Epilepsy Awareness & Protocols
Epilepsy is a tendency to recurrent seizures originating in the brain. It can be an inherited condition but can also be the result of physical damage to the brain as a result of a head injury, an infection, substance abuse, tumour or stroke. An epileptic seizure is an intermittent disturbance of consciousness, behaviour, emotion, motor function, perception or sensation. Seizures can be partial, affecting part of the brain, or generalised, affecting the entire brain and resulting in a loss of consciousness.
Partial Seizures can be simple or complex:
- A simple partial seizure does not cause a loss of consciousness
- A complex partial seizure can cause a change to consciousness and perception
Generalised Seizures typically occur in 5 sub types:
- Absence: Staring and blinking
- Myoclonic: Brief jerking movements, usually of upper body
- Tonic-clonic: Going stiff and falling - followed by convulsions (jerking movements)
- Tonic: Going stiff and falling without convulsions
- Atonic: Falling limply to the ground
Procedures for dealing with students with epilepsy are as follows:
- The student must identify themselves to College as having epilepsy
- The student must apply for reasonable accommodations with the Disability Service
- A Needs Assessment is carried out, specific to the student’s circumstances and the demands of his/her course of study.
- If any issues emerge, a risk assessment will be carried out to determine strategies to support the student in their course.
- If the student is applying for accommodation, the Needs Assessment also addresses those requirements.
- The Registrar of Chambers and the Warden of Trinity Halls allocate rooms, taking into consideration the Needs Assessment.
- The student is offered an accommodation contract which includes the student’s general responsibilities as well as any responsibilities arising from the Needs Assessment.
- The Disability Service continues to engage with the student to ensure reasonable accommodations are available.
- A Fitness to Study Group exists to review cases to determine if a student is able to continue in Trinity. In this context Fitness to Study refers to the student’s fitness to engage in the full range of College life, including academic activities, social activities and accommodation.
- In the case of epilepsy, the Needs Assessment follows the guidelines of Epilepsy Ireland.
Relevant Supports & Accommodations
During a Needs Assessment it is vital to attain the following information so that a complete understanding of the person's epilepsy can be used to identify reasonable accommodations:
- Epilepsy type
- Seizure type/types
- What exactly happens
- Specific support needs during and after a seizure
In general, students with epilepsy will benefit from some or all of the following supports and accommodations:
- Needs Assessment to determine support requirements
- Additional tuition
- Exam accommodations
- Extended library loans
- Extensions to assessment deadlines
- LENS report will link to this information page
Guidelines for responding to Epilepsy Seizure
During a Seizure DON'T:
- Put anything in the month
- Restrain or restrict movement during the seizure
- Give anything to eat or drink
- Move the person unless they are in danger
During a Seizure DO:
- Note the time
- Clear a space around the person
- Cushion the head to prevent head and facial injury
- Remove spectacles, if worn
- Loosen tight neckwear
- Loosen chest and leg safety straps on wheelchair
- Turn on side if possible, to aid drainage
- Reassure others and explain what you are doing
At the end of a Seizure:
- Reassure the person and tell them what has happened
- Check for signs of injury and apply first aid if necessary
- Observe the person and stay with them until recovery is complete (they may need assistance to return to their routine)
- Provide privacy and offer assistance if there has been incontinence
- Record appropriately
Call an Ambulance:
- If it is the person's first seizure
- If a seizure lasts more than 5 minutes and you do not know the usual length of the person's seizure
- If a seizure lasts 2 minutes more than is usual, and rescue medication isn't prescribed
- If a tonic clonic seizure follows another without full recovery in between, and rescue medication has not been prescribed or been effective
- If concussion/head injury is suspected
- If you are concerned about the person's colour/breathing
- If water is inhaled
- When directed by organisational policy
Epilepsy Care Plan & Emergency Medicine Protocol
Trinity have developed a Epilepsy Care Plan and Emergency Medicine Protocol based on information provided by Epilepsy Ireland. The care plans describe the student’s epilepsy and the appropriate first aid. Even if seizures are well controlled staff may need to be informed in case of breakthrough seizures or any impact on memory, learning and behaviour. If a student only has sleep seizures staff still need to know about any effects of disrupted sleep. Information from the care plan may be disclosed with the student’s permission to ensure all parties involved in the students education are aware of the student’s epilepsy and management.
Trinity Epilepsy Protocol for the administration of Buccal Midazolam
A Protocol for the administration of Buccal Midazolam in epilepsy may be required for students seeking rooms on Campus or in Trinity Hall or who have personal care needs while attending their course and related activities. This protocol should be completed by, or in consultation with, the prescribing medical practitioner.
Further resources and information
Epilepsy Ireland, 249 Crumlin Road, Dublin 12.