Epilepsy in Learning Disabilities - Essay Example

www.allwriting.net Sumanta Sanyal Dated: 15/01/2006 Epilepsy in Learning Disabilities: Social Implications Introduction According to the latest statistics there are approximately 1.2 million people with learning disabilities in the UK and of these approximately 2,00,000 are severely affected (Epilepsy Action – Education, 2005). Another reliable source, the Foundation for People with Learning Disabilities, UK, states that about 30 % of these people with learning disabilities in the UK – 30 % of 1.2million = 3,60,000 – are afflicted with epilepsy. The foundation states that the frequency of people with learning disabilities having epilepsy is higher than in people with normal learning dispositions. This probability of epilepsy incidence increases with the severity of the learning disability. The frequency for people with such severe learning disabilities thus increases to 50 % (Foundation for People with Learning Disabilities, 2005). All this indicates that there are almost 3,60,000 people in UK with both epilepsy and learning disabilities of whom almost 1,00,000 have epilepsy as well as severe learning disabilities. This is a significant figure and requires special attention, as the purpose of this essay intends to focus. People with both learning disabilities and epilepsy need some special levels of health and social attention – specialist neurology clinics, EEG and brain scan facilities, primary medical care from a GP and day centre placements and long and short term residential care at specialist centres. In addition, they also require specialist community facilities such as those offered by the Community Team for Learning Disabilities of the organisation Epilepsy Action. This effort offers home and social support, intensive supervision and introductions to local leisure facilities and sheltered work opportunities (Epilepsy Action – Education, 2005). Causes: Epilepsy and Learning Disability Both epilepsy and learning disabilities are outward symptoms of brain dysfunction or damage. This does not signify that those who have epilepsy have learning disability or those that have learning disability have epilepsy but there is a significant correlation between the two dysfunctional symptoms. Learning disabilities can be brought on by serious brain damage, such as from an accident involving injury to the head, a difficult birth, or an infection to the brain such as from meningitis or encephalitis. The affected part of the brain becomes a focus of irritation and possibly epilepsy. The epileptic symptoms may be latent at the initial stage but may surface with age (Epilepsy Action – Education, 2005). Also, conversely, epileptic seizures, if they are severe enough, may damage the brain and cause initiation of learning disabilities (Epilepsy Action – Education, 2005). Epilepsy and learning disabilities can also be part of certain symptoms like Tuberous Sclerosis that may initiate brain structural damages that can in turn initiate both epilepsy and learning disabilities. Down’s Syndrome, genetic in origin, is not associated with childhood epilepsy but the risk increases with age (Epilepsy Action – Education, 2005). In many instances the causes of both epilepsy and learning difficulties cannot be accurately identified (Epilepsy Action – Education, 2005). Nevertheless, BBC Online reports that an article published in Nature Genetics reveals that there is a set of genes that initiate epilepsy when mutated in some way and this can also possibly lead to learning disabilities as well (BBC Online, 2002). The principal reason why the causes of both epilepsy and learning disabilities are treated at length here is to demonstrate that there is no immediate comprehensive preventive measure that can avert incidence of these two disorders and, thus, it is necessary to do all that can be done in both the social and health context to help people with these combined disorders lead as full a life as is possible in their conditions. Also, medication can only alleviate and mitigate the difficulties, both physical and mental, brought on by these conditions without hope of complete cure. Thus, it is more necessary in this context to provide lifelong social and healthcare help to affected persons. The Social Context In the context of these combined disorders it is relevant to note that diversity of culture and ethnicity is not very germane in the UK sense. Instead a recent study into the social deprivation status of people afflicted with the combined disorders has been resorted to elicit information that there exists a strong correlation between epilepsy, with and without learning disabilities, and social deprivation and a weaker correlation between social deprivation and mean hospital activity (Morgan, C.L.I. et al, 2000). Epilepsy and learning disabilities either diminishes employment opportunities thereby decreasing social status or the incidence of the combined disorders places a financial and emotional burden on the incident family that also decreases familial social status. This is true of all age groups and ethnic and cultural sets. In this context Morgan et al says – “It is likely therefore that a positive association between epilepsy and social deprivation will exist which may be increased by the confounding effect of psychiatric illness and learning disability. Epilepsy is well-documented as a comorbidity of both these conditions” (Morgan, C.L.I. et al, 2000). The group also notes that there were positive correlations between social deprivation for people with epilepsy and hospital activity as well as with outpatient appointments (Morgan, C.L.I. et al, 2000). Nevertheless, since the exact causes of the two conditions are not precisely ascertainable, possibly often due to genetic mutations that are very difficult to pinpoint at their exact locations in the human chromosomes, no definite reason can be ascribed to these two conditions being co-existent with social deprivation. Genetic mutation is often the effect of environmental pollution. Other factors responsible for these two conditions are accidental injuries and heredity factors. People subjected to social deprivation may be more exposed to some of these factors except the heredity