Epilepsy

A Guide for Teachers

Meena.K.S, Ph.D

Prakashi Rajaram,Ph.D

Marimuthu.P, Ph.D

Kannappa Setty, PSW

Copyrights © 2015 by National Institute of Mental Health and Neurosciences (NIMHANS).
All rights reserved.

ISBN Number:81-86466-00-X
NIMHANS Publication No.117

Dr. Meena.K.S Assistant Professor

Department of Mental Health Education
NIMHANS

Dr. Prakashi Rajaram Professor

Department of Psychiatric Social Work
NIMHANS

Dr. Marimuthu.P Additional Professor

Department of Biostatistics
NIMHANS

Mr. Kannappa Setty Psychiatric Social Worker & PhD Scholar

Department of Psychiatric Social Work
NIMHANS

For further information contact or email the author at [email protected]

COVER ILLUSTRATION BY Rajeev.V

SKETCHES: Mr.Sripathacharya. S
Mr.Rajeev. V
Note by Authors

Epilepsy is one of the most common pediatric neurological disorders with higher incidence during the
school years. These years represent a critical period of the child's social, psychological, and physical
development. The school period will significantly impact the child's quality of life and future adult roles. Children
with epilepsy are at increased risk of educational underachievement, learning difficulties, mental
health problems, social isolation, and poor self-esteem. Teachers play a vital role in the physical, emotional,
and academic well-being of students with epilepsy. Teachers who know how to respond to seizures both
improve safety standards in the school and influence the reactions of fellow students and school staff. A
teacher who reacts to seizures calmly and supportively will help others learn to do the same. In some cases,
teachers are the first to notice and recognize the symptoms of seizures in a student. Teachers who
understand, encourage, and inspire students with epilepsy facilitate learning, independence, and self
esteem. This guide is designed to provide general information about Epilepsy to the teachers. It does not
include specific medical advice, and people with epilepsy should not make changes based on this
information to previously prescribed treatment or activities without first consulting their physician

Special thanks to our former Director & Vice Chancellor Prof.P.Satish Chandra for permitting us to undertake the
NIMHANS funded project on training teachers and school students in epilepsy awareness. This guide is an
outcome of his support and encouragement. Thank you Sir

Our deep sense of gratitude to Dr.Sanjib Sinha, Professor, Department of Neurology, NIMHANS, for his inputs
towards the completion of the guide.

Our gratitude and thanks to Dr. Ravindranath, Assistant Professor, Department of Neurology, NIMHANS for his
painstaking scrutiny of the guide and suggesting modifications towards the guide.

Our sincere thanks to

Dr. Parthasarathy, Senior Professor,(Retd) Dept of PSW, NIMHANS
Dr. Janaradhan, Associate professor, Dept of PSW, NIMHANS
Dr. Prasanthi Nattala, Associate Professor of Nursing, NIMHANS
Dr. Vrindha, Assistant Professor of Psychiatric Social Work, NIMHANS
Dr. Priya Thomas, Assistant Professor of Psychiatric Social Work, NIMHANS
Dr. Aruna Kapanee, Assistant Professor of Clinical Psychology, NIMHANS for valuable feedback in
improvising the guide and knowledge, Attitude &Practice (KAP) tool

Our thanks to Teachers & Students who were instrumental in shaping this guide without which this would not
have been possible.

Our sincere thanks to staff of Department of Mental Health Education, NIMHANS for their support and
encouragement.

Meena.K.S

Prakashi Rajaram

Marimuthu.P

Kanappa Setty
Table of Contents

Introduction to Epilepsy

How to tell the difference between one type of seizure and another

What can trigger a seizure

Do I need to call an ambulance

How to respond to a seizure

Are there side effects with anti-epileptic drugs

Effects on learning

How Teachers Can Help

Epilepsy check list at a glance

 Why this guide matters
As a teacher you could be the first adult to see a child having an epileptic seizure. Or a parent may tell

you that their child has epilepsy. This guide provides basic information about epilepsy. It will help you

understand this condition and how it can affect a child's learning. It will also tell you how to recognise

seizures and how to deal with them. For many children, their epilepsy will not affect their behaviour or

learning ability. Yet, we know children with epilepsy do underperform at school and achieve less than

would be expected. There are many reasons for this.

