Student Presentations • November 2015

Here are three presentations, two using Prezi and one using Emaze. All three require Flash.


Living with intractable epilepsy made easier

Epilepsy is a disease that not only affects the individual suffering from it, but it can also be a source of significant stress and anxiety for the family or caregivers. Treatment resistant epilepsy is an especially difficult diagnosis: typically, even though your child is taking a combination of anti-epileptic drugs (AEDs), she/he is likely to suffer a “breakthrough” seizure once in a while. In some individuals, the seizure activity may manifest few times during the day, while in others it may be much less frequent. Every patient and their caregiver should have an action plan, outlining the actions to be taken when the individual manifest a cluster of seizure activity or has prolonged seizures, lasting more than 5 minutes (from the concern for status epilepticus). The action plan should be carefully reviewed and discussed with the physician, as to answer any questions that you may have. It is important that you feel confident and know what actions to perform when your child is actively seizing.

An important part of each action plan is the “emergency” medications.

Sample Action Plan (source: Epilepsy Foundation)

Often, parents or caregivers are instructed to administer rectal diazepam when they notice a cluster of seizure activity occurring or prolonged seizure that does not resolve in 5 minutes. Rectal diazepam is safe and relatively easy to administer in a non-hospital setting. However, its administration is often times “socially unacceptable.” It also requires removal of clothing and proper positioning, which may be difficult to do when the person affected by epilepsy is an adolescent/adult and is violently convulsing. A recent meta-analysis of the available literature of randomized controlled studies, revealed that use of buccal midazolam (which can be administered either via oral mucosa or via intranasal route), is even slightly more effective than the traditional rectal diazepam and has a similar safety profile.1 It makes it a desirable option for many families who struggle with the administration of rectal formulations of the medication. If you or the people involved with the care of someone who suffers from epilepsy have found it difficult to administer rectal diazepam, it is certainly worth discussing other options that may be available with the physician who is taking care of your child.

To view a short a short video demonstrating the administration of buccal midazolam, please click below:  https://www.youtube.com/watch?v=8bINlAxRDa8

Sources:

  1. My Seizure Plan. Accessed online
  2. Adminstration of Buccal Midazolam. Accessed online 
  3. Brigo et al. Nonintravenous midazolam versus intravenous or rectal diazepam for the treatment of early status epilepticus: A systematic review with meta-analysis. Epilepsy & Behavior. 49 (2015) 325–336. PMID: 25817929.

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