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  1. 1. Care for patient with BrainDisorders BY DR. Fatma Abbas Salem
  2. 2. Care for patient with seizures Definition:Seizures are episodes of abnormal motor,sensory, autonomic, or psychic activity or acombination of these that result fromsudden excessive discharge from cerebralneurons (Hickey 2009).
  3. 3. Care for patient with seizures The international classification  Partial seizures that begin in one part of the brain.  Generalized seizures that involve electrical discharges in the whole brain.
  4. 4. Causesa. Idiopathic (genetic, developmental defects)b. Acquired seizures include:1. Cerebral anoxia.2.Cerebro vascular disease.3.Fever (childhood).4.Head injury.5. Hypertension.
  5. 5. Causes6. Central nervous system infections.7. Metabolic and toxic conditions (renalfailure, hypornatremia, hypo calcemia, hypoglycemia, pesticide, exposure)8. Brain tumor.9. Drug and alcohol withdrawal.10. Allergies.
  6. 6. CLINICAL COURSE Aura epileptic cry, loss of consciousness, fall, tonic & clonic convulsions and incontinence - postical confusion – headache & sleep.
  7. 7. Medical Management Major anticonvulsive medications as.  Carbamazepine (Tegretol)  Clonazepam(Klonopin)  Lamotrigine (Lamicatal)  Phenol barbital (Luminal)  Phenytoin (Dilantin)
  8. 8. Surgical treatment. Indicated for patients whose epilepsy results from intracranial tumors, abscesses, cysts or vascular anomalies.
  9. 9. Nursing management Assessment: A major responsibility of the nurse is to observe and record the sequence of signs. The natural of the seizure usually indicates the type of treatment that is required (AANN, 2007) 1. Description of circum stances before the seizure (visual, auditory, or olfactory stimuli, tactile stimuli, emotional or psychological disturbances sleep, hyperventilation). 2. The occurrence of an aura. 3. The first thing the patient does in the seizure where the movements or the stiffness begins, the position of the head at the beginning of the seizure.
  10. 10. Nursing ASSESSMENT4. The type of movements in the part of the body involved.5. The areas of the body involved.6. The size of both pupils and whether the eyes are open.7. Whether the eyes or head turned to one side.8. The presence or absence of automatisms (involuntary motor activity, such as lip
  11. 11. NURSING ASSESSMENT9. Incontinence of urine or stool.10.Duration of each phase of the seizure.11.Unconsciousness if present and its duration.12. Any obvious paralysis or weakness of arms or legs after seizure.13. Inability to speak after the seizure. 14. Whether or not the patient the patient sleeps afterward.15. Cognitive statues (Confused or not confused) after the seizure.
  12. 12. Care during seizure1. Provide privacy and protect the patient from curious on lookers.2. Ease the patient to the floor if possible.3. Protect the head with a pad to prevent injury from striking a hard surface.4. Loosen constrictive clothing.5. Push aside any furniture that may
  13. 13. Care during seizure6. If the patient is in bed, remove pillows and raise side rails.7. IF an aura precedes the seizure, insert an oral air way to reduce the possibility of the patients biting the tongue or cheek.8. Do not attempt to pry open jaws that are clenched in a spasm or to insert anything.
  14. 14. Care during seizure9. No attempt should be made to restrain the patient during the seizure, because muscular contractions are story and restrain can produce injury.10. If possible, place the patient on one side with head flexed forward which allows the tongue to fall forward and facilitates drainage of saliva and mucous. If suction is available use it if necessary to clear secretions.
  15. 15. Nursing care after the seizure 1. Keep the patient on one side to prevent aspiration. 2. Make sure the airway is patent. 3. There is usually a period of confusion after a grand mal seizure. 4. The patient on awaking should be reoriented to the environment. 5. If the patient becomes agitated after a seizure (postictal use persuasion and gentle restrain to assist him or her to stay calm.)1.