Certificate of Merit in Disorders of the Body Lesson 2: Epilepsy, Diabetes and Multiple Sclerosis
Epilepsy Epilepsy is a condition in which there is a sudden burst of electrical energy in the brain, which causes a temporary disruption in the normal messages which passes between the brain cells. It is not a single condition in itself but is a symptom of a range of other conditions which causes repeated fits, known as seizures. Epilepsy is more common than might be thought, with over 450,000 people in the UK being affected, with a third of those who experience the disorder having a form of learning difficulty. (Epilepsy Research) There is not always a known cause for the condition, but it usually begins during childhood with around 1 in 280 children being affected. Sometimes the cause is apparent after the person experiences brain damage through a difficult birth or a head injury. For those patients who have a known cause, the condition is known as symptomatic epilepsy. For the majority of peope, where there is no known cause, the condition is known as idiopathic epilepsy.. During a seizure, the millions of cells in our brain (neurons) which normally communicate with each other via electrical impulses have their transmission disrupted, which affects the body. There are two main types of seizures; a partial seizure and a generalized seizure. A partial seizure is where only a small part of the brain is affected. Symptoms can include an intense feeling of déjà vu, differing experiences of the senses and a sudden emotion. During these seizures, consciousness remains, but it may be possible to have no memory of the event. A generalized seizure causes most or all of the brain to be affected but its severity will depend upon the type of seizure, of which there are six. The symptoms can range from a loss of awareness to a full seizure in which the body twitches, jerks and consciousness will be lost. Any type of seizure can be experienced but usually the pattern remains the same and diagnosis will usually be made after several episodes. They can last from anything from a few seconds to several minutes.
There is no single test to diagnose epilepsy, though an EEG (electroencephalogram) of the brain can record brainwave patterns and give vital information to a specialist doctor (neurologist) in Epilepsy. When a diagnosis of epilepsy is made, usually after at least 2 seizures it is made for life as there is no cure for it. Epilepsy is not usually life threatening, but physical injury can occur as a result of a seizure, however, it is possible to control the seizures with the right medication and dosage of anti-epileptic drugs. (AEDs) A CT or MRI scan maybe carried out but it is still possible to have epilepsy and have a clear scan. Before a seizure occurs, many people are aware that one is going to happen due to a situation, known as a trigger. This trigger can be tiredness, stress or alcohol. Rarely a seizure can be caused by flashing or flickering lights. The trigger is not the cause of epilepsy but the situation has just triggered it to happen. If someone experiences a seizure in your presence, try and remove any objects that may cause injury and place the person into the recovery position. Stay with the person until they regain consciousness and talk to them to keep them calm. An ambulance should be called if the seizure lasts for more than 10 minutes. All therapists are taught that epilepsy is a contra- indication as the treatment can affect the way the AED works, but some research is showing that complementary therapies can have some benefit, especially for people who have stress as a trigger for a seizure. However, complementary therapies must never replace AED s and medical clearance should be sought before any treatment is carried out.
Diabetes Diabetes is a condition in which there is too much glucose (sugar) in the blood. It is fairly common with over 2 million people in England who have the condition, but with not all of them knowing it. The condition is also known as diabetes mellitus. The pancreas produces a hormone called insulin which controls the amount of glucose in the blood. It carries this out by moving out any glucose from the blood into cells where it is broken down and used for energy. However, with diabetes, the body is unable to break down glucose into energy, due to either not enough insulin to move the glucose, or the insulin not working correctly. There are two types of diabetes which have different causes. Type 1 is caused by the body's failure to produce any insulin. It's sometimes called early-onset diabetes because it usually appears before the age of 40. This diabetes is very dangerous if left untreated or not treated correctly as very high glucose levels can build up. Dehydration, drowsiness, and serious illness can occur which can be life-threatening. Type 2 diabetes is caused by the body not producing enough insulin or the insulin it does produce is not used effectively. This is the most common form and accounts for around 90% of all diabetes. Those with type 2 tend to have a family history of diabetes, and may be obese with high blood pressure. If the blood glucose level is higher than normal over a long period of time, it can cause damage to the blood vessels, resulting in poor circulation or heart damage. This can occur even if the glucose level is not very high above the normal level.
This picutre illustrates the damage of poorly/untreated diabetes in which gangre occurs Nerve problems can also occur which can effect the eye. Diabetes can also occur during pregnancy, and is known as gestational diabetes. This may occur because higher levels of glucose is found in the blood due to the pancreas not producing enough insulin to meet the extra demands of pregnancy. Gestational diabetes affects less than one in 20 pregnant women and usually disappears after birth. Once you have this type of diabetes, it is more likely that type 2 diabetes occurs later in life. The symptoms of diabetes are usually noticed when there is an increased thirst and frequent urination. There may be weight loss and possible regular episodes of thrush and genital itching. Tiredness is common for most people. Some people ignore these symptoms and put them down to other circumstances, however it is very dangerous to leave diabetes untreated as it can increase the risk of developing other conditions. If diabetes is suspected there is a very simple test that can be carried out to diagnose it. Urine tests can be performed to detect the amount of glucose in the urine, as urine does not normally contain it. If there is a trace of glucose it means that the blood glucose level has risen above a certain level and some glucose has spilt through the kidneys into the urine. If the test shows glucose, it is important to visit a GP and have a blood test.
