Seizures are caused by excessive neuronal discharges in the brain and can manifest as changes in consciousness, movements, sensations, behaviors, and posture. Epilepsy is characterized by two or more unprovoked seizures and can be caused by various brain pathologies. Seizures are classified as partial or generalized based on the region of brain involved. Diagnosis involves obtaining a detailed history and physical exam. Treatment depends on the seizure type but may include oxygen, benzodiazepines, phenytoin, or phenobarbital to stop prolonged seizures.
occupational therapy for epilepsy: an overviewSara Sheikh
This document discusses epilepsy, its causes, prevention, and the role of occupational therapy. It defines epilepsy as abnormal neuronal discharge in the brain that can cause loss of consciousness or odd behavior. Risk factors include premature birth, brain infections, abnormal brain structures, cerebral palsy, hypoxia, brain tumors, stroke, and drug abuse. Occupational therapy focuses on safety, adaptations to the home, relaxation techniques, exercise, routine management, leisure activities, and support groups to help epileptic patients live independently and cope with emotional and cognitive challenges.
This document provides an overview of the history, definitions, classification, epidemiology and psychiatric disorders associated with epilepsy. It discusses how epilepsy was viewed in ancient times as a supernatural condition and outlines key developments in understanding including Hippocrates' view of it as a brain disorder. It defines terms like seizure, aura and epilepsy and classifies seizure types. Statistics on prevalence and risk factors for psychopathology in epilepsy are presented. Specific psychiatric conditions like depression, anxiety and inter-ictal psychosis are also examined.
This document provides information about seizures and epilepsy. It defines what a seizure is, the different types of seizures including absence, tonic-clonic, simple partial and complex partial seizures. It discusses epilepsy as a neurological disorder characterized by recurrent seizures and covers common causes, prevalence, myths and facts. The document outlines appropriate first aid for different seizure types and signs that indicate a medical emergency. It also discusses potential learning impacts and provides tips for supporting students with epilepsy.
Epilepsy is a neurological disorder that causes recurring seizures and affects over 5 million people in the US. Seizures occur when brain cells misfire and send too many electrical signals at once, causing changes in awareness, movement, or sensation. While epilepsy can be caused by head injuries or other brain damage, in many cases the cause is unknown. The Epilepsy Foundation provides resources and support for those affected by epilepsy and works to reduce the stigma around this common condition.
Epilepsy is a chronic neurological disorder characterized by recurrent seizures resulting from abnormal electrical discharges in the brain. Seizures can be generalized, affecting both sides of the brain, or partial, affecting one area. Epilepsy is diagnosed when a person has two or more unprovoked seizures more than 24 hours apart. While the specific cause is unknown in many cases, potential contributing factors include genetic predisposition, head injuries, brain tumors, infections, and developmental disorders. Treatment involves anticonvulsant medications to prevent seizures.
The document discusses convulsive disorders in children, including febrile seizures and epilepsy. It defines febrile seizures as seizures precipitated by fever between 6 months and 6 years of age. Epilepsy is defined as recurring seizures that can be classified as partial or generalized. Diagnostic procedures and treatment principles for seizures are also outlined.
Epilepsy is characterized by abnormal electrical discharges in the brain that cause seizures. It can be caused by genetic or structural factors. There are several types of seizures including generalized tonic-clonic, absence, myoclonic, simple partial, and complex partial. Diagnosis involves determining if events are true epileptic seizures and identifying any underlying cause. Treatment typically involves antiepileptic drugs to control seizures, with the goal of monotherapy using the drug with the best safety and tolerability profile for the individual patient. Combination therapy may be used if one drug is ineffective. Managing medications and potential interactions is important long-term.
Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills. It is the most common cause of dementia among those aged 65 and older, with around 4.5 million current cases in the US. By 2050, that number is expected to rise to 13.2 million without effective treatments. Alzheimer's disease causes beta-amyloid plaques and neurofibrillary tangles to build up in the brain, slowly destroying neurons, especially in the hippocampus and cerebral cortex. While symptoms usually appear after age 60, the changes in the brain may begin 10-20 years earlier. Currently available drugs can temporarily slow symptoms but do not stop or reverse the progression of the disease. Researchers continue to study
occupational therapy for epilepsy: an overviewSara Sheikh
This document discusses epilepsy, its causes, prevention, and the role of occupational therapy. It defines epilepsy as abnormal neuronal discharge in the brain that can cause loss of consciousness or odd behavior. Risk factors include premature birth, brain infections, abnormal brain structures, cerebral palsy, hypoxia, brain tumors, stroke, and drug abuse. Occupational therapy focuses on safety, adaptations to the home, relaxation techniques, exercise, routine management, leisure activities, and support groups to help epileptic patients live independently and cope with emotional and cognitive challenges.
This document provides an overview of the history, definitions, classification, epidemiology and psychiatric disorders associated with epilepsy. It discusses how epilepsy was viewed in ancient times as a supernatural condition and outlines key developments in understanding including Hippocrates' view of it as a brain disorder. It defines terms like seizure, aura and epilepsy and classifies seizure types. Statistics on prevalence and risk factors for psychopathology in epilepsy are presented. Specific psychiatric conditions like depression, anxiety and inter-ictal psychosis are also examined.
This document provides information about seizures and epilepsy. It defines what a seizure is, the different types of seizures including absence, tonic-clonic, simple partial and complex partial seizures. It discusses epilepsy as a neurological disorder characterized by recurrent seizures and covers common causes, prevalence, myths and facts. The document outlines appropriate first aid for different seizure types and signs that indicate a medical emergency. It also discusses potential learning impacts and provides tips for supporting students with epilepsy.
Epilepsy is a neurological disorder that causes recurring seizures and affects over 5 million people in the US. Seizures occur when brain cells misfire and send too many electrical signals at once, causing changes in awareness, movement, or sensation. While epilepsy can be caused by head injuries or other brain damage, in many cases the cause is unknown. The Epilepsy Foundation provides resources and support for those affected by epilepsy and works to reduce the stigma around this common condition.
Epilepsy is a chronic neurological disorder characterized by recurrent seizures resulting from abnormal electrical discharges in the brain. Seizures can be generalized, affecting both sides of the brain, or partial, affecting one area. Epilepsy is diagnosed when a person has two or more unprovoked seizures more than 24 hours apart. While the specific cause is unknown in many cases, potential contributing factors include genetic predisposition, head injuries, brain tumors, infections, and developmental disorders. Treatment involves anticonvulsant medications to prevent seizures.
The document discusses convulsive disorders in children, including febrile seizures and epilepsy. It defines febrile seizures as seizures precipitated by fever between 6 months and 6 years of age. Epilepsy is defined as recurring seizures that can be classified as partial or generalized. Diagnostic procedures and treatment principles for seizures are also outlined.
Epilepsy is characterized by abnormal electrical discharges in the brain that cause seizures. It can be caused by genetic or structural factors. There are several types of seizures including generalized tonic-clonic, absence, myoclonic, simple partial, and complex partial. Diagnosis involves determining if events are true epileptic seizures and identifying any underlying cause. Treatment typically involves antiepileptic drugs to control seizures, with the goal of monotherapy using the drug with the best safety and tolerability profile for the individual patient. Combination therapy may be used if one drug is ineffective. Managing medications and potential interactions is important long-term.
Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills. It is the most common cause of dementia among those aged 65 and older, with around 4.5 million current cases in the US. By 2050, that number is expected to rise to 13.2 million without effective treatments. Alzheimer's disease causes beta-amyloid plaques and neurofibrillary tangles to build up in the brain, slowly destroying neurons, especially in the hippocampus and cerebral cortex. While symptoms usually appear after age 60, the changes in the brain may begin 10-20 years earlier. Currently available drugs can temporarily slow symptoms but do not stop or reverse the progression of the disease. Researchers continue to study
Children with epilepsy are at risk for cognitive difficulties like lower IQ, learning problems, and academic underachievement due to factors like underlying brain abnormalities, seizures, and medication side effects. While half of children with epilepsy develop normally, certain epilepsy syndromes carry a higher risk of intellectual disability or unfavorable cognitive outcomes. Autism also commonly co-occurs with epilepsy, especially among those with intellectual disabilities, suggesting shared neurological mechanisms. Anti-seizure medications can cause mild to moderate cognitive impairments involving slowed processing, reduced working memory, and decreased mental flexibility, with effects varying between medications.
1) Seizures and epilepsy are common in children, affecting 4-7% and 1-2% respectively. The majority of childhood epilepsy cases are treatable, but treatment gaps remain high.
2) Focal seizures originate from one hemisphere and present with aura, behavioral arrest or focal motor symptoms. Generalized seizures involve both hemispheres and include absence, myoclonic, tonic and tonic-clonic seizures.
3) Evaluation of a child with seizures includes a detailed history, neurological exam, EEG and neuroimaging in certain cases to determine seizure type and diagnose epileptic syndromes which guide treatment and prognosis. Correct diagnosis and management is important to optimize outcomes in pediatric epilepsy.
This document discusses epilepsy, including its causes, types, clinical manifestations, diagnostic tests, treatment options, nursing care, and patient education. It defines epilepsy as a sudden alteration in normal brain activity that causes changes in behavior and body function. The two main types are petit mal/minor seizures and grand mal/major seizures. Causes include brain injuries, tumors, infections, drug toxicity, and metabolic disorders. Nursing care focuses on airway protection, injury prevention, education to improve knowledge and coping, and alleviating fear. First aid involves safety measures and calling for emergency help. Ongoing treatment involves anti-seizure medications and lifestyle modifications.
The document discusses the management of epilepsy in children. It covers the etiology, classification, clinical features and treatment of different types of childhood epilepsy including neonatal seizures, infantile spasms, Lennox-Gastaut syndrome, benign epilepsy of childhood, and febrile seizures. It also discusses diagnostic evaluation, choice of antiepileptic drugs, prognosis, and management of refractory seizures.
Epilepsy: A Neurological Condition Affecting the Nervous System. Epilepsy is also known as a seizure disorder. Here is a quick who, what, where, when, why, and how about epilepsy.
This document defines seizures and epilepsy and describes different types of seizures. It discusses partial and generalized seizures. Partial seizures are further divided into simple and complex seizures. Generalized seizures include absence, tonic, clonic, tonic-clonic, myoclonic and atonic seizures. Various case examples are provided to illustrate the clinical presentation of different seizure types. Risk factors, causes and classification of seizures are also outlined.
DEFINITION :
It is defined as abnormal ,paroxysmal, excessive, involuntary neurological discharge from the brain which may be manifested as –
Loss of Conciousness,
Abnormal- Motor
- Sensory ,
- Behavioral disturbance
- and Autonomic dysfunction.
The document discusses seizures and epilepsy, defining a seizure as a paroxysmal event due to abnormal neuronal activity in the brain, while epilepsy is defined as recurrent seizures due to an underlying chronic condition. It describes different types of seizures including partial seizures, which originate in one area of the brain, and generalized seizures, which involve both hemispheres simultaneously. Various causes, classifications, characteristics, evaluations, and treatments of seizures are discussed.
This document discusses several epilepsy syndromes categorized by age of onset:
- Neonatal onset syndromes include benign neonatal seizures and early infantile epileptic encephalopathy.
- Infantile onset syndromes include Dravet syndrome, West syndrome, and myoclonic epilepsy in infancy.
- Childhood syndromes include Panayiotopoulos syndrome, Lennox-Gastaut syndrome, and benign epilepsy with centrotemporal spikes.
- Later onset syndromes extending into adolescence and adulthood include juvenile absence epilepsy and juvenile myoclonic epilepsy.
The document discusses neuropsychiatric aspects of epilepsy. It begins with definitions of key terms like seizure, epilepsy, and convulsion. It then provides epidemiological data on epilepsy prevalence and incidence globally. It describes different types of seizures including primary generalized seizures, partial seizures, and epilepsy syndromes. Causes of epilepsy including genetic, acquired, congenital, and withdrawal factors are outlined. Risk factors for developing epilepsy and common seizure triggers are mentioned. The pathophysiology involving glutamate and GABA neurotransmitters is explained. Finally, clinical presentations of different seizure types and differential diagnosis considerations are covered.
This document defines seizure disorders and classifies different types of seizures. It discusses focal seizures, generalized seizures, infantile spasms, and several epilepsy syndromes that typically present in the neonatal period or childhood such as West syndrome, Ohtahara syndrome, and benign childhood epilepsy with centrotemporal spikes. Causes, clinical presentations, diagnostic workups, and treatment options are provided for many of the conditions.
EPILEPSY AND SEIZURE DISORDERS
The document discusses epilepsy and seizure disorders. It defines seizures as paroxysmal events due to abnormal neuronal activity in the brain. It classifies seizures as either focal or generalized based on their origin. Focal seizures originate in one hemisphere while generalized seizures rapidly engage both hemispheres. Common types of seizures include absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures. The document also discusses the etiology, diagnosis, treatment and management of epilepsy through use of anti-epileptic drugs, surgery, or other methods.
seizure among children is always difficult to differentiate It is always good to have basic knowledge about seizure in children if you are working in small KLinik kesihatan orr PPAT/RSAT.
An EMT's guide to seizures provides information about recognizing and treating seizures. Generalized seizures, characterized by unconsciousness and full-body twitching, are the most common type and usually last 3-5 minutes. Febrile seizures occurring in children due to high fevers are also common. Upon arrival, EMTs should protect the patient, maintain their airway, and provide oxygen before transporting them urgently to the hospital for further treatment.
This 3-year-old male child presented with episodes of unconsciousness not associated with tonic-clonic seizures. Prior investigations including EEG and treatment with anti-epileptic drugs did not reveal a clear diagnosis. After further examination, the child was diagnosed with Panayiotopoulos syndrome based on autonomic symptoms during episodes and EEG findings. Panayiotopoulos syndrome is an early-onset childhood occipital epilepsy characterized by emesis, other autonomic symptoms and abnormal EEG patterns, with seizures typically remitting after 1-2 years.
