Seizure Disorders

by: Bryan Mae H Degorio, RN

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 Seizure disorders
- the brain's electrical activity is periodically disturbed, resulting
in some degree of temporary brain dysfunction.
-some seizures cause uncontrollable shaking and loss of
consciousness, but more often, people simply stop moving or
become unaware of what is happening.

-normal brain function requires an orderly, organized,

coordinated discharge of electrical impulses. Electrical impulses
enable the brain to communicate with the spinal cord, nerves, and
muscles as well as within itself. Seizures may result when the brain's
electrical activity is disrupted.
Two basic types of seizures

1. Epileptic (idiopathic)

- These seizures have no apparent cause (or trigger)

and occur repeatedly. These seizures are called a “seizure
disorder” or “epilepsy.”
-It often begins at the age of 20 and rarele begin ot
the age of 30
2. Nonepileptic (secondary epilepsy)

-These seizures are triggered (provoked) by a disorder

or another condition that irritates the brain. In children, a
fever can trigger a nonepileptic seizure.
-Psychogenic nonepileptic seizures
-Certain mental disorders can cause symptoms
that resemble seizures.
Causes:
1. High fever
2. Brain infections
3. Metabolic disorders
4. Inadequate oxygen supply to the brain
5. Structural damage to the brain
6. Fluid accumulation in the brain (cerebral edema)
7.Prescription drugs
 Pathophysiology

alteration in the neural cell integrity

increase in firing of electrical impulses

(reaching threshold)

Neural firing spread to the adjacent normal neurons

Clinical manifestations
1. AuraAbnormal – smells or tastes Butterflies in the stomach
feeling of déjà vu. An intense feeling that a seizure is about
to begin

Base on the Classification:

1.Partial Seizures:
- Only one side of the brain is affected. Partial
seizures may be simple or complex.
A. simple partial seizures- abnormal electrical
discharges begin a small area of the
brain and remain confined to that
area.
-no loss of consciousness And the
most common type of seizure
B. complex partial seizures-abnormal electrical
discharges begin in a small area of
the temporal lobe or frontal lobe
and quickly spread to other nearby
areas.
-The seizures usually begin with
an aura that lasts 1 to 2 minutes.
During the aura, people start to lose
touch with the surroundings. During the
seizure, consciousness is
impaired but not completely lost.

2 types of complex seizure

1. complex partial with automatism
Stare
Chew or smack the lips involuntarily
Move the hands, arms, and legs in
strange, purposeless
ways
Utter meaningless sounds
Not understand what other people
are saying
Resist help
 2.Partial seizure evolving into generalized seizure

2.a Grand mal (tonic-clonic)

-he most common type of seizure that is
associated with epilepsy
- tonic phase- characterized by contraction
and the body becomes rigid
- the client may fall, “cry may be
uttered” and it may
last for 30-60 seconds
-clonic phase- characterized by jerky,
rhythmic contraction and relaxation of
all body muscles
-accompanied by drooling, dyspnea
and urinary incotinence
- during the post-ictal phase there
1. cessation of of tonic-clonic phase
2. characterized by
exhaustion,headache and drowsiness, deep
sleep of 1-2 hours and disorientation.
2.b. Absence seizures may be typical (petit mal) or
atypical
- not preceded by an aura
- has little or no tonic-clonic movement
- Instead, they have episodes of staring
with fluttering eyelids and sometimes twitching
facial muscles.
-They are completely unaware of their
surroundings. These episodes last 10 to 30
seconds. People abruptly stop what
they are doing and resume it just as
abruptly.

2.c.Febrile seizure
- common among children less than 5yo
whem temp is rising
2.d. Psychomotor seizure
-has a psychomotor component
characterized by mental clauding (out of
touch with the environment)
-aura is present such as hallucination and
illusion

2.e. Status epilepticus

- is the most serious seizure disorder and a
medical emergency because the
seizure does not stop.
-Status epilepticus is diagnosed when a
seizure lasts more than 5 minutes or when people do
not completely regain consciousness between
seizures.
-People have convulsions with intense muscl

contractions and cannot breathe adequately.

Body temperature increases. Without rapid
treatment, the heart and brain can
become overtaxed and permanently
damaged, sometimes resulting in death.
Diagnostic procedures:
1. Doctors diagnose a seizure disorder when people have at
least two unprovoked seizures that occur at different times.
2. Computed tomography (CT)
-is usually done promptly to check for
bleeding,
tumors, and other structural damage to
brain t issue (for example, by a stroke). If results
are negative, magnetic resonance imaging
(MRI) is usually done later. It provides
detailed images of abnormalities and can
detect most neurologic disorders.
3. Electroencephalography (EEG) can help confirm the
diagnosis.
MANAGEMENT:
1. Prevention of injury during seizure
a. maintaining a patent airway and observe seizure
activity
-present of oral airways and suctioning
-turning to the side to displace the tongue that
results in airway opening
-loosen tight clothing
-provide safe environment for seizure activity
b. do not leave the client alone an do not apply
restraints
c. do not insert tongue blade during the attack
d. pad the side rail.
 e. Client education
-take the medication on aregular basis
-avoid alcohol and have adequate rest
-avoid driving, operate machines, swimming until
seizure is well controlled
2. Pharmacologic management
-use of AED’s (phenytoin, phenobarb and
carbamazipine and benzodiazipine)