Nonconvulsive Seizure Disorders: Importance and Implications for School Social Workers

Nonconvulsive seizure disorders are often mistaken for emotional disturbances, behavior disorders, or psychiatric illnesses. They can interfere with a child's ability to learn and adapt socially by causing symptoms such as confusion, fatigue, anxiety, irritation, depression, hallucinatory and dissociative experiences, and personality and behavior changes. Nonconvulsive seizure disorders can co-occur with and complicate treatment for other conditions, including mental retardation, cerebral palsy, dyslexia, attention deficit disorders, and learning disabilities. Seizures are not volitional and are usually controlled only by appropriate medical treatment—in most cases anticonvulsant medication—and the informed involvement of the child and significant others. This article discusses features of nonconvulsive seizure disorders, describes symptoms, presents an illustrative case, and provides an observation recording instrument to help in differential diagnosis and evaluation of treatment efficacy. The importance of early intervention and the school social worker's active involvement on the interdisciplinary educational planning and clinical management teams are stressed to help avoid the serious physical, educational, and psychosocial consequences of misdiagnosis and inappropriate treatment.