Seizure/ Epilespy Disorder Flashcards
Possible causes of seizures metabolic disturbances
Acidosis
Electrolyte imbalances
Hypoglycemia
Hypoxia
Alcohol or barbiturate withdrawal
Dehydration or water intoxication
Extraacranial disorders associated with seizures
Hypertension
Heart lung liver and kidney disease
Systemic lupus erythematosus
Diabetes meilitus
Septicemia
Other possible causes
Age
Genetic link
Idiopathic
Vascular diseases
Epilepsy
Chronic disorder
Reoccurring seizures, unprovoked, unpredictable
Detected by EEG ( if not detected then its not a seizure , its not epilepsy, its another condition )
Why is it important to know exactly where in the brain is the seizure happening?
It is critical for successful surgical intervention
When you send them to epilepsy monitoring unit they want pt to have at least 3 seizures in the same part of the brain
If its in two different spot, you can’t do surgery and will give pt medication back
Two major classes of seizures
Generalized and focal
Focal seizures
In one area
Simple and complex
Generalized seizures
Happening in multiple parts of the brain
Tonic clonic
Absence
Myoclonic
Atonic
Tonic
Clonic
Seizures phases
Prodromal phases
Aural phase
Ictal phase
Postictal phase
Prondromal
Only the pt knows about this
(Behavioral changes)
Aural phase
Sensory warning that is similar everytime, different for every pt
Ictal phase
First symptoms up to the end of seizure
Don’t know exactly unless pt is on eeg because it can be monitored when it happens and when it ends
Posticatal phase
The seizure already happened , recovery phase
Triggers of seizure
Anything extreme or excessive
Bright flashing light, extreme excercising, excessive drinking, drug use, sepsis , or overwhelmed with emotions, stress
Tonic-clonic seizures
Loss of consciousness and falling
Body stiffens (tonic) with subsequent jerking of extremities
Cyanosis, excessive salivation , tongue or cheek biting and incontinence may occur
With knowing the s/s of tonic clonic seizures what nursing precautions do we take in place
Fall risk, seizure pads, room should have working sunction, code teamed assigned , always make sure pt has working ID bracelet, have IV inserted make sure its patent at every shift
Incontinence may happen (brief, pad, wipes) also O2 is important
During posticatal phase for tonic- clonic seizures
Will experience muscle soreness and fatigue
Pt may sleep for hours
Not feel normal for hours to days
No memory of seizure
Absence seizures
Typical and atypical
Typical absence seizures
Can be precipitated by flashing lights and hyperventilation
“Day dreaming”-brief staring spell
EEG demonstrates pattern unique to this type of seizure
Atypical absence seizures
Characterized by staring spells and others like eye blinking, chewing, jerking movements of the lip last more than 10 seconds
Can continue into adult hood
Myoclonic seizure
Sudden excessive jerk or twitch of body and extremity,
Can be forceful enough to cause fall
Brief, few seconds
May occur in clusters
Atonic seizure
Involves tonic episodes or paroxysmal loss of muscle tone
Begins suddenly and person falls
Typically last less than 15 seconds
Person usually remain conscious can resume normal activity
Great risk for head injury
Tonic seizures
Involve sudden onset of maintained
Increased tone in the extensor muscles
Often occur in sleep
Affect both sides of body
Usually last less than 20 seconds
Consciousness is usually preserved
Clonic seizures
Relatively rare
Simple focal seizure
Person remains conscious and alert
Unusual feelings or sensations that can take many forms- joy , anger, sadness, or nausea
May hear smell taste see or feel things that are not real
Complex focal seizures
Pt have loss of consciousness or alteration in awareness
Eyes remain open but cannot react
Automatisms
Do not remember an activity started before or continued during seizure
Automatisms
Repetitive, purposeless actions
Psychogenic seizures (focal )
Can be misdiagnosed as epilepsy
History of emotional or physical abuse
A specific traumatic event
Accurate diagnosis-EEG
Does not need o2 and does not affect vital signs
Status epilepticus ( se )
Any seizure that last longer than 5. Minutes (anything more than 2 minutes)
No return of consciousness
Neuro emergency
Can occur with any type of seizure
Medical emergency
May result in permanent brain damage or death
Diagnostic assessments
H&P
Seizure history
Diagnostic studies
EEG
What should you never call a psychogenic seizure?
Psuedoseizure (fake)
Nursing management
Avoid chairs , headinjuries
During seizure put pt on side to avoid aspiration
Have optimal mental and physical functioning while taking AED
Have satisfactory psychosocial functioning
What are some things we want to pay attention to , to tell physician or epiileptologist
Cyanosis
Drooling
Incontinence
Are they kicking or moving arms
All nurses should be at the side of bed not at the foot
