Seizure Disorders

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Seizure Disorders
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Seizures

• Abrupt, uncontrolled electrical discharges of
  cerebral neurons that interrupts normal brain
  function

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Epilepsy

• A chronic disorder characterized by recurrent (2
  or more) unprovoked seizure activity
• spontaneous reoccurring seizures

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Causes of Seizures

• Over ½ are Idiopathic (unknown)
• Other causes
• Birth injury
• CNS defects or infection
• Head trauma
• Brain tumors
• CVA- cerebral vascular disease
• Chronic disease
• Metabolic disorders

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PRECIPITATING FACTORS

• Fatigue
• Decreased physical health
• Alcohol ingestion
• Emotional stress
• Flashing lights
• Menstrual cycle
• Hypoglycemia

• Sleep deprivation
• Stimulants
• Withdrawal
• Substance abuse
• High Fever
• Electrolyte imbalance
• Hypoxia

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Classification of Seizures

• Partial Seizures
• Generalized Seizures

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Generalized Seizure Partial Seizures
(Simple or Complex)

• Local onset - affects a specific area of brain
• Simple - no loss of consciousness
• Complex loss of consciousness

• Affects entire brain
• Loss of consciousness

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Generalized Seizures
Tonic Clonic
Absence
Myoclonic
Atonic
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Complex Partial
Simple Partial
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Diagnostic Studies

• MOST USEFUL - an accurate and comprehensive
  history/description of the seizures and health
  history
• Electroencephalogram (EEG)
• Brain scans (CT/CAT, MRI, PET)
• Labs

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Electroencephalography EEG
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Video with EEG
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Phases of Seizure Activity

• Prodromal- precedes a seizure with a sign or
  activity ( e.g. epileptic cry)
• Pre-ictal or aura precedes a seizure
• with a sensory warning
• Ictal-during seizure
• Postictal-after the seizure

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Seizure Precautions
Padded side rails
Suction machine
IV access
Oxygen at bedside
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During a Seizure
Maintain patent airway
If seizure last gt 5 min
MD
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Document

• Length of seizure
• Preceding aura
• Loss of consciousness, precipitating factors,
  incontinence, resp difficulty

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Post-Seizure Assessment and Intervention

• -
• -
• -
• -

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Status Epilepticus

• State of continuous seizure activity
• Period of one continuous seizure lasting longer
  then 10 minutes or several seizures occurring
  during a 30 minute time frame
• Neurological emergency

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Emergency Care

• During a Status Epilepticus
• -
• -
• -

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Common Medications

• Phenytoin (Dilantin)
• Carbamazepine (Tegretol)
• Valproic acid (Depakene)
• Barbiturates -Phenobarbital
• Succinimides -Zarontin
• Benzodiazepines Valium, Ativan
• Clonazepam Klonopin

• Newer Antiseizure Drugs
• Neurontin
• Lamictal
• Felbatol
• Topamax
• Cerebyx

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Education

• Medication
• Therapeutic drug levels
• Drug-drug and food-drug interactions
• Stress compliance with medications
• Do not stop abruptly

• Client and Family Education
• Care of client during a seizure
• When to call 911
• Seizure precautions
• Keep seizure diary
• Rest Manage stress
• Take medications as prescribed
• States laws re driving and operating machineries