seizures

Question 1

what is a seizure?

Answer 1

A transient, uncontrolled electrical discharge of neurons in the brain that interrupts normal function

• often symptoms of an underlying illness
• seizures resulting from systemic and metabolic disturbance are not considered epilepsy if the seizures cease when the underlying problem is corrected

Question 2

what are some metabolic disturbances that cause seizures?

Answer 2

acidosis
electroyle imbalances 
hypoglycemia 
hypoxia 
alcohol & barbiturate withdrawal
DKA pts

Question 3

what is epilepsy?

Answer 3

is a condition in which at least two spontaneous seizures occur more than 24 hours apart and is caused by chronic underlying pathology

Question 4

why does epilepsy happen?

Answer 4

• recurring seizures that has long been attributed to a group of abnormal neurons that seem to undergo spontaneous firing
• the firing spreads by physiological pathways to involve adjacent or distant areas of the brain
• if this activity spreads to involve the whole brain, a generalized seizure occurs

Question 5

what Is a general seizure?

Answer 5

• characterized by bilateral synchronous epileptic discharges in the brain from the onset of seizure
• because the entire brain is affected, there is no warning
• most cases the pt loses conciousness for a few seconds to several minutes

Question 6

what would rigidity and jerking seizure mean?

Answer 6

a tonic clonic seizure

Question 7

what is a tonic?

Answer 7

rigidity

Question 8

what is clonic?

Answer 8

jerking movements

Question 9

what is a tonic clonic seizure?

Answer 9

Characterized by a loss of conciousness and falling to the ground, followed by stiffening of the body (tonic phase) for 10-20 seconds, and subsequent jerking of the extremities (clonic phase) for another 30-40 seconds

Question 10

when a person is seizing, what is happening to the brain?

Answer 10

it is not getting any O2 or glucose, causing them to become cyanotic

Question 11

what is common when a person is seizing?

Answer 11

excessive salivation
tongue or cheek biting
incontinence may accompany

Question 12

what is an absence seizure?

Answer 12

• occurs only in children
• involves sudden lapse in consiousness and staring blankly into space, the episodes last less than 15 seconds
• can often be precipitated by hyperventilation and flashing lights (seeing flashing rights
• this is called an aura

Question 13

what happens when absence seizures are left untreated?

Answer 13

-when left untreated, seizures can occur up to 100 times a day

Question 14

what areas of the brain does a general seizure affect?

Answer 14

the whole brain

Question 15

what are focal seizures?

Answer 15

• aka partial seizure (partially affects the brain)
• are caused by electrical activity that is focal to a particular area of the brain, resulting in unilateral manifestations
• may affect one side of the brain, or they may spread to involve the whole brain, culminating in generalized tonic-clonic seizures

Question 16

any tonic clonic seizure that is preceded by an aura..

Answer 16

is a focal seizure that then generalizes secondarily

Question 17

what is a complication of seizures?

Answer 17

• status epilepticus
• it is a state of continuous seizure activity in which seizure recur in rapid succession without return to conciousness between seizures

Question 18

why is status epilepticus an neurological emergency

Answer 18

• because during repeated seizures to the brain, it uses more energy then can be supplied
• permanent brain damage may result
• sedation and endotracheal intubation usually required

Question 19

what are some psychosocial complications?

Answer 19

• seizure disorders place many limitations on a persons lifestyle
• epilepsy generally carries a social stigma and pts may experiance depression, anxiety, or anger
• pts may experiance discrimination in employment and educational opportunities
• obtaining a drivers license may be difficult because of legal sanctions against driving

Question 20

What is used to diagnose?

Answer 20

• most useful diagnostic tools are accurate and comprehensive description of the seizures and the pts health history
• the EGG is a useful diagnostic tool to the history but only if it shows abnormalities

Question 21

what should always be done with new onset of seizure?

Answer 21

-CT or MRI scan should be done with any new onset seizure to rule out structural abnormalities (tumor)

Question 22

during a seizure, what should a nurse do?

Answer 22

• maintain pt airway by turning pt to the side and ensuring the tongue falls forward
• protect the pts head, loosen constrictive clothing, ease the pt to the floor (if seated)
• do not restrain the pt
• do no place objects in the pts mouth
• get pt on high flow of O2 therapy

Question 23

what are seizures primarily treated with (drug)

Answer 23

anticonvulsants

Question 24

How do anticonvulsants work?

Answer 24

-Drugs generally act by stabilizing nerve membranes and preventing spread of the epileptic discharge

Question 25

what is the goal of drug therapy for seizures?

Answer 25

• max seizures control with minimal toxic effects

- serum levels of drug should be monitored

Question 26

what is given when a pts is compliant with meds but still has them?

Answer 26

treated with lorazepam or diazepam

Question 27

what are some alternative therapies?

Answer 27

-ketogenic diet is a special high fat, low-card diet that has been used to control seizures
ketones are produced and pass into the brain to replace glucose as a energy source
-other therapies: vagal nerve stimulation, surgical resections