1) The document is a pathology assignment submitted by a group of 10 nursing students to their professor on paroxysmal disorders (seizures). 2) It outlines the course topics which include the types of seizures, pathophysiology, clinical manifestations, and complications of seizures. 3) The main types of seizures discussed are focal (partial) seizures which affect only part of the brain and generalized seizures which affect the whole brain. Focal seizures can be simple, with just motor or sensory signs, or complex with impaired consciousness. Generalized seizures include absence, tonic, clonic, and tonic-clonic seizures.

1. SALALE UNIVERSITY COLLEGE OF HEALTH SCIENCE
DEPARTMENT OF ADULT HEALTH NURSING ,MATERNITY
AND PEDIATRICS
.
PATHOPHYSIOLOGY ASSIGNMENT
TITLE: PAROXYSMAL DISORDERS (SEIZURES )
SUBMITTED TO :DR.AYANA(PATHOLOGIST )
March 2023
FICHE
10/25/2023 Group 4 1

2. S.N Name ID
1 Tolesa Nigussie
2 Mulunesh Mosisa
3 Merga Wekwaya
4 Yadeta Kebede
5 Azazhu Abate
6 Geleto Hinika
7 Sufa Mengistu
8 Amansisa Dabasa
9 Worku Daba
Group members (G-4)
10/25/2023 2
Group 4

3. Course outlines
• Paroxysmal disorders
• Seizures vs. Epilepsy
• Type of Seizure
• Pathophysiology
• Clinical manifestation of seizures
• Complications of seizures
10/25/2023 Group 4 3

4. Paroxysmal disorders:
• Paroxysmal; is derived from Greek word
paroxysmos or paroxyno meaning to sharpen
or irritate.
• Abrupt onset of a clinical episode that tends
to be stereotyped and repetitive , lasts
seconds or minutes (rarely hours ), and ends
abruptly.
10/25/2023 Group 4 4

5. Types of Paroxysmal disorders
• Seizure
• Movement disorder
• Migraine
10/25/2023 Group 4 5

6. Seizure :
• A seizure is “a brief, temporary disturbance in the
electrical activity of the brain” and may affect:
• Muscle control and movement
• Speech
• Vision and/or eye movement
• Awareness and/or behavior
• Seizures can be:
Convulsive or non-convulsive
Vary in frequency and severity
10/25/2023 Group 4 6

7. Signs of a Seizure
• Extended blank stare
• "Empty" look in eyes
• Rapid blinking
• Eyes rolling upward
• Periods of
unresponsiveness
• Inability to pay attention
• Repetitive (tic-like)
movements of body
parts, usually head, arms,
legs
• Uncontrollable jerking
body movements
• Mouth movements with a
dazed look
• Frothing at mouth
• Loss of consciousness
• Loss of body control
• Dazed walking
• Temporary confusion
10/25/2023 Group 4 7

8. Seizures vs. Epilepsy
• Seizures
• Often symptoms of
another health
problem: Provoking
factors : fever ,infection,
syncope, hypoxia,
toxins, head trauma,
stress,fatigue, cardiac
arrhythmias
• Epilepsy
• is the occurrence of two
or more unprovoked
seizures at an interval >
24 hours
10/25/2023 Group 4 8

9. Types of Seizures
Focal (partial)
GENERALIZED
10/25/2023 Group 4 9

10. Focal (partial)Type of Seizure
• Partial (Only a portion of the brain)(Focal Seizures) :
common, 80 % patients
• Simple partial(do not cause loss of consciousness)
o Simple with motor signs- convulsive jerking, chewing
motions, lip smacking
o Simple with sensory signs- Paresthesias, auras
o Autonomic: abdominal epilepsy
o Psychic :dejavu,fear,…
• Complex(Impaired consciousness)
psychomotor seizures or temporal lobe epilepsy or limbic
Aggressive behavior (Violence)
Visual, auditory, or olfactory hallucinations
10/25/2023 Group 4 10

