Treating Epilepsy And Seizures In Your Massage Therapy Clinic
The terrified voice over the radio screamed for help.
It took about a minute to get there after we had been called. Adrenaline pumping, no idea what we were running into, just hearing panicked screams for help.
I had an awesome first aid instructor who would simulate what a seizure looks like whenever I took a course with him. Fortunately he was pretty bang on with the way he re-enacted it. When I saw what was happening, I instantly knew what was going on.
As the tremors started to slow down, we could finally get access to him after we had cleared the area around his side.
He laid there unconscious, frothing at the mouth.
I tried to put an oral airway in, to help him breathe and maintain the airway. He wouldn’t accept it.
He was still breathing, so we did our best to support him. Called 9-1-1 to get an ambulance there and had no idea how this happened. Looking up at his co-workers they were all shaken and bewildered over the last couple of minutes, watching their friend go through something so traumatic.
I was at his side supporting his head when he started to regain consciousness. He looked at me confused and couldn’t sound out proper words. It just sounded like gibberish. Slowly, he started to come back, only to be confused by the multiple people standing around him wondering what the hell just happened.
Why Helping Someone Having A Seizure Can Be Scary
I’ve written about this story a couple of times now, but I wanted to write about it again because I think it bears repeating.
Dealing with someone having a seizure can be a pretty scary thing, especially if you’ve never seen it before. Even after watching my First Aid teacher re-enact a seizure, I was still pretty surprised that first time.
While it is depicted so often on TV and movies where the person is just flopping around on the floor, from my experience it doesn’t look like that. The person can also experience prolonged contractions through their whole body as opposed to actually shaking. There can also be incomprehensible sounds and cursing coming from the person while the contractions are happening.
The person can be frothing at the mouth and possibly have blood present in the area. I will admit that the first time I helped someone in this case the frothing from the mouth is what threw me off the most until I realized it was normal and part of the process.
Causes Of Epilepsy And Seizures
Seizures can result from several different things, but the most common one is Epilepsy. Epilepsy only affects about 1% of the population and is characterized by short recurrent attacks of motor, sensory and physiological malfunction.The seizures start from abnormal electrical discharges in the brain that stimulate nerve impulses over their pathways.
Partial seizures have milder symptoms that begin on one side of the brain, while generalized seizures happen on larger areas on both sides of the brain resulting in loss of consciousness.
Epilepsy is usually controlled by medication and there are surgeries that some people elect to have if the medications aren’t controlling the condition well. But people with Epilepsy can still have seizures from time to time even if using medication. The person in the story had epilepsy, but just forgot to take their medication that day. Unfortunately none of us knew he had epilepsy, so we had no idea why this seizure was happening.
There are several things that cause Epilepsy including:
- Brain damage at birth.
- Metabolic disturbances.
- Toxins (ie: drugs and alcohol).
- Vascular issues.
- Head injuries (happened to me when I was 18).
- Abscess on the brain.
This is where a good Massage Therapy intake form is priceless. Making sure you look over an intake form to see if one of your new patients is on medication or lists Epilepsy as a medical condition, puts you a step ahead in preparation for dealing with this one day. Also making sure that each patient’s intake form is updated every so often, just in case someone develops a condition like this is just as important.
But Epilepsy isn’t the only cause of seizures. There are a few other things to consider (especially if Epilepsy isn’t listed on that intake form): (First Aid and CPR Manual)
- Heat Stroke.
- Drug or alcohol withdrawal.
- Video Games (some even come with a warning now before you start playing them).
- Infants and young children with a high fever (febrile seizures).
While the causes may be different, most generalized seizures are going to look the same and providing care for the person is something we can all easily do.
The Signs Of A Seizure Massage Therapists Need To Recognize
There are a few stages to a seizure that Massage Therapists need to recognize. In the case of someone with Epilepsy they will usually be able to recognize that a seizure is coming on. However with someone who has never experienced a seizure before, it’s less likely they would realize what’s going to happen.
In the case of a generalized seizure there are some warning signs that come on before the uncontrolled muscular contractions take place. The stages of the seizure will look like this:
- Aura phase – they sense something unusual is happening with a strange sound, taste or smell.
- Tonic phase – they go unconscious and experience tense muscles.
- Clonic phase – the seizure (which can range from blackout to convulsions lasting minutes).
- Postictal phase – the gradual recovery from the seizure.
Having the ability to recognize what’s about to happen goes a long way to being able to help a person if they are having a seizure.
