Management of Seizures

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Management of Seizures
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Management of Seizures

• Seizure management
• Introductions
• House keeping items
• Washrooms
• Breaks
  

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Learning Objectives

• Definition of a seizure/epilepsy.
• Facts about epilepsy.
• Cause of seizures.
• Common types and treatments of seizures.

• Emergency care during a seizure.
• Documenting a seizure.
• 5 new facts about seizures that participants can
  share with school and staff.

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What is a Seizure? Think Brain!
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Definition of a Seizure

• A brief abnormal disturbance of electrical
  activity of the brain.
• A seizure may be a brief staring spell, unusual
  movement of the body or limb, a change in
  awareness, or a convulsion.
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What is the difference between a seizure and
epilepsy?

• Im not sure!
  
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Seizure versus Epilepsy

• A seizure may happen in a person due to an
  illness, fever or a temporary medical condition(
  i.e. brain tumor).
• After the illness is treated and resolved the
  seizure does not happen again.
• Epilepsy is a ongoing series of seizures. The
  seizures can occur frequently without a known
  cause.

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Seizure versus Epilepsy

• Many people with epilepsy have different types of
  seizures that can happen frequently.
• Having one seizure does not mean you have
  epilepsy.

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General Information

• Most of the people with epilepsy can lead a
  normal life.
• Approximately 30,000 people in Canada have
  epilepsy.
• Anyone can development epilepsy at any age.
• Epilepsy is usually diagnosed in childhood.

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General Information

• Seizures can last a few seconds or a few minutes.
  
• Seizure may need medical attention if they last
  too long.
• People cannot swallow their tongue

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Causes of Seizures

• Head trauma car and sport accidents, falls,
  blows to the head.
• Brain tumors and strokes
• Poisoning lead poisoning and drug withdrawal
• Lack of oxygen to the brain for any reason the
  person can develop seizures.

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Types of Seizures

• Partial seizures seizures that involve part of
  the brain. Examples are simple partial or complex
  partial seizures.
• Most common seizures.
• Non-convulsive.
• May spread to the whole brain.
• Consciousness can be impaired, but not lost.

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Partial Seizures

• Simple Partial Seizure
• No loss of consciousness.
• Generally no warning.
• Person does not lose awareness of environment.
• Jerking in one part of the body (ie arm/leg).

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Partial Seizures

• Complex Partial
• Consciousness is impaired.
• May start with a blank stare.
• May see altered behavior like picking at
  clothing, lip smacking or chewing.
• Person may be unaware of surroundings.

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Complex Partial Seizures

• Unresponsive when spoken to.
• May walk about the room.
• Seizure may last a few minutes.
• Will be confused when the seizure is over.
• No memory of what happened during seizure.

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Generalized Seizures

• Seizure affects the whole brain
• Person loses consciousness.
• Can be convulsive or non-convulsive.
• An aura could occur first.
• Can be detrimental to the health of a person if
  continuous.

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Generalized Seizures

• Include
• Absence Seizures-
• Blank stare, beginning and ending abruptly.
• Lasts a few seconds.
• Looks like the child is day dreaming.
• Most common in children.

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Generalized Seizures

• Myoclonic Seizures-
• Sudden brief, massive muscle jerks.
• Parts of /or the whole body may be involved.
• May fall out of a chair.

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Generalized Seizures

• Tonic Clonic-
• Loss of consciousness.
• Sudden cry
• Fall to the ground.
• Stiffening and rhythmic jerking of muscles
• Altered or shallow breathing.
  
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Generalized Seizures

• May stop breathing temporarily.
• Skin may turn a bluish color.
• Possible loss of bowel and bladder.
• Can last a few minutes.

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• Atonic Seizures (drop attacks)-
• Sudden collapse and fall.
• May recover after 10 seconds to a minute.

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Status Epilepticus

• Any seizure that lasts longer than 30 minutes
  with or without loss of consciousness.
• May occur after stopping medications.
• Can be life threatening if not treated
  immediately.

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Treatment for Seizures

• Medication
• Surgery
• Ketogenic Diet
• Vagal Nerve Stimulator

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Goals of Treatment

• Decrease the frequency and severity.
• Use the smallest amount of drug.
• Suffer the fewest side effects
• Improve the quality of life.

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Medication

• Most common treatment.
• Many types of medications available.
• Side-effect of drugs depend on the drug and
  person.
• Epilepsy can be controlled with medications.
• Common side-effects

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Side-Effects of Medications

• Drowsiness
• Irritability
• Nausea
• Skin rash
• Visual impairment
• Hyperactivity

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Ketogenic Diet

• High fat, low carbohydrate, low protein.
• Fluids are restricted.
• Burns body fat instead of glucose.
• Must have medical advice and instruction.
• Risks low blood sugar and weight loss.
• Difficult to follow.

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Surgery

• Only possible if seizures occur in a small part
  of the brain.
• Used as last resort.
• Cannot be done if speech or memory will be
  affected.
• Results vary from partial to full improvement.

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Vagus Nerve Stimulator

• Vagus nerve stimulator (VNS) is designed to
  prevent seizures.
• Works similar to heart pacemakers.
• VNS sends mild electrical impulses to the brain
  by way of the vagus nerve.
• View following video on next slide re VNS

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Vagus Nerve Stimulator

• http//www.epilepsy.com/epilepsy/vns

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Documentation

• Why do we document seizures?

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Documentation

• Assists in the diagnosis and treatment of the
  disorder.
• Indicates changes in the pattern or severity of
  seizures.
• Help the doctors evaluate the treatment.
• Alerts the family to events that may cause
  seizures.

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Record

• Date and time of the seizure.
• Any warning signs prior to the seizure.
• Describe the body parts involved and the
  progression.
• Type of movement (jerky, rhythmic, rigid).
• Breathing changes and changes in color.

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Record

• Loss of consciousness.
• Behavior after the seizure (i.e. drowsiness,
  disorientation, recovery time.)
• Loss of bladder or bowel control.
• Who needs to know about the seizure?

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Management of Seizures

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Seizure First Aid
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First Aid

• Position person, stay, and remain calm
• Wheelchair or side position only
• Never put them on their back
• Never leave a person during a seizure
• Call for help
• Protect Person-put something soft under their
  head
• Do not restrain move objects out of thrashing
  range
• Put nothing in the mouth
• Loosen restrictive clothing
• Offer reassurance following seizure
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Seizure First Aid

• Record the seizure time or length
• Describe the seizure behavior before during and
  after the seizure
• Notify appropriate people, parents, others
• Aspiration / choking

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• http//www.bcepilepsy.com/publications_and_resourc
  es/lecture-and-info-videos.aspx