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Seizure Disorder

This document discusses seizures, their causes, types, assessment, diagnosis, prevention, and management. It defines a seizure as abnormal neuronal activity resulting from sudden excessive discharge in the brain. Seizures can be partial or generalized, and are classified based on their origin and symptoms. Their causes include various neurological and medical conditions. Nursing management involves safely monitoring patients during and after seizures to prevent injuries, maintaining airway patency, and documenting observations of the seizure. Status epilepticus is a medical emergency requiring prompt treatment to stop prolonged seizure activity. Long-term antiseizure medication can increase risk of bone disease as a side effect.

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Karolien Faye Donga
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19 views

Seizure Disorder

This document discusses seizures, their causes, types, assessment, diagnosis, prevention, and management. It defines a seizure as abnormal neuronal activity resulting from sudden excessive discharge in the brain. Seizures can be partial or generalized, and are classified based on their origin and symptoms. Their causes include various neurological and medical conditions. Nursing management involves safely monitoring patients during and after seizures to prevent injuries, maintaining airway patency, and documenting observations of the seizure. Status epilepticus is a medical emergency requiring prompt treatment to stop prolonged seizure activity. Long-term antiseizure medication can increase risk of bone disease as a side effect.

Uploaded by

Karolien Faye Donga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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SEIZURE DISORDER

EMILY M. OLMEDO RN, USRN


WHAT IS SEIZURE?

• Seizures are episodes of


abnormal motor, sensory,
autonomic, or
• psychic activity (or a
combination of these) that result
from sudden excessive discharge
from cerebral neurons.
CAUSES:

• • Cerebrovascular disease
• • Hypoxemia of any cause, including vascular insufficiency
• • Fever (childhood)
• • Head injury
• • Hypertension
• • Central nervous system infections
• • Metabolic and toxic conditions (eg, renal failure, hyponatremia,
• hypocalcemia, hypoglycemia, pesticide exposure)
• • Brain tumor
• • Drug and alcohol withdrawal and allergies
International Classification of Seizures

• A. Partial Seizures (seizures beginning locally)


• Simple Partial Seizures
• ∙ With motor symptoms
• ∙ With special sensory or somatosensory symptoms
• ∙ With autonomic symptoms
• ∙ Compound forms
International Classification of Seizures

• Complex Partial Seizures


• ∙ With impairment of consciousness only
• ∙ With cognitive symptoms
• ∙ With affective symptoms
• ∙ With psychosensory symptoms
• ∙ With psychomotor symptoms
• ∙ Compound forms
• Partial Seizure Secondarily Generalized
International Classification of Seizures

• Generalized Seizures (Convulsive or nonconvulsive, bilaterally


• symmetric without local onset)
• ∙ Tonic-clonic seizures
• ∙ Tonic seizures
• ∙ Clonic seizures
• ∙ Absence (petit mal) seizures
• ∙ Atonic seizures
• ∙ Myoclonic seizures (bilateral massive epileptic)
• ∙ Unclassified seizures
Nursing Management
During Seizure:
∙ The circumstances before the seizure (visual, auditory, or olfactory stimuli; tactile stimuli; emotional or
psychological disturbances; sleep; hyperventilation)
∙ The occurrence of an aura (a premonitory or warning sensation, which can be visual, auditory, or olfactory)
∙ The first thing the patient does in the seizure—where the movements or the stiffness begins, conjugate
gaze position, and the position of the head at the beginning of the seizure. This information gives clues to the
location of the seizure origin in the brain. (In recording, it is important to state whether the beginning of the
seizure was observed.)
∙ The type of movements in the part of the body involved
∙ The areas of the body involved (turn back bedding to expose patient)
∙ The size of both pupils and whether the eyes are open
∙ Whether the eyes or head turned to one side
∙ The presence or absence of automatisms (involuntary motor activity,
such as lip smacking or repeated swallowing)
Nursing Management
∙ Incontinence of urine or stool
∙ Duration of each phase of the seizure
∙ Unconsciousness, if present, and its duration
∙ Any obvious paralysis or weakness of arms or legs after the seizure
∙ Inability to speak after the seizure
∙ Movements at the end of the seizure
∙ Whether or not the patient sleeps afterward
∙ Cognitive status (confused or not confused) after the seizure
Nursing Management
After Seizure:
∙ to document the events leading to and occurring during and after the
seizure and to prevent complications (eg, aspiration, injury).
∙ placed in the side-lying position to facilitate drainage of oral secretions,
and suctioning is performed, if needed, to maintain a patent airway and
prevent aspiration.
NURSING MANAGEMENT

After Seizure:
∙ Seizure precautions are maintained, including having available
functioning suction equipment with a suction catheter and oral
airway.
∙ The bed is placed in a low position with two to three side rails
up and
padded, if necessary, to prevent injury to the patient.
The Epilepsies
It is a group of syndromes characterized by unprovoked, recurring seizures.
Clinical Manifestations:
Epileptic syndromes are
classified by specific patterns
of clinical
features, including age at
onset, family history, and
seizure type.
Assessment and Diagnostic Tests:
Prevention:

Society-wide efforts are the key to prevention of epilepsy.


Head injury
is one of the main causes of epilepsy that can be prevented.
Through highway safety programs and occupational safety
precautions, lives can be saved and epilepsy due to head
injury prevented.
Medical Management:

Pharmacologic Therapy:
Status Epilepticus
Status epilepticus (acute prolonged seizure activity) is a series of
generalized seizures that occur without full recovery of
consciousness between attacks.
Medical Management:
∙ to stop the seizures as quickly as possible
∙ to ensure adequate cerebral oxygenation
∙ to maintain the patient in a seizure-free state.
Nursing Management:
∙ The nurse initiates ongoing assessment and monitoring of respiratory
and cardiac function because of the risk for delayed depression of respiration
and blood pressure secondary to administration of
antiseizure medications and sedatives to halt the seizures. Nursing
assessment also includes monitoring and documenting the seizure
activity and the patient’s responsiveness.

∙ The patient is turned to a side-lying position.


Nursing Management:
∙ A person who has received long-term antiseizure therapy has a
significant risk for fractures resulting from bone disease (osteoporosis,
osteomalacia, and hyperparathyroidism), a side effect of therapy.

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