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 Introduction to Epilepsy
Teachers play a vital role in the physical, emotional, and academic

well-being of students with epilepsy. Teachers who know how to

respond to seizures both improve safety standards in the school

and influence the reactions of fellow students and school staff. A

teacher who reacts to seizures calmly and supportively will help

others learn to do the same. In some cases, teachers are the first to

notice and recognize the symptoms of seizures in a student.

Teachers who understand, encourage, and inspire students with

epilepsy facilitate learning, independence, and self-esteem.

The way you react and how readily you accept the child and their condition can make a big difference.

How to recognise Seizures

Seizures take many different forms. A seizure may last for a

few seconds and involve a blank stare or a sudden fall.

Sometimes it is difficult to distinguish between a seizure and

unusual behaviour. What is important to watch for is a

pattern of behaviour that happens too often. Signs that may

indicate that a student is having a seizure include:

F A sudden loss of awareness that may appear like daydreaming

F A brief lack of response

F Difficulty in memory

F Head nodding

Fsudden onset

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F rapid eye blinking

F repeated movements that appear unnatural

F repeated jerking movements of the body, arms, or legs

F sudden falls without an apparent reason

Fsudden stomach pain followed by sleepiness and confusion

F frequent complaints that things taste, sound, smell, look, or feel strange

F sudden fear, panic, or anger without an apparent reason.

If you notice these symptoms, record your observations, discuss the observations with the school principal,

and report to parents and doctor.

Why seizures happen?

The brain is made up of billions of nerve cells or neurons that communicate through electrical and chemical

signals. When there is a sudden excessive electrical discharge that disrupts the normal activity of the nerve

cells, it causes a seizure. This abnormal activity in the brain that results in a change in the person's

behaviour or function is a seizure.

A number of causes can result in a disruption of the normal activity of the nerve cells and result in seizures.

The causes vary according to the age of onset of epilepsy. The causes of seizures include genetics, birth

injury, developmental disorder such as brain damage to the fetus, brain trauma from accidents, parasitic

infections sports injuries, drug and alcohol abuse and many more

Who epilepsy affects

Epilepsy is a condition that is more common than most people realize. In the general population,

approximately one person in a hundred has epilepsy, meaning that approximately one in every one

hundred students has epilepsy. People of all ages have epilepsy. The condition can begin at any age

although its onset is most often in childhood or in the later years of life. All seizures are not epileptic.

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 How to tell the difference between one type of seizure and another
There are many types of seizures. The location in the brain of the abnormally discharging nerve cells

determines the form the seizure will take. The different types of seizures begin in different areas of the brain

and they are grouped into two categories: partial and generalized.

1. Partial seizures

Partial seizures only affect part of the brain. Often seizures start in those areas of the brain that may have

been damaged by a head injury, or an infection like encephalitis. Sometimes a seizure can start in one part

of the brain but then spread to the whole of the brain. This is called a secondary generalised seizure. Partial

seizures are either simple or complex,

Simple partial seizure: These affect a smaller part of Complex partial seizure: These usually affect a larger

the brain. You may observe the child's arm twitching area (but still only part) of the brain. During a complex

or some other unusual movement. The child may partial seizure a child may experience strange and

experience strange sensations or visions, such as unusual feelings with impaired consciousness. The child

seeing shapes, colours or faces. The child may feel may appear unresponsive and switched off from what is

'dreamy', sick, or experience emotions such as fear or going on around them. Often, they start to perform

anger. Sometimes there is a tingling sensation or inappropriate or automatic movements. These can include

numbness across parts of the body. In some children, a plucking at clothing, lip smacking, slurred speech,

simple partial seizure acts as a warning for a repeating words, head turning, wandering aimlessly,

secondary generalized seizure could happen. The running or even undressing. The child does not lose

child knows the seizure is going on but cannot stop it. consciousness but their level of consciousness is altered.

