‘Few pathological disorders of human function elicit more negative emotional reactions than epilepsy. Throughout history, in almost all cultures, people afflicted with this disorder encountered severe discrimination, perhaps second only to that incurred by leprosy. Epileptic attacks were often viewed as possession by the devil, punishment for sins, evidence of severe psychosis, or a highly contagious disease. Unfortunately, these stigmata have not been completely eradicated by advances of modern biomedical science, and persons with epilepsy and their families still often find it necessary to conceal their affliction out of shame, or the logical desire to avoid the restrictions that society places on individuals who experience sudden losses of control without warning.’ (Engel 1997 p vii)
Epilepsy refers to recurrent seizures. A seizure is a disruption in normal brain functioning that can cause disturbance of consciousness and/or body movements. This disruption occurs due to the uncontrolled overactivity of brain cells, and is seen as a seizure that can last several seconds, minutes or occasionally hours. Once this abnormal activity ceases, so does the seizure. Seizures are also known as fits, turns or convulsions. About 2 percent of the general population are known to have epilepsy, approximately 400 000 Australians. Of these, over 60 percent have had their first seizure before the age of 12 and there are approximately 50 000 students with epilepsy in Australia. Not every person who has a seizure, or even more than one seizure, will be diagnosed with epilepsy. Seizures can be caused by, for example, a high fever in young children. In addition, a diagnosis of epilepsy will usually not be made by a doctor until the epilepsy is confirmed, because of the impact that such a diagnosis can have. Epilepsy can affect anyone at any age. The following famous people are known to have or had epilepsy:
Epilepsy planning and support guide for education and children’s services DECS 2007
In 40 percent of cases the cause of epilepsy is unidentified. Known causes include:
infectious diseases, especially of the brain. The area of the brain that is involved will determine the type of seizures a person will have. There can be a genetic pre-disposition to epilepsy although it is not commonly a major factor.
A person is not generally diagnosed with epilepsy in the absence of recurrent seizures. This will be decided by a doctor, based on medical assessments and information from people who have observed the seizure activity. On occasions, education and childcare workers will be asked to document their observations of a child’s or student’s behaviour to enable the treating doctor to make a medical assessment and potential diagnosis.
Related medical conditions and disabilities
Epilepsy is not an indicator of intellectual disability or any other limitation. Many people have epilepsy and no other associated health problems. With effective medication management and a healthy lifestyle, people with epilepsy lead active and fulfilling lives. Epilepsy can be associated with mild learning difficulties through to severe and multiple disabilities, with the most common being intellectual disability. There is an increased incidence of epilepsy with certain disabilities, including autism, cerebral palsy, Down syndrome and intellectual disability. The effects of epilepsy may impact neurologically in various ways. It can be direct as a result of damage to the brain during seizures or indirect through medication side effects. Each person will be affected differently and needs to be assessed individually by their treating health professional(s) to identify the impact on:
visual perception (which may affect motor
Epilepsy planning and support guide for education and children’s services DECS 2007
Educators play an important role in the lives of children with epilepsy. Many children need assistance from time to time with their learning, behaviour, health support and other well-being issues. Children with epilepsy are no different in this regard. To ensure a child with epilepsy has the same opportunities as other learners to develop to their full potential, it is important for educators to be aware of the different ways in which epilepsy can manifest and children’s individual epilepsy care and support plans. People with epilepsy may face challenges. Whether these challenges are major obstacles or small inconveniences depends on many factors. Some of these factors are related to the student’s epilepsy. While most people with epilepsy lead a normal, healthy life, difficulties that may affect the life of student with epilepsy include:
attention and concentration difficulties
learning difficulties. These can be influenced by the seizures, medications, missed childcare/schooling, attitudes and level of understanding of others, or their own social and psychological adjustment to having epilepsy.
Night-time seizures or poor sleep patterns caused by abnormal brain activity can
increase fatigue during the day. As a result the child can be less attentive and less available to learn.
Frequent ―invisible‖ seizure activity in the brain during the day can result in slower
processing, consolidation, and retrieval of information recently learned.
Children who have seizures, sometimes even a single seizure during the day, can
experience disruptions in their memory that cause them to forget what they have just learned. In some cases, they cannot remember much about what happened just before or for some time after the seizure.
Some anti-epileptic medications (for example, topiramate) can slow down
processing of information in some children, while other anti-epileptic medications can induce fatigue that decreases the child’s availability to learn.
Absence seizures are more common than other seizure types in children. They are also more common in children than adults, and are often not recognised as a seizure, or misunderstood. During an absence seizure, the child is briefly unconscious and unresponsive. These seizures usually only last for a few seconds, but this might mean the child misses information which may affect their learning. Briefly going over any information that has been missed may help a child who has had an absence seizure.
Epilepsy planning and support guide for education and children’s services DECS 2007
Just because a child has epilepsy does not automatically mean they have a learning difficulty. Most children will achieve academic milestones and develop social skills in line with their peers. Some children may experience difficulties and the needs of each individual should be assessed and supported accordingly. Educators can take several simple but significant steps to support a child with epilepsy:
Access information on epilepsy and its effects and learn first aid for seizures:
A – Z Health Support Index on the chess website: www.chess.sa.edu.au is a good starting point
Be aware of each individual child’s epilepsy care plan, and implications for the
Maintain a seizure first aid log and provide to parents to assist the child’s doctor
Observe behaviour patterns and learning issues and share this information with
parents and other staff to support consistent management
Encourage active participation by ensuring that potential safety issues are
Encourage discussion and understanding of epilepsy with other students and
Maintain contact with the family during any extended hospital stays (see Education
Services on the chess website: www.chess.sa.edu.au).
Epilepsy planning and support guide for education and children’s services DECS 2007
Brett Charles Plyler, M.D. Employment 2008-Present Northwestern Memorial Hospital. Instructor for second year residents’ psychotherapy class and individual resident supervision. Chicago IL. Chicago Research Center, Inc. Private Practice. Outpatient/Inpatient and psychotherapy/psychopharmacology. Chicago IL. Northwestern Memorial Hospital. Attending psychiatri
Unsafe Use of Intravenous Haloperidol Pervasive in Hospitalized Elderly University of Colorado Hospital and University of Colorado Denver at Anschutz Medical Campus, Aurora, Colorado Background Limitations Delirium is present in 11-24% of elderly patients on hospital 556 patients received IV haloperidol during the study period. admission while another 6-56% will develop it during the