This document discusses psychiatric presentations in epilepsy. It begins by noting the increased prevalence of psychiatric disorders in patients with epilepsy compared to the general population. It then categorizes psychiatric disorders seen in epilepsy into several groups: disorders related to the underlying brain pathology causing epilepsy, disorders related to the seizure occurrence itself (pre-ictal, ictal, post-ictal), and interictal psychiatric disorders not clearly related to seizures. Specific syndromes and disorders are discussed within each category. Ictal phenomena include epileptic auras, automatisms, and non-convulsive status epilepticus, which can resemble psychiatric symptoms but are distinguished by their brief and stereotyped nature.
This document provides information about epilepsy including:
1. It defines epilepsy as two or more unprovoked seizures occurring more than 24 hours apart, with some exceptions. The incidence is about 3% globally.
2. It discusses the various causes/aetiologies of epilepsy including idiopathic, congenital, infections, trauma, vascular issues, tumors, and degenerative conditions.
3. It classifies seizure types according to the International League Against Epilepsy including partial seizures, generalized seizures like absence seizures, myoclonic seizures, and infantile spasms.
4. It outlines the management of epilepsy including establishing the diagnosis, deciding if antiepileptic drug therapy is
This document provides information on convulsions and epilepsy in children. It discusses the history of epilepsy, notable figures associated with epilepsy like St. Valentine, important epilepsy awareness days, common misconceptions about epilepsy, types of seizures including partial seizures, generalized seizures, absence seizures, and infantile spasms. It also covers the classification, causes, mechanisms, and syndromes of epilepsy as well as comparisons between different seizure types.
The document discusses prehistoric art from the Stone Age, divided into the Paleolithic, Mesolithic, and Neolithic periods. The main forms of prehistoric art were rock art including petroglyphs (rock carvings) and pictographs (paintings and drawings) created using materials like stone, bone, and pigments. Examples of important Stone Age art sites mentioned include cave paintings at Lascaux from 15,000-13,000 BC and Stonehenge from 3000-2000 BC, believed to be an astronomical calendar or burial ground. Mesopotamian art from modern Iraq is also noted for early cultural developments in writing, schools, and irrigation.
Children with epilepsy are at risk for cognitive difficulties like lower IQ, learning problems, and academic underachievement due to factors like underlying brain abnormalities, seizures, and medication side effects. While half of children with epilepsy develop normally, certain epilepsy syndromes carry a higher risk of intellectual disability or unfavorable cognitive outcomes. Autism also commonly co-occurs with epilepsy, especially among those with intellectual disabilities, suggesting shared neurological mechanisms. Anti-seizure medications can cause mild to moderate cognitive impairments involving slowed processing, reduced working memory, and decreased mental flexibility, with effects varying between medications.
1) Seizures and epilepsy are common in children, affecting 4-7% and 1-2% respectively. The majority of childhood epilepsy cases are treatable, but treatment gaps remain high.
2) Focal seizures originate from one hemisphere and present with aura, behavioral arrest or focal motor symptoms. Generalized seizures involve both hemispheres and include absence, myoclonic, tonic and tonic-clonic seizures.
3) Evaluation of a child with seizures includes a detailed history, neurological exam, EEG and neuroimaging in certain cases to determine seizure type and diagnose epileptic syndromes which guide treatment and prognosis. Correct diagnosis and management is important to optimize outcomes in pediatric epilepsy.
This document discusses epilepsy, including its causes, types, clinical manifestations, diagnostic tests, treatment options, nursing care, and patient education. It defines epilepsy as a sudden alteration in normal brain activity that causes changes in behavior and body function. The two main types are petit mal/minor seizures and grand mal/major seizures. Causes include brain injuries, tumors, infections, drug toxicity, and metabolic disorders. Nursing care focuses on airway protection, injury prevention, education to improve knowledge and coping, and alleviating fear. First aid involves safety measures and calling for emergency help. Ongoing treatment involves anti-seizure medications and lifestyle modifications.
The document discusses the management of epilepsy in children. It covers the etiology, classification, clinical features and treatment of different types of childhood epilepsy including neonatal seizures, infantile spasms, Lennox-Gastaut syndrome, benign epilepsy of childhood, and febrile seizures. It also discusses diagnostic evaluation, choice of antiepileptic drugs, prognosis, and management of refractory seizures.
Epilepsy: A Neurological Condition Affecting the Nervous System. Epilepsy is also known as a seizure disorder. Here is a quick who, what, where, when, why, and how about epilepsy.
This document defines seizures and epilepsy and describes different types of seizures. It discusses partial and generalized seizures. Partial seizures are further divided into simple and complex seizures. Generalized seizures include absence, tonic, clonic, tonic-clonic, myoclonic and atonic seizures. Various case examples are provided to illustrate the clinical presentation of different seizure types. Risk factors, causes and classification of seizures are also outlined.
DEFINITION :
It is defined as abnormal ,paroxysmal, excessive, involuntary neurological discharge from the brain which may be manifested as –
Loss of Conciousness,
Abnormal- Motor
- Sensory ,
- Behavioral disturbance
- and Autonomic dysfunction.
The document discusses seizures and epilepsy, defining a seizure as a paroxysmal event due to abnormal neuronal activity in the brain, while epilepsy is defined as recurrent seizures due to an underlying chronic condition. It describes different types of seizures including partial seizures, which originate in one area of the brain, and generalized seizures, which involve both hemispheres simultaneously. Various causes, classifications, characteristics, evaluations, and treatments of seizures are discussed.
This document discusses several epilepsy syndromes categorized by age of onset:
- Neonatal onset syndromes include benign neonatal seizures and early infantile epileptic encephalopathy.
- Infantile onset syndromes include Dravet syndrome, West syndrome, and myoclonic epilepsy in infancy.
- Childhood syndromes include Panayiotopoulos syndrome, Lennox-Gastaut syndrome, and benign epilepsy with centrotemporal spikes.
- Later onset syndromes extending into adolescence and adulthood include juvenile absence epilepsy and juvenile myoclonic epilepsy.
The document discusses neuropsychiatric aspects of epilepsy. It begins with definitions of key terms like seizure, epilepsy, and convulsion. It then provides epidemiological data on epilepsy prevalence and incidence globally. It describes different types of seizures including primary generalized seizures, partial seizures, and epilepsy syndromes. Causes of epilepsy including genetic, acquired, congenital, and withdrawal factors are outlined. Risk factors for developing epilepsy and common seizure triggers are mentioned. The pathophysiology involving glutamate and GABA neurotransmitters is explained. Finally, clinical presentations of different seizure types and differential diagnosis considerations are covered.
This document defines seizure disorders and classifies different types of seizures. It discusses focal seizures, generalized seizures, infantile spasms, and several epilepsy syndromes that typically present in the neonatal period or childhood such as West syndrome, Ohtahara syndrome, and benign childhood epilepsy with centrotemporal spikes. Causes, clinical presentations, diagnostic workups, and treatment options are provided for many of the conditions.