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2.Generalized seizures(Convulsive Seizures):

These kind of seizures affect the whole brain. People with

generalized seizures will always lose consciousness, even

just for a few seconds. The following are the more common

generalized seizures:

Tonic-clonic seizure: Most people will recognise a Absence seizure: You may notice that a child

tonic-clonic seizure. In fact, this is what many assume lacks concentration and does a lot of day dreaming.

epilepsy looks like. A child suddenly stiffens, loses Sometimes the child appears to be in a trance-like

consciousness and falls to the ground. This is followed by state. This is what an absence seizure looks like.

convulsions. The child's breathing may also be affected The child may appear awake to you but in fact loses

turning their lips blue. The child may make grunting noises consciousness for a few seconds. You may see

or accidentally bite their tongue or the inside of their cheek. some slight movements of the eyelids. A child can

The child may be incontinent. When the child comes round have absence seizures many times a day. This can

they may be confused and have a headache. It is normal for affect the child's learning and ability to retain

a child to want to sleep after such a seizure. Find a quiet information.

place for the child to rest. Make sure an adult stays with the
Atonic seizure :These are sometimes known as
child until their breathing has returned to normal and any
'drop attacks'. The child's body will go limp
confusion has gone.
because muscles suddenly relax. If the child is

Myoclonic seizure :These are sudden muscle spasms standing, they will fall to the ground. The child will

or jerks affecting the child's arms, head and sometimes the usually recover and get up very quickly.

whole body. The child will quickly recover from a brief loss
Tonic seizure: These are similar to tonic-clonic
of consciousness. These seizures are more common in the
seizures but without the convulsions. The child's
morning, shortly after waking or if the child is tired.
body will suddenly stiffen. If the child is standing,

they will fall to the ground. The child's breathing

may also be affected.

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 What can trigger a seizure?
Some children find that certain things can trigger a seizure. Some triggers are common to many children, others are

unique to one child. However, in many cases, seizures happen without a specific reason. You should always ask the

parents if they are aware of any specific triggers.

Common seizure triggers are:

¯lack of sleep/being tired
¯forgetting to take medication
¯stress or anxiety
¯dehydration or too much liquid
¯not eating regular meals
¯recreational drugs or alcohol
¯flashing or flickering lights
¯Hot water head bath
¯Fever
A common misconception is that everyone who has epilepsy is affected by these. In fact, only a small percentage of

children and adults (less than six per cent) have photosensitive epilepsy. Seizures can be triggered by using a

computer or watching TV or any other flashing or flickering lights. Photosensitive epilepsy affects more girls than

boys. LCD and plasma screens are safe as they don't flicker. However, using these screens does not protect a child from

the content of a computer game or TV programme. If the game or programme contains flashing or flickering lights,

images or patterns, it can trigger a seizure in a child with photosensitive epilepsy.

School-related triggers: Exam times are stressful for most pupils. However, for a child with epilepsy, the stress

and anxiety on the day of exams can be a seizure trigger. As a teacher, it helps to be aware of general epilepsy-

related factors, as well as the child's unique triggers. This will give you confidence to anticipate, recognise and deal

with a child's seizures in the most appropriate and sensitive way

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Do I need to call an ambulance?

Seizures can be frightening to watch. In most cases, you let a seizure run its course, there is nothing you can do to stop

it. You don't need to call an ambulance if the seizure stops after five minutes or whatever time is usual for the child. You

should always call an ambulance:

¯if this is the child's first seizure (as far as you know)

¯if the seizure lasts for more than five minutes; or

¯if the seizure lasts longer than the child's usual time

¯if the child has injured himself /herself

¯if you suspect the child may have aspirated liquid, food or vomit

When is a seizure a medical emergency?

On rare occasions, emergency medication is needed to stop

repeated and continuous seizures. Unless school staff are

trained and authorised by the child's parents to give

emergency medication, you will need to call an ambulance.

