this content will be useful for nursing students

1. SEIZURE DISORDER OR EPILEPSY:

2. SEIZURE DISORDER OR EPILEPSY:
DEFINITION:
Convulsions are a series of forceful involuntary
contraction and relaxation of voluntary muscles due
to disturbance of brain function.
Convulsions are abnormal, involuntary, paroxysmal,
motor, sensory, autonomic or sensorial changes
resulting from abnormal electrical discharges from
the brain.

3. INCIDENCE AND ETIOLOGY:
Epileptic seizures usually begin between age 5- 20
years, but can happen at any age.
Cause of convulsion according to age are:
a) Early neonatal period
I. Birth asphyxia
II. Intraventricular hemorrhage
III. Pyridoxine dependency
IV. Inborn error of metabolism
b) Late neonatal period
I. Hypocalcemia
II. Kernicterus
III. Meningitis

4. IV. Intrauterine infections
V. Tetanus neonatrum
VI. Inborn error of metabolism
c) From one month to three year
I. Infection of central nervous system
II. Post vaccination encephalopathy
III. Metabolic causes
IV. Brain lesion
V. Drugs or poisons
VI. Heat stroke

5. PATHOPHYSIOLOGY:
Genetic
Na+, K+, Ca2+ transport
across neurons
Neuronal
depolarization
Excitatory
neurotransmitter
Inhibitory
Neurotransmitters
Hypoglycemia,
hypoxia, hypercapnia
Toxins, endogenous
ammonia, PKU,
BACTERIAL TOXINS
Environment

6. CLASSIFICATION OF SEIZURE:
Seizure
GeneralizedPartial Seizure
Tonic- Clonic
Seizure
Absence
Seizure
Complex partialSimple Partial

8. 1. PARTIAL SEIZURES:
Partial seizures begin focally and result from
abnormal electrical discharges from a
circumscribed small portion of brain. Partial
seizure are of two types:
a) Simple partial seizures:
It do not affect awareness or memory. It often
begin with thumb/ mouth. Jacksonian seizures
also called March seizures.
b) Complex partial seizures:
Complex partial seizures affect awareness or
memory of events before, during and immediately
after seizures.

10. The symptoms include:
i. Abnormal muscle contraction
• Muscle contraction/ relaxation
• One side of the body is affected
• Abnormal head movement
ii. Automatism
• Repetitive purposeless movements
• Starring spells
• Lip smacking
iii. Abnormal sensation
• Numbness, tingling, crawling sensation on the skin
• May occur with or without motor symptoms

11. 2. GENERALIZED SEIZURE:
It involve abnormal electrical discharges from both
cerebral hemisphere, consciousness is always
impaired. Generalized seizure are of two type:
a) Absence or Petit- mal Seizures:
It is a brief (usually less than 15 seconds) disturbances
of brain function, it is commonly occur under 20 years
of age.
b) Generalized Tonic- clonic Seizure (Grandmal
Seizures):
They can occur at any age and onset is usually abrupt.
Child loses consciousness suddenly and falls on the
ground, convulsion consist of orderly sequence of
steady muscle contraction (tonic phase) followed by
repeated coarse muscle jerks (clonic phase).

12.  Initial phase consist of intense muscle contraction,
jaw clenches, abdomen and chest become rigid,
pallor and cyanosis occur, neck and leg extended,
arms are flexed or contracted
Next phase is clonic phase in which jerking
movements are produced. It last for 30 seconds to
30 minutes.

15. 3.OTHER TYPES OF SEIZURES ARE:
a) Myoclonic seizures:
It is sudden repeated contractures of the muscles
of head, extremities or torso. It is occur when the
child is drowsy and just falling asleep or just
waking up. There is no loss of consciousness.
b) Akinetic seizures (Drop attacks)
These seizure occur between age 2 and 5 years
and are manifested by sudden loss of muscle tone
with head dropping forward for few seconds and
child losses consciousness.

17. DIAGNOSTIC EVALUATION:
1) History
2) EEG
3) Other neurodiagnostic tests include:
• Roentgenogram
• Computed axial tomography
• Positron emission tomography
• Magnetic resonance imaging
4) Miscellaneous tests include:
• Blood chemistry
• Complete blood count
• Kidney and liver function test
• Lumbar puncture

18. MANAGEMENT:
1. Medical management:
TYPE OF SEIZURE NAME OF DRUG
1. SIMPLE OR COMPLEX PARTIAL
SEIZURE
CARBAMAZEPINE,
PHENOBARBITONE, PHENYTOIN
AND PRIMIDONE
2. GENERALIZED TONIC- CLONIC
SEIZURE
SODIUM VALPROATE,
CARABAMAZEPINE,
PHENOBARBITONE
3. GENERALIZED ABSENCE
SEIZURE
ETHOSUXIMIDE AND VALPROIC
ACID
4. MYOCLONIC SEIZURE CLONAZEPAM OR VALPROIC ACID
5. AKINETIC SEIZURE VALPROIC ACID

19. 2. Surgical management:
Corpus callostomy is done.
3. Nursing management:
Emergency care during seizures:
Assist the child to lying position
Take off eye glasses, loosen tight clothes
Maintain patent airway
Administer prescribed medication on time
Side rails of bed should be padded
Do not force anything into the child mouth during
seizures.

20. Care of the child after seizure:
Child should be provided complete bed rest
Change the clothes and bed sheet, if soiled
Suction the airway
Turn the face of the child to one side, to avoid
aspiration of secretion

21. Thank
You…!