Seizure Disorders

Question 1

Seizure - Pathophysiology

Answer 1

• Abnormal sudden, excessive, uncontrolled electrical discharge of neurons w/in section of brain
  > characteristic “seizure” mani of this excessive neuronal discharge
• Genetic
• Structural/metabolic condition

Question 2

Seizure - Classifications

Answer 2

• Generalized
  > tonic/clonic
• Partial
• Absence
• Many subcats
• Epilepsy: 2 or more seizures experienced by a person
  > idiopathic

Question 3

Seizure - Diagnostics

Answer 3

• Hx
• MRI
• EEG
• Microelectrodes/Depth Electrode Placement

Question 4

Seizure - Medical Surgical Treatment

Answer 4

• Medications
  > Anticonvulsants: Dilantin, Tegretol
• Surgical
  > tumors, abscesses, cysts, or vascular anomalies
  > refractory to meds; vagal nerve stimulator (VNS), responsive neurostimulation system (RNS)

Question 5

Seizure - Nursing Diagnosis

Answer 5

• Acute confusion
• Social isolation
• Risk for ineffective airway clearance
• Risk for falls
• Risk for injury
• Risk for powerlessness

Question 6

Seizure - Nurisng Interventions

Answer 6

• Observation & documentation
• Side rails up & padded
• Side-lying position
• Oxygen
• Suction equipment
• Airway
• IV access
• Monitor comps; lab
• Meds must be on time

Question 7

Status Epilepticus: Medical Emergency

Answer 7

• Prolonged seizures last more than 5 mins or repeated seizures over course of 30 mins
  > interfere w/ resps
  > repeated episodes of cerebral anoxia & edema; irreversible & fatal brain damage
• Risk Events
  > interruption of anticonvulsants meds
  > fevers
  > concurrent infection

Question 8

Status Epilepticus: Emergency Care

Answer 8

• Establish airway
• ABCs
• IV push Lorazepam, Diazepam
  > rectal diazepam (if no IV)
• IV phenytoin
  > later to keep seizure free
• ICU
  > may need IV drip to keep seizure free