EPILEPSY AND SEIZURE DISORDERS
The document discusses epilepsy and seizure disorders. It defines seizures as paroxysmal events due to abnormal neuronal activity in the brain. It classifies seizures as either focal or generalized based on their origin. Focal seizures originate in one hemisphere while generalized seizures rapidly engage both hemispheres. Common types of seizures include absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures. The document also discusses the etiology, diagnosis, treatment and management of epilepsy through use of anti-epileptic drugs, surgery, or other methods.
seizure among children is always difficult to differentiate It is always good to have basic knowledge about seizure in children if you are working in small KLinik kesihatan orr PPAT/RSAT.
An EMT's guide to seizures provides information about recognizing and treating seizures. Generalized seizures, characterized by unconsciousness and full-body twitching, are the most common type and usually last 3-5 minutes. Febrile seizures occurring in children due to high fevers are also common. Upon arrival, EMTs should protect the patient, maintain their airway, and provide oxygen before transporting them urgently to the hospital for further treatment.
This 3-year-old male child presented with episodes of unconsciousness not associated with tonic-clonic seizures. Prior investigations including EEG and treatment with anti-epileptic drugs did not reveal a clear diagnosis. After further examination, the child was diagnosed with Panayiotopoulos syndrome based on autonomic symptoms during episodes and EEG findings. Panayiotopoulos syndrome is an early-onset childhood occipital epilepsy characterized by emesis, other autonomic symptoms and abnormal EEG patterns, with seizures typically remitting after 1-2 years.
This document discusses psychiatric presentations in epilepsy. It begins by noting the increased prevalence of psychiatric disorders in patients with epilepsy compared to the general population. It then categorizes psychiatric disorders seen in epilepsy into several groups: disorders related to the underlying brain pathology causing epilepsy, disorders related to the seizure occurrence itself (pre-ictal, ictal, post-ictal), and interictal psychiatric disorders not clearly related to seizures. Specific syndromes and disorders are discussed within each category. Ictal phenomena include epileptic auras, automatisms, and non-convulsive status epilepticus, which can resemble psychiatric symptoms but are distinguished by their brief and stereotyped nature.
This document provides information about epilepsy including:
1. It defines epilepsy as two or more unprovoked seizures occurring more than 24 hours apart, with some exceptions. The incidence is about 3% globally.
2. It discusses the various causes/aetiologies of epilepsy including idiopathic, congenital, infections, trauma, vascular issues, tumors, and degenerative conditions.
3. It classifies seizure types according to the International League Against Epilepsy including partial seizures, generalized seizures like absence seizures, myoclonic seizures, and infantile spasms.
4. It outlines the management of epilepsy including establishing the diagnosis, deciding if antiepileptic drug therapy is
This document provides information on convulsions and epilepsy in children. It discusses the history of epilepsy, notable figures associated with epilepsy like St. Valentine, important epilepsy awareness days, common misconceptions about epilepsy, types of seizures including partial seizures, generalized seizures, absence seizures, and infantile spasms. It also covers the classification, causes, mechanisms, and syndromes of epilepsy as well as comparisons between different seizure types.
The document discusses prehistoric art from the Stone Age, divided into the Paleolithic, Mesolithic, and Neolithic periods. The main forms of prehistoric art were rock art including petroglyphs (rock carvings) and pictographs (paintings and drawings) created using materials like stone, bone, and pigments. Examples of important Stone Age art sites mentioned include cave paintings at Lascaux from 15,000-13,000 BC and Stonehenge from 3000-2000 BC, believed to be an astronomical calendar or burial ground. Mesopotamian art from modern Iraq is also noted for early cultural developments in writing, schools, and irrigation.
This document lists several green roof projects in Chicago along with their square footage. It provides details on green roofs installed at buildings like 900 N. Michigan East, Loyola University, Mariano Azuela Elementary School, CVS, Dickens Place, and a Jewel Osco store, with sizes ranging from 2100 to 23,000 square feet. In total, the document outlines 15 different green roof projects across Chicago.
This document provides an overview of U.S. immigration policy from 1790 to the present. It discusses how stereotypes and fears influenced the development of exclusionary policies over time, from the Alien and Sedition Acts to the National Origins System and Bracero Program. While immigration was initially encouraged, the gold rush and increased immigration from Ireland and China led to nativist opposition. The document traces the implementation of the quota system in the 1920s, shifts in immigration demographics after 1965, and current debates around illegal immigration and proposed reforms.
This document provides an overview of U.S. immigration policy from 1790 to the present. It discusses how stereotypes and fears influenced the development of exclusionary policies over time, from the Alien and Sedition Acts to the National Origins System and Bracero Program. While immigration was initially encouraged, the gold rush and increased Catholic immigration led to restrictive laws like the Chinese Exclusion Act. The document concludes by noting how the immigration debate continues today regarding issues like amnesty, border security, and proposed legislation.
La Unión Europea ha propuesto un nuevo paquete de sanciones contra Rusia que incluye un embargo al petróleo. El embargo prohibiría la importación de petróleo ruso a la UE y también prohibiría a los buques europeos transportar petróleo ruso a otros lugares. Sin embargo, Hungría se opone al embargo al petróleo, lo que podría retrasar la aprobación del paquete de sanciones de la UE.
La Unión Europea ha acordado un paquete de sanciones contra Rusia por su invasión de Ucrania. Las sanciones incluyen restricciones a las transacciones con bancos rusos clave y la prohibición de la venta de aviones y equipos a Rusia. Los líderes de la UE esperan que las sanciones aumenten la presión económica sobre Rusia y la disuadan de continuar su agresión contra Ucrania.
La Unión Europea ha acordado un embargo petrolero contra Rusia en respuesta a la invasión de Ucrania. El embargo forma parte de un sexto paquete de sanciones y prohibirá la mayoría de las importaciones de petróleo ruso en la UE a finales de este año. Algunos estados miembros aún dependen en gran medida del petróleo ruso y se les ha concedido una exención, pero se espera que el embargo reduzca de manera significativa los ingresos de Rusia por la venta de petróleo.
The document discusses the Philippine-American War from 1899-1902 between the United States and Filipino rebels. It began after the US acquired the Philippines from Spain in the Treaty of Paris, ignoring Emilio Aguinaldo's declaration of independence. Though Filipinos initially saw Americans as allies against Spain, the US installed a colonial government, starting a guerrilla war as Aguinaldo and his rebels fought for independence. US troops struggled in unfamiliar guerrilla warfare, leading to increased violence on both sides over the course of the bloody three year conflict.
The French and Indian War was a conflict between France and Britain over land in North America from 1754 to 1763. The war began with skirmishes over territory in the Ohio Valley between French and English colonists and their respective Indian allies. Though the French initially had success, the tide turned when William Pitt became British Prime Minister in 1757 and increased funding and troops. The British went on to capture Quebec in 1759 and Montreal in 1760, eliminating French control in North America. The war ended with the 1763 Treaty of Paris, in which France ceded its North American territories to Britain and Spain. Native Americans grew unhappy with the British after the war, leading to Pontiac's Rebellion from 1763 to 1766
The document discusses the Philippine-American War from 1899-1902 between the United States and Filipino rebels. It began after the US acquired the Philippines from Spain in the Treaty of Paris, ignoring Emilio Aguinaldo's declaration of independence. Though Filipinos initially saw Americans as allies against Spain, the US installed a colonial government, starting a guerrilla war as Aguinaldo and his rebels fought for independence. US troops struggled in unfamiliar guerrilla warfare, leading to increased violence on both sides over the course of the bloody three year conflict.
