Seizures in People with
Developmental Disabilities

Seizures

Epilepsy (also known as seizure disorder) is a neurological condition.

Damage of the brain cells disrupts the
smooth-running pattern of electrical activity in the brain causing overload.

The electrical overload can create seizure activity.

Seizure Types

Generalized or Grand Mal Seizures

Partial Seizures

Complex partial seizures

Simple partial seizures

Generalized or Grand Mal Seizure

Entire brain is affected.

Consciousness always impaired or lost

Convulsions may occur.

Also called tonic-clonic seizures.

Grand Mal Seizures

Common effects:
Person may stop breathing, turn pale or blue. Biting of tongue, eyes may role back into head. Loss of bladder or bowel control.

No control of movement, speech or action. Following seizure sleep or temporary confusion may occur.

Partial Seizures

Complex partial Affect a large area of the brain and affect consciousness.

Simple partial Decrease consciousness but there is no loss of consciousness.

Complex Partial Seizure

Common effects:

Dazed state
Drooling and purposeless behavior (i.e. lip smacking or jerking movements) Wandering

May run in fear or cry out.

No control of movement, speech or actions.

Simple Partial

Decrease in the level of consciousness, but no loss of consciousness

Common effects:
Eye movements or shifting of facial features. Shaking of hand or foot

Sudden nausea

Sweating, flushing or becoming pale

Person may become very emotional

Recognizing Seizures

Generalized or grand mal

Easy to recognize

Loss of consciousness

Convulsions

Recognizing Seizures

Complex or Simple Partial

Can be difficult to recognize in a non-verbal person

Many “seizure like” movements could be the person’s baseline, for example:

Stiffening, jerking, tongue biting, tremors, and/or facial shifting

Recognizing Seizures

If the person is unable to respond they are most likely having a seizure

Have a simple task or response plan.

Recognizing Seizures

“Aura” is a partial seizure that is experienced as a peculiar sensation that precedes the onset of a generalized seizure

Can involve any one of the five senses

Can take the form of taste, visual, or auditory experience.

People who experience an “Aura” may sit down or not get up from a chair recognizing they are going to have a seizure

Seizures Requiring Immediate

Medical Care

Status epilepticus.
When significant bodily harm occurs. If the event is a first time seizure.

Any seizure lasting greater then 5 minutes requires immediate medical response unless otherwise indicated by the health care provider.

Treatment

There is no known cure for epilepsy/seizures. Treatments for management include:

Medication
Surgical intervention Vagus nerve stimulator Ketogenic diet

Typical Placement of Vagus Nerve

Stimulator

Vagus Nerve Stimulation Therapy

Complete seizure control is seldom achieved but the majority of people experience fewer seizures.

•Used when medications fail to stop seizures

•Designed to prevent seizures by sending regular small pulses of electrical energy to the brain via the vagus nerve

•The battery is programmed by the health team to send a few seconds of electrical energy to the vagus nerve every few minutes.

•A small magnet can be used to stop a seizure by passing it over the device(prescribed by the HCP)

Ketogenic Diet

•   Used for children

•   High in fat and low in carbohydrates

•   Makes body burn fat instead of glucose

•   More research needed

Treatment

Medications are used to minimize or block the spread of excess electrical stimuli.  These medications are called anti-convulsants or epileptics

Approximately 70 – 80% of people use one anti-convulsant to control seizures

50%, require two anti-convulsants to control seizures

Treatment

Medication

Most anti-convulsant medications require time to reach a therapeutic level
Frequent blood levels should be checked Certain people are very sensitive to medication changes.
Missed doses or medication adjustments can increase the risk of seizure activity

Triggers

Even with therapeutic blood levels certain events can alter the person’s seizure threshold

Stress, emotional upset Physical illness or infections Temperature changes Photosensitivity

Responding to Seizure Activity To effectively provide support to a person with a seizure disorder, It is crucial to have

a response plan in place.

REHABILITATIVE RESOURCES, INC.
CARE AND AFTERCARE OF AN INDIVIDUAL WITH A SEIZURE

CALL FOR MEDICAL HELP (911) WHEN:
______________________________________________________________________
•If this is a NEW or a CHANGE from the individual’s seizure pattern.
•Convulsive seizures lasting more than FIVE minutes.
•The individual does not resume breathing after the seizure.  Give CPR.
•The individual has one seizure after another.
•The individual is injured.

CARE DURING A CONVULSIVE SEIZURE:
•REMAIN CALM
•PROTECT HEAD BY REMOVING GLASSES AND SHARP OBJECTS
•LOOSEN CLOTHING AROUND THE NECK
•TURN PERSONON SIDE TO PROTECT AIRWAY
•NEVER PLACE ANYTHING IN MOUTH
•TRACK TIME
FOR A NON-CONVULSIVE SEIZURE (COMPLEX PARTIAL) CARE:
•DO NOT RESTRAIN
•STAY CALM AND TRACK TIME
•REDIRECT FROM HAZARDS
•DO NOT AGITATE, SPEAK CALMLY
•ALWAYS STAY WITH INDIVIDUAL DURING SEIZURE

AFTERCARE:
Do reassure the individual.  They may be very tired and require rest.  Stay with the individual until they are fully awake and reoriented.  Don’t offer
food or drink until the individual is fully conscious.  Follow the individualized seizure protocol for additional care.  If this is a new seizure or is a change from the normal pattern of individual’s seizure this would require activating EMS. If an individual is having an increased number of seizures call the HCP.  Document seizure using Rehabilitative Resources Seizure Record and medical progress notes.

Suzanne Collins  scollins@scrri.org

Epilepsy Foundation:

www.epilepsyfoundation.org

1-800-213-5821