Blood samples can also be taken to measure the amount of glucose in the blood, carried out by either a random glucose test where the test is performed at random times on two occasions and the fasting glucose test. This reading shows the amount of glucose in the blood after the body has fasted overnight. It is carried out on two different days. If the measurement of the random glucose test is above 11.1mm0l/l, and the fasting glucose test is above 7.0mm0l/l, a diagnosis will be made. Diabetes needs to be treated to maintain the blood glucose levels to near normal levels which should be between 4 to 7 mm0l/l before meals, less than 10mm0l/l 90 minutes after a meal and around 8mm0l/l at bedtime. If the diabetes is type 1, the treatment becomes a combination of a calculated diet, glucose testing and daily insulin injections If the diabetes is type 2, it may not be necessary to inject with insulin, as it may be controlled by diet or oral tablets. It will still be necessary to carry out glucose testing. If the diabetes is not treated correctly, it is possible to develop hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar) Hypoglycaemia will cause confusion, dizziness, hunger and a shaky feeling. The pulse may be erratic and race, creating a trembling feeling. If the condition is not treated, there will be deterioration and numbness in the mouth may occur before passing out and going into a coma. Hyperglycemia will cause an increased thirst, frequent urination, headaches, blurred vision and a lack of concentration. Diabetes is classed as a contra-indication for a treatment as there is a theoretical risk that the treatment could affect the way the body deals with the medication used. People with diabetes are more prone to a condition called arteriosclerosis, where the blood vessels become thicker and therefore more narrowed. There is a body of evidence to show that massage can be used by diabetic clients, if they monitor their blood glucose before the treatment and eat or treat accordingly, but medical clearance should be sought before a treatment commences.
Multiple Sclerosis Multiple Sclerosis (MS) is the result of damage to the myelin sheath which protects the nerve fibres. The sheath becomes hardened (sclerosis) in many (multiple) places. This scarring affects the way messages are transmitted between the brain and the rest of the body. For most people, the first sign that something is wrong is when they have pins and needles in areas of their body, or visual disturbances. It can take a while before any testing is done because the process can be so gradual, and there are more than fifty symptoms linked to MS, so for many people, they live for years undiagnosed. Once acknowledged that something is wrong, a variety of neurological tests can be carried out as there is no single test which is used to diagnose it; it is more a process of elimination. Procedures such as lumbar punctures and MRI s can be used along with a detailed record the medical history and a symptom log. There is no cure for MS, but many people live fulfilling lives, whilst using different treatments such as drugs or complementary therapies. The majority of people who have MS live unpredictably with the condition due to its nature of having remissions and relapses. When a relapse occurs, symptoms will arrive unexpectedly, but this will usually be followed by remission, where there is a period of improvement. As
the condition progresses, other symptoms such as bladder weakness, fatigue, tremors and speech difficulties may develop as there is more damage to the myelin sheath. There is some evidence to show that reflexology, aromatherapy and massage can be of benefit to people living with Multiple Sclerosis so it is not a contra indication. The nature of both of these therapies is both very relaxing, so any therapy that induces relaxation can be of use. It is important to remember that conventional medicine should not be stopped in favour of complementary therapies. MS is thought to be an autoimmune disease, meaning that the body's immune system, attacks its own healthy tissue which causes inflammation. At the moment there is not enough known about the cause of MS, but there are some theories that MS is not inherited, although there are certain genes which may it more likely to get. Some people believe that it is linked to environmental factors such as viruses or bacteria. Case Study Carmel, at twenty eight years of age, had been diagnosed with Multiple Sclerosis four years ago and was still coming to terms with the effects it had on her life. Recently she had found that she was beginning to experience bladder incontinence, which she was devastated about. A friend she had met through a self help group had put her in touch with a reflexologist that she went to. Carmel was nervous at first as she did not know what to expect, but after an in-depth consultation and a discussion over her treatment plan, Carmel was put at ease. The reflexologist explained that the treatment was holistic in that it treated the whole of the body, but that she would also be able to work on specific relaxes points which were relevant to Carmel s condition. Carmel thoroughly enjoyed the treatment and found it very relaxing. She felt she was able to take some control over her own health and looked forward to her weekly treatments. Well done. You have now reached the end of lesson 2. When you feel ready to, please answer the questions to lesson 2. Once completed, please return your question paper, answers and completed diagram to alliemaisey@wsbht.co.uk, ensuring you leave 2 lines between your answers for teacher s comments.
Student Name Address.... Date.. Questions on Lesson 2 1. Define epilepsy in your own words (5) 2. State and describe the two different types of epilepsy (6) 3. How is epilepsy diagnosed (4) 4. What is the situation regarding carrying out a treatment with someone who has epilepsy. (3) 5. What happens during a seizure (2) 6. Carry out some research into how epilepsy may affect your life (4) 7. Define diabetes in your own words (5) 8. State and describe the two different types of diabetes (6) 9. How is diabetes diagnosed (4) 10. What are the effects on the body if diabetes is left untreated (4) 11. How is diabetes monitored (2) 12. What are the dangers of treating someone who has diabetes with a complementary therapy (2) 13. What is the definition of Multiple Sclerosis (1) 14. Why is it difficult to diagnose MS (4) 15. Carry out some independent research to show how complementary therapies may be of benefit to someone who has MS (8) Total marks 60