seizures/epilepsy

Card Set Information

Author:
jsullivan
ID:
52906
Filename:
seizures/epilepsy
Updated:
2010-12-02 15:42:22
Tags:
seizures epilepsy
Folders:

Description:
exam 3 seizures, epilepsy
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user jsullivan on FreezingBlue Flashcards. What would you like to do?


  1. define seizure
    • an abnormal, sudden, excessive discharge of electrical activity within the brain.
    • -may be caused by metabolic disorders, acute ETOH withdraw, electrolyte disturbances (hyperkalemia, water intoxication, hypoglycemia), heart disease (causing brain anoxia) or tumor or a single seizure may occur for no known reason
  2. define epilepsy
    • a chronic disorder characterized by recurrent, unprovoked seizure activity and my be inherited.
    • -caused by abnormal electrical activity of neurons, imbalance in neurotransmitters (GABA) or both

    -typical triggers: incr. physical activity, excessive fatigue, alcohol or caffeine, some foods or chemicals
  3. tonic-clonic aka grand-mal
    • -a generalized epileptic seizure
    • -typically lasts 2-5 min
    • -tonic phase: (stiffening or rigidity of the muscles)and immediate loss of consciousness followed by clonic phase (rhythmic jerking of all extremities), you may hear an epileptic cry before start of seizure
    • -post ictal fatigue, confusion, and lethargy may last for an hour- safety risk high
  4. Tonic
    • -a generalized epileptic seizure
    • -pt stiff
    • -abrupt incr. in muscle tone, loss of consciouslness and loss of autonomic signs lasting from 30 sec to several min.
  5. clonic
    • -a generalized epileptic seizure
    • -pt. shaking
    • -muscle contraction and relaxation lasting several min.
  6. Abscence, (Petit mal)
    • -a generalized epileptic seizure
    • -more common in children
    • -few sec. of loss of consciousness and blank staring, "daydreaming appearance"
    • -often manifested by automatisms- involuntary (often repetative) behaviors such as blinking, staring straight forward
    • -pt. returns to baseline immediately after seizure (no post-ictal period)
  7. Myoclonic
    • -a generalized epileptic seizure
    • -brief jerking or stiffening of the extremities
    • -may occur singly or in groups, may be symmetric or asymmetric lasting just a few sec.
  8. Atonic (akinetic, "drop attack")
    • -a generalized epileptic seizure
    • -sudden loss of muscle tone, lasting seconds, followed by post-ictal confusion
    • -in most cases this seizure causes pt. to fall
  9. Partial seizures
    • -begin in one part of the cerebral hemisphere, there are 2 classes: complete and simple
    • -more diff. to control w/ meds (than general), and seen more commonly in the elderly
  10. complete partial seizure
    • -loss of consciousness for 1-3 min
    • -characterized by automatisms
    • -may be amnesic afterwards
    • -knwon as "psychomotor" or "temoporal lobe" seizures bc of the area of the brain often involved
  11. simple partial seizure
    • -No loss of consciousness
    • -client reports aura before seizure
    • -during the seizure,may have unilateral movement of an extremity, experinece unusual sensations or have autonomic sx (e.g. change in HR, skin flushing, epigastric discomfort)
  12. Unclassified seizures (idiopathic)
    • -account for 1/2 of all seizure activity!
    • -occur for no known reason and do not fit onto the generalized or partial classifications
  13. Status Epilepticus
    • -a medical emergency!
    • -prolonged seizure lasting longer than 5 min, or repeated seizures over the course of 30 min, potential complication for ALL TYPES OF SEIZURES....seizures lasting longer than 10 min can cause death

    • common causes of staus epilepticus:
    • -sudden withdrawl from antiepileptic drugs
    • -infections
    • -acute ETOH or drug withdrawl
    • -head trauma
    • -cerebral edema
    • -metabolic disturbances
  14. Discuss emergency tx for a seizure
    • -911
    • -abc's
    • -remove objects that might injure pt., loosen clothing if poss
    • -don't insert tongue blade!
    • -ensure IV access- large bore needle and saline infusion preferred
    • -usually Lorzepam (Ativan) or Diazepam (Valium) preferred to treat Status Epilepticus, possible followed by Phenytoin (Dilantin) or Fosphenytoin (Cerebyx)
    • -suction PRN, assess for resp. distress, have ET equipment available, collab w/ RT
    • -after seizure take VS w/ neuro checks, facilitate rest, document details of seizure
  15. Anticonvulsant meds (antiepileptic drugs)
    -act on motor cortex of brain to reduce the spread of elecrical discharges from the rapidly firing epileptic foci on this area

    -
    teach pt. to not stop meds even if seizures have stopped, to avoid hazardous tasks until the drug has been regulated, w/ Dilantin maintain good OH, get regular labs: liver function, kidney function, CBC and drug levels as indicated
  16. Vagal Nerve Stimulation
    • -like a pacemaker around vagal nerve, pt. feels seizure coming on and activates it w/ a magnet
    • -observe for hoarseness (common), cough, dyspnea, neck pain, dysphagia
    • -teach pt. to avoid MRI, microwaves, shortwave radios and ultrasound diathermy
  17. Temporal or Frontal Lobe Resection (Conventional surgery)
    • -for quality of life when other tx options exhausted
    • -most candidates have complex PARTIAL seizures
  18. Partial Corpus Collostomy ("split-brain surgery")
    • -anterior 2/3 of corpus callosum sectioned to prevent passage of neruonal discharges between hemispheres
    • -for tonic-clonic or atonic seizures ehn pt is not a candidate for other surgical procedures
    • -s/e: HA, scalp numbness, depression
  19. Ketogenic diet for children
    -ketosis (super high fat diet at all times) improves seizure control for some children

What would you like to do?

Home > Flashcards > Print Preview