Seizures

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SEIZURES

 f.   Atonic Seizures -  are associated with a total loss of muscle tone. -  They may be mild, with the client briefly nodding the head, or the client may fall to the floor -  Consciousness is impaired only briefly

are re episodes of abnormal motor, sensory, autonomic, or  a psychic activity (or combination of these) that result  from sudden excessive discharge from cerebral neurons. (Hickey, 2009)  A part or all of the brain may be involved. Frequently, it  is manifested by involuntary repetitive movements or abnormal sensations.

2.  Partial Seizures   also called focal seizures   involve one area of the brain and do not  spread throughout the entire organ  organ  

Etiology





  The specific causes of seizure are varied and can be



categorized as Idiopathic (genetic, developmental Acquired.   defects) Acquiredand seizures can be caused by cerebrovascular



Types of Partial Seizures a.  Simple Partial Seizures -  occur in a single area of the brain and may involve a single muscle movement or sensory alteration b.  Complex Partial Seizures -  Involve complex sensory changes such as hallucinations, mental distortion, and changes in personality, loss of  consciousness, and loss of social inhibitions. -  Motor changes include involuntary urination, chewing motions, diarrhea and so on.

disease, head injury, brain tumor, CNS infections, hypoxemia, hypertension, fever (childhood), allergies, drug and alcohol withdrawal, and metabolic and toxic conditions (e.g. hypoglycemia, renal failure, etc.) Classifications 1.  Generalized Seizures  Seizures    begin in one area of the brain and rapidly spread throughout both hemispheres of  the brain (Karch,2008)   Patients who have a generalized seizure usually experience a loss of consciousness resulting from this massive electrical activity throughout the brain. 





 

They can be convulsive or nonconvulsive

Types of Generalized Seizures: a.   Absence Seizures -  formerly known as petit mal seizures -  abrupt periods of staring and lapses of  awareness lasting a few seconds to a few minutes -  Occur commonly in childhood and early adolescence -  Tonic-clonic or partial seizures may develop at any time in clients who have had absence seizures

EPILEPSY > a group of syndromes characterized by unprovoked, recurring seizures Status Epilepticus > a state in which a client has continuous seizures or seizures in rapid succession, without regaining unconsciousness, lasting at least 30 minutes. Diagnostic Tests

b.  Myoclonic Seizures -  Involve sudden, uncontrollable, jerking movements of either a single muscle

-  - 

group or multiple groups, sometimes causing the client to fall The client loses consciousness for a moment and then is confused postically Often occur in the morning

c.  Clonic Seizures  Seizures  -  Include rhythmic muscular contraction and relaxation lasting several minutes -  Distinct phases of clonic seizures are not  easily observed

EEG (Electroencephalogram (Electroencephalogram)) -  This test assists in (1)  Locating the focus of abnormal electrical discharges (2)  Establishing a diagnosis of epilepsy (3)  Identifying the specific type of seizures

     

CT Scan MRI PET









 

SPECT

Nursing Diagnosis

  Risk for Injury related to uncontrolled movement 



and/or loss of airway patency during a seizure Interventions:   Seizure precautions should be implemented in all

clients with a history of seizures and epilepsy   No oral temperatures should be taken, use axillary or rectal routes   The bedrails should be padded and up when the client is in bed and the bed is in a low position.   Seizure precautions also include inserting an IV needle for medication administration, keeping oxygen with a nasal cannula, and suction

d.  Tonic Seizures -  Include an abrupt increase in muscular tone and muscular contraction -  There is a loss of consciousness and may last from 30 seconds to several minutes e.  Tonic-clonic Seizures -  formerly known as grand mal seizures  seizures   -  they are most closely associated with epilepsy -  it may last from 2-5 minutes -  sudden loss of consciousness may occur

 



equipment 

 



Risk for Impaired Adjustment related to complex and long-term health management needs

 

Interventions:   Five

types of seizure precautions should be discussed with clients and their families:

1.  Driving motorized vehicles: Generally no driving is allowed for 6 to 12 months following a seizure. 2.  Water precautions: Ensure that the clients are in the presence of an adult lifeguard who can pull them out of the water if needed. Wearing a life jacket in a boat is important. 3.  Heights: Clients should not work at heights because they could fall and sustain injuries 4.  Fire: Teach clients to cook with other people present and to avoid using the front burners 5.  Power tools: Caution with the use of power tools is required.

 



Ineffective Health Maintenance

Interventions:   Provide the client with verbal information about 

how AEDs prevent seizures, the importance of  taking prescribed medications regularly, and care during seizures.   Consult with the client to plan ways to make taking medication part of daily activities.   Help the client to identify factors that precipitate seizures and ways of avoiding these factors. Management  The goals of management of clients with seizures and epilepsy are:

 



To prevent injury to the client during seizures

  Objects should be moved out of the way so that the

client doesn’t strike his/her head or extremities  extremities   clothing around the person’s neck is loosened   Put a pillow or folded blanket under the affected person’s head, but do not flex the neck sharply or close the airway

  Any tight

 



To eliminate factors that precipitate seizures

  Eating a balanced diet 

  Restricting excessive caffeine and alcohol intake   Sleeping well   Avoiding seizure triggers

  Minimizing emotional stress

 



To diagnose and treat the cause of the seizure

  Observers’ descriptions of a seizure can be helpful in

making a diagnosis.

 



To control seizures to allow a desired lifestyle

  Medications are used to control seizures. Currently

available antiepileptic drugs appear to act primarily by blocking the initiation or spread of seizures Tonic-Clonic Seizures:   Phenytoin   Barbiturates   Benzodiazepine

Absence Seizures   Valproic acid

  Ethosuximide

Partial Seizures   Carbamazepine   Lamotrigine

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