Seizures

1. Seizures

2. Definition According to the Understanding Pathophysiology (2004): -A seizure results from a sudden, explosive, disorderly discharge of cerebral neurons and is characterized by a sudden, transient alteration in brain function, usually involving motor, sensory, autonomic, or psychic clinical manifestations and altered level of arousal (p. 363). -A seizure can last only a few seconds or several minutes.

3. Types of Seizures Absence (Petit Mal) Symptoms: Stare, eyes fluttering, little to no change in muscle tone, usually able to maintain posture. Last only a few seconds. Not easily detectable. (Epilepsy Foundation, 2005)

4. Types of seizures Tonic-Clonic (Grand Mal)-most common type of seizure Symptoms: A cry, fall, limbs become stiff and then jerk, lose consciousness, may urinate and/or defecate on themselves, breathing may stop briefly. Last about 1-2 minutes. (Epilepsy Foundation, 2005)

5. What is epilepsy? A neurological condition that causes disturbances in the electrical functions of the brain. This makes them susceptible to having recurring seizures. A seizure is a symptom of epilepsy. (Epilepsy Foundation, 2005)

6. What may bring a seizure on? Hypoglycemia Fatigue or not enough sleep Stress both emotional and physical Fever Use of stimulant drugs (Ex. Cocaine & Ecstasy) Withdrawal from alcohol Loud noises or bright lights Head injury Not taking anti-seizure medications as prescribed It is important to remember that seizure can come on for no apparent reason.

7. What to do when a child has a seizure Keep calm. Do NOT hold the person down or try to stop their movements. Time the seizure. Clear the area around the individual to ensure they are safe. Place something soft under the individual’s head. Turn them on their side, helps keep airway clear. Do NOT place anything in their mouth. Stay with the individual until the seizure ends. Reassure them. (Epilepsy Foundation, 2005)

8. When to call 911 Prolonged seizure activity (Greater than 5 minutes). Falling and hitting head during seizure. Not able to arouse after a seizure. Trouble breathing or cessation of breathing. Seizures continue one after another. The individual is pregnant, has diabetes, or has a high fever.(Epilepsy Foundation, 2005)

9. Common Medications for Seizure Disorders Dilantin Uses: Management of generalized tonic-clonic seizures, complex partial seizures, cortical focal seizures, and status epilepticus. Frequent side effects: Drowsiness, lethargy, confusion, slurred speech, irritability, gingival hyperplasia (gum overgrowth), hypersensitivity reaction (fever, rash), constipation, dizziness, and nausea. Signs of toxic levels in bloodstream: muscle incoordination, painful eye movements and double vision. As levels rise they may be extremely lethargic and can even lead to a coma. Important information Must take medication as prescribed in order for it to be effective. Promote good oral care because gums can become overgrown. Report a sore throat, fever, and skin reaction to physician, these are signs of toxicity. Do not drink alcohol with this drug. (Hodgson & Kizior, 2008)

10. Common Medications for Seizure Disorders Tegretol Uses: Treatment of partial seizures with complex symptoms, generalized tonic-clonic seizures and mixed seizure patterns. Frequent side effects: Drowsiness, dizziness, nausea and vomiting. Toxic effects: Harmful affects on blood such as anemia, cardiovascular problems (Congestive heart failure, low/high blood pressure, arrhythmias), skin problems such as a rash, itching, and sensitivity to light. Early toxic signs include fever, sore throat, mouth ulcers, unusual bruising/bleeding, and joint pain. Important information: Do not suddenly stop taking this medication. Do not take with grapefruit juice as this may increase the amount of drug in the bloodstream. constipation, diarrhea, and behavioral changes in children. (Hodgson & Kizior, 2008)

11. Common Medications for Seizure Disorders 3. Valproic Acid (Depakote) Uses: Prophylaxis of absence seizures, myoclonic, and tonic-clonic seizure control. Frequent Side effects: Abdominal pain, irregular periods, diarrhea, hair loss, indigestion, nausea, vomiting, tremors, and changes in body weight. Toxic effect: Liver damage with early symptoms of being weak and tired, not wanting to eat and vomiting. Important information: Do not suddenly stop taking medication after long-term use. Must take medication as prescribed in order to control the seizures. Do not drink alcohol. Tell your doctor if any of the following occur: nausea, vomiting, drowsiness, change in mental status, not wanting to eat, abdominal pain, skin turning yellow, and unusual bruising/bleeding appear. (Hodgson & Kizior, 2008)

12. Emergency Action Plan for Duplin County Schools 1. Stay with child during and after seizure. Note the duration and type of body movement during the seizure episode. 2. Assist to horizontal position if loss of consciousness occurs. Loosen restrictive clothing if necessary. 3. Turn student on his/her side as soon as possible. 4. Clear the area around the child to prevent injury. 5. Do NOT restrain movement of place anything in the mouth.

13. Emergency Action Plan for Duplin County Schools continued… 6. Monitor breathing and begin artificial respiration if breathing does not resume spontaneously. 7. If the seizure lasts more than five minutes or student has one seizure after another without walking, call 911 and transport to nearest hospital. 8. When seizure is over, allow child to rest and always notify parents. 9. Notify school nurse, if in the building. 10. Additional instructions provided by physician:

14. References Hodgson, B. B., & Kizior, R. J. (2008). Saunders Nursing Drug Handbook. St. Louis, MO: Saunders Elsevier. Epilepsy Foundation. (2005). Received February 8, 2009, from http://www.epilepsyfoundation.org/ Huether, S. E., McCance, K. L., (2004). Understanding Pathophysiology (3rd ed.). St. Louis, MO: Mosby. Netter Collection. (2009). Received February 8, 2009, from www.netterimages.com/images