Epilepsy

1. Epilepsy or Seizures By Melissa VanDyke

2. What is Epilepsy????? • A transitory disturbance in consciousness or in motor, sensory, or autonomic, function with or without a loss of consciousness. Associated with paroxysmal, uncontrolled electrical discharges in the neurons of the brain that result in the sudden, violent, involuntary contraction of a group of muscles.

3. Seizures are classified according to the varied features of the attack : • Generalized tonicclonic (grand mal) • Absence (petit mal) • Psychomotor (automatisms) • Jacksonian (focal) • Miscellaneous seizures (myoclonic and akinetic)

4. Reasons seizures occur: • Variety of reasons including hypoglycemia, infection, electrolyte imbalance, alcohol, barbiturate with-drawl, water intoxication, stroke, approximately 70% of patients with epilepsy a cause hasn’t been determined There is excessive neuronal discharge which results in a tonic convulsion. Seizures are followed by a rest period of variable lengths (postictal period)

5. Assessment: • Aura preceding a seizure is important to consider. Aura occurs in about 50% of all patients with tonic-clonic seizures. Aura is a sensation, as of light or warmth that may precede an attack of an epileptic seizure. • Epileptic aura may be psychic, sensory with olfactory, visual, auditory, or taste hallucinations. • Assessing the number of seizures occurring within a specific time period, any behaviors noted and injuries suffered • Character of the seizure should be described as completely as possible including duration, patients movements, if the patient was incontinent, and cries or sounds that were made and the level of alertness.

6. Diagnostics: • Usually diagnosed thru a complete history and physical assessment. • An electroencephalogram (EEG) is usually used to make a diagnosis of epilepsy. An EEG measures the electrical activity of the brain and certain abnormalities may be seen in patients with epilepsy.

7. How to manage Epilepsy: • Anti-seizure drugs, therapy is aimed at prevention of the seizures because cure is not possible • Drugs generally act by stabilizing nerve cell membranes and preventing spread of the epileptic discharge blood levels may be checked to provide an accurate check on the therapeutic level of medication • 70% of patients with seizures use meds to control them • If medication is not effective surgical removal of the brain tissue where the seizures occur will be done

8. How does effect daily living????? • Patients are encouraged not to drive operate machinery or swim until epilepsy is controlled • Adequate rest and good nutrition • NO ALCOHOL!!!!!!!!! • Patients receiving longterm phenytoin (Dilantin) should be encouraged to use good oral hygiene because of side effects of edematous and enlarged gums. • Patient should wear a medical-alert bracelet

9. Nursing Interventions: • Care during a seizure: • Protection from aspiration • If patient is sitting or standing they should be lowered to the floor • NEVER LEAVE THE PATIENT ALONE!!!! • Support the head if possible turn the head to the side to maintain airway • Do not restrain patient, and NEVER NEVER NEVER EVER PRY OPEN THE JAW!!!

10. Interventions con’t: • Nurse should carefully observe and record details of the seizure because the diagnosis and subsequent tx often rests solely on seizure discription • All aspects of the seizure when did it occur, how long did each episode last, what happened after the seizure.

11. And the Prognosis Is……. • Most patients with seizures are able to control them with meds. And can lead a normal life. • And with most seizure disorders the number and intensity usually stay the same.