Defination of Epilipesy(Occupational therapy).pptx

Epilepsy is a chronic condition following by seizure attack. It is a phycho pathological conditions happens in patients having medical issues.

1. EPILEPSY

2. Definition Epilepsy : chronic neurologic condition of recurrent seizures that occur with or without the presence of other brain abnormalities. Seizure : a temporary involuntary change of consciousness, behaviour, motor activity, sensation, or automatic functioning.

3. causes A seizure starts with an excessive rate and hypersynchrony of discharges from a group of cerebral neurons that spreads to the adjoining cells called the epileptogenic focus.

4. Types Generalized seizures : involve the entire cerebral cortex Partial seizures : begin in a single location and remain limited or spread to become more generalized

5. Types of Generalized seizure Absence seizures : brief in nature, lasts less than 10 secs but may occur as often as 100 times per day. No aura or warning precedes onset. It is sudden, affects the entire brain and causes rapid loss and regaining of consciousness. No postictal confusion occurs. The child may drop objects, blink and jerk.

6. 2. Myoclonic seizures : tonic muscle spasms without loss of unconsciousness. A sudden mild or massive jerk may occur. Infantile spasms are a specific type of myoclonic seizure. 3. Atonic or drop seizure : brief involuntary sudden loss of muscle tone, may cause a sudden slumping of body with inability to stay in upright position. It can lead to injury and bruising of head and face. The atonic seizure is rare and is usually associated with more severe or progressive forms of epilepsy.

7. 4. Tonic – Clonic Seizures : in past termed as “grand – mal” seizures. May have an aura, or sensation , that the seizure is about to begin. This is usually followed by a loss of conciousness , during which the body becomes rigid, or tonic, and then rhythmic clonic contractions of all extremities occur. The seizure may be characterized by tongue biting, excessive drooling and incontinence. The seizure may last for 5 minutes and is followed by a postictal period that may last 1 to 2 hours. This period may be seen as confusion, headache, and/or deep sleep. After the seizure the child may complain of headache, sore muscles or exhausation .

8. Types of Partial seizure Simple partial seizure : involve the motor cortex and result in clonic activity of the face or extremities. The child does not lose conciousness . Psychic symptoms include visual hallucinations, illusions, auditory hallucinations or olfactory sensations. The typical seizure include night time awakenings and twitching of facial muscles; this twitching interferes with speech and spreads to hand.

9. 2. Complex Partial Seizure : Usually originate in temporal lobe. Children may show automatic reaction such as lip smacking, chewing, and buttoning and unbuttoning of clothing. The seizure are focal. He or she may not recall this behaviour when regaining consciousness. An aura may precede the seizure and postictal confusion or drowsiness may follow.

10. Unspecified Seizures Febrile seizures : seen in healthy babies, usually in children ranging in age from 6 months to 5 yrs. It is characterizes by a fever over 101 ° F (38.3 °C). Usually associated with infections such as otitis media or urinary tract infections and not with meningitis, encephalitis or trauma.

11. 2. Status epilepticus : generalized seizure extending more than 10 minutes. It is a life threatening disorder, continues or reocurs in rapid sessions over a prolonged period of time. It requires emergency help and is frightening experience for the families and health care professionals. Seizure of this type lasting more than 1 hour can cause permanent damage to the brain.

12. Features of seizure/ epileptic disorder Developmental delay Abnormal muscle tone : hypertonic, hypotonic, fluctuating tone. ataxic Sensory/perceptual problems Hyperactivity, short attention span, hyperactivity, distractibility are some side effects of epileptic drugs Deficits in memory, attention, concentration Personality changes

13. Fine motor hand function : buttoning, feeding, grooming, hand writing( speed, quality) Problems in Activity of Daily Living : swallowing and eating problems Behaviour problems : hyperactivity, mood problems, conduct problems

14. Assessment History : birth history, family history, medical history and developmental history Seizure event : length of time, type of activity ( behaviour observed), how the seizure began, child’s behaviour after seizure Diagnostic tests : electroencephalography(EEG), CT Scan, Magnetic Resonance Imaging (MRI), videomonitoring

15. Occupational Therapy Assessment Developmental Assessment : the goal is to identify the exact areas of delay and the developmental problems the child is experiencing (delayed verbal skills) Muscle Tone Ataxia Sensory assessment Perceptual assessment Cognitive assessment

16. Hand function School performance ADL Assessment Requirement of Adaptive assistive devices Behaviour Assessment

17. Management Medical management : anticonvulsive drugs The choice of drugs depends on type of seizure, age of patient, and risk of non compliance Side affects may be : overgrowth of gums, hyperactivity, lethargy, irritability, poor sleep patterns, impaired memory and decreased attention span

18. Occupational T herapy M anagement Remain calm, stay with the child, protect the child from injury, and facilitate breathing Developmental therapy Hand therapy ADL training Assistive and adaptive devices : children with atonic or drop seizure may need protective head gear. Different positioning and mobility devices

19. Adapted / paediatric wheelchair Padded lap trays Early Intervention assists parents to set limits, enforce rules, assign responsibilities and reinforcement of positive behaviours, enforce rule