Chapter 19 Flashcards
seizure
sudden and temporary alteration in brain function caused by massive, continuing electrical discharges in a group of nerve cells in the brain.
convulsion
unresponsiveness and the jerky muscle contractions
epilepsy
chronic brain disorder characterized by recurrent unprovoked seizures.
categories of primary seizures
generalized seizure and partial seizure
generalized seizure
involve both hemispheres of the brain and the reticular activating system, which typically results in a loss of consciousness. Generalized seizure activity is usually characterized by a jerking muscle activity known as convulsions.
partial seizure
typically related to abnormal activity in just one cerebral hemisphere. Partial seizures are either simple or complex.
simple partial seizure
awake and aware
aware state means the patient’s cognition is intact
complex partial seizure
awake but not aware
cognition
having perception, attention, emotion, memory, and executive function.
primary seizures
unprovoked seizure
secondary seizure
occur as the result of an insult to the body, such as fever, infection, hypoxia, hypoglycemia, hyperglycemia, drug intoxication, drug withdrawal, eclampsia in pregnancy, degenerative brain diseases, toxins, or imbalances in the electrolytes in the body
status epilipticus
A continuous seizure activity lasting longer than 30 minutes
Two or more sequential seizures without a full recovery of consciousness between seizures
brief seizure
seizure less than 5 minutes
prolonged seizure
lasting 5 to 30 minutes
Status epilepticus may lead to the following complications
Aspiration
Brain cell damage from hypoxia and lack of glucose
Dehydration
Fractures or dislocations
type of generalized seizures (involve whole brain)
tonic-clonic
absence
myoclonic
tonic
atonic
febrile
partial seizure types
simple partial
simple partial motor
simple partial sensory
simple partial autonomic
simple partial psychic
complex partial
partial seizure with secondary generalization
tonic clonic seizure
involvement of both cerebral hemispheres also produces the characteristic jerky, convulsive motor activity involving the entire body.
Loss of consciousness; muscle rigidity; convulsions, incontinence; postictal
aura
unusual sensory sensation that can precede a seizure episode by seconds or hours
absence seizure
seizures do not involve convulsive activity, but instead, they are characterized by a sudden cessation of conscious activity that involves a lack of vocalization and a blank stare, beginning and ending abruptly, and lasting only 5 to 15 seconds
myoclonic seizure
involves sporadic brief jerks of muscle groups on both sides of the body. Some patients describe it as electrical shocks. If severe enough, the muscle jerk may cause the patient to drop an object or throw it. These seizures often occur during sleep or when the patient is just falling asleep.
tonic seizure
characterized by a sudden onset of greatly increased muscle tone in the body, arms, or legs causing sudden muscular rigidity. Tonic seizures most often occur during sleep and usually involve most of or the entire brain
atonic seizure
results in the total loss of muscle tone resulting in loss of muscle strength. The eyelids may droop, the head nods forward, and the loss of muscle strength causes the person to suddenly drop to the ground. Because of this presentation, atonic seizures are frequently referred to as “drop attacks” or “drop seizures.”
febrile seizure
a seizure associated with a high fever without any evidence of intracranial infection or other definite cause of seizure
simple partial motor seizure
jerking or stiffening of only one part of the body and on only one side of the body. The abnormal motor activity may spread to other areas of the body on the same side.
simple partial sensory seizure
may smell or taste something; hear abnormal sounds such as ringing, clicking, or someone’s voice; feel pain, tingling, or numbness; feel as if they are floating in space or spinning; have visual hallucinations; or have illusions.
simple partial autonomic seizure
signs or symptoms commonly include strange or unpleasant sensations in the stomach, head, or chest; changes in the heart rate; changes in the respiratory rate; or goose bumps.
simple partial psychic seizure
changes in how the patient thinks, feels, or experiences things. The patient may present with memory disturbances, garbled speech, trouble understanding, difficulty speaking, fear, depression, happiness for no reason, or deja vu
secondarily generalized seizure
when simple partial or complex partial seizure activity spreads to both sides of the brain and involves the entire body
s/s of generalized tonic clonic seizure
Aura
Loss of consciousness
Rigid muscular contraction throughout the entire body
Convulsive activity (jerky muscular movement throughout the entire body)
Bitten tongue
Excessive saliva
Urinary or bowel incontinence
Hyperventilation and tachycardia following the convulsion
Postictal state of confusion and physical exhaustion
syncope
fainting, is a sudden and temporary loss of consciousness
syncope vs seizure
The episode usually begins in a standing position.
The patient remembers feeling faint or light-headed.
The patient becomes responsive almost immediately after becoming supine.
The skin is usually pale and moist.
serious causes of syncope
Myocardial infarction
Cardiac dysrhythmias
Stroke or TIA
Hypovolemia or blood loss
Drug use or poisoning
Pulmonary embolism
Cardiac tamponade
seizure opa considerations
do not insert opa during seizure
