Seizures & Epilepsy
Beth Blakeley, M.S.
Director of Education
Epilepsy Foundation of
National Epilepsy Facts:
Over 3 million Americans have epilepsy.
Roughly 181,000 new cases of seizures and
epilepsy occur each year.
50% of people with epilepsy develop seizures by the
age of 25; however, anyone can get epilepsy at any
Now there are as many people with epilepsy who are
60 or older as children aged 10 or younger.
Kentucky Epilepsy Facts:
Over 90,000 of Kentucky’s residents have epilepsy.
This was discovered using the Centers for Disease
Control & Prevention’s (CDC) Behavioral Risk Factor
Surveillance System (BRFSS).
BRFSS interviewed young – middle age adults via
Because the very young nor very old were
interviewed, experts at UK and UofL believe this
number is actually closer to 180,000.
It is not getting better soon….
Studies suggest that traumatic brain injury (TBI) leads to post-
traumatic epilepsy (PTE) in approximately 20 – 25% of civilians
with closed head injuries.
Approximately 1.4 million soldiers were recently deployed to and
are now returning from missions in Afghanistan and Iraq, and
many have sustained TBI’s because of improvised explosive
Approximately 50% of military head injuries lead to PTE.
Kentucky is home to two military bases (Forts Knox and
Campbell), therefore epilepsy experts are expecting a wave of
epilepsy diagnoses in the very near future.
Epilepsy & Employment Facts:
Workers with epilepsy have a job performance record that
compares favorably with the job performance record of
workers who do not have epilepsy.
Most people with epilepsy do not need accommodations to do
For those that do need accommodations, most are less than
What causes epilepsy?
In about 70% of people with epilepsy, the cause is not
In the remaining 30%, the most common causes are:
Brain tumor and stroke
Infection of brain tissue
Prenatal disturbance of brain development
Dispelling Misconceptions about Epilepsy
Most seizures are NOT medical emergencies.
Epilepsy is NOT contagious.
Epilepsy is NOT a form of mental illness, it is a
People rarely die or have brain damage from a
A person can NOT swallow his/her tongue during a
Who is at a risk for developing epilepsy?
Approximately 1% of the general population will develop epilepsy.
The risk is higher in people with certain medical conditions:
What is a Seizure?
Your brain cells (neurons) constantly send tiny electrical impulses
(signals) that direct the functions of your body.
All brain functions – including feeling, seeing, thinking and moving in
the brain – depend on these electrical impulses passed between the
A seizure occurs when too many neurons in the brain “fire” too
quickly, causing an “electrical storm”.
These uncontrolled electrical impulses can cause a change in
awareness or movement.
Symptoms that may indicate a seizure disorder:
Periods of blackout or confused memory
Occasional “fainting spells”
Episodes of blank staring in children
Sudden falls for no apparent reason
Episodes of blinking or chewing at inappropriate
A convulsion, with or without fever
Clusters of swift jerking movements in babies
What is the difference between Epilepsy and
Seizure – a brief, temporary disturbance in the
electrical activity of the brain
Epilepsy – a disorder characterized by recurring
A seizure is a symptom of epilepsy
There are over 20 different types of seizures.
Some seizures cause people to shake, fall or have
Other seizures involve staring, confusion, muscle
spasms, aimless wandering.
Many seizure types do not cause loss of
What can trigger a seizure?
Missed medication (#1 reason)
Lack of sleep/extreme fatigue
Drug/alcohol use; drug interactions
Involve the whole brain and loss of consciousness
• Generalized Tonic -Clonic
Involve only one part of the brain; may or may not include loss of
Symptoms relate to the part of the brain affected
• Simple partial
• Complex partial
Type Duration Seizures Symptoms Symptoms
Simple 10-90 No loss of consciousness Possible transient
Partial seconds Sudden jerking weakness or loss
Sensory phenomenon of sensation
Complex 1-10 May have aura Amnesia of
Partial minutes Staring seizure events
Automatisms (such as lip Mild to moderate
smacking, picking at clothes, confusion
Unaware of environment
Each part of the brain is responsible for controlling Parietal lobe –
various activities controls the reception
and processing of
Frontal lobe –
from the body
Temporal lobe –
emotion, hearing Occipital lobe –
Possible Affects of Partial Seizures
Parietal lobe –
Frontal lobe – seizures here can cause
seizures here strange physical
may cause sensations, such as a
disruptive tingling or warmth down
behavior, running, one side of the body
Temporal lobe –
of sounds such as Occipital lobe –
ringing sounds or seizures here
music. Seizures in create visual
this area can also distortions and
alter mood or images of people
consciousness or things that
are not actually
First Aid for Complex Partial Seizures
Stay calm and track the time.
