Epilepsy Case Study
Cora was two years old when she had her first seizure. As a mother, I was frantic and scared that my little girl was dying of causes I could not understand. After rushing her to the hospital, the doctors asked many questions about what happened. I told them exactly what I saw which I describes as, “My child was just watching a cartoon on TV. She began to throw a fit for no reason so I walked away as I always did. However, unlike normal she screamed louder and fell to the floor where she started to have small convulsions. I had one of her older siblings call the family doctor while I tried to figure out what was happening.
The convulsions lasted less than a minute. Soon afterwards she clung onto me and fell asleep” (Jeanine Hansen, personal communication, October 13, 2012). The doctor left the room for a while after this discussion and returned with another doctor. That’s when I was told that my two-year-old daughter most likely had a seizure. The doctors then discussed with me that this may be a one-time thing and she may never have another one again. However, they also stated, that I need to watch Cora carefully to make sure that she does not have another one, which would then classify her as Epileptic.
If that were the case, then there would have to be more discussion of possible medication and/or tests. At that moment, though, the doctor’s best advice was to go home and continue with normal routines (Freeman, 2002, 73-76). I had begun to think that Cora was never going to have another seizure again since it had been two months since I had rushed her to the hospital. It was a beautiful day outside and I happened to have the day off at work. Cora and my niece were in the playroom, while my sister and I were in the kitchen making supper. When out of nowhere, I hear a high-pitched scream and a loud thud from up-stairs.
By the time that I got to the room, which was about forty-five seconds, Cora was just laying on the ground looking up in exhaustion. This time I was a little calmer; however, I still called the doctor for precaution matters. They asked me to bring Cora in to the doctor to discuss the next steps in helping my daughter to get better. When I went in to explain the second seizure my daughter had, the doctors told me that Cora was most likely having what was called a generalized tonic-clonic seizure or better known as grand mal.
This is where the seizures happen without warning, the child has rapid convulsions, eyes roll p, and they may end lose urine (Hasselt, 1988, 248). The doctors could not be for sure that was what type of seizure Cora was having until they did further test with the specific electroencephalogram, EEG. (Hasselt, 1988, 248) The next step then was to set-up an appointment to have an EEG to determine the possible source of what was triggering the seizures. The doctors stated that for the test to work best Cora needed to be tired and relaxed. They suggested that I keep her up longer the night before and wake her up early in the morning, which I did (Freeman, 2002, 96).
Then as I thought about her being relaxed I allowed her to bring one item that she wanted to bring, which of course was her blanket. On the way to the appointment, I explained to Cora that the nurse would be placing circle stickers, the monitors, in her hair. I explained what was going to happen while we were in the room and how throughout the whole process she was not going to get hurt. When we arrived at the hospital, I of course had to fill out paper work. Cora played during this time and she seemed to be relaxed. After sitting in the waiting room for about forty-five minutes we were called into a counsel room.
This was where the doctor explained what this test could really tell everyone. Going into that room I had the belief that the EEG would be able to diagnose Cora as epileptic; however, the minute the doctor started to talk my hopes were crushed. He explained to me that the EEG scan would indeed not diagnose that she for sure was having seizures, unless one would occur while the scan was being performed. The best that the scan could do was to help in suggesting the appropriate treatment for Cora by determining the possible cause or causes (Freeman, 2002, 75-76).
That’s when the first suggestion of a brain tumor came into play (Freeman, 2002, 74). My heart stopped a beat when the doctor said this. How could this be happening to my little girl? As the discussion continued, I was struck with continuing bad news of what could be causing these possible seizures and what the options were to fix them. Then we were moved into the examining room where I was allowed to sit next to Cora as she laid on the hospital bed. The nurse talked calmly to my little girl as she measured, marked and then glued on the monitors onto Cora’s head.
At first Cora would not stop moving, I was worried that she would not be able to settle down for the test. Yet, when it was time, the nurse asked me to read Cora a story. She told me that Cora hearing my voice would calm her enough and indeed it did work. The test took about 30-45 minutes (Mayo Clinic, 2012) in which the nurse asked Cora simple questions, showed her cards, and to look at a flashlight to stimulate her brain in different ways (Mayo Clinic. 2012). Afterwards, the nurse took all of the monitors off and I scheduled to come in a week later to discuss the results.
Cora had to continue these test every six months to a year based on how many seizures she had and how often her medication was upped. The initial results ruled out the fact that they were caused by a tumor, which was a huge relief to me. However, there was still the uncertainty what was causing them. The scan showed some abnormalities based on the spikes and absents of spikes in certain areas of the brain (Freeman. 2002. 97-102). Then the discussion was whether or not to use medicine to treat the possible seizures that could occur. We decided to put her on the lowest dosage possible.
The first year went well with only one seizure occurring and at the year check up the scans came back with good news that not much had changed since the year before. However, the summer before Cora went to preschool that changed. During June, my three children and I moved out of the house they all grew up in and were moved to a strange house and neighborhood. Since I was a single parent trying to move while taking care of my three children, I neglected to put the children to bed at the regular time. After this new routine, Cora had six seizures in five days.
I called the emergency doctor who prescribed me a narcotic that was given to Cora up both her nostrils with an aspirator (Jeanine Hansen, personal communication, October 13, 2012). The medicine made Cora a little silly; however, it helped stop the episodes of seizures. Two weeks before school started, I went into talk to Cora’s Preschool teacher about the precautions that had to be taken before, during, and after the grand mal seizures that Cora could possibly have during school. We sat and talked about the signals that Cora usually has before she has a seizure such as screaming or a loud noise and her body begins to go limb.
We talked about the procedure that has to take place to keep Cora and the other students safe. The teacher needs to stay calm and assure the students that Cora will be okay. I suggested that the other students be given time for a break to ensure they could leave the room during the seizure. The teacher or a helper needs to clear the area of any thing that could hurt Cora during the seizure. Then I had a meeting with the principal and the teacher, where we all discussed the option of having a record of the seizures that happened while Cora was at school.
This record would have “date and time the seizure started, behaviors before the seizure, body parts involved in the seizure, ending time and recovery period, and behaviors during the recovery period”(Smith. 2012. 356). Then there was the discussion of if the seizure could affect Cora’s learning and how we can assess the learning with technology. One of the major concerns was that certain light structures (strobe lights, video games) could trigger a seizure. Thus, we all agreed to the idea of low stimulating computer programs and games.
Throughout Cora’s early and late elementary years she had a few seizures; however, since they never interfered with her time in the class or her learning she was never suggested for special education. As Cora approached the end of seventh grade, her seizures were less often than ever before. When the doctor analyzed this fact at the next check-up, they suggested that her seizures could be lessening and may eventually stop. At that time, the doctor lessened the dosage and decided that they would try to discontinue the medication slowly.
The goal was for Cora to go six months to a year seizure free (Freeman. 2002. 178-179). Cora went into her eighth grade year seizure free, which continued into high school. I had always had the dream that Cora would have many adventures when she grew up. As any mother wishes for their child, I wanted Cora to go to college, travel the world, get married and eventually have a family of her own. However, those wishes and dreams ended the night of the crash (Freeman. 2002. 352). Cora had gone over three years without a seizure.
She had been cleared to drive and the dream of her having a normal adulthood was in front of her. Yet, on that cold October evening, when she was on her way home from a football game, she had a grand mal seizure, where she lost control of the car. The car hit a bump in the road where it caused the car to roll. Cora was killed on impact. The part that I, as a mother, hate the most is that the doctors were unable to identify what caused the seizure. There are days that I still think of what Cora would be doing if she were still here today.
