 Also known as convulsions, epileptic seizures, and if recurrent,

epilepsy.

 EPILEPTIC SEIZURE (FIT)

The manifestation of an abnormal and excessive synchronized

discharge of a set of cerebral neurons

 EPILEPSY

A chronic condition, of various etiologies, characterized by

recurrent, usually spontaneous, epileptic seizures when 2 or more
unprovoked seizure fits occur

 It is a sudden alteration in normal brain activity that cause distinct changes in behavior and body function.
They are thought to result from abnormal, recurrent, uncontrolled electric discharges of neurons in the brain.
 Pathophysiology of seizures is poorly understood but seems to be related to metabolic and electrochemical
factors at the cellular level.
 Predisposing factors include head or brain trauma, tumors, cranial surgery, metabolic disorders
(hypocalcemia, hypoglycemia or hyperglycemia, hyponatremia, anoxia); central nervous system infection;
circulating disorders; drug toxicity; drug withdrawal states (alcohol, barbiturates); and congenital
neurodegenerative disorders.
 Seizures are classified as partial or generalized by the origin of the seizure activity and associated clinical
manifestations.

a. SIMPLE PARTIAL SEIZURES – manifest motor, somatosensory, and psychomotor symptoms without
impairment of consciousness.

b. COMPLEX PARTIAL SEIZURES – manifest impairment of consciousness with

or without simple partial symptoms.

c. GENERALIZED SEIZURES – manifest a loss of consciousness with

convulsive or non-convulsive behaviors and include tonic-clonic,
myoclonic, atonic, and absence seizures.

 Simple partial seizures can progress to complex partial

seizures, and complex partial seizures can secondarily become
generalized.
 Seizures affect all ages. Most cases of epilepsy are identified
in childhood, and several seizure types are particular to children.

The body cells discharges too much

electrical impulse, more
PATHOPHYSIOLOGY than what theSEIZURE
OF CONVULSIVE
nerve cells can carry when performing
task.
 The cells continue to discharge even
before the previous electrical impulses
are interpreted by the brain

Period of repeated anomalous

discharge of electrical impulse

The muscles begin to contract and relax

repeatedly and certain parts of the body
function erratically

Hyperexcitability and
hypersynchrony of the
nerve cells

Signs and symptoms

Brief blackout followed by period of

confusion
Drooling or frothing at the mouth
Eye movements
Grunting and snorting
Loss of bladder or bowel control
Sudden falling
Teeth clenching
Temporary halt in breathing
Uncontrollable muscle spasms
 The first phase of seizure is PRODROMAL PHASE which involves mood or behavior changes that may precede a seizure by
hours or by days.
AURA PHASE is premonition of impending seizure activity and may be visual, auditory, or gustatory.
The ICTAL STAGE is characterized y seizure activity usually musculoskeletal.
The POSTICTAL STAGE is a period of confusion, somnolence, irritability that occurs after the seizure.

DIFFERENCE BETWEEN CONVULSION & SEIZURE

Seizures occur due to abnormal electrical impulses in the brain. The

type of seizure depends on where in the brain the electrical impulse
originates. Different types of seizures have different symptoms,

CONVULSIONS

1. Convulsions involve violent jerking of the muscles. According to

Web MD, convulsions occurring during seizures often last for 30
to 60 seconds.

TONIC-CLONIC SEIZURES

2. Sometimes called grand mal seizures, tonic-clonic seizures

involve loss of consciousness followed by convulsions. Patients
often lose control of their bladder during the convulsions.

MYOCLONIC SEIZURES

3. Myoclonic seizures involve sporadic jerking movements, similar to

convulsions. Movements may be slight or may be severe.

CLONIC SEIZURES

4. Clonic seizures involve repetitive jerking movements or

convulsions. Convulsions are similar to those involved in tonic-clonic seizures, but patients do not lose consciousness
first.

Other Types of Seizures

5. Other types of seizures include absence seizures, characterized by

a brief loss of consciousness; tonic seizures, characterized by muscle stiffness; and atonic seizures, characterized by
sudden loss of muscle tone. These types of seizures do not cause convulsions.

