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Student
Activities

Set Induction
(1 min)

Introduction to Epilepsy Begin the
lesson by
asking the
students
what is
asking the
class what is
epilepsy?

Answering
question
given

Hand-outs,
students
Knowledgeabl
e
Step 1
( 2 min)

Learning Objectives

Read to the
class
Listen
Observe
Hand-outs


Step 2
Define
Epilepsy
( 2 min )
Define Epilepsy
Epilepsy is a condition in
which a person has
spontaneously recurring seizure
caused by a chronic underlying
condition.
Read to the
class
Listen and
observe
Handouts

Step 3
Anatomy and
physiology of
nerve cells
( 3 min)
Anatomy & physiology:
Anatomy:
The nervous system consists of
a vast number of cells called
neurons, supported by a special
type of connective tissue,
neuroglia. Each neurons
consists of a cell body end its
process. On e axon and many
dendrites.
Physiology:
The physiological units of
nervous system are nerve
impulses , or action potentials,
which are skin to tiny electrical
charges. In effect the strength
of the impulse is maintained
through out the length of the
Provide
students with
hand-out
Listen

Observe the
hand-out
given

Hand-outs


neurons.
Properties of neurons:
1.Irritability
2.Conductivity
Irritability is the ability to
initiate nerve impulse in
response to stimuli from,
-outside the body
-inside the body

Conductivity means the ability
to transmit an impulse































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Step 4
Explain the
types of
seizures
( 3 min )
Types:
It is mainly divided into two,
1. Generalized seizures
2. Partial seizures

1) Generalized seizures:
They are characterized
by bilateral synchronous
epileptic discharges in the brain
from the onset of the seizure, it
is divided into,
a) Tonic clonic seizures
b) Typical absence
epileptic seizures
c) Atypical absence
seizures
d) Myclonic seizures
e) Akinetic epileptic
seizures

a) Tonic clonic seizures:
It is characterized by loss of
consciousness and falling to
ground If the patient is upright ,
followed by stiffening of the
body.

b)Typical absence epileptic
seizures:
It usually occurs only in
Explain the
two types of
seizures.



Briefly
define what
is
generalized
seizure and
the types of
generalized
seizures and
what is
partial
seizure













Listen and
read the
handouts
and lecture
notes
Handouts
and Lecture
notes
To wash away
any microbes
that might be
on their hand

They might get
ill

children which characterized by
brief starring spell that last only
a few seconds
c)Atypical absence seizures:
it is characterized by starring
spell accompanied by other
signs and symptoms including
brief warnings
d)Myoclonic Seizures:
it is characterized by sudden,
excessive jerk of the body or
extremities.
e)Akinetic seizures:
it is characterized by loss of
tone, astatic (loss of balance)
and arrest of movement.
2)Partial seizures:
Partial seizures may be
confined to one side of brain
end remain partial or focal in
neturs.



















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Step 5
Explain the
etiology of
epilepsy
Etiology of epilepsy
Severe birth injury
Congenital defects
involving CNS
Infections
Inborn errors of
metabolism
Trauma
Genetic factors
Brain tumors
Vascular disease
Cerebrovascular lesions
Metastatic brain tumors
Idiopathic
Genetic pre disposition

Explain to
the students
of the
etiology of
epilepsy
Listen

Observe
the hand-
out given
Hand-out
and lecture
notes



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Step 6
Explain the
pathophysiolo
gy of epilepsy
( 3 min )
Pathophysiology:
Messages from the body are
carried by the nerve cells of the
brain by means of
electrochemical energy. These
impulses occur in bursts
whenever a nerve cell has a test
to perform.
Due to etiological factors

The nerve cells or groups of
cells continues firing after a
task is finished

Unwanted electrochemical
discharges forms

Resultant dysfunction ranges
from mild to incapacitating and
often cause unconsciousness

When these uncontrolled,
abnormal discharges occur
repeatedly a person is said to
have epilepsy.

