Seizures and Epilepsy

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Seizures and Epilepsy

• Professor Luci Mendonça-Cali RN, MSN

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Overview

• Seizure is a paroxysmal, uncontrolled electrical
  discharge of neurons in the brain that interrupts
  normal function.
• Epilepsy is a condition in which a person has
  spontaneously recurring seizures caused by a
  chronic underlying condition.

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Etiology

• First 6 months of life
• 2 and 20 years of age
• 20 and 30 years of age
• After 50 years of age

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Pathophisiology
a group of abnormal neurons spontaneously fire
firing spreads
adjacent or distant areas of the brain
activity spreads through the whole brain
generalized seizure

• Scar tissue (gliosis)
• Scarring interfere with the normal chemical and
  structural environment of the brain neurons
  making them more likely to fire abnormally.

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Clinical Manifestations

• The specific clinical manifestations of a seizure
  are determined by the site of the electrical
  disturbance.
• Method of classifying recurring seizures
• International Classification System
• Generalized
• Partial

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Phases of Seizure

• Prodromal phase
• Aural phase
• Ictal phase
• Postictal phase

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A. Generalized Seizures

• Tonic-clonic seizures
• Typical absence seizures
• Atypical absence seizures
• Other types of generalized seizures
• Myoclonic
• Akinetic

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B. Partial Seizures

• Simple partial seizures
• Complex partial seizures

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Complications

• Physical
• Status epilepticus
• Severe injury and even death
• Psychosocial

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Diagnosis

• History and Physical Examination
• Seizure History
• Diagnostic Studies

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Collaborative Therapy

• Drug Therapy
• Emergency Management
• Surgical Therapy
• - Wadas Test
• Other Therapies
• - Vagal nerve stimulation
• - Biofeedback

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Nursing Assessment

• Subjective Data
• Past health history
• Medications
• Cognitive-perceptual
• Self-perception-Self-concept
• Sexuality-reproductive
• Objective Data
• Precipitating factors, Integumentary,
  Respiratory, Cardiovascular, GI and GU,
  Neurologic, and Musculoskeletal

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Nursing Implementation

• Health Promotion
• Acute Intervention
• Ambulatory and Home Care
• Family Teaching
• Patient Teaching