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Flashcards in Seizures Deck (34)
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1

Seizure

Epilepsy

-periods of abnormal electrical discharges in brain that may cause involuntary movement or behavior, or sensory alterations


-chronic disorder characterized by recurrent seziures secondary to CNS disorder

2

Seizure pathophysiology

-abnormal excessive concurrent electrical discharges from cortical neuronal netowrk of cells
-when multiple neurons become excited, they discharge abnormally
-can be caused by environmental, physical stimuli, CNS infection, ypoxia, and brain trauma

3

Focal Seizures

-partial seizures
-abnormal electric activity in 1 hemisphere, most often in temporal, frontal, or parietal lobes

4

Generalized seizures

-electrical activity that begins on both hemisperes simultaneously
-spasm movements are bilateral and symmetric

5

Febrile seizures

-generalized seizures tha occur during rapid increase of temperature
-associated wth acute illness
-seen between 3 months-5 years
-often a family history is present
-Tonic clonic manifestations less than 15 mins

6

Risk factors for infants developing epilepsy

-median age 5-6 yrs
-SGA
-neurological syndrome
-brain tumor/infections
-stroke
-cp
-autism
-FH
-drug abuse

7

Tonic Phase manifestations

-unconsciousness, and continous muscular contraction
-BMR increases, increases demand for oxygen and glucose
-may become pale and cyanotic as result of hypoxia
-hypoglycemic

8

2 types of seizures

-partial (focal)
-Generalized (tonic clonic)- most common in children

9

Clonic Phase

-alternating muscular contraction and relaxation

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Postictal Period

-following seizure activity
-decreased LOC, sleepy but arousable

11

Auras

-early warning sign of seizure
-sensory alteration such as odor, taste, or vision
-if feeling aura, pt should get on floor to prevent injury during seizure

12

Simple Partial Seizures Etiology

-involves activation of only part of one cerebral hemisphere

13

-Simple Partial Seizures manifestations

-no alteration in consciousness
-muscle movements may be restricted to one area
-may have abnormal sensations or hallucinations
-tachycardia, flushing, hypotension or hypertension
-sense of deja vu or fear or anger

14

Simple partial seizure therapies

-antieleptic meds
-maintain safety
-assess manifestations and document
-vagal nerve stimulation therapy

15

Complex partial seizure etiology

-same as simple partial, but usually in temporal lobe

16

Complex partial seizure manifestations

-aura of visual, auditory, smell or psychic
-impaired consciousness that last several hours
-repetitive activity such as lip smacking, aimless walking, or picking at clothing called automatisms
-amnesia

17

Complex partial seizure therapies

-antiepileptic meds
-maintain client safety

18

Absence seizures (petit mal) etiology

-both hemispheres of brain as well as deeper structures such as thalamus, basal ganglia, and upper brainstem

19

Absence seizures (petit mal) manifestations

-impaired LOC
-sudden brief cessation of motor activity with blank stare and unresponsiveness
-common in children
-last 5-10 sec, as long as 30 sec
-occasional to several hundred a day

20

Absence seizure (petit mal) therapies

-antiepileptic meds
-maintain safety

21

Tonic clonic seizures etiology

-most commonly seen in adults

22

Tonic clonic seizures manifestations

-aura such as visual, gustatory, visceral, or sense or uneasiness
-sudden loss of consciousness
-tonic phase: sharp muscle contraction forcing air out of lungs, which may make client cry out, pupils fixed, incontinence, breathing ceases, last about 15-60 sec
-Clonic phase: alternating contraction and relaxation, hyperventilation, eyes roll back froths at mouth, aout 60-90 sec
Postical Phase: unconscious and unresponsive, relaxed breathing, confused and disoriented upon waking, tired, amnesia

23

Tonic Clonic seizure therapies

-antiepileptic meds
-client safety
-suspension of driving
-helmets
-dont restrain
-pad bedrails
-diazepam, lorazepam, or phenobarbital

24

Status Epilepticus etiology

-continuous seizure lasting longer than 30 mins
-requires immediate intervention

25

Status Epilepticus manifestations

-continuous seizure activity
-can be any type,usually tonic clonic
-client in great danger of hypoxia, acidosis, hypoglycemia, hyperthermia, and exhaustion

26

Status Epilepticus therapies

-maintain airway
-administer 50% glucose to prevent hypoglycemia
-diazepam, or lorazepam IV, repeat every 10 mins until seizure stops
-antiepileptics such as phenytoin
-phenobarbital

27

2 ways AEDs act

-raise seizure threshold
-limit spread of abnormal activity in brain

28

Goal of AED treatment

-protect the client from harm and to reduce or prevent seizure activity without impairing cognitive function or producing undesirable side effects

29

Febrile Seizure treatment for children

-usually not treated with anticonvulsants
-Parental education on keeping fever low with antipyretics, keeping child cool and light clothing, and protect child from harm
-may have second seizure and treated with rectal diazepam
-if seizure last longer than 10mins, child needs to be monitored for electrolytes, glucose, blood gass, increasing fever, and abnormal blood pressure.

30

Intraceable seizures

-seizures that continue to occur even with optimal medical management
-common in children
-often treated with multiple anticonvulsants and regular blood test