Explain to
the students
of the
pathophysiol
ogy of
epilepsy
Listen

Observe the
hand-out
given
Hand-out
and lecture
notes





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Step 7
Clinical
Manifestation
of epilepsy
( 2 min )
Clinical manifestations:
In adults:
Loss of consciousness
Fear
Anger
Elation
Irritability
Jerky alternation of
muscle relaxation and
contraction
Contraction of
diaphragm and chest
muscles
Tongue is often chewed
incontinence of urine
and stool
Head ache
In children:
Numbness
Tingling
Paraesthesia
Pallor
Sweating
Flushing
Papillary dilation

Explain the
clinical
manifestatio
n of epilepsy
in adults and
in children
Listen
Observe
the handout
given
Hand-out
and
brainstroing



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Step 8
Explain
management
of epilepsy
( 40 min)








































Management:
The management of
epilepsy to meet the needs of
each patient and not just to
manage and to prevent seizure.
Pharmacological
management:
Epileptic disorder are treated
primarily with anti seizure
drugs.
Aim
To prevent epilepsy
because cure is not
possible.
In adults:
Eg: clonazepam
Carhanzepine
Primidone
Phenytoin
Fethamate
Phenobarbital
In children:
Epileptic drugs:
Carbamazepine-5-
25mg/kg/day
Phenytoin -5-
7mg/kg/day
Valporic acid 10-
30mg/kg/day
Phenobarbital 3-
Explain the
management
of epilepsy
by sub
dividing
them into
pharmacolog
ical, Surgical
and Nursing
























Listen
Observe
handouts




























































































































5mg/kg/day
Ethosunimide-15-
40mg/kg/jday

Surgical management:
There are 3 types of
surgical interventions are in
children.
1)Resective Surgery: In this the
focal area of the seizures
activity is excised.
2)Callostomy: Include the
separation of the connection
between the two hemispheres
of the brain and is used in some
generalized seizures.
3)Vagus nerve stimulation:- It
uses an implantable device that
reduces seizure in individuals
who have not had effective
control with drug therapy.
In adult:
1) Cerebral resection
2) Temporal lobectomy
3) Vagus nerve stimulation







































































































































































Nursing management:
Assess the
condition of the
patient
Help in taking
medication
Moderation in a
temperature
controlled
environment to
avoid excessive
heat.
Keep a drug
and seizure
chart
Assess for
trauma to mouth
Provide teaching
to patient and
family














































































































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Step 9
List out the
Nursing
diagnosis
related to
seizure
Nursing diagnosis:
1.Ineffective breathing pattern
related to neuromuscular
impairment and production of
secretion
Planning
Patient will maintain adequate
oxygenation and normal
breathing pattern during and
after seizure
Interventions:
1.Loosen constricting to
clothing to avoid restricting
breathing
2.Assess breathing pattern
3.Provide manual ventilation
4.Insert oral airway
5.Suctioing after episode of
seizure
6.Asses oral cavity for any
injuries
Rationale
1.Loosen clothing to avoid
restriction of movement and
breathing
2.evaluate breathing pattern and
provide manual ventilation to
ensure adequate oxygenation
as seizure disturbs the level of
consciousness causing patient
Ask the
student to
list out
possible
nursing
diagnosis
related to
epilepsy
Discussion
and
brainstormi
ng
Knowledgeabl
e and able to
come up with
specific
nursing
diagnosis
to poor breathing.
3. Insert oral airway to secure
airway and facilitate suctioning
only after seizure as occur
4.asses oral cavity for injury
such as broken teeth of injuries
to the tongue as it might disturb
breathing pattern
Evaluation
Patient maintain adequate
oxygenation and normal
breathing pattern

2.Risk for injury related to
epileptic activity and impaired
physical mobility.
Planning
Patient will not have any
injuries during seizure.
Interventions:
1.Assess for trauma to mouth
2.Assess for weakness
Refrain from moving or
restraining patient during a
seizure
3.use padded protection on the
side rails and floor if possible.
4.remove any furniture or
barrier
5.Do not insert anything into
the patients oral cavity during
seizure episode.
Rationale
1.Loosen clothing to avoid
restriction of movement
causing injuries
2.Remove any furniture of
barrier so that the patient can
move freely and not hit against
it.
3. Avoid restraining patient,
this might act as a barrier and
4.avoid inserting things in the
patients oral cavity this may
cause injury such as broken
teeth of injuries to the tongue.
Evaluation
Patient maintain adequate
oxygenation and normal
breathing pattern

























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Step 10
Conclusion
Conclusion on the definition,
types, pathophysiology, clinical
manifestation and management
of epilepsy

Discuss all the content of
epilepsy. Key points of the
topic.
Ask what is
the
definition,
types,
pathophysiol
ogy, clinical
manifestatio
n, and
management
of epilepsy
Discussion
and
brainstormi
ng
Conclusion:
Students are
able to tell
about
definition,
types,
pathophysiolog
y, clinical
manifestation
and
management of
epilepsy