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1. By – SURESH KUMAR ( Nursing Tutor )
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2. Epilepsy
• Epilepsy is a central nervous system (neurological)
disorder in which brain activity becomes abnormal,
causing seizures or periods of unusual behavior,
sensations, and sometimes loss of awareness. Epilepsy
is the most common childhood brain disorder. The
seizures are triggered by changes in the electrical and
chemical activity in the brain.

3. Causes of Epilepsy
• Seizures can be caused by anything that injures the brain,
including head injuries, infections, poisoning or even brain
development problems prior to birth. Often exact cause for
the seizures and epilepsy cannot be found.
• Predisposing factors in children includes- Prenatal
complications, electrolyte imbalance, errors of metabolism,
developmental defects, infections, trauma etc.

4. Causes of Epilepsy
• Prenatal complications such as birth asphyxia and intracranial
injury during delivery together account for about 50 % of
neonatal and childhood seizures.
• Acute and severe electrolyte imbalances can manifest with
seizures, which may be the sole presenting symptom. Seizures
are more frequently observed in patients with sodium
disorders (especially hyponatremia), hypocalcemia, and
hypomagnesemia.

5. Causes of Epilepsy
• Several inborn errors of metabolism can cause
epilepsy including ceroid lipofuscinosis, sialidosis type
1, Gaucher disease type III, mitochondrial cytopathies,
and Lafora disease .
• Infections such as neonatal septicemia, meningitis,
tetanus neonatrum can cause seizures.

6. Causes of Epilepsy
• Developmental defects (congenial anomalies of
brain) such as microcephaly, dysgenesis of brain
tissue, microgyria and agenesis of corups callosum
may result in epilepsy .
• Traumatic injury to the brain during delivery or there
after such as home and road accidents can cause
seizures.

7. Types of Seizures
in Epilepsy
• Epileptic seizures they are classified into two main groups-
•1. Focal seizures
•2. Generalized seizures

8. Focal (partial )seizures
• The term focal is used instead of partial to be more accurate
when talking about where seizures begin. Focal seizures can
start in one area or group of cells in one side of the brain.
• Partial seizures are further classified as
• Simple partial seizure and
• Complex partial seizure.

9. Focal (partial )seizures
• Simple partial seizure - During these seizures, the child awake
and aware. Some people may not be able to respond during
the seizure, but they're still aware of what's going on. Focal
aware seizures can last from just seconds up to a couple of
minutes and may involve muscle jerking, stiffening, or
limpness; only one area or side of your body is affected.

10. Focal (partial )seizures
• Complex partial seizure - When a person is confused or their
awareness is affected in some way during a focal seizure, it’s
called a focal impaired awareness seizure. This used to be
called a complex partial seizure. The child may have a blank
stare and repeat the same action over and over like chewing,
rubbing your fingers together, or lip smacking, known as
automatism, or he/she may simply freeze.

11. Generalized seizures
• Generalized seizures are characterized by the sudden onset of
abnormal electrical activity involving both sides of the brain. There
are six different types of generalized seizures.
-Absence seizures: -Tonic seizures: .
-Atonic seizures: -Myoclonic seizures:
-Clonic seizures: -Tonic-clonic seizures:

12. Generalized seizures
• Absence seizures: Historically known as petit mal seizures,
absence seizures involve a short period of time in which you
lose a sense of awareness or "space out.“In absence seizure
the child blank out or stare into space for a few seconds This
type is most common in children between the ages of 4 and
14 and usually lasts 20 to 30 seconds.

13. Generalised seizures
• Tonic seizures: These seizures cause your muscles to
suddenly stiffen, which can prompt you to fall if
you're standing up. Tonic seizures often happen during
sleep and usually involve a loss of
consciousness. After the seizure, the person may feel
tired or confused.

14. Generalised seizures
• Atonic seizures: Atonic seizures are a type
of seizure that causes sudden loss of muscle strength.
These seizures are also called akinetic seizures, drop
attacks or drop seizures. The sudden lack of muscle
strength, or tone, can cause the person to fall to the
ground.

15. Generalised seizures
• Myoclonic seizures: If someone suddenly woken up
because one of the muscles suddenly jerked, it is
known as myoclonic seizure. These seizures involve
sudden, quick jerks in your arms or legs. You may have
a number in a row or just one on occasion.

16. Generalised seizures
• Clonic seizures: Similar to myoclonic seizures, clonic
seizures involve sudden, jerky muscle movement, only in this
case, it's repetitive. Clonic seizures are characterized by
repeated jerking movements of the arms and legs on one or
both sides of the body, sometimes with numbness or
tingling. Usually, clonic seizures are involved in a tonic-clonic
seizure.

17. Generalised seizures
• Tonic-clonic seizures: Previously called grand mal seizures,
these seizures are the type that most people associate with
epilepsy. First, in the tonic stage, your muscles stiffen, then
you lose consciousness and fall to the ground. Next is the
clonic stage, in which your arms and sometimes legs begin
jerking or twitching quickly and repeatedly. These seizures
typically last for a few minutes.

18. Diagnostic
investigations
• History and exact description of onset of a seizure.
• Electroencephalography(EEG)
• Megnatic Resonance Imaging (MRI)
• CT scan
• positron emission tomography (PET)
• single-photon emission computerized tomography

19. Treatment
of Epilepsy
• The first-line treatment for epilepsy is antiseizure
medication. These drugs help reduce the frequency
and severity of seizures. Common epilepsy
medications include:
• levetiracetam , lamotrigine , topiramate , valproic acid,
carbamazepine, ethosuximide etc. These medications
must be taken consistently and as prescribed.

20. Treatment
of Epilepsy
• If medication can’t decrease the number of seizures, another
option is surgery. The most common surgery is a resection.
This involves removing the part of the brain where the
seizures start. Most often, the temporal lobe is removed in a
procedure known as temporal lobectomy. In some cases, this
can stop seizure activity

21. Care of
Epileptic child
• Nursing care of an epileptic child involves two phases. One
is care at the time of seizure and second is general
management of child.
• At the time of seizure we should- Keep the seizing person
away from obstacles that may harm them.
• Remove glasses, sharp objects or other harmful objects in
the area.

22. Care of
Epileptic child
• Place a pillow, blanket, jacket, or other soft, preferably flat,
object under the person's head if available. Be sure that the
person is not face down to prevent suffocation.
• Do not try to stop the person's movements or hold them
down, but turn the person onto one side if possible.
• Observe and record the type of convulsions duration , part
involved and frequency .

23. Care of
Epileptic child
• Warning signs for seizures should be noted. Nurse should
make sure to make arrangement for safety precautions in
advance and give medication as ordered.
• After the seizure vital signs are checked and recorded. Biting
of toungue and incontinence are also reported
• .Provide psychological support to parents to reduce their
anxiety level.

24. Care of
Epileptic child
• Continued and carful reporting of the incidence of fits and
their description is very important in deciding medication
and other therapeutic measures for epileptic patient.
• Special attention is given for diet plan of the client to
maintain proper nutrition.
• During a fit , the most important duty of a nurse is to
prevent any type of injury to the child.

25. By – SURESH KUMAR ( Nursing Tutor )