This document defines convulsion disorder and provides information on its causes, types, symptoms, diagnosis, and treatment. Convulsions are involuntary muscle contractions caused by abnormal brain electrical activity. They can be caused by various early life factors like birth asphyxia or infections. Febrile seizures are the most common type in young children and are associated with fever. Epilepsy is recurrent seizures and is classified based on seizure type. Diagnosis involves medical history, exams, and tests. Treatment includes anticonvulsant drugs, dietary therapy, and sometimes surgery.
This presentation summarizes key information about epilepsy, including its definition, types of seizures, and treatment options. Epilepsy is characterized by excessive and synchronous neuronal discharge that can cause loss of consciousness or abnormal movements. Seizures are classified as partial or generalized. Partial seizures are limited to one part of the brain while generalized seizures affect both hemispheres. Common generalized seizure types include tonic-clonic, myoclonic, atonic, and absence seizures. New anti-seizure drugs discussed include vigabatrin, zonisamide, and topiramate. The presentation stresses the importance of planning and prenatal vitamin intake for women with epilepsy who are considering pregnancy.
This document provides an overview of epilepsy, including definitions, types of seizures, causes, diagnosis, and treatment. Some key points:
- Epilepsy is defined as recurrent seizures due to an underlying neurological condition. A seizure is a brief episode caused by abnormal neuronal activity in the brain.
- Seizures are classified as either generalized or partial/focal, depending on where in the brain the abnormal activity originates. Common types include generalized tonic-clonic, absence, myoclonic, atonic, and complex partial seizures.
- Epilepsy has various causes including genetic factors, brain injury, infection, tumors, and metabolic imbalances. Diagnosis involves a neurological exam, medical history
This document provides an overview of epilepsy and psychiatric aspects of epilepsy. It defines key terms like seizure, epilepsy, and status epilepticus. It describes different types of seizures including partial seizures, generalized seizures, tonic seizures, atonic seizures, myoclonic seizures, and absence seizures. Causes of epilepsy like genetic predisposition, trauma, poisoning, and tumors are discussed. The document also covers management of psychiatric patients with epilepsy and first aid for pre-ictal, ictal, and post-ictal phases of seizures.
- Seizures are caused by abnormal excessive neuronal activity in the brain and can be classified as either partial or generalized seizures. Partial seizures originate in a localized region of the brain while generalized seizures involve both hemispheres.
- Common types of generalized seizures include absence seizures, characterized by brief lapses of consciousness, and tonic-clonic seizures which involve tonic muscle contraction followed by clonic movements.
- Complex partial seizures originate in the temporal lobe and involve psychic experiences such as hallucinations followed by automatisms like lip smacking and confusion after the seizure.
Epilepsy is characterized by recurrent seizures that result from abnormal neuronal activity in the brain. Seizures can be generalized, originating simultaneously across both hemispheres of the brain, or partial, originating in a localized region of the brain. Generalized seizures include absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures. Partial seizures can be simple, with motor, sensory or other symptoms but no change in consciousness, or complex, with impaired consciousness. Seizures can have various causes including genetic factors, head injuries, infections, or other acquired brain abnormalities. Evaluation and treatment involve diagnostic testing, medication, and management of any underlying conditions.
Seizures are episodes of abnormal brain activity that result from excessive neuronal discharge. They can be classified as partial or generalized seizures. Partial seizures remain localized in one area of the brain while generalized seizures involve both hemispheres. Common causes include brain injuries, tumors, infections, genetic factors, and chemical imbalances. Diagnosis involves a neurological exam, EEG, and MRI. Treatment involves anti-seizure medications tailored to the individual. Generalized seizure types include tonic-clonic, absence, and atonic seizures which are characterized by muscle contractions, staring spells, and loss of muscle tone respectively. Status epilepticus is a medical emergency defined as continuous seizures lasting more than 30 minutes.
Epilepsy is a neurological disorder characterized by recurrent seizures that are brief changes in brain activity. The document discusses the classification, causes, symptoms, and treatment of epilepsy. It notes that epilepsy can be classified as either generalized or partial seizures depending on which area of the brain is affected. The goals of treatment are to eliminate seizures without side effects through tailored medication regimens. Left untreated, epilepsy can cause health issues, cognitive impairments, and even sudden death.
This document summarizes information about epilepsy and seizures. It defines epilepsy as recurrent seizures and describes different types of seizures including focal-onset, generalized-onset, tonic-clonic, absence, myoclonic, atonic, and tonic seizures. Causes, pathophysiology, diagnosis and treatment options are discussed. Treatment involves antiepileptic medications as first-line treatment, with surgery, neurostimulation or dietary therapies as options for refractory cases. Potential risks and complications of treatments are also summarized.
Seizures are caused by abnormal electrical activity in the brain and can be classified as generalized or partial based on where they originate. Common types include generalized tonic-clonic, absence, myoclonic, and complex partial seizures. Seizures have various causes like genetics, head trauma, infections, and developmental disorders. Diagnosis involves a medical history, neurological exam, EEG, and imaging tests. Treatment primarily consists of anti-seizure medications to control seizures, while management focuses on preventing complications and improving quality of life.
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This document discusses epilepsy, including:
- Defining epilepsy as involuntary muscle contractions and relaxations due to brain disturbances.
- Childhood epilepsy is common, with causes including birth defects, infections, injuries and genetic factors.
- Seizures are classified based on location in the brain and symptoms. Diagnostic tests include EEG and MRI.
- Treatment involves anticonvulsant drugs to control seizures. Surgery may help for uncontrolled epilepsy localized to one brain region. Ketogenic diets and vagus nerve stimulators are also used. Nursing focuses on safety during seizures and proper medication administration.
Epilepsy is characterized by recurrent unprovoked seizures and affects approximately 0.5% of the US population. A seizure involves abnormal neuronal discharge in the brain. Seizures can be focal, involving only part of the brain, or generalized, involving both hemispheres. Common causes include genetic factors, structural lesions, metabolic disturbances, infections, and unknown etiology. Diagnosis involves witness accounts of seizures and EEG. Treatment involves anti-seizure medications. Seizures can be difficult to distinguish from syncope, panic attacks, or psychogenic nonepileptic seizures based on history and examination findings.
Epilepsy is characterized by recurrent seizures and is common, affecting 0.5% of the US population. Seizures can be focal, involving only part of the brain, or generalized, involving both hemispheres. Focal seizures may or may not involve impaired consciousness and can evolve to generalized seizures. Generalized seizures include absence seizures, myoclonic seizures, and tonic-clonic seizures. Epilepsy has many potential etiologies including genetic factors, structural lesions, metabolic disturbances, infections, and unknown causes. Diagnosis involves witnessing recurrent seizures and characteristic EEG changes.