ASSESSMENT

1. GENERALIZED TONIC-CLONIC (GRAND MAL) SEIZURE

a. May be preceded by an aura such as a peculiar sensation or dizziness; then sudden onset of seizure with loss of
consciousness.

b. Rigid muscle contraction in tonic phase which clenched jaw and hands; eyes open with pupils dilated; lasts 30 to 60
seconds.
 c. Rhythmic, jerky contraction and relaxation of all muscles in clonic phase with incontinence and frothing at the lips; may
bite tongue or cheek, lasts several minutes.

d. Sleeping or dazed postictal state for up to several hours.

2. ABSENCE (petit mal) SEIZURE

a. Loss of contact with environment for 5 to 30 seconds.

b. Appears to be day dreaming or may roll eyes, nod head, move hands, or smack lips.

c. Resumes activity and is not aware of seizure.

3. MYOCLONIC SEIZURE (infantile spasm)

a. Seen in children or infants, caused by cerebral pathology, often with mental retardation.

b. Infantile spasms usually disappear by age 4, but child may develop other types of seizures.

c. Brief, sudden, forceful contractions of the muscles of the trunk, neck, and extremities.

d. Extensor type – infant extends head, spreads arms out, bend body backward in “spread eagle” position.

e. Mixed flexor and extensor types may occur in clusters or alternate.

f. May cause children to drop or throw something.

g. Infant may cry out, grunt, grimace, laugh, or appear fearful during an attack.

4. PARTIAL (focal) MOTOR SEIZURE

a. Rhythmic twitching of muscle group, usually hand or face.

b. May spread to involve entire limb, other extremities and face on that side, known as jacksonian seizure.

5. PARTIAL(focal) SOMATOSENSORY SEIZURE

a. Numbness and tingling in a part of the body.

b. May also be visual, taste, auditory, or olfactory sensation.

6. PARTIAL PSYCHOMOTOR (temporal lobe) SEIZURE

a. May be aura of abdominal discomfort or bad odor or taste.

b. Auditory or visual hallucinations, déjà vu feeling, or sense of fear or anxiety.

c. Repetitive purposeless movements (automatisms) may occur, such as picking at clothes, smacking lips, chewing, and
grimacing.

d. Lasts seconds to minutes.

7. COMPLEX PARTIAL SEIZURE – begin as partial seizures and progress to impairment of consciousness or impaired consciousness at
onset.

8. FEBRILE SEIZURE

a. Generalized tonic-clonic seizure with fever over 101.8 degrees Fahrenheit.

b. Occurs in children younger than age 5.

c. Treatment is to decrease temperature, treat source of fever, and control seizure.

d. Long-term treatment to prevent recurrent seizures with fever is controversial.

FIRST AID FOR SEIZURE (CONVULSION)

The goal of FIRST AID for SEIZURE (convulsion) is to protect the casualty from injury and manage the air way.

Here are the general steps:

Stay Calm
Note the time of seizure

Cushion Head
Protect the person's head by placing a cushion, such as folded clothing, beneath it.

Loosen Necktie
To make the client comfortable

Turn On Side

If there is saliva, blood, or vomit in the person's mouth, move him or her to the
recovery position so that it drains from the mouth.

Move away nearby objects and furniture that might cause injury. Try to keep the
person away from dangerous situations such as fire, heights, or water.

Nothing In Mouth

Do not pour any liquid into his mouth.

Do not try to place anything between the person's teeth

 Biting the tongue or cheek hard enough to cause much bleeding is rare.

Don't Hold Down

Do not restrain the patient.

Look For ID
To identify the client’s identity

As Seizure Ends

Re-orient the client to time and place.

…Offer help

Although most seizures end naturally without emergency treatment, a seizure in someone who does not have epilepsy could be a
sign of serious illness.

Call for medical assistance if:

The seizure lasts more than 5 minutes;

There is no "epilepsy/seizure disorder" I.D. present;
There is slow recovery, a second seizure, or difficult breathing afterwards;
The woman is pregnant or if there is medical I.D. indicating the presence of another medical condition
There are any signs of injury.