awareness
Patient journey (3)
• Take these tablets • Come back in a month
• Take these tablets• Come back in a month
Some side effects of AEDs
• Nausea• Dizziness, headaches• Double vision• Skin rash• Weight gain• Change in mood• Change in behaviour
(particularly children)
Exhaustion• Tiredness• Drowsiness• Below par• The smallest thing can
be a huge effort• “Like wading through
treacle”
Memory• Thought processes slowed
down• Can’t remember names• Can be embarrassing• Learning memory
techniques• Retraining brain
Social issues - “A sense of loss”
• Self confidence/self esteem• Independence• Job & career prospects• Income• Social/leisure activities• Relationships• Driving Licence• Ability to care for children
Social issues - Other factors
• Unpredictability of seizures
• Hidden nature of the condition
• Social stigma (real or perceived)
However…………………..
• Laura Sandys (MP)• Edith Bowman• Rik Mayall• Dai Green• Neil Young• Max Clifford• Dean Ryan• Julius Caesar• Vincent Van Gogh
Epilepsy ResearchTripartite: Epilepsy Society, UCL, and UCLH• Attracts funding and facilitates integration of basic
science with clinical application• Developing new research programmes in both
depth and breadth• Major strengths in applications of genetics and
imaging, pharmacology and epidemiology • Application of low-power electronic device and
microsensors to epilepsy is emerging growth area
Further information on activities; awards & appointments; research grants; and research publications on website: www.epilepsysociety.org.uk.
Want to know more ?
Please contact us :
Helpline: Mon – Fri (9am-4pm)01494 601400
Website:www.epilepsysociety.org.uk
Regional Services: 01494 601391
join our digital community:
www.epilepsysociety.org.uk/digital