11. Generalized Seizures
• Absence Seizures (Petit mal)- alterations of
consciousness (absence) last10-30sec
• Tonic- sudden stiffness in the arms and body, which
can cause falls and injuries.
• Clonic- Sustained muscle contractions alternating with
relaxations
• Tonic/Clonic (Grand mal)-A sequence of a brief tonic
episode followed by an atonic seizure
• Atonic Seizures (Drop attacks)- sudden loss of body
tone that results in collapsing, often with injuries.
• Myoclonic Seizures: Sudden, involuntary jerking of
facial, limb or trunk muscles, in rhthmic manner.
10/25/2023 Group 4 11

12. Etiology of seizures
• Perinatal conditions : CNS malformation,
hemorrhage, congenital infection, Brain injury to
fetus during pregnancy & birth
• Metabolic conditions:
hypoglycemia,hypocalcemia,B6 deficiency
hypomagnesemia, hypo or hypernatremia ,
storage disease, degenerative
• Poisoning :lead , cocaine, cyanide , co, pesticide,
strychnine
• drugs :
10/25/2023 Group 4 12

13. Etiology of seizures Systemic
disorders :
• Neurocutaneous syndromes : Tuberous sclerosis,
Systemic disorders :
• Vasculitis ( CNS or systemic ); renal failure,
hepatic encephalopathy
• Infection: Meningitis: Viral encephalitis, Measles,
Mumps, Diphtheria
• Other : trauma , tumor, idiopathic , familial
Over-the-counter drugs, illicit substances herbal
preparations, can precipitate seizure
10/25/2023 Group 4 13

14. Pathophysiology Seizure
• Paroxysmal discharges in cortical Neurons
• A seizure originates from grey matter of any cortical or
subcortical area
• Abnormal firing of neurons
• Breakdown of normal membrane conductance and
inhibitory synaptic currents
Locally widely
Focal Seizure Generalized seizure
10/25/2023 Group 4 14

15. Focal Seizure Generalized seizure
 Abnormality of potassium
conductance
 Defect in voltage sensitive
ion channels
 Deficiency in membrane
ATPase
Neuron membrane instability
Seizures
 Deficiency of inhibitory
neurotransmitters
 Increase in excitatory
neurotransmitters
Promotes
Abnormal neuronal activity
Seizures
10/25/2023 Group 4 15

16. Pathophysiology of Epilepsy
Cortical cell membrane level
Instability of the nerve cell membrane
Polarization abnormalities (excessive
polarization ,hypopolarization , or lapses in
repolarization), allowing the cell to be more
susceptible to activation Hypersensitive
neurons with lowered thresholds for firing and
firing excessively , related to
10/25/2023 Group 4 16

17. Cont.…
1- Excess of Excaitatory ( acetylecholine- or
Glutamate –related activity )
2- Decreased inhibitory ( GABA –related
activity)Together leading to instability of cell-
membrane & lowered threshold for exciatation
excessive polarization, hypopolarization allowing
the cell to be more susceptible to activation
spontaneously or by any ionic imbalances in the
immediate chemical environment of neurons
10/25/2023 Group 4 17

18. Complication:
• Hypoxemia and acidosis Hyperglycemia &
hypoglycemia
• Hyper tension & hypotension
• IICP and cerebral herniation
• Hyperpyrexia
• Hyperkalemia
• Myoglobinuria
• Non cardiogenic pulmonary edema
• Leukocytosis(60%)
• CSF pleocytosis(13%)
• Aspiration pneumonia
10/25/2023 Group 4 18

19. References
1. Harvey S, King MD and Gorman KM(2021)
Paroxysmal Movement Disorders. Front. Neurol.
12:659064.doi: 10.3389/fneur.2021.659064.
2. https://images.app.goo.gl/bCYjzmZ6bVLcBZUN9
3. https://www.hopkinsmedicine.org/health/condi
tions-and-diseases/epilepsy/types-of-seizures.
4. https://images.app.goo.gl/rBcx4sSrUXKivKM28.
5. https://www.slideshare.net/SachinDwivedi15/se
izures-152346588
10/25/2023 Group 4 19

20. Thank You!
10/25/2023 Group 4 20