Seizures are episodes of abnormal brain activity resulting from excessive neuronal discharge. Epilepsy is characterized by recurrent seizures and is caused by various factors like brain tumors, genetic predisposition, trauma and infections. Seizures can be classified as partial or generalized based on the area of brain involved. Diagnostic tests include EEG, MRI and blood tests. Treatment involves medications, surgery, vagus nerve stimulation or lifestyle modifications. Nursing care focuses on safety during seizures and education about managing the condition.

1. SEIZURES /EPILEPSY
Mr.VEERABHADRA.B.B
ASST PROFESSOR
DEPT OF MEDICAL SURGICAL NSG

2. SEIZURES /EPILEPSY
 Seizures are episodes of abnormal motor, sensory,
autonomic, or psychic activity resulting from sudden
excessive discharge from cerebral neurons.
 Epilepsy is a condition of the brain characterized by
sudden, brief attacks of altered consciousness,
motor activity, sensory phenomena, or
inappropriate behavior

3. ETIOLOGY
*About half the cases of epilepsy are
unknown.
*Possible causes include the following:
 Disorder of the Brain: Tumor, Abscess,
Atrioventricular malformation [AVM], aneurysm, or
hematoma
 Genetic /Family History.
 Congenital Abnormalities.
 Perinatal Factors:- Birth trauma and asphyxia
neonatorum

4. .
 Infectious Diseases: Meningitis , Encephalitis.
 Toxic Factors:- Lead poisoning, alcohol, and drugs
 Trauma and Physical Agents:- Cerebral injuries
 Circulatory Disturbances
 Neoplasms

5. INCIDENCE OF SEIZURE
 300,000 people have a first convulsion each year.
 120,000 of them are under the age of 18
 75,000 - 100,000 of them are children under the age of 5
who have experienced a febrile (fever-caused) seizure .

6. RISK FACTORS
 Babies who are small for their gestational age.
 Babies who have seizures in the first month of life
 Babies who are born with abnormal brain structure
 Abnormal blood vessels in the brain
 Serious brain injury or lack of oxygen to the brain.
 Brain tumors.
 Infections of the brain: abscess, meningitis, or
encephalitis
 Stroke resulting from blockage of arteries

7. CONTINUED…..
• Cerebral palsy.
• Mental handicap
• Seizures occurring within days after head injury
("early posttraumatic seizures")
• Family history of epilepsy or fever-related
seizures
• Alzheimer's disease (late in the illness)
• Fever-related (febrile) seizures that are unusually
long
• Use of illegal drugs such as cocaine.
• Mild head injuries, such as a concussion with
just a very brief loss of consciousness, do not
cause epilepsy

8. SEIZURE-PROVOKING FACTORS
 Missed medication
 Lack of sleep
 Illness (both with and without fever)
 Severe psychological stress
 Heavy alcohol use.
 Use of cocaine and other recreational drugs such
as Ecstasy
 Over-the-counter or prescription medications or
supplements that decrease the effectiveness of
seizure medicines
 Nutritional deficiencies: vitamins and minerals
 The menstrual cycle

9. PATHOPHYSIOLOGY
 .
Due to various stimuli
Depolarization of cell membrane
of the neuron
Induction of abnormal
neurons
Spontaneous firing
Spreads by physiological
pathways
Involve adjacent and distal areas of
brain
Seizures(generalized
/partial)

10. CLINICAL MANIFESTATIONS
Prodromal Phase: with signs or activity which
proceeds to seizure
-Aural Phase: Sensory warning
-Icter Phase: With full seizure
-Post Ictal Phase : Recovery period

11. .

12. CLASSIFICATION OF SEIZURES
I. Partial (focal, local) seizures
A. Simple partial seizures: No impairment of
consciousness
B. Complex partial seizures: Impaired
consciousness, frequently include automatisms
C. Partial seizures that secondarily generalize

13. CONTINURD…..
 II. Generalized seizures: All have impairment of
consciousness
A. petit mal of “blank stare”; generally in children
B. Myoclonic seizures: Short, abrupt muscular
contractions
C. Clonic seizures: Muscle contraction and
relaxation
D. Tonic seizures: Abrupt increase in muscle tone
E. Tonic-clonic seizures (previously known as grand
mal): quick, bilateral, severe jerking movements
F. Atonic seizures (drop attacks): Abrupt loss of
muscle

14. DIAGNOSTIC MEASURES
 Complete health history and Physical Examination
 EEG- within 24 hours brain activity / brain
wave.location of abnormal activity in brain.
 complete blood count, serum chemistries, LFT.
RFT, Urine Analysis done to rule out metabolic
disoreders.
 MRI Scan: Structural brain changes such as
sclerosis, tumors, infarcts, or atrophy.
 MRA of Brain.
 Positron Emission tomography

15. MEDICAL MANAGEMENT

16. SURGICAL MANGEMENT
 Limbic resection
 Primarily anterior temporal lobe resection.
 Neocortical resection
 Hemispherectomies
 Multilobar resections
 Corpus collosum sections

17. .
 Vagal nerve stimulation:Transmission of
electrical stimulation to reduce frequency and
intensity of seizures.
 Psychosocial counseling: Biofeedback
aimed at teaching the patient to maintain a certain
brain wave frequency that is refractory to seizure
activity.

18. NURSING DIAGNOSIS
 Ineffective breathing pattern related to neuromuscular
impairement secondary to tonic phase of Seizure
 Ineffective coping related to perceived loss of control
and denial of diagnosis
 Ineffective therapeutic regimen related to lack of
knowledge about the disease management as evidenced
by verbalization of lack of knowledge.
 Risk for injury related to seizure activity.

19. .
Seizure activity
 HOME CARE
 Maintain adequate rest and nutrition; check with a
physician before dieting.
 Limit alcohol intake.
 Report infections promptly.
 Avoid trigger factors (flashing lights, hyperventilation,
loud noises, video games, television).
 Brush the teeth regularly with a soft toothbrush.
 Avoid activities that precipitate seizure activity.
 Keep follow-up appointments.
 Lead as normal a life as possible.