ones but there is no hope of comprehensive measures minimising these factors in the immediate future. In that context it may be said that social deprivation cannot be taken to be a principal cause of these two conditions but it is definitely the most important one that aggravates them. People with both these conditions are socially deprived and thus unable to fend properly for themselves. They are unable to take alleviative measures, often quite financially and emotionally costly, that would bring them succour. Morgan et al report further that often minor epilepsy seizures are misconstrued as symptoms of other diseases and remain unreported and the patient subsequently remains untreated until the condition has progressed to a stage where it has to be taken to inpatient department of health facilities whereas if it had been treated initially the condition would required only outpatient appointments (Morgan, C.L.I. et al, 2000). This report suggests a general lack of awareness of both conditions that is extremely detrimental to the affected ones as early detection is one of the primary alleviative measures. Social and Psychological Needs Detection and Care Epilepsy with learning disabilities has same type of seizures as other epilepsies. Nevertheless it is stated that epilepsy is difficult to detect at first and this requires expert judgement (Epilepsy Action – Education, 2005). The Joint Epilepsy Council, 2002, suggest some strict guidelines for detection and treatment of epilepsy. It recommends that integrated care should be provided in the manner of providing and improving not only medical care but also social and psychological reinforcements in the manner of educational and emotional support (Joint Epilepsy Council, 2002). It provides extensive guidelines for practitioners and healthcare staff in the manner of treatment of the condition with heavy emphasis on expert referral practice so that particularly specific treatment is available to all affected persons. Early detection is strictly recommended for speedy alleviation and a prolonged diagnosis and treatment measure with expert guidance, if necessary, is recommended. The particular emphasis all the time is on prolonged observation and treatment (Joint Epilepsy Council, 2002). This is quite in line with the fact that both conditions are not totally curable on a lifelong basis. It is also recommended that not only should healthcare professionals dealing with the case be acquainted with its intricacies but also all those others associated with it on a family and community. Thus, backup support is in effect sought form all those who are in contact with the case no matter of what manner of calling in life they are from. Educational Needs Those children with both learning difficulties and epilepsy are to be provided for by Special Education Needs teachers who are supposed to be acquainted with methods of not only dealing competently with the particular learning difficulty of the student but also with the epileptic condition (Epilepsy Action – Education, 2005). If such a teacher is not available a classroom support assistant is recommended. Constant and facile communication between home and school is also highly recommended and deemed essential (Epilepsy Action – Education, 2005). For severe and/or frequent forms of epilepsy a small number of residential learning centres are available that school students with both conditions (Epilepsy Action – Education, 2005). Aggravating Conditions Epilepsies often change with age. That is one principal reason why constant expert observation and treatment is recommended. It is also found that in certain individuals extra stress and other exacting conditions aggravate epilepsy. Specific diagnosis can alert the person or his or her guardians as to what condition has this aggravating effect and how it can be avoided (Epilepsy Action – Education, 2005). Sports Most sporting activities are available to patients with both conditions. For example, swimming, canoeing, football and cycling are all available. The person and/or carer should decide what sporting activity to pursue on the basis of what triggers the seizures, what the person would like to do, what possible risks are involved, etc. Any effective risk-minimising factors that can be employed should be taken. Often only unobtrusive observation is all that is required. Here also community effort is recommended (Epilepsy Action – Education, 2005). Conclusion Is there than no hope for those with these lifelong irritable conditions? Yes! There is! That is why a comprehensive community-wide support is recommended. With it the afflicted person can lead a life that is as full as is maximally possible for the level of severity of the conditions for that particular individual. Also, while elimination of social deprivation would improve availability of healthcare facilities to all on an equitable basis there should be provision for certain extra fiduciary benefits assigned under the social welfare scheme for those of such afflicted people whose capabilities for income generation are seriously hampered. Also, such benefits should also be made available on a proportionate basis for all those on whom such persons may be dependent. With these and improved research on the causes that initiate these conditions it may be hoped that the quality of lives of these unfortunate individuals will be much enhanced on a positive basis. References BBC News (Health), Epilepsy ‘master gene’ found, 2002. Extracted on 13th January, 2006, from: http://news.bbc.co.uk/1/hi/health/1862740.stm#top British Epilepsy Association, Epilepsy Action – Education, 2006. Extracted on 13th January, 2006, from: http://www.epilepsy.org.uk/info/learning.html Morgan, C.L.I. et al, Social deprivation and prevalence of epilepsy and associated health usage, Journal of Neurology, Neurosurgery and Psychiatry, 2000;69;13-17. Extracted on 13th January, 2006, from: http://jnnp.bmjjournals.com/cgi/reprint/69/1/13 National statement for good practice for the treatment and care of people who have epilepsy, National Guideline Clearinghouse, Joint Epilepsy Council, 2002. Extracted on 13th January, 2006, from: http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=4979#s23 Read More