What Massage Therapists Can To Do Help A Seizure
If you recognize that a seizure is about to happen (someone with Epilepsy will know what’s about to happen and may ask for help), get the person sat down on the floor in an open space.
Once the actual seizure starts, clear everything away from the person. We want to make sure there is an open area for them, so that they are not bumping into anything and causing an injury while the seizure happens.
- Don’t try to suppress them, or stop the seizure from happening, just let it happen.
- If they’re on your table when a seizure happens, try to prevent them from falling off the table.
- Make some noise if you have to and get some of the other practitioners in your clinic to come in and stand at the side of the table to prevent the person falling off.
- If they were face down on the table, grab some pillows and do your best to support their head coming off the face piece.
If they were face up when it happened, still do what you can to prevent falling off the table and support their head. DO NOT stick anything in their mouth. Biting the tongue enough to cause any injury isn’t common. However you can end up causing significant injury to yourself by trying to put something in the person’s mouth.
Your biggest responsibility now is to manage the person’s airway. Watch for any frothing at the mouth or possible vomiting. Once the seizure stops, get the person turned onto their side to help maintain the airway and keep it clear.
When the seizure is over and the airway is being maintained, go into your secondary survey. Check out the rest of the person’s body to see if there were any other injuries that occurred. Look for medical alert bracelets or necklaces to see if the person has a medical condition that would suggest this happening.
If the person was naked or in their underwear on your table, make sure to cover them up with a blanket, not only to help prevent shock but also to show them respect and privacy. As the person begins to come out of a seizure they will be a little disoriented and possibly embarrassed. Try to give as much reassurance to them as possible.
10 Reasons A Seizure Can Be A Medical Emergency
Someone who has epilepsy or is known to have seizures doesn’t necessarily mean you have to call 9-1-1…yet.
In the story I told at the beginning, he was mad at me for calling the Ambulance (although I had no idea he had epilepsy). With individuals that are prone to having seizures, it is usually part of everyday life, and they manage the condition with directions from their Doctor. However there are some guidelines that show when it’s necessary to get more advanced help:
- Seizure lasts more than a few minutes.
- The person sustained an injury.
- They experience repeated seizures.
- You don’t know why the seizure happened.
- The person is pregnant.
- It is a baby or a child.
- The seizure happened in water.
- The person has diabetes.
- They don’t regain consciousness afterwards.
- It is a febrile (baby or child) seizure combined with a high fever.
With any of the above instances make sure to call 9-1-1 and get some more advanced medical care. There is also something called “status epilepticus” where a person has continuous seizures and do not regain consciousness. This is a case where Ambulance must be called in to get the person to a hospital ASAP. They must get to advanced medical care.
In a case where a baby or child is having a seizure due to a fever, do what you can to cool the baby. Use room temperature water, give the baby a sponge bath and provide what care you can until Ambulance arrives.
While a seizure can be a scary thing to deal with, there are so many things we can do as healthcare professionals to assist our patients if it happens. Taking the time to recognize the events leading up to a seizure and how to properly handle what happens will help to make it not so scary.
“I feel so lucky that I met the love of my life. You know somebody’s in it to win it when…you’re having a seizure and they’re holding you…” Kathleen Hanna
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Great article. I just wanted to add something from personal experience too….
Once the person is in recovery phase and becomes conscious enough to start understanding what just happened, try to keep them from getting up right away. I’ve been injured myself trying to assist someone (much bigger than me) to the washroom afterwards as he insisted he was going there. (The bowels also strongly contract during a seizure so there is a strong urge to use the washroom to void them.) He was unable to walk well as he was uncoordinated and weak from exhaustion so kept tumbling as he walked.
The person may also just be extremely embarrassed afterwards and may try to get up to get away from you – so again try to keep them still and assure them that they are safe and not to worry.
So though it is a common misconception to try to restrain them during a seizure, it may be necessary to attempt to do so once they have partially recovered and attempt to get upon order to protect them (& you) from further injury.
Thanks Elizabeth, that’s some great feedback. Always important to remember that your safety comes first!
Great article Jamie, you definitely know your stuff!
Thanks, glad you liked it, hopefully it was helpful for you
Loved this! Coming from the other side, I have generalized epilepsy and use massage therapy in the days following a seizure because of how helpful it is when every muscle you didn’t even know existed is suddenly sore.
One point—it’s a dangerous generalization to assume that epileptic people will know when a seizure is coming on and be able to communicate that. The warning signs here are huge takeaways, massage really is a great field of medicine!