Seizure Disorder Flashcards
seizure
uncontrolled electrical discharge of neurons in brian
what are the 3 major classes of seizures?
generalized, focal, and unknown onset
what are the potential phases seizures can occur?
prodromal, aural, ictal, postictal
what are the generalized-onset seizures?
tonic-clonic; absence; atypical absence; myoclonic
tonic-clonic seizure
loss of unconsciousness; body stiffens with subsequent jerking of extremities; postictal phase characterized by muscle soreness, fatigue
symptoms of tonic-clonic seizure
cyanosis; excessive salvation and tongue or cheek biting; incontinence
absence seizure
common in children; brief staring spell, lasts <10 seconds
atypical absence seizure
staring spell; eye blinking; jerking movements of the lips; lasts >10 seconds; usually continues with adulthood
myoclonic seizure
characterized by rhythmic arm abduction (3 movements per second) leading to progressive arm elevation; 10-60 seconds; jerking eyelids
focal-onset seizure
begin in specific region of cortex in one hemisphere of brain; produce manifestations based on function of area of brain involved: sensory, motor, cognitive, emotional
what are the different types of focal-onset seizures
awareness and impaired awareness
focal awareness seizures
patients remain conscious and alert; sudden and unexplainable feelings of joy, anger, sadness, or nausea; may hear, smell, taste, see, or feel things that are not real
psychogenic nonepileptic seizures (PNES)
may look like epileptic seizures but are not epileptic because they are caused by psychological factor
status epilepticus
state of continuous seizure activity or condition when seizures recur in rapid succession without return to consciousness between seizures; any seizure lasting longer than 5 minutes; permanent brain damage may result
convulsive status epilepticus
prolonged or repeated tonic-clonic seizures; can lead to fatal respiratory insufficiency, hypoxemia, dysrhythmias, hyperthermia, and systemic acidosis
complications of nonconvulsive status epilepticus
long or repeated focal impaired awareness seizures
refractory status epilepticus (RSE)
continuous seizure activity despite administration of first and second line therapy
complications of seizures
severe injury and death; sudden unexpected death in epilepsy (cause unknown and usually tonic/clonic seizures); depression, social stigma still exists, discrimination in employment and educational opportunities, driving sanctions
intermediate medical care is needed if…
status epilepticus occurs; significant bodily harm occurs; first-time
gerontologic considerations of antiseizure medication
more likely to have SE at lower doses; phenytoin may be problematic for older adults with compromised liver function; phenobarbital, carbamazepine, and primidone may negatively affect cognitive function
vagal nerve nerve stimulation
pacemaker for the brain
precipitating factors of seizures
metabolic acidosis/alkalosis; hyperkalemia; hypoglycemia; dehydration; water intoxication
priority problems for seizures
impaired breathing
planning for seizures
be free from injury during seizure; have optimal mental and physical functioning
acute care during seizure
provide privacy; ensure patient airway; protect pateint from injury; do not restrain patient; remove or loosen tight clothing; establish IV access; stay with patient until seizure has passed; anticipate giving IV medications: LORAZEPAM, DIAZEPAM, DILANTIN; afterwards anticipate suction or O2 or intubation; observe
after seizure monitoring
vital signs; LOC; GCS; pupils; reassure and oreint patient after seizure; BG