This document provides an overview of epilepsy, including its essentials of diagnosis, general considerations, etiology, classification of seizures, clinical findings, imaging and laboratory studies, and differential diagnosis. Some key points:
- Epilepsy is defined by recurrent unprovoked seizures and affects 0.5% of the US population. Seizures can be focal, involving one brain region, or generalized, involving both hemispheres.
- Causes include genetic factors, structural abnormalities, tumors, infections, trauma, degenerative disorders, and unknown causes. Genetic epilepsy often has an autosomal dominant pattern of inheritance.
- Seizures are classified based on clinical features, such as absence seizures involving brief impairment of
This document provides an overview of seizures in childhood, including definitions, classifications, etiologies, approaches, and complications. It discusses the main types of seizures including focal, generalized tonic-clonic, absence, myoclonic and neonatal seizures. It also covers febrile seizures and status epilepticus. The management of seizures involves stabilizing the child, treating the underlying cause, and using anticonvulsant medications like phenobarbital, phenytoin or benzodiazepines. Outcomes depend mainly on the underlying etiology.
A 2-year-old boy named Aminul Gazi was brought to the OPD after his mother reported that he often fell to the ground spontaneously without warning. During these episodes, which lasted less than a minute, he would go limp and appear powerless. Sometimes he would tell his mother before falling. The attacks started 6 months ago and occurred every 2-3 weeks. Aminul was diagnosed with atonic seizures, which involve a sudden loss of muscle tone causing the person to collapse.
The document provides information on seizures, convulsions, and epilepsy. It defines these terms and describes the different types of seizures including partial/focal seizures and generalized seizures. It discusses the causes, signs and symptoms, diagnostic evaluation, and management of seizures which includes anti-seizure medications, surgery, and vagus nerve stimulation. Nursing care focuses on protecting the individual during a seizure and observing/reporting seizure characteristics. Complications include prolonged seizures known as status epilepticus.
The document provides guidelines for the management of childhood epilepsy. It discusses the classification of seizures and epilepsy syndromes. Some key seizure types include partial seizures, generalized seizures like absence seizures, myoclonic seizures, atonic seizures, and tonic-clonic seizures. It also discusses approaches to diagnosing and treating common idiopathic or genetic epilepsy syndromes in children like benign childhood epilepsy with centrotemporal spikes and childhood absence epilepsy. Treatment involves antiepileptic drugs and considering neuroimaging in some cases.
- Many motor phenomena in neonates are non-epileptic, including tremors, jitteriness, myoclonus, and hyperekplexia. These are often misdiagnosed as seizures.
- Tremors and jitteriness are very common in neonates and are usually benign, caused by immature spinal inhibitory interneurons or elevated catecholamines. Fine tremors especially are typically benign.
- Myoclonus can also occur, such as benign neonatal sleep myoclonus. Hyperekplexia involves an exaggerated startle response and muscle rigidity.
- It is important to differentiate epileptic from non-epileptic events to
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SEIZURE DISORDERS
Seizures
Seizures are episodic, stereotypic behavioral syndromes that have an abrupt onset,
generally are not provoked by external stimuli & result in loss of responsiveness. Seizures are
caused by excessive and disorderly neuronal discharges in the brain. The manifestation of
seizure depends on the region of the brain in which they originate and may include
consciuousness; involuntary movements; and changes in perception, behaviors, sensations
and posture.
Seizures are the most common treatable neurologic disorder in children and can occur with
variety of conditions involving CNS.
Epilepsy
Epilepsy is a condition characterized by two or more unprovoked seizures and can be caused
by a variety of pathologic processes in the brain. Seizures are a symptom of an underlying
disease process. A single seizure event should not be classified as epilepsy and is generally
no treated with long-term anti-epileptic drugs. Some seizures may result from an acute medical
or neurological illness and cease ones the illness is treated. In other cases, children may have
a single seizure without the cause ever being known. Once it is determined that the child has
had the seizure, it is important to classify the seizure. Optimum treatment and prognosis
require accurate diagnosis and determination of etiology whenever possible.
Incidence & Etiology:
An estimated 0.5% of all children experience at least 1 afebrile seizure (Huff, 2000).
Etiology can be caused by many factors. The cause of seizure is often unknown, or idiophatic,
although there maybe genetic factors present predisposing children to particular types of
seizure. Febrile seizures are brief, clonic, or tonic-clonic nature; can be simple or complex,
and can develop with temperatures as low as 37.8°C (100°F). Simple febrile seizure usually
last less than 15 mins. & don’t recur within a 24-hour period. However, complex febrile
seizures can have focal attributes, recur on the same day, and last longer than 30 mins
(Blosser & Burns, 2004). They are also an example of a type of seizure that has an unknown
cause. Seizures can also be acquired, resulting from traumatic brain injury, central nervous
system infection, hypoglycemia or other endocrine dysfunction, toxic ingestion or exposure, or
intracranial lesion or vascular malformation. Typically, infants develop seizures because of
birth injury, anoxic episodes, infection, intraventricular hemorrhage, or a congenital brain
anomaly. Seizures in older children occur most often secondary to trauma or infection. In
addition, changes in diet or hydration status, fatigue, or not taking prescribed medications may
precipitate seizure activity. Prognosis depends on etiology, the type & the age of initial onset.
Pathophysiology
Seizures are the result of a spontaneous electrical discharge of hyper-excited brain cells in an
area called the epileptogenic focus. These cells can be triggered by either environmental or
physiological stimuli such as emotional stress, anxiety, fatigue, infection or metabolic
disturbances. The exact location of the epileptogenic foci & the number involved determines
the nature of the seizure. If a small area of the brain is affected, a focal (localized) seizure may
occur. However, if the electrical discharge continues, it may become generalized. A
generalized seizure will occur if the epileptogenic focus is located in the brain stem, midbrain
or reticular formation.
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Status epilipticus is a prolonged seizure or series of convulsions where loss of
consciousness occurs for at least 30 mis. Refractory seizures last more than 60 mins.
Epilepsy refers to achronic seizure disorder often associated with central nervous system
pathology.
Clinical Manifestations
Clinical manifestations depend on the specific type of seizure.
Types of Seizure:
1. Partial Seizure – arise from the abnormal electrical activity in a small area of the brain,
most often the temporal, frontal, or parietal lobes of the cerebral cortex, will have
symptoms associated with the area of the brain affected. It is characterized by local
motor, sensory, psychic & somatic manifestations. It has 2 types:
a. Simple Partial Seizures (Focal seizure) – can be manifested at any age. There is
no aura (a somatic, or psychic warning that it will occur, which is often described as
a strange sensation in the stomach that rises up to the throat) associated with these
episodes & consciousness is generally not lost. Most often, the symptoms seen are
motor or sensory in nature. Movements, may involve one extremity, a part of that
extremity, or the head & eyes will twist in the opposite direction of the extremities.
The arm toward which the head is turned is abducted & extended with the fingers
clenched. There maybe numbness, tingling or painful sensations as well that begins
in one area of the body & spreads out to others. Alterations in sensory perception
may also be present. The child may have visual hallucinations & report seeing
images or light flashes. In addition, a buzzing sound maybe heard, unusual odors
identified, or an odd taste experienced. The child may also report feeling emotional
or anxious (Behrman et al., 2004; Blosser & Burns, 2004). There are several types
of simple partial seizures:
- Jacksonian seizures are motor episodes beginning with tonic contractions of
either the fingers of one hand, toes of one foot, or one side of the face. The
spasm progress into tonic-clonic movements that march up adjacent muscles of
the affected extremity or side of the body (Encyclopedia Britannica, 2001).