Do not restrain the person.
Remove dangerous objects from the person’s path.
Calmly direct the person to sit down and guide him or her from
Use force only in an emergency to protect the person from
immediate harm, such as walking out in front of an oncoming car.
Observe, but do not approach a person who appears angry or
Remain with the person until he or she is fully alert.
No first aid is necessary for simple partial seizures.
Type Duration Seizure Symptoms Postictal Symptoms
Brief rapid muscle contractions
1 – 15 seconds Usually affects both sides of body
may occur in clusters
Similar to leg jerks while sleeping
Abrupt loss of muscle tone
Atonic 1 – 15 seconds Head drops
(or Drop Attacks) may occur in clusters Loss of posture, or sudden collapse
Injuries – head gear
Amnesia for seizure
Absence No confusion
2 – 15 seconds Eyes fluttering
(petit mal) Promptly resumes
Automatisms if prolonged
Generalized Sudden cry Amnesia for seizure
Tonic-Clonic Fall events
1 – 10 minutes Confusion
(grand mal) Rigidity
Convulsions Deep sleep
First Aid for Generalized Tonic-Clonic Seizures
Stay calm and track the time.
Do not restrain the person, but help them avoid hazards.
Protect head, remove glasses, loosen tight neckwear.
Move anything hard or sharp out of the way.
Turn person on one side.
Check for epilepsy or seizure disorder identification.
Stay until person is fully aware and help re-orient them.
Call ambulance if seizure lasts longer than 5 minutes, or if it is
unknown whether the person has had prior seizures.
First Aid for Generalized Tonic-Clonic
Seizures on School Bus
• Safely pull over and stop bus
• Place student on his/her side across the seat facing
away from the seat back (or in aisle if necessary)
• Follow standard seizure first aid protocol until
seizure abates and child regains consciousness
• Continue to destination or follow school policy
• Put anything in the person’s mouth.
• Try to hold down or restrain the person.
• Attempt to give oral antiseizure medication.
• Keep the person on their back face up throughout
When to call an ambulance
A convulsive seizure occurs in a person not known to
have seizures or lasts more than 5 minutes.
A complex partial seizure lasts more than 5 minutes
BEYOND its usual duration for the individual.
Another seizure begins before the person regains
Also call if the person:
Is injured or pregnant
Has diabetes/other medical condition
Does not resume normal breathing
Help person with epilepsy lead full and
Eliminate seizures without producing side
Vagus nerve stimulation (VNS)
Factors that Determine Response
Consistent use Seizures
Inadequate dosage or reduced
ineffective medication (30%) Seizures
Drug factors (50%)
Factors influencing decision:
Likelihood seizures are due to
Likelihood surgery will help
Ability to identify focus of seizures
Other treatments attempted
Benefits vs risks
Vagus Nerve Stimulation
Used to treat partial seizures when medication does not work.
Vagus nerve serves many organs and structures, including:
Larynx (voice box)
Vagus nerve has connections to areas of the brain that are
instrumental in producing seizures.
Pacemaker-like device is implanted in the left side of the
chest with electrodes wrapped around the vagus nerve.
Controls seizures by delivering electrical stimulation at
pre-set time intervals to the left vagus nerve in the neck,
which relays impulses to widespread areas of the brain.
How does VNS work?
The electrical stimulation produced by the VNS device can
significantly decrease the brain’s ability to generate seizure
activity in most patients.
VNS therapy does not eliminate the occurrence of seizures
in most cases.
However, the VNS device can stop or decrease the time and
severity of seizures when activated right before or during a
Most patients will continue to take their anti-seizure
Stimulating the Vagus Nerve to
Stop a Seizure
If a person has a seizure warning sign (aura), he/she or a
trained observer may swipe the magnet over the VNS device
to activate it and help abort the seizure.
The magnet may be swiped during an actual seizure to
shorten the length of the seizure.
Once activated, the device will send an additional electrical
impulse to the vagus nerve.
The magnet may be swiped over the VNS device as often as
needed with at least one minute between swipes.
VNS magnets are usually worn on a belt or on the wrist.
Based on finding that starvation – which burns fat for
energy – has an antiepileptic affect.
Used primarily to treat severe childhood epilepsy, has been
effective in some adults and adolescents.
High fat, low carbohydrate and protein intake.
Usually started in the hospital.
Requires a strong family commitment.
Beth Blakeley, M.S.
Director of Education
Toll Free: 1-866-275-1078