seizure disorder

FACT SHEET

There are two kinds of seizure disorders, an isolated, non-recurrent attack, such as may occur during a febrile illness or after head trauma, and epilepsy--a recurrent, paroxysmal disorder of cerebral function characterized by sudden, brief attacks of altered consciousness, motor activity, sensory phenomena, or inappropriate behavior caused by excessive discharge of cerebral neurons. This fact sheet will focus more on the isolated, non-recurrent attacks and those seizures that are drug-induced.

CHARACTERISTICS

· Aura - warning signs of a seizure

· Postictal state - symptoms that follow a seizure

Ø deep sleep

Ø headache

Ø confusion

Ø muscle soreness

· Simple partial seizure - motor, sensory, or psychomotor phenomena without a loss of consciousness

· Jacksonian seizure - a seizure that starts in one part of the body and spreads. Ex - starts in hand and moves up arm

· Complex partial seizure - a seizure in which the individual will lose contact with surroundings for 1-2 minutes. The individual might:

Ø Stare

Ø Perform automatic purposeless movement

Ø Utter unintelligible sounds

Ø Resist aid

Ø Mental confusion continues for 1-2 minutes after the seizure

· Generalized seizure - this type of seizure causes a loss of consciousness and motor function. It is genetic or metabolic in cause

· Infantile spasms - a seizure characterized by sudden flexion of arms, forward flexion of trunk, and flexion of legs. They last only a few seconds and repeat many times a day. They only occur in children within the first three years.

· Absence seizure - (petit mal) - brief primarily generalized attacks manifested by a 20-30 second loss of consciousness, eyelid fluttering, may or may not have the presence of axial muscle tone loss. The individual will not fall over or convulse and will resume activity as soon as seizure is over. They will have no knowledge of the seizure once it is over. These types of seizures often happen when an individual is sitting quietly, they rarely occur during activity.

· Generalized tonic-clonic seizure - begins with outcry, continues loss of control and a fall, tonic-clonic contractions of muscles, possible loss of bowels. Lasts 1-2 minutes, usually begins with simples or complex partial seizure.

· Atonic Seizure - brief, primarily generalized seizure in children

Ø complete loss of muscle tone and consciousness

Ø fall or pitch to the ground

Ø chance of serious head trauma

Ø Myoclonic seizure - brief, lightening like jerks of the limbs or trunk, may be repetitive leading to tonic-clonic seizure. No loss of consciousness

Ø Febrile seizure - associated with fever without evidence of intracranial infection. They occur in children ages 5 and younger.

CAUSE

The following may be triggers for a seizure:

· Convulsant drug

· Growth spurts

· Hypoxia

· High alkalinity of blood

· Hypoglycemia

· Low blood sugar

· Lack of sleep

· Constipation

· Stress

· Excessive noise

· Alcohol

· Improperly used medication

· Flickering lights

· Intense concentration

· Hyperventilation

· Menstruation

· Hypothermia

· Hyper hydration

ETIOLOGY AND PROGNOSIS

Our brain is an enormously huge and complex network of electrical circuits. Seizures are the result of abnormal activity in one area of this circuit which causes abnormal currents to spread to the rest of the brain. The result is a seizure with physical and/or behavioral manifestations.

Seizures are associated with many medical conditions:

· Most convulsions in infants and toddlers are caused by fever; rarely cause lasting damage

· Gastrointestinal disease

· Poisoning

· Head injury

· Brain disease such as a tumor

· Breath-holding during a tantrum (rare)

In order for a medical provider to diagnose cause of the seizure the following needs to be recorded:

· Eyewitness account of a typical seizure

· Frequency of seizures and the longest and shortest intervals between them

· History of prior head trauma, infection, or toxic episodes must be evaluated

· Family history of seizures or neurological disorders

IMPLICATIONS FOR PHYSICAL EDUCATION

A PE teacher can best help a student with seizure disorder by trying to prevent a seizure from occurring by choosing appropriate activities for the class to participate in. They should also be prepared by knowing what to do if a student does have a seizure in class.

A PE teacher should:

· Encourage a normal life for a student with seizure disorder

· Recommend exercise

· Encourage student to be social

If a seizure occurs the PE teacher should:

· Remain calm

· Remove sharp objects from the area

· Loosen clothing around neck to help person breathe

· Place a pillow or soft object (mat) under the head

· Roll the patient onto his/her side to keep air passage clear

· Do not attempt to force open the person's mouth or insert any objects inside the person's mouth

· Do not try to hold the person down or restrict movement

· Do not attempt CPR, unless the person does not start breathing again after the seizure is over

· Remain with the person until the seizure has ended

· Reassure the person as consciousness return

ASSESSMENT SUGGESTIONS

What to assess in PE if a child has seizure disorder:

· Motor skills; if the skills seem to change a doctor should be notified

CONTRAINDICATED ACTIVITIES

Students with seizure disorder should refrain from:

· Doing activities that require them to be off the ground:

Ø balance beam

Ø jumping from elevated mats

Ø cargo net

Ø adventure activities that require elevation

Ø rope climbing

Ø ex-rock climbing

· They should also be monitored closely when participating in any water activity:

Ø swimming

Ø water aerobics

Ø water polo

Ø diving

Ø synchronized swimming

Ø scuba diving or snorkeling

EFFECTIVE TEACHING STRATEGIES

Teachers who have students with seizure disorder in their class should be aware of the disorder and know the implications and etiology for that specific child. They should know the situations or external factors that affect the student and teach and to avoid those situations. Teachers could use a buddy system with students with seizure disorder. This would assure that the student always had someone with them to alert a teacher if a seizure were to occur. The other student should be educated about seizures so they do not become frightened if a student has a seizure in class.

RESOURCES

Websites:

· http://www.familyvillage.wisc.edu/lib_epil.htm

Ø This is a comprehensive website giving a huge amount of information. It gives parents associations to contact to find out more about seizure disorder and what they can do for their children. It gives parents a place to go online to talk with others and get support. There are links to other websites that teach about seizure disorder and finally there are links to other organizations and websites that deal with seizure disorder.

· http://xpedio02.childrenshc.org/stellent/groups/public/@xcp/@web/@bibliography/@parents/documents/policyreferenceprocedure/web020893.asp & http://www.amazon.com/exec/obidos/tg/detail/-/0596500033/103-4185789-3707031?v=glance

Ø These two websites talk about books parents can purchase to learn more about seizure disorder and what they can do for their children.

· http://health.indiamart.com/kidshealth/illness/seizures.html

Ø This is a very easy to read, informational website about seizures and seizure disorder.

REFERENCES

http://www.merck.com/mrkshared/mmanual/section14/chapter172/172a.jsp

http://groups.msn.com/ParentsofVaccineDamagedChildren/yourwebpage2.msnw

http://health.indiamart.com/kidshealth/illness/seizures.html