How do you know the seizure won't stop? You won't. Therefore,

as a rule of thumb, call an ambulance if the seizure goes on for

more than five minutes, or if it is longer than normal for the child

A medical emergency arises when the seizure lasts for more than 5-10 minutes; or the child has one seizure after

another without recovery time in between which is called status epilepticus. Recovery means being fully conscious

and breathing normally

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 How to respond to a seizure
You cannot stop a seizure from occurring. Most seizures last for seconds or several minutes and will end

naturally. Once a seizure is over, the student will typically return to normal. As a teacher, it is important to

assure that the student is not in jeopardy during and following the seizure and to be aware of how to

differentiate between a typical seizure and what is considered a medical emergency

First Aid

What to do if child has a simple/complex partial seizure:

1. Stay with the child. Let the seizure take its course. Speak calmly and explain to others what is happening.
2. Gently guide the person away from danger.
3. After the seizure, talk reassuringly to the child .Stay with the child until complete awareness returns.

What to do if a child has a generalized seizure

1. Stay calm. Let the seizure take its course.

2. Time the seizure.

3. Protect the child from injury. If necessary, ease the child to the floor.

Move hard or sharp objects out of the way. Place something soft under

the head.

4. Loosen anything tight around the neck.

5. Do not restrain the child.

6. Do not put anything in the mouth.

7. Gently roll the child onto his or her side as the convulsive seizure

subsides to allow saliva or other fluids to drain away and keep the airway

clear.

8. After the seizure, talk to the child reassuringly. Do not leave until the

child has recovered. Call the child's parents and ask them to take him or

her to home as the child may need rest or sleep.

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Call an Ambulance

ª If a convulsive seizure lasts longer than 5 minutes.

ª If consciousness or regular breathing does not return after the seizure has ended.

ª If seizure repeats.

ª If confusion after a seizure persists for more than one hour.

ª If a seizure occurs in water and there is any chance that the child has inhaled water.

After first aid procedures have been followed,

teachers or school staff should:

1.Reassure and comfort the student if confusion follows

the seizure.

2.Allow the student to remain in the classroom until full

awareness returns.

3.Help to re-orient the student.

4.Allow the child to rest if required.

5.Allow the child to go to the restroom if he/she has lost bowel or bladder control during the seizure.

6.Provide a change of clothing if required

7.Help others to understand what happened.

8.Allow time for discussion.

9.Encourage a positive reaction amongst classmates.

10.Proceed with regular class work.

Don't's during first aid procedures:

1. Giving keys /iron objects

2. Over crowding

3.Restraining

4.Giving water during/after seizures

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 Are there side effects with anti-epileptic drugs?

Anti-epileptic drugs can have some side effects. These are more intense when a child starts new medication or

changes dosage. Common side effects can include drowsiness, dizziness, weight loss or gain, or mood changes.

A child's short-term memory and ability to concentrate can also be affected by anti-epileptic drugs. When you

assess a child's learning and progress, make sure potential side effects are taken into account. As a teacher, you

may be the first adult to notice any difference in a child's mood, behaviour or level of concentration. This can be

important information for the child's parents, neurologist, general practioner or nurse

Why are memory problems so common?

Children with epilepsy often have problems with their short-

term memory. There can be a number of reasons:

ªThe memory problem could be linked to the cause of the

child's seizures. This can be scarring on the brain following

a head injury or infection. There may be scarring on the

part of the brain that deals with making and storing new

memories (temporal lobe).

ªA child's short-term memory can also be affected before,

during and after a seizure. Before a seizure, information may not be processed well enough to pass to the

child's long-term memory. This is why a child will usually not remember anything that has happened in the

run-up to a seizure.

ªIf a child has frequent seizures, this too can affect their memory. In between seizures, brain activity may

also be disrupted even if it does not lead to a seizure. Up to 70% of children find that their seizures stop

with the right medication or they grow out of epilepsy. Once seizures have stopped, the associated memory

problems with frequent seizures will usually disappear.

