Seizure/ Epilespy Disorder

Question 1

Possible causes of seizures metabolic disturbances

Answer 1

Acidosis
Electrolyte imbalances
Hypoglycemia
Hypoxia
Alcohol or barbiturate withdrawal
Dehydration or water intoxication

Question 2

Extraacranial disorders associated with seizures

Answer 2

Hypertension
Heart lung liver and kidney disease
Systemic lupus erythematosus
Diabetes meilitus
Septicemia

Question 3

Other possible causes

Answer 3

Age
Genetic link
Idiopathic
Vascular diseases

Question 4

Epilepsy

Answer 4

Chronic disorder
Reoccurring seizures, unprovoked, unpredictable

Detected by EEG ( if not detected then its not a seizure , its not epilepsy, its another condition )

Question 5

Why is it important to know exactly where in the brain is the seizure happening?

Answer 5

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

Question 6

Two major classes of seizures

Answer 6

Generalized and focal

Question 7

Focal seizures

Answer 7

In one area
Simple and complex

Question 8

Generalized seizures

Answer 8

Happening in multiple parts of the brain
Tonic clonic
Absence
Myoclonic
Atonic
Tonic
Clonic

Question 9

Seizures phases

Answer 9

Prodromal phases
Aural phase
Ictal phase
Postictal phase

Question 10

Prondromal

Answer 10

Only the pt knows about this
(Behavioral changes)

Question 11

Aural phase

Answer 11

Sensory warning that is similar everytime, different for every pt

Question 12

Ictal phase

Answer 12

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

Question 13

Posticatal phase

Answer 13

The seizure already happened , recovery phase

Question 14

Triggers of seizure

Answer 14

Anything extreme or excessive
Bright flashing light, extreme excercising, excessive drinking, drug use, sepsis , or overwhelmed with emotions, stress

Question 15

Tonic-clonic seizures

Answer 15

Loss of consciousness and falling
Body stiffens (tonic) with subsequent jerking of extremities
Cyanosis, excessive salivation , tongue or cheek biting and incontinence may occur

Question 16

With knowing the s/s of tonic clonic seizures what nursing precautions do we take in place

Answer 16

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

Question 17

During posticatal phase for tonic- clonic seizures

Answer 17

Will experience muscle soreness and fatigue

Pt may sleep for hours
Not feel normal for hours to days
No memory of seizure

Question 18

Absence seizures

Answer 18

Typical and atypical

Question 19

Typical absence seizures

Answer 19

Can be precipitated by flashing lights and hyperventilation
“Day dreaming”-brief staring spell
EEG demonstrates pattern unique to this type of seizure

Question 20

Atypical absence seizures

Answer 20

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

Question 21

Myoclonic seizure

Answer 21

Sudden excessive jerk or twitch of body and extremity,
Can be forceful enough to cause fall
Brief, few seconds
May occur in clusters

Question 22

Atonic seizure

Answer 22

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

Question 23

Tonic seizures

Answer 23

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

Question 24

Clonic seizures

Answer 24

Relatively rare

Question 25

Simple focal seizure

Answer 25

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

Question 26

Complex focal seizures

Answer 26

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

Question 27

Automatisms

Answer 27

Repetitive, purposeless actions

Question 28

Psychogenic seizures (focal )

Answer 28

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

Question 29

Status epilepticus ( se )

Answer 29

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

Question 30

Diagnostic assessments

Answer 30

H&P
Seizure history

Question 31

Diagnostic studies

Answer 31

EEG

Question 32

What should you never call a psychogenic seizure?

Answer 32

Psuedoseizure (fake)

Question 33

Nursing management

Answer 33

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

Question 34

What are some things we want to pay attention to , to tell physician or epiileptologist

Answer 34

Cyanosis
Drooling
Incontinence
Are they kicking or moving arms
All nurses should be at the side of bed not at the foot