Seizure Flashcards
Epilepsy (seizure disorder) is diagnosed when a patient has ___ seizures within ______.
a patient has 2+ seizures w/in 24 hours (without another cause)
Describe the different classifications of seizures:
-Generalized vs Focal onset
-Motor vs Nonmotor/absence
-Generalized = both hemispheres. Can be motor and nonmotor
-Focal = one hemisphere. Can be motor, nonmotor, aware, and impaired awareness seizures.
-Motor = involuntary movement/stiffening, Nonmotor/absence = change in emotion/sensation. Can be typical or atypical.
Describe the presentation of generalized motor tonic-clonic seizures (& duration).
Tonic = ‘stiffening’
Clonic = ‘jerking’
-tongue/cheek biting
-salivation
-incontinence
Lasts minutes.
Describe the presentation of generalized motor tonic seizures, duration, & when they are likely to occur.
Tonic = stiffening
Lasts < 20 seconds.
Usually occurs right before falling asleep or during sleep.
Describe the presentation of generalized motor clonic seizures.
Loss of awareness and sudden loss of muscle tone –> clonic jerking
rare
Describe the presentation of generalized motor atonic seizures.
AKA ‘drop attack’
Sudden atonia. Fall risk!
Describe the presentation & duration of a typical absence generalized nonmotor seizure.
Age group this most commonly occurs in, then rarely after?
Brief, unresponsive staring spell for 10-20 seconds.
Usually occurs in kiddos age 4-8.
Describe the presentation & duration of a Atypical absence generalized nonmotor seizure.
Jerky, repetitive lip-finger-eye movement for ~30 seconds.
Describe the presentation of focal motor seizures.
Similar to motor categories (tonic, clonic, atonic), can also include:
-automatisms (repetitive motor picking/lip smacking/blinking/tapping/rubbing)
-myoclonic seizure (irregular, brief jerking)
Describe the presentation of focal nonmotor seizures.
Changes only in emotion and sensation.
Focal seizures can also include ‘aware’ or ‘impaired awareness’ seizures. Describe the two.
Aware: conscious and alert but bizarre emotion/feelings/sensations/hallucinations.
Impaired awareness: dreamlike state, movements seem intentional but ARE NOT: walking into traffic, removing clothes, counting change. Last 1-2 min, pts cannot remember what happened, are usually confused/fatigued.
Nursing management of seizures
-pad side rails
-remove/loosen tight clothes
-lay pt on side
-ensure IV access
-airway: suction, ventilate PRN
-record details and times
-anticipate meds
NOTHING PO, don’t leave unattended
Medications for Status Epilecticus: 3 lines
-1st line: benzodiazapenes (diazepam, midazolam, lorazepam)
-2nd: phenytoin, fosphenytoin, carbamezepine, gabapentin, Lamotrigine, valproic acid, Depakote
-3rd–for refractory SE only–anesthesia (ex: propofol)
Status Epilecticus is defined as seizure activity that lasts longer than ___ minutes, or multiple seizures occurring _________ __________.
It carries the risk of:
-longer than 5 minutes or multiple seizures without post-ictal recovery
-risk of brain damage
Super-refractory seizures continue or occur again 24+ hours after starting __________ treatment.
anesthesia (3rd line treatment)