ªCommon side effects of anti-epileptic drugs like poor concentration or drowsiness can also affect a

child's memory. The doctor titrates the dose or takes other measures to address the side effects

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5.How epilepsy can be treated

Seizure medication is the primary treatment for epilepsy. Medicine often reduces or even stops seizures

from occurring by altering the activity of neurons in the brain. The

majority of people achieve seizure control with seizure medication. It

may be necessary for students to take medicine at various times

during the day. Arrangements should be made based on the doctor's

instructions and in discussion with the parents. Taking seizure

medication as prescribed is essential.surgery may also be an option, if

the seizures are not controlled with medications

An informed teacher can:

F Be the first to notice symptoms of seizures and alert others.

F Handle seizures calmly and effectively.

F Provide seizure records that will assist the doctor in making a

diagnosis and in treatment.

F Help others to be positive and supportive and to accept those with epilepsy.

Fencourage a studentʼs potential.

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 Effects of epilepsy on learning

Epilepsy has a long history of stigma due to ignorance. This

is improving but you will still come across children and

parents who are reluctant to talk about having epilepsy.

They may use other words to describe epilepsy such as

'blackouts' or 'fainting fits'. You can help by trying to make

the child's experience at school as 'normal' as possible.

Don't be too protective or put unreasonable restrictions on

a child's activities. This is particularly important in the child's

early years. Your support will help the child's emotional development.

Teachers are in a good position to spot, record and discreetly monitor the child's seizures. You can also be

the first to notice when this seizure pattern changes. Or you may see changes in a child's behaviour, ability

or achievement. This will be important information when talking to parents and other support agencies.

When epilepsy affects learning

Children with epilepsy have the same range of intelligence as other children and often epilepsy itself has no

effect on intelligence or ability. Children with epilepsy do, however, have a higher rate of learning problems

and difficulty in school and a lower level of achievement. This may

be influenced by many factors including:

1.Medication: Seizure medications can result in drowsiness,

loss of coordination, fatigue, headache, decreased appetite,

behavioural changes, nausea, drooling, tremor, weight gain or

loss, double or blurred vision, dizziness,and/or depression.

The side effects tend to be more common when a medicine has

just been started, when the dosage has been increased, or when

more than one medicine has been prescribed.

Teachers can be of great assistance by being alert to changes

in learning, behaviour, and emotional well-being in students
with epilepsy and by providing information to the appropriate
contacts.

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2.Anxiety: Sudden attacks of seizures could result in
anxiety and insecurity in a student. This may affect

initiative and independence in the classroom.

If a teacher is calm and effective in dealing with seizures and

reassures the student with epilepsy as well as fellow students,
this may help to bring down the student's anxiety.

3.Being absent to school: Seizures ,medical tests and

treatment may result in a student missing more class time

than is typical. This could also influence achievement.

Teachers can assist the student by assuring that all missed

class work is available.

4. Neurological Causes

In some cases, the underlying neurologic problem causing epilepsy may also result in learning problems.

For example, if the condition results in problems in the association areas of the brain, letter recognition or

the recollection of word meaning could be affected resulting in poor school performance.

Teachers may be able to introduce new teaching strategies to

assist the student.

5.Seizures

Seizures may affect learning and disrupt their day to day

learning at school. Memory can also be affected following

seizures. This could result in further learning challenges.

Seizures occurring at night also can result in tiredness at

school.

Assigning a classmate to the student who can answer

questions and explain what was missed will provide both
emotional and academic support to the student. Providing
visual instructions and/or repeating verbal instructions can
also be used to assist the student.

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 How Teachers Can Help
Teachers may employ strategies to accommodate and encourage a student with epilepsy, by following the

below guidelines

Communicate

At the beginning of each school year, a teacher can/should meet with the student with epilepsy and his or

her parents. Discuss the academic and social impact that epilepsy may have on the student and find out

information regarding doctors, medications, seizure descriptions, allergies, other medical conditions, and

first aid instructions. Assure that the school has a medical

record on file with all relevant information of the student.

Parents play a critical role in how a child adapts both

intellectually and emotionally. There are many advantages

to involving the parents as partners in the education of

their child. Keeping the lines of communication open

between the school and the parents through methods such

as regular phone calls, meetings, or writing in a diary, will

help to assure the well-being of the student. Teachers should report any seizure activity to the parents.

