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What are seizures?
- brief disturbance in the brain's electrical activity
- causing temporary changes in:
What is epilepsy?
a general term for a variety of neurological conditions causes recurrent seizures
- general absence (petite mal)
- clonic tonic(grand mal)
What are partial seizures?
activation of only a restricted part of one cerebral hemisphere
What are generalized seizures?
they affect the entire brain.
What are simple partial seizures?
memory, awareness, consciousness retained/preserved manifestations depend on involved area of brain
What are some manifestations of simple partial seizures?
- muscle rigidity
- head turning
- Sensory: Unusual sensations affecting either:
- can have hallucinations
- Autonomic Nervous System
- Memory or emotional disturbances
- feelings of déjà vu
- inappropriate fear
What are complex partial seizures?
- consciousness is impaired
- Most common type of seizure in older adults
- Loses consciousness with environment
- Amnesia common after seizure
- Several hours may elapse before pt regains full consciousness
What are automatisms?
- non-purposeful movements such as:
- lip smacking
- other repetitive, involuntary but coordinated movements
What usually are the phases of a tonic clonic generalized seizure?
- Warning aura
- tonic phase
- clonic phase
- deep sleep
Describe the tonic phase of a genralized seizure.
- Patient loses consciousness and usually collapses. stiffening of the body
- 15-60 seconds
Describe the tonic phase of a generalized seizure.
- violent jerking
- 30-60 seconds
Describe the postical phase of a generalized seizure.
What are some things to be aware of during and after a generalized seizure?
- tongue biting
- urinary/bowel incontinence.
- Unconscious and unresponsive to stimuli initially
- then confused
Describe an absence general seizure.
- 5-10 seconds, maybe more
- few seconds loss of consciousness
- few if any, other symptoms
- typically interrupts an activity and stares blankly.
- begin and end abruptly
- may occur several to 100 times a day.
- Patients are usually not aware that they are having a seizure
- but may be aware of losing time.
What are some safety precautions for a tonic clonic seizure?
- time the duration of the seizure
- lower the person to the floor to prevent injury
- Clear the area of any sharp or dangerous objects
- Gently turn the person on one side to keep the airway open
- Place a soft object under the person’s head or cradle the head with your hand
- Gently loosen any restrictive clothing
- remove glasses
- cover the person with a blanket to maintain dignity
What to do after a clonic tonic seizure.
- help to reorient
- allow the person to rest somewhere comfortable
What should one NOT do during a clonic tonic seizure?
- Place anything in the mouth
- touch or hold the tongue
- Restrain the person
- Administer liquids or foods until the person is fully conscious
- Attempt to give oral medications
When to call 911:
- The seizure lasts more than 5 minutes = Status Epilepticus
- Continuous seizures or short periods of calm between seizures
- Repeated seizures have cumulative effect, leading to muscle contractions, leading to resp complicaitons and exhaustion.
- Maintain airway – priority.
- This is the person’s first seizure or if you don’t know whether the person has had a seizure before
- The seizure takes place in water
- The person is injured during the seizure
- the person has diabetes or is pregnant
- Normal breathing or complexion does not return after the seizure has stopped
What are some meds used to treat seizures?
- IV Valium
- Dextrose for hypoglycemia
What are some precepitating factors of seizures?
- Keep a journal of events to determine precipitating factors
What causes shingles?
Herpes Zoster virus enters body during a chicken pox infection, it remains dormant until it has an opportunity to florish
Is shingles contagious?
- You can't catch shingles from someone else.
- But there is a small chance that a person with a shingles rash can spread the virus to another person who hasn't had chickenpox and who hasn't gotten the chickenpox vaccine.
What are the s/s of shingles?
- Early s/s:
- headache, sensitivity to light, and flu-like symptoms without a fever.
- itching, tingling, or pain where a band, strip, or small area of rash may appear
- rash is only on one side of the body
- blisters, then scab over,
- pain more than itch
How is shingles treated?
- Antiviral medicines:
- acyclovir, famciclovir, or valacyclovir
- Over-the-counter pain medicines:
- acetaminophen, aspirin, or ibuprofen
- topical antibiotics
How is postherpetic neuralgia (PHN), treated?
- Antidepressant medicines
- tricyclic antidepressant (for example, amitriptyline).
- Topical anesthetics
- benzocaine, Lidocaine patches, (Lidoderm)
- Anticonvulsant medicines,
- gabapentin, pregabalin.
What is a migraine?
a recurring primary headache, often initiated by a triggering event and usually accompanied by a neurologic dysfunction.
What are some migraine triggers?
- Rapid changes in blood glucose levels
- emotional excitement
- alcohol intake
- stimuli such as bright lights
- food high in tyramine or other vasoactive substances ( e. g., aged cheese, nuts, chocolate, and alcoholic beverages)
- menstrual cycle
Describe a migraine.
- unilateral pain
- (can become bilateral later)
- moving can intensify pain
- Chills, nausea and vomiting, fatigue, and sensitivity to light, sound, or odor are often present.
- blurred vision,
- abdominal cramping,
- facial pallor,
- stiffness or tenderness of the neck.
- lasts 4 to 72 hours and then gradually subsides.
What happens after a migraine headache?
- the headache area is sensitive to touch,
- deep aching is present.
- The patient is exhausted.
What are some meds used to abort a migraine?
- Almotriptan (Axert)
- Eletriptan (Relpax)
- Frovatriptan (Frova)
- Naratriptan (Amerge, Naramig)
- Rizatriptan (Maxalt)
- Sumatriptan (Alsuma, Dosepro, Imitrex, Sumavel, Treximet)
- Zolmitriptan (Zomig)
What are some meds used to prevent migraines?
- high blood pressure meds:
- beta-blockers (propranolol (Inderal), timolol)
- calcium channel blockers (verapamil (Covera)Antidepressants:
- amitriptyline (Elavil)
- nortriptyline (Pamelor)
- Antiseizure medications:
- gabapentin (Neurontin)
- topiramate (Topamax)
- valproic acid (Depakote)