Types of Seizures - The following describes types of seizure and staff responses. The Medical Safety Plan outlines specific symptoms, staff responses and the emergency plan for individual students.
1. Generalized Tonic Clonic:
Previously called Grand Mals seizures are convulsions in which the body stiffens, the child may cry out, fall unconscious and then undergo massive jerking movements. Bladder and bowel control may be lost and the child may vomit. Seizures usually last one to two minutes. Breathing may be shallow or even stops briefly and renews as jerking movements end. The child may be confused, or belligerent as consciousness returns.
Treatment – First Aid:
Keep calm. Reassure the other children that the child will be fine in a minute. Keep track of how long the seizure lasts. Follow the child's individual Medical Safety Plan to determine when a call to 911 should be made. Generally a call would be made if the seiaure lasts more than 5 minutes or if it repeats without full recovery. Ease the child gently to the floor and clear the area around him/her of anything that could hurt him. Put something flat and soft (like a jacket) under the head so the child will not be injured during the seizure activity. Loosen any tight neckwear. Turn the child gently on his side in the Recovery Position after seizure subsides. This keeps the airway clear and allows any fluid or vomit in the mouth to drain harmlessly away.
- Don’t put anything in the mouth.
- Don’t try to force the mouth open.
- Don’t try to hold their tongue.
- Don’t try to restrain the movements.
When the jerking movements stop, let the child rest until full consciousness returns. Breathing may have been shallow during the seizure and may even have stopped briefly. This can give child’s lips and skin a bluish tinge, which corrects naturally as the seizure ends. In the unlikely event that breathing does not begin again, check the child’s airway for any obstructions and give artificial respiration. Call 911 (Call parents)
2. Status Epilepticus
Continuous seizure activity, is a life-threatening medical emergency. Seizures occur one after another, lasting 5 minutes or more without recovery of consciousness between seizures. Immediate medical care is required.
Treatment – Call 911 (Call parents)
3. Post-ictal Psychoses
Refers to short-lived events, behavioural manifestations following seizures. It may include, but is not limited to the following in various degrees: clouding of consciousness, disorientation or delirium, delusions and hallucinations.
4. Simple Partial Seizures
Are limited to one area of the brain. Consciousness is not lost, though the child may not be able to control body movements. Senses may be distorted during the seizures so that the child sees, hears, and smells, or experiences feelings that are not real or heightened senses of perception. Examples: such as smells of burnt toast or eggs. They may see flashing lights.
Treatment – First Aid is usually not required although the child may require comforting and reassurance and re-orientation to present activities (Inform parents).*See Post-ictal psychosis.
Previously called petit mal seizures produce momentary loss of awareness, sometimes accompanied by movements of the face, blinking or arm movements. These may be frequent. The child immediately returns to full awareness after one of these episodes. These seizures are at times difficult to see. Children appear confused or “lost” in current discussions or activities. Providing opportunities for “review” of material or “written” instructions may help the children in class.
Treatment – No first aid is required (Inform parents). * See Post-ictal psychosis.
6. Complex Partial Seizures
Also called temporal lobe or psychomotor epilepsy, produce a sequence of automatic behaviour in which consciousness is lost or clouded. The child may get up and walk around, may pick at clothes, may fling off restraints, may mutter, or tap a desk in aimless undirected way. He may appear to be sleepwalking or drugged. Some children experience fear or paranoia as part of the seizure and may try to leave the room. This type of seizure lasts only a minute or two, but feeling of confusion afterwards may prolong. The child will not remember what he did during the seizure. His actions while having it will not have been under
Treatment – First Aid: take arm gently to guide the child to their seat, speak to them calmly. Do not grab hold or speak loudly. If child resists just make sure he/she is not in jeopardy. If child is in seat, ignore automatic behaviour but have him/her stay in the classroom until full awareness returns. Help re-orient the child if he feels confused afterwards (Inform parents).
7. Other Generalized Seizures
Akinetic, Atonic, Myoclonic, produce sudden changes in muscle tone that may cause the child to fall abruptly or jerk the whole body. A child with this kind of seizures may have to wear a helmet to protect the head. The seizures are more difficult to control than some of the others and in some cases may be accompanied by some degree of developmental delay.
Treatment – First Aid: The child should be helped up and examined for injury from the force of the fall, reassured and allowed to sit quietly until fully recovered (Inform parents).