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PAT202 WINTER > w9 seizures > Flashcards

w9 seizures Flashcards

1
Q

what are seizure disorders?

A

Is a symptom of disease, not a specific disease

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2
Q

what is a seizure?

A

is a sudden, transient disruption in brain electrical function caused by abnormal excessive discharges of cortical neurons

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3
Q

what is epilepsy?

A

is a recurrence of seizures and a disorder for which no cause can be found

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4
Q

what is convulsion?

A

-is a tonic-clonic (jerky, contract-relax) movements associated with some seizures

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5
Q

what are conditions that are associated w/ seizure disorders?

A

any conditions that affect the CNS or neuronal environment

  • metabolic disorders
  • congenital malformations
  • genetic predispositions
  • perinatal injury
  • postnatal trauma
  • myoclonic syndromes
  • infection
  • brain tumour
  • vascular disease
  • drug/alcohol abuse
  • some environmental stimuli (blinking lights) known to imitate seizures
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6
Q

types of seizures -generalized seizures

A

affect neurons bilaterally

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7
Q

types of seizures-focal (partial) seizures-

A

affect neurons unilaterally

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8
Q

types of seizures-epilepsy syndromes

A

-usually a genetic or developmental cause

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9
Q

types of seizures-unclassified epileptic seizures-

A

the etiology is unknown

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10
Q

what is status epilepticus?

A

is a medical emergency !!

-continuing/recurring seizures w/ incomplete recover, unrelenting seizure activity that lasts 30 minutes or more

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11
Q

what are the 6 causes of epilepsy?

A
  • genetic
  • structural
  • metabolic
  • immune
  • infections
  • unknown
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12
Q

patho of epilepsy

A
  • is the interaction of complex genetic mutations w/ environmental effects
  • abnormalities synaptic transmission
  • imbalance in the brain’s neurotransmitters
  • development of abnormal nerve connections after injury
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13
Q

what is epileptogenic focus -epilepsy

A
  • Group of neurons that appear chronically hyperexcitable; fire more frequently and with greater amplitude
  • Cortical excitation spreads when the intensity threshold is reached
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14
Q

what is the tonic phase -epilepsy

A

A state of muscle contraction in which there is excessive muscle tone

  • Excitation of subcortical thalamic and brainstem areas
  • Associated with loss of consciousness
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15
Q

what is the clonic phase in epilepsy?

A

(alternating contraction and relaxation of muscles)

  • Inhibitory neurons in cortex, anterior thalamus, and basal ganglia react to cortical excitation –> muscle contractions gradually cease
  • Epileptogenic neurons exhausted
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16
Q

what is the postictal phase -epilepsy

A
  • following an epileptic seizures and pt returns to baseline

- Headache, confusion, aphasia, memory loss, and paralysis, lip-biting

17
Q

what are the consequences of epilepsy?

A
  • cerebral blood flow increase
  • cerebral oxygen consumption is increased by 60%
  • glucose depletion
  • accumulation of lactate in brain tissues
  • potential for progressive brain injury and irreversible damage
18
Q

what is prodroma?

A

Early clinical manifestations, such as malaise, headache, or a sense of depression, that may occur hours to a few days before the onset of a seizure

19
Q

what is aura?

A

-A focal seizure experienced as a peculiar sensation preceding the onset of a generalized seizure or complex partial seizure that may take the form of gustatory, visual, or auditory experience; a feeling of dizziness or numbness; or just “a funny feeling”
-sensation that occurs that is a warning sign of a seizure
“smelling, lip-smacking

20
Q

what is ictus?

A

The episode of the seizure

Relaxation of urinary and bowel sphincters → incontinence

21
Q

treatment of seizures

A
  • Antiseizure medication
  • Ketogenic diet for epilepsy
  • Surgery; vagal nerve stimulation
22
Q

what is the ketogenic diet?

A
  • high in fat, moderate in protein, and low in carbohydrates
  • limits water intake to avoid ketone dilution and carefully controls caloric intake
  • used when seizures cannot be controlled through pharmacotherapy or when the adverse effects of an antiepileptic drug (AED) are unacceptable
  • equally effective for every seizure type but not all clients respond to the diet
23
Q

what is drug therapy for seizure disorders? goal

A
  • goal of antiseizure pharmacotherapy is to suppress neuronal activity just enough to prevent abnormal or repetitive firing
  • drug choice depends on the type of seizure
  • drug therapy: pt is placed on an initial low dose
  • amount is gradually increased until seizure control is achieve or drug side effects prevent additional increase
  • if seizure activity continues, different medication in small dose increments are added while reducing the initial dose of the first drug
24
Q

what are the 3 vernal mechanisms of drug therapy for seizures?

