Ch. 13: Seizures Pt. 1-Types of Seizures Flashcards
What are seizures?
Abnormal, excessive electrical discharges of neurons within the brain caused by a disease process
What is epilepsy?
Chronic, recurring, and diagnosed after all other possible etiologies for seizures have been ruled out
T/F: Some seizures have no known etiology
True
What are 4 types of generalized seizures?
- Tonic-clonic
- Absence
- Myoclonic
- Atonic or akinetic
What is tonic-clonic previously referred to as?
Grand mal
How long does the tonic phase last in tonic clonic?
10-20 seconds
Tonic-clonic: TONIC PHASE
- What happens to eyes?
- Is there loss of consciousness?
- How is the tonic contraction?
- Any sort of cry?
- Increased ____
- What goes on with swallowing reflex?
- ___ leading to ____
-Eyes roll UPWARD
-Yes, there is loss of consciousness
-Tonic contraction of ENTIRE body; arms=FLEXED and
legs, head, and neck=EXTENDED
-Possible PIERCING cry
-Increased salvation
-Swallowing reflex=Lost
-Apnea leading to cyanosis
Tonic-clonic: CLONIC phase
- How long does it last?
- What may happen with the mouth?
- May be ____
- Gradual ____ of movements until cessation
- Time varies
- Foaming of mouth
- May be INCONTINENT
- Gradual SLOWING of movements until cessation
The last part of the tonic-clonic seizure is the postictal state. Several things happen here:
- How is arousal: easy or difficult?
- How long is pt. confused?
- Impairment of fine or gross motor skills?
- Lack of ?
- Possible what?
- Sleeps for how long?
- Any relocation of the seizure?
- Arousal=dificult
- Pt confused HOURS
- Impairment= fine motor skills
- Lack of coordination
- Possible vomiting, headache, visual or speech difficulties
- Sleeps several hours
- No relocation of seizure
What are absence seizures previously referred to as?
Petit mal
What is the onset of absence seizures? Ceases?
4-12 years; ceases by puberty
What are characteristics of absence seizures?
- Loss of consciousness lasting 5-10 seconds
- Minimal to no change in behavior
- Resemble daydreaming
- May drop items in hand
Absence seizures: What kind of physical problems may appear?
Lip smacking
Twitching of eyelids or face
Slight hand movements
Absence seizures: Does the person know they had it?
No, unable to recall episodes
What happens with a myoclonic seizure? (5)
- Variety of seizure episode
- Symmetric or asymmetric involvement
- Breift contractions of muscle or muscle groups
- No postictal state
- May or may not loose consciousness
What happens with atonic or akinetic seizure? (3)
- Muscle tone lost for a few seconds
- Period of confusion follows
- Loss of muscle tone frequently results in falling
What seizure is most common during first 8 months of life?
Infantile spasms
How are the contractions with infantile spasms?
Sudden, brief, and symmetric muscle contractions
How is the body during an infantile spasm?
Flexed head
Extended arms
Legs drawn up
What is the eye movement like during infantile spasm?
Rolled upward and inward
Is there loss of consciousness with infantile spasm?
Possible
What is skin color in infantile spasm?
Possible flushing, pallor, or cyanosis
What may happen before or after the infantile spasm?
Possible cry or giggle before or after
Partial (focal/local)
What are the two types of simple partial seizures with MOTOR signs?
- Aversive seizure
2. Rolandic seizure
Partial seizure with MOTOR signs
What is aversive seizure?
Eyes and head turn away from the side of focus, with or without loss of consiousness
Partial seizure with MOTOR signs
What is rolandic seizure?
Tonic-clonic movemnts involving the FACE; most common during SLEEP
Partial seizure with SENSORY signs
What happens?
- Tingling
- Numbness or pain in one area of the body–then spreading to other body parts with VISUAL sensations
Complex partial seizures:
- What kind of behavior?
- ____ to respond to environment
- What kind of consciousness: lost, impaired, or intact?
- Any confusion?
- Can they recall event?
- Behavior= altered
- INABILITY to respond to environment
- Consciousness: Impaired
- Confusion? YES
- Recall event? NO
Complex partial seizure:
What is complex sensory aura?
Strange feeling in stomach that rises to throat
Auditory or visual hallucinations
Feelings of fear
Distorted sense of time and self
What is the diagnostic procedure for seizures?
EEG to record electrical activity and may identify origin of seizure activity
When is EEG done?
Can be done during sleep, when awake and with stimulation and hyperventilation
Can EEG be done with video monitoring?
Yes
EEG: Pre procedure client info?
- No caffeine for several hours prior
- Wash hair before (don’t put in oils or spray) and after *after to remove electrode gel
- Let client know they may be asked to take deep breaths and/or be exposed to flashes of light during procedure
EEG: Pre procedure..Why may client be asked to withold sleep prior to procedure?
Sleep may be withheld prior to test and be induced during test if the doc wants the client to be tested while sleeping
A nurse is caring for a child who has absence seizures. Which of the following findings can the nurse expect? (SATA)
A. Loss of conscious B. Appearance of daydreaming C. Dropping held objects D. Falling to floor E. Having a piercing cry
A, B, C
A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for nurse to take?
A. Maintain side lying position
B. Monitor VS
C. Reorient child to environment
D. Assess for injuries
A
A nurse is providing teaching to the parent of a child who is to have an EEG. Which of the following should be included in teaching?
A. Decaffeinated beverages should be offered on morning of procedure
B. Do not wash childs hair night before procedure
C. Withhold all foods morning of procedure
D. Give you child an analgesic night before
A
A nurse is teaching a group of parents about risk factors for seizures. Which of following should be included in teaching? (SATA)
A. Febrile episodes B. Hypoglycemia C. Sodium imbalances D. Low serum lead levels E. Presence of diphtheria
A, B, C