If the student's seizures are uncontrolled, a discussion with the family regarding confidentiality and/or how

to share information with other students is important. If a discussion is to be arranged, the student should be

given the option to choose whether or not to be present.

Offer Support

A diagnosis of epilepsy may result in a student experiencing a range of emotions including low self-esteem,

anxiety, anger, or a feeling of powerlessness. There is also an increased risk of depression in those with

epilepsy. Depression may be a reaction to the insensitivity of others or of living with the constant fear of

having a seizure.

Even if seizures are being effectively controlled by medication, a student may be concerned about having a

seizure in public. Children and teenagers are often afraid of being different. They may also be reluctant to

take seizure medication when they are with others. Depending on the reactions of others to their condition,

students with epilepsy may feel isolated.

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Watch for signs of depression

Depression is common with epilepsy. A child can find it difficult to come to terms with having epilepsy. This can

affect their self-esteem. If a child misses many days at school because of seizures, they may feel they will never

catch up. Sometimes parents can be overprotective. This can

increase the child's feeling of being 'different' and can make

them feel isolated from their friends. Occasionally, a child

with epilepsy is teased or bullied by their peers.Watch out for

instances where the child may be addressed in a derogatory

manner. It is demeaning to call a person 'epileptic'. Only

seizures are 'epileptic'. How you react can make all the

difference to how the child will feel about their epilepsy. Positive

feedback from family and friends plus support from pupils and teachers is important. Depression can also be

linked to the cause of the child's epilepsy. This can be a head injury or scarring on the brain. The brain controls

emotions and moods. If there is scarring on the part of the brain which deals with these feelings, this can lead to

depression. It can also be a side effect of taking anti-epileptic drugs.

How to spot possible depression:

ª Appearing unhappy or troubled by something

ª Seeming worried, fearful or helpless

ª Being quiet or withdrawn, refusing to play with friends or take part in fun activities

ª Having trouble concentrating

ª Expressing frequent negative thoughts

ª Getting poorer marks than expected

ª Complaining of headaches or general aches and pains

ª Appearing unmotivated or lethargic

ª Eating problems

ª Crying easily

ª Displaying anger or aggressive behaviour

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 By offering ongoing support and remaining calm if and when

a student has a seizure, a teacher can have significant

influence on both the student's reaction to the learning

environment and on the response of others. Teachers can

also assist by informing the parents and doctor of any

depression or behavioural changes in the student.

Behavioral changes can be a side effect of medication or can

be caused by anxiety, low self-esteem, need for acceptance,

overprotection or overindulgence on the part of family or teachers, and/or the seizure activity itself.

Identifying what is causing the behaviour changes is an important first step in helping the student.

Educate Others

Sometimes students face ridicule, teasing, or prejudice from schoolmates. The classmates and friends may

not understand the condition and children and young people can sometimes be unkind. One of the

challenges facing those with epilepsy is the public's lack of

knowledge about the condition. A lack of public awareness

and inaccurate television and movie depictions do result in

incorrect assumptions about epilepsy. Sometimes these

create the impression that those with epilepsy are mentally

ill or are more likely to be violent. In older students,

unusual behaviour could be misinterpreted as alcohol or

drug abuse.

Sometimes the forms that seizures take can be mistaken to be deliberate acts. They are not. If a student

does show aggressive behaviour, it could be influenced by factors including the side effect of seizure

medication, anxiety over the seizures, or a teacher's approach to the student. It is important for a teacher to

discuss these problems with the parents. A family discussion with the student's doctor may assist the

student in determining the cause and working through the problem.

Through public awareness and education, attitudes towards the condition are slowly changing. How the

teacher responds to a seizure and to a student with epilepsy is very important. A positive and calm

approach can reassure other students that a person having a seizure typically poses no risk to himself or

Page:17
herself or to others. Stressing that epilepsy is not a disease and that a person cannot catch epilepsy from

someone else is also important. Explaining that seizures are not painful and that most seizures end naturally

may also minimise some of the concerns of classmates.

