Seizure Disorders Flashcards
(22 cards)
Definition of a Seizure
finite event caused by excessive discharge of cerebral neurons. effect awareness movement or sensation.
Definition of Epilepsy
Chronic disorder of recurrent seizures
chronic medical condition
Pathophysiology of Seizure
- Sudden excessive electrical discharge of aggregates of neurons
- Disruption of normal physiochemical mechanism of nerve cells
- related to decreased inhibition
Seizures accompanied by focal lesion of CNS immaturity
- hyper excitable neuron in partially depolarized state near lesion
- susceptible to activation by hyperthermia, hypoxia, hypoglycemia, hypercalcemia
Types of Partial Seizures
- Simple partial seizures (focal seizures)
- Complex partial seizures
- Complex partial progressing to generalized
Simple partial seizure
- limited to one area of the brain
- consciousness maintained
Complex partial seizures
- repetitive behaviors present
- consciousness is altered or lost
Complex partial progressing to generalized
can effect all of the surrounding areas as well
Types of generalized seizures
- Absence Seizure
- Myoclonic Seizure
- Tonic-Clonic Seizure (Grand Mal)
Absence Seizure
Minor convulsive muscular activity with sudden cessation of conscious activity
Myoclonic Seizure
- Sudden brief single or repetitive muscular contraction
- Consciousness is generally maintained
Tonic-Clonic seizure (Grand Mal)
- Sudden loss of consciousness
- Falls are common
- Generalized rigidity phase followed by a rapid generalized jerking phase
Tonic Phase
- eyes open
- elbows fix
- arms pronated
- Legs ext
- teeth clenched
- pupils dilated
- breath held (cyanosis)
- Bowel/bladder control may be lost @ end of phase
Clonic Phase
- Tremor gives to violent generalized shaking
- Eyes roll backwards & forwards
- tounge may be bitten
- tachycardia develops
- breathing recommences @ end of phase
Generalized Seizures: Convulsive Status Epilepticus
- generalized tonic clonic seizures are prolonged & repeated w/ no recovery in b/t
- medical emergency
- often associated w/tumor, CNS infection, or drug abuse
3 common Epilepsies of Childhood
- Severe myoclonic epilepsy of childhood
- Lennox-Gastaut
- Landau-Kleffner
Aura
Specific feeling/experience an individual experiences as the onset of a seizure
Most common aura
- smell of burnt rubber
- could have a variety of sensory experiences as an aura
Medical Management of Seizures
- EEG
- Metabolic studies
- X-ray
- MRI or CT
Immediate Management of Seizures
Protect them from Harm!
- lower pt to floor
- soft object under head
- turn head to side if vomiting to prevent aspiration
- Do NOT try to stop the mov NOR force anything into the mouth
Control of Seizures
- Support & education
- 80% controlled by meds
- Ketogenic diet-high fats low sugars
- Surgery (if localized to a specific region) requires intense pre-surgical work-up & only successful in 50% of cases
Prognosis
- idiopathic epilepsy, dx before 10 there is a 75% remission rate (seizure free for 5 yrs)
- generally not life threatening
- death by asphyxia or drowning