A
  • Stimulate a influx of chloride ions → potentiates GABA (inhibitory)
  • Delay an influx of sodium ions
  • Delay an influx of calcium ions
25
Q

what are the 3 vernal mechanisms of drug therapy for seizures?

A
  • Stimulate a influx of chloride ions → potentiates GABA (inhibitory)
  • Delay an influx of sodium ions
  • Delay an influx of calcium ions
26
Q

Benzodiazepines: diazepam

A
  • Indication: Anxiety, adjunct in seizure disorders
  • Mechanisms of action: binds to GABA (inhibitory) receptor-chloride channels through the CNS. Suppresses abnormal neuronal activity in the limbic system and subsequent impulses to the reticular activating system that may seizures.
  • Desired effects: Decreased seizures, anxiety, restlessness
27
Q

Benzodiazepines: diazepam-adverse effects

A

Dizziness, headache, hypotension, blurred vision, constipation, nausea & vomiting, neutropenia, respiratory depression

28
Q

Gamma-aminobutyric acid (GABA) Inhibitors: valproic acid

A
  • Indication: Seizures
  • Mechanisms of action: desensitizes sodium channels in the CNS that are responsible for neuronal responsibility. Desensitization prevents the spread of disruptive electrical charges in the brain the produces seizures.
  • Desired effects: Decreased symptoms of epilepsy, bipolar disorder
29
Q

Gamma-aminobutyric acid (GABA) Inhibitors: valproic acid-adverse effects

A

sedation, drowsiness, GI upset, and prolonged bleeding time
-Other effects: visual disturbances, muscle weakness, tremor, psychomotor agitation, bone marrow suppression, weight gain, abdominal cramps, rash, alopecia, pruritus, photosensitivity, erythema multiforme, and fatal hepatotoxicity

30
Q

Anticonvulsants: Succinimides: ethosuximide

A
  • Indiciation: seizure disorders
  • Mechanisms of action: delay entry of Ca++ = increase the electrical threshold and decrease neurons from firing too quickly
  • Desired effects: absence of seizures
31
Q

ethosuximide -adverse effects

A

: psychosis or extreme mood swings, depression with suicidal intent, dizziness, headache, lethargy, fatigue, ataxia, sleep pattern disturbances, attention difficulty, and hiccups

32
Q

what is generalized absence seizure?

A
  • last seconds- no change in muscle tone
  • may occur over several times in a day
  • appears as if they are daydreaming
  • more common in children and often misdiagnosed w/ ADHD
33
Q

what is tonic-clonic?

A

may begin w/ an aura- “I smell burnt toast” - a warning sign
tonic phase- muscle stiffness and rigidity last 10-20 seconds, followed by unconsciousness
clonic phase- hyperventilation and jerking of the extremities - last about 30 seconds

34
Q

what is atonic or akinetic “drop attacks”

A

-sudden loss of muscle tone

35
Q

what is myoclonic?

A

it is jerking or stiffening of the extremities

-may fall from the seizure

36
Q

what is simple partial?

A
  • produces sensory and motor symptoms localized or confirmed to an area
  • remains consciousness and may result in aura
  • no post-ictal phase
37
Q

what is complex partial?

A

psychomotor seizures

  • temporal lobe is most often involved
  • altered behaviour of the client- loss of consciousness for a few seconds -altered behaviour in these pt’s
  • has a post-ictal phase
38
Q

interventions for seizures

A
  • ensure patent airway -support airway, prepare to suction
  • first thing–> make sure pt are on the floor and protecting the head and body, never restrain the pt
  • side-rail are paded-
  • make sure nothing is in the mouth
  • preventing injury at this time, removing/loosen restrictive clothing
  • assess behaviour at the onset of the seizure- the client has experienced an aura, if a change in facial expression occurs
  • if client is sitting/standing plane on the floor and protect head/body
  • turn client to the side to allow secretions to drain
  • note type, character and progression of seizure

PAT202 WINTER (16 decks)

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