Create a Safe School Environment

There is an increased risk of injury in people with epilepsy. For example, avoiding activities involving

heights or hot surfaces that could result in burns are precautionary measures that a student with

uncontrolled seizures should take. Standing back from road while waiting at a bus stop may also be

necessary if seizures are uncontrolled.

Appropriate safety measures should be discussed with the school administration and with the parents of the

student.

Allow Participation

Children and teenagers with epilepsy should be encouraged to participate in social and recreational

activities and sports. Socializing with others builds self-

esteem. Recreational activities and sports enhance well-

being and maintain health. There is some evidence that

regular exercise may improve seizure control by reducing

the stress that sometimes triggers seizures.

Being too overprotective can hinder a student's

development. If a student learns to be fearful or is

continually being restricted, he or she may become

incapable of taking decisions and become dependent on others.

Many sports and recreational activities such as basketball,

volleyball, track and field games, are considered safe for

those with epilepsy. Some activities such as swimming

require careful supervision. Instructors and coaches

should be informed of the student's condition.

Participation in sports and recreational activities should be

on a doctor's recommendation and consistent with the

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parents' instructions.

It is also important that students with epilepsy use the appropriate safety gear (e.g. helmets etc.) and avoid

related problems such as low blood sugar, dehydration, or overexertion which could increase the risk of

seizures.

Teachers should not exclude students from field trips, play activites or camps. Appropriate support and first

aid should be there and could be requested so that students are able to participate in the activities that

others enjoy. If necessary, teachers could also enlist the help of parents to support their request.

Record Seizures and Other Changes

As doctors often have to rely on the description of seizures provided by those who are with a person when a

seizure takes place, recording information about the seizure will benefit the student. Determining what type

of seizure a person is having is important in the doctor's diagnosis as well as in the decision regarding the

appropriate treatment.

In a seizure record, it is important to record information

1st Attack:................

such as: Date:........................

Time:........................

F The time the seizure occurred

F The date the seizure occurred

F How long the seizure lasted

FInformation that describes the behavior before, during,

or after the seizure.

Parents of a child with epilepsy should be informed of

seizures that occur at school.

School activities :Children with epilepsy can enjoy most

sport and leisure activities. Too many restrictions can affect

the child's self-esteem and self image. Latest research

shows that being active helps reduce a child's seizure.

Where seizures are well controlled, the child will be able to

take part in almost all activities. If a child's seizures are

frequent and unpredictable, a careful assessment of risk

needs to be carried out. Parents should always check with

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their child's doctor or epilepsy specialist nurse first to make sure an activity is safe for their child. Some

simple precautions can often remove unnecessary barriers. This is important to bear in mind when doing

risk assessments.

To assess the possible risk to the child, questions to ask include:

ªHow frequent are the seizures?

ªWhat type of seizures does the child have?

ª How long do the seizures usually last?

ª Does the child get a warning sign before a seizure?

ªAre there certain triggers that are likely to lead to a seizure?

ªIs there a certain time when the child is more likely to have a seizure?

þ If yes, is there a written care plan in place?

þ How long does the child need to rest after a seizure?

þ Is the child likely to be incontinent during a seizure?

þ Does the child have any other kind of disability?

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 Myths & Misconceptions about Epilepsy
Myth
Epilepsy is due to the effect of "evil spirits" or "supernatural powers". It is also a form of "madness". So,
epilepsy should be treated by faith-healers, sorcerers (witch-craft) or in a
lunatic asylum..

Fact
Epilepsy is a disease of the brain. Hence, epilepsy should be treated by neurologists, epileptologists,
physicians and pediatricians.
Myth
One should never touch a patient having a seizure in order to avoid the disease being passed on to you.

Fact
If a patient is having a seizure, he/she needs your help and care. Epilepsy cannot be passed on to others
by touching the patient.

Myth
An epileptic seizure can be terminated by putting a key in the patient's hand or by making a patient smell
onions or a dirty shoe.

Fact
None of these non-medical measures are of any use. Family members and teachers should be made aware
of first-aid measures required during a seizure.