- Rolandic or Sylvian Seizure are manifested as tonic-clonic movements of the
face with increased salivation & arrested speechthat occur commonly during
sleep (Huff, 2000).
b. Complex Partial Seizures, also known as partial psychomotor or temporal lobe
episodes. They can be manifested from age 3 years through adolescence. Just
before the event, the child may have an aura. In addition, the youngster may have
feelings of anxiety, fear, or de javu, the sense an event has occurred before, or
complain of abdominal pain, having an unusual taste in the mouth, smelling an odd
odor, or visual or auditory hallucinations.
Consciousness is not completely lost during complex partial seizures. Rather,
the child will appear confused or dazed, especially at the onset. When the seizure
begins, the child stops activity involved in & begins purposeless behaviors such as
starting into space or assuming an unusual posture. The child may also perform
automatisms, or repeated non-purposeful actions, such as lip smacking, chewing,
sucking, or uttering the same word over & over, wander aimlessly or remove
clothing. Violent acts or rages are rare. A postical period follows this type of seizure
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when the child will be drowsy, confused aphasic, or display sensory or motor
impairments. Children usually do not remember the behaviors displayed (Wertz,
2002).
c. Simple or Complex seizures secondarily generalized – simple or complex partial
seizures that evolve into generalized, usually a toni-clonic event.
2. Generalized seizures – secondary to diffuse electrical activity throughout the cortex
& into the brain stem, will cause the child to loose consciousness as well as
demonstrate uncontrolled motor involvement with movements & spasm bilateral &
symmetricalin nature (Blosser & Burns, 2004; Huff 2000). This can occur at any time
& last from several seconds to hours. There is no aura, but always loss of
consciousness. Generalized seizures appearing in children under 4 years of age are
frequently associated with developmental delays, learning disabilities, and behavior
disorders. There are four types of generalized seizures:
a. Tonic-clonic seizures, often referred to as grand mal seizures, can occur at any
age. Onset is usually abrupt & begins when the child loses consciousness & falls
to the ground. The initial phase is tonic when there are intense muscle
contractions. The jaw clenches shut; the abdomen& chest become rigid; and
often the child emits a cry or grunt as exhaled air is forced out because the taut
diaphragm. Pallor or cyanosis may occur as oxygenation & ventilation are
impaired. The airway is compromised because of increased salivation the
youngster cannot manage because of muscular contractions as well as the
diminished mental status. The neck & legs are also extended while the arms are
flexed or contracted. The eyes roll upward or deviate to one side, the pupils
dilate, and there may also be bladder or bowel incontinence. The tonic phase of
the seizure usually persists for 10-30 seconds. During the clonic phase, jerking
movements are produced as a result of contraction & relaxation of the muscles.
These spasms dissipate as the seizure ends & can last from 30 sec – 30 mins
after onset of the seizure(Behrman et al., 2004; Blosser & Burns, 2004; Wetz,
2002).
A postical or post-convulsive state follows a tonic-clonic seizure.
Hence, the child may become somnolent or if awake, confused or combative;
there maybe no memory of the event, hypertension & diaphoresis. Headache,
nausea, vomiting, poor coordination, slurred speech, or visual disturbances may
follow.
b. Absence seizure, which used to be called petit mal seizures, appear around the
4th birthday& generally disappear near adolescence. They are characterized by a
transient loss of consciousness, which may appear as cessation of current
activity. The child seems to stare into space or the eyes may roll upward with
ptosis or fluttering of the lids. There also maybe lip smacking or a loss of muscle
tone causing the head to droop or any objects in the hands to be dropped. These
events usually last from 5-10 seconds & can occur as often as 20 or more times
per day. Children with this type of seizure are often accused of daydreaming &
being inattentive in school Behrman et al., 2004; Burns e al., 2004; Huff, 2000;
Wetz, 2002).
c. Myoclonic seizures are sudden repeated contractures of the muscles of the
head, extremities, or torso. The child, who can be as young as 2 years but is
usually school-age or an adolescent, recovers quickly. These seizures occur
when the child is drowsy & just falling asleep, or just waking up. There is usually
no loss of consciousness nor is there any postictal period (Burns et al., 2004).
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d. Atonic or astatic-akinetic seizures (drop attacks) occur between ages 2 & 5
years & are manifested by sudden loss of muscle tone with the head dropping
forward for a few seconds. More significant events occur when the youngster
losses consciousness & falls to the ground, most often face down. In either case,
amnesia follows. These seizure often cause repetitive head injuries if the child is
not protected by wearing a football or hockey helmet. Many have underlying
brain abnormalities & are mentally retarded (Behrman et al., 2004; Burns et al.,
2004; Wetz, 2002).
e. Akinetic Seizures are manifested by total lack of movement as the child
appears frozen in a position. Mental status during the event is diminished.
3. Unclassified Epileptic Seizure- seizures that lack sufficient information to classify.
a. West Syndome
Infantile spasm are a rare disorder that has an onset within the first 6-8
months of life. The underlying cause of infantile spasms is often not found.
The pathophysiology is poorly understood. Nearly all children with this will
have some degree of mental retardation. Also known as massive spasm,
salaam seizures, flexion spasm, jackknife seizures, massive myoclonic jerks,
or infantile myoclonic spasm. It is twice common in boys as in girls.
Types:
a.1. Flexor spasms- consists of brief contractions of the neck, trunk, arms
and legs. The arms may either adduct or abduct with the arms flexed at
the elbow.
a.2. Extensor spasms- consists predominantly of extensor contractions
resulting in abrupt extension of the neck and trunk with extensor adduction
or abduction of the arms and legs. Eye deviation or nystagmus often
occurs.
b. Lennox-Gastaut Syndrome (LGS)
Many children who have infantile spasms eventually develop LGS. LGS is
diagnosed on the evidence of mixed seizure types (atonic, myoclonic, tonic,
and atypical absence), slow EEG changes. Onset of LGS is between 1 to 7
years of age, after which it is far less common. Children with this typically
have multiple seizures daily. Tonic seizures are most common seizure type in
this syndrome. In addition to mental retardation, many of these children
develop other problems, including hyperactivity, aggression, or autistic
features. Treatment is difficult and most cases do not respond to therapy. The
prognosis is typically poor. Additional family support is often required to
maintain the child at home.
Diagnosis
The objectives of diagnosis are threefold: to ascertain whether or not the child truly had
a seizure, to determine the cause of the episode, & to classify the type of seizure. This process
begins with obtaining a thorough history from the caregivers or witnesses. In addition, a
complete medical history must be obtained, noting any illnesses, medications, hospitalizations,
or toxic exposures the child may have had as well as if previous episodes occurred. Family
history is also important because of genetic predisposition to some types of seizures (Berhman
et al., 2004; Burns et al., 2004; Huff, 2000).
