Coping with Epilepsy: Types of Seizures and Care

Epilepsy is the most common serious neurological condition and is caused by electrical changes in the brain's neurons. The reasons for someone having epilepsy are usually unknown but can include antenatal factors, family history, jaundice and some drugs that the Mother takes during pregnancy.. There are also some external factors that can be taken into consideration. Something that affects the brain from the outside such as a temporary lack of oxygen which can be caused by an injury or birth damage, susceptibility to flashing or flickering lights (photosensitivity), severe infections often associated with brain infections and certain severe diseases.

There are in fact more than forty types of seizure and are usually classified as either generalized seizures or partial seizures. They do need to be managed in different ways though.

Generalized seizures

Tonic/clonic seizure

The tonic/clonic seizure used to be referred to as 'grand mal'. The start of this type of seizure is sudden and a third of people that have these seizures also experience auras where they can see colored lights or taste and smell something quite specific.

The second stage is the tonic or spasm stage. The body of the person seizing will become stiff and they will fall to the floor and lose consciousness. The face may become pale and distorted with they eyes fixed in one position, often rolled back. The back and neck may arch with arms flexed and hands clenched. He may utter a piercing cry, become incontinent and bit the inside of his cheek during thee first spasm. There may also be frothing at the mouth and difficulty in swallowing saliva.

Once this stage has been reached the clonic stage will begin. During the clonic phase a person will start twitching. This can either be just the face or the whole body and can last from seconds to several minutes.

Once the clonic stage has come to an end the post convulsive stage is reached. In the post convulsive stage a person is usually very sleepy and may complain of a headache. They may also appear dazed and have a memory loss of the convulsion.

Absences

There are other generalized seizures that can occur and these can be much less dramatic in presentation. The most significant to be aware of are 'absences'. An absence is a brief interruption of consciousness without any other signs except perhaps for the fluttering of the eyelids. This is especially common in children and used to be known as 'petit mal'.

Partial seizures

Simple partial seizures

During a simple partial seizure consciousness is not affected and the seizure is confined to rhythmical twitching of one limb or part of a limb or to unusual tastes in the mouth, or a sensation such as pins and needles in a specific part of the body (this may be similar to the aura that may precede a major tonic/clonic seizure).

Complex partial seizures

During these seizures consciousness is affected and the child shows 'semi-purposive' movements such as fiddling with clothing or objects, wandering around or appearing confused. These types of seizure occasionally lead to other forms of generalized seizures.

Diagnosis

A person is said to have epilepsy if he has repeated fits from a cause triggered internally or externally. Confirmation of the decision is made by looking at the electrical impulses of the brain on an electroencephalogram. Electrodes are attached to the head and a moving record of the brain's activity is recorded. This procedure is painless and harmless.

Care

Major seizure

During this time there is little complex treatment required. In fact basic first aid is all that is required.

Stay calm, keep onlookers away and remember that a low quite voice is reassuring.

Make sure that there is nothing around, hard furniture for instance, that could cause damage.

Remove eye glasses if necessary.

If at all possible place something soft under the head.

Once the spasm has finished proceed with the following:

Turn the patient onto his side and place him in the recovery position.

Check (with sensitivity) if the clothes need changing ( he may have become incontinent).

Encourage a return to usual activities when he feels ready.

If the patient fell during the seizure check for any injuries

And maintain a matter of fact approach at all times.

During a seizure never try and force anything between the teeth, do not try and restrain the person seizing, make a record of how long the seizure lasted and if this is a first convulsion seek medical help.

Non-convulsive seizures

These seizures vary in type and intensity so the response required may differ. The main principles are:

Gently guide the person away from obvious danger

Keep onlookers away.

Speak gently and calmly

Remember that he may be confused for a while so it is best to leave him alone and not over crowd him. Observe him discreetly.

Management

Epilepsy can usually be controlled by medication but the success does depend on several factors:

The type of epilepsy

The accuracy of diagnosis

The accuracy of treatment

A person's response to the medication

Additional problems.

With appropriate drug treatment seizures can be completely controlled in around 80% of sufferers

Sources:
Good Practice in Caring for Young children with Special Needs by Angela Dare and Margaret O'Donovan
Author's work with children and adults with learning disabilities