Myth
Children with epilepsy are dull and cannot learn. They should not be sent to school.

Fact
Children with epilepsy can be extremely intelligent. It is usually ignorance about various aspects of
epilepsy that prevents parents from sending their children to school. Many times the teachers also have
misconceptions and do not encourage children with epilepsy to attend school.

Myth
Treatment for epilepsy with modern medicines is ineffective and expensive.

Fact
"Seizures" or "fits" that occur in epilepsy can be completely controlled by using a single, inexpensive
medicine in 60-70% patients. Another 15-20% patients can be helped by the use of new, but slightly
expensive drugs. A few cases can be successfully treated with surgery. Epilepsy can even be cured in
some cases.

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A checklist for teachers

We have put together a list of questions you should ask a parent whose child has epilepsy. The answers will give you a
good understanding of how epilepsy affects the child. You can then decide what measures you need to put in place to
support the child's learning:

þ What kind of seizures does the child have?

þ How long do seizures usually last?

þ How often does the child have seizures?

þ Do the seizures tend to happen at particular times of the day?

þ Does the child get any warning before a seizure?

þ Are the child's seizures triggered by certain conditions or events?

þ How often does the child take medication?

þ Is it necessary to take any medication in school?

þ Does the child experience any side effects from the medication?

þ What kind of first aid is likely to be required?

þ Will the child need emergency medication?

þ Does the child have an understanding of epilepsy and treatment for seizures?

Have parents checked with their doctor or epilepsy specialist

about any restrictions to the child's school activities

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 Epilepsy at a glance
What you need to know!

Epilepsy is one of the most common serious neurological conditions. People with epilepsy tend to have

repeated seizures. Up to 70% of children with epilepsy will either grow out of their epilepsy or have their

seizures controlled by medication. Seizures vary from person to person. Most seizures are self-limiting and

last only a short time. There are over 40 different types of seizures. Not all of them involve a sudden fall and

jerking.

How to spot possible seizures:

«A child seems to daydream and not take in information.

«A child falls down suddenly for no obvious reason.
«A child rolls their eyes and blinks very fast.
«A child makes repeated movements that may look out of place.
«A child nods their head as if falling asleep and acts as if nothing has happened.
«A child stops what they are doing and stares at nothing for a moment or two.

Seizure triggers – the most common ones are:

«Forgetting to take medication

«Stress or anxiety, particularly around exam times
«First day nerves at school
«Name-calling/bullying
«Sound stimuli
«Lack of sleep
«Dehydration/too much liquid
«Not eating regularly
«Menstruation/hormones
«Recreational drugs/alcohol
«Flashing/flickering lights – photosensitive epilepsy only Natural light patterns/sunlight – photosensitive
epilepsy only
«Hot water head bath
«Eating during eating epilepsy

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Other effects on a child's learning

«Problems with short-term memory and concentration

«Tiredness and/or confusion before and after a seizure
«Depression linked to either the cause of seizures
«side effect of medication
«Psychological factors like Low self-esteem
«Isolation from peers
«Bullying
«Overprotective parents
«Teachers placing unnecessary restrictions on a child's activities
«Missing lessons/staying at home if seizures are frequent
«Not taking in all of the information in class because of absence seizures (this looks like daydreaming)

Safety – keep safety measures in Common side effects of anti-epileptic

proportion: drugs
Seizures which involve sudden falling down have

a higher risk of injury. Consider clearing extra «Drowsiness

space around the child's desk. Cover sharp «Dizziness

«Weight loss or gain
furniture edges with shaped plastic pieces.
«Mood changes
Children with epilepsy can enjoy most sport and

leisure activities. Do individual risk assessment

for each activity.

Seizures which involve sudden falling down have

a higher risk of injury. Consider clearing extra

space around the child's desk. Cover sharp

Treatment Emergency medication

Is with anti-epileptic drugs (AED). This is Is sometimes prescribed to stop prolonged
taken usually twice a day outside school seizures. It can only be administered by a
hours. There is usually no need to store trained and named person. The child's care
medication at school. plan will have all the necessary information

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