A detailed account of the event must be explored, and an assessment made of whether
or not the child suffered any trauma, had been ill or febrile, ingested any toxin or poison, or
5. Page 5 of 7
was exposed to dangerous chemicals. It is also important to determine if the youngster had an
aura just before the event.
Once the history is obtained, a complete physical examination must be performed. A
CBC can determine the presence or absence of infection such as meningitis or encephalitis,
and serum electrolytes should be analyzed to rule out metabolic disturbances, particularly
hypoglycemia. A lumbar puncture may also be performed to investigate for infectious
processes or bloody cerebrospinal fluid. If a toxic investigation is suspected, both urine & blood
can be checked for its presence (Huff, 2000).
A complete neurological evaluation should follow including checking the level of
consciousness, reflexes & sensory & motor responses. Radiologic imaging such as CT Or MRI
maybe performed to note any structural abnormality while angiography would pinpoint vascular
irregularities. In addition, an EEG might be indicated to assess the brain’s electrical activity
while the child is asleep, awake or receiving noxious stimuli & a positron emission tomography
(PET) scan done to highlight areas of brain abnormality (Huff, 2000).
Treatment
The child with tonic-clonic seizures must be managed quickly. The airway must be
assured; a short term method is to perform the jaw thrust. Nothing including a tongue blade
should never be placed in the child’s mouth. The child may then be placed on the side if the
airway is patent to help prevent secretions from pooling in the mouth, and suction should be
readily available. Because of thoracic & diaphragmatic muscle rigidity, air exchange is
impaired & hypoxia may result. Therefore, children having tonic-clonic seizures should receive
oxygen during the event either by face mask or assisted ventilations. Many seizures are self-
limiting & last less than 5 mins. these require no further management other than the jaw thrust
& oxygen administration (Behrman et al., 2004).
However, the child in status epilipticus will need intravenous medications. The
benzodiazepines (Diazepam [Valium] or Lorazepam [Atavan] are usually administered first,
and if seizures continue , phenytoin (Dilantin) or fospenytoin (Cerebyx) are administered next>
Phenobarbital (Luminal) may also be given but it takes 30 mins before onset. It is important to
place the child on a cardiorespiratory monitor during medication administration as an apneic
response may follow administration of the benzodiazepines. There is alsothe risk of
hypotension or cardiac dysrhythmias when phenytoin is administered. Once the seizure is
over, the child should be closely monitored during the postical period. If the episode is a first-
time event, diagnostics should begin after recovery.
Once the diagnosis & the type & cause of the seizure are identified, more definite
treatment can begin. If the cause was infectious, a toxic exposure, metabolic abnormality, an
intracranial lesion, or a vascular malformation, that particular cause would be treated. For the
child with convulsions caused by nonstructural pathology, anticonvulsant medications would be
prescribed, and the child followed by neurologists who would carefully monitor during serum
levels to ensure they remained within the therapeutic ranges. If episodes continue,
medications could be changed or added to the youngster’s current regimen.
Over the last several years, the Ketogenic Diet has gained popularity in treating are
carbohydrates thereby forcing the body to use ketones for fuel. The amount of protein in the
diet is regulated so that 90% of the calories are derived from fat, & the fat to carbohydrate ratio
is 4:1. The reason ketones have an effect on seizure is not ell understood, but theoretically
they (1) change lipid concentrations, (2) change fluid & electrolyte balances, (3) modify the
seizure threshold, or (4) stabilize the central nervous system.
The diet is especially useful in young children with infantile spasms, myoclonic or
atonic-kinetic seizures & those with mixed seizures of Lennox-Gastaut Syndrome when side
effects to medications are intolerable or when allergies preclude administration.
6. Page 6 of 7
For the child with intractable seizures, surgery maybe the last hope for control. The
epileptogenic focus maybe removed if there are no critical structures involved. The temporal
lobectomy or a hemispherectomy could be performed on the client with unrelenting partial
seizures with widespread hemispheric origin. Oftentimes, these youngsters will also display
pre-existing motor, cognitive & sensory deficits. The goal of surgery is not only to decrease
seizure activity, but also to improve child’s behavior & intellectual status.
Nursing Diagnosis
• Ineffective breathing patterns as evidenced during tonic-clonic motions
• High risk for injury secondary to tonic-clonic movements as well diminished level of
consciousness
• High risk for injury related to medication administration during the acute episode
• Interrupted family dynamics related to caring for a child with a chronic condition.
Nursing Management
The nurse caring for the child with seizures has multiple responsibilities. If the child os actively
convulsing, a patent airway & adequate oxygenation must be assured. Prescribed medications need to
be administered safe & efficient manner noting the specific rates of delivery, need for cardiorespiratory
monitoring & watching for potential adverse reactions. Once the episode is controlled, the nurse must
document the event in detail, including the onset of any aura to resolution.
Nurses should provide a safe environment for the child with seizures to ensure injury will not
occur. Suction & oxygen should be at hand & bed rails padded. If the event occurs when the child is in
a chair or standing, the child should be gently helped to the ground & place on one side & any nearby
objects moved out of the way. Children with recurrent seizures may wear helmets to protect their heads
during falls.
The nurse must also care for the emotional needs of the child & family as seizures can often
have a negative sigma, making the victim as well as the caregivers & siblings uncomfortable &
ashamed. The child may resent feeling different from peers & taking medications several times per day,
or fear having a seizure in front of friends. The nurse should encourage the child to talk about these
feelings & provide help so the condition can be accepted.
Family Teaching
The nurse must work with the family as well. Some caregivers feel guilty, especially if the
episodes are a result of trauma, or genetic predisposition. The nurse should allow these family
members to express their feelings & frustrations. Caregivers may also worry about the financial aspects
of having a youngster with a chronic condition, requiring daily medications, visits to the neurologist, and
frequent drug serum monitoring. The nurse can arrange for caregivers to speak with social services for
assistance in working out these issues.
Caregivers must also be taught how to give medications & the importance of not missing doses.
They also need to know drug serum levels should be checked periodically as the child grows. School-
age children should be encourage to accept responsibility for taking their own medications as this gives
them feelings of control over their illness.
Safety is another issue to discuss with the child, caregivers, teachers, baby sitters & family
members. All should know what to do when seizure occurs, & when to call emergency medical
services. The child should wear a Medical Alert bracelet or necklace & people caring for this youngster
should be aware of activities that can & should not be encouraged. While most play is acceptable,
contact sports are ill-advised. In addition, the child with seizure disorder must be carefully watch at all
times during a bath or if involved in any water activities such as swimming or boating. Instruct what to
do if child seizes & whom to call for help. It will also be helpful to teach them CPR. Provide teachers,
classroom assistants, school nurse or school aides & administrative staff with information on what to do
if the child has seizure in school. If the school nurse or health aide must give a medication during the
day, provide information about the drug. If the child & caregiver agree, talk to the children in the class at
school about the child’s condition as well as what a seizure is & what looks like in order to reduce fears
7. Page 7 of 7
& anxieties about their classmate. Refer family & child to groups offering support to families whose child
has a seizure disorder.