1) Seizures in children can be caused by factors like birth injuries, head trauma, infections, genetic conditions, and tumors. They are classified as generalized or partial based on where they originate in the brain.
2) Generalized seizures involve the entire brain and include tonic-clonic, absence, myoclonic, clonic, and atonic seizures. Partial seizures originate in one area of the brain and can be simple, with retained awareness, or complex, with impaired awareness.
3) Diagnosis involves medical history, physical exams, blood tests, EEGs, and brain imaging. Treatment includes medications, dietary therapies, surgery, and management of acute seizures. The prognosis depends on factors like
Seizures are episodes of abnormal motor, sensory, autonomic, or psychic activity (or a combination of these) resulting from sudden excessive discharge from cerebral neurons.
Seizures are episodes of abnormal motor, sensory, autonomic, or psychic activity (or a combination of these) resulting from sudden excessive discharge from cerebral neurons.
Every year more than 10 million children die in developing countries due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, or malnutrition - and often to a combination of these illnesses. In 1990s, the WHO, in collaboration with UNICEF and many other agencies, institutions and individuals, responded to this challenge by developing a strategy known as the Integrated Management of Childhood Illness (IMNCI).This strategy adopted in India as Integrated Management of Neonatal and Childhood Illness (IMNCI). IMNCI caters to two groups of children
• 0-2 months, referred to as young infants.
• 2 months to 5 years, referred to as children.
A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
Increased intracranial pressure is defined as cerebrospinal fluid pressure greater than 15 mm Hg.
Infections
Tumors
Stroke
Aneurysm
Epilepsy
Seizures
Hydrocephalus
Hypertensive brain injury
Hypoxemia
Meningitis
Due to etiological factors
Components of ICP is disturbed- brain tissue, CSF, blood volume
An increase in the volume of ANY ONE component must be accompanied by a reciprocal decrease in one of the other components.
When this volume-pressure relationship becomes unbalanced, ICP increases.
Sudden temporary change in PHYSICAL movement, SENSATION, BEHAVIOUR because of abnormal discharged of electrical impulses from nerve cells.
CLASSIFICATION
PARTIAL SEIZURE / FOCAL SEIZURE
>> Aimed to determine:
Type of seizure
Frequency
Severity
Aura
LOC
Dyspnea
Fixed and dilated pupil
Incontinence
Factors that precipitate them.
Developmental history taking (events of pregnancy and childbirth)
Questioned about illnesses or head injury
Every year more than 10 million children die in developing countries due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, or malnutrition - and often to a combination of these illnesses. In 1990s, the WHO, in collaboration with UNICEF and many other agencies, institutions and individuals, responded to this challenge by developing a strategy known as the Integrated Management of Childhood Illness (IMNCI).This strategy adopted in India as Integrated Management of Neonatal and Childhood Illness (IMNCI). IMNCI caters to two groups of children
• 0-2 months, referred to as young infants.
• 2 months to 5 years, referred to as children.
A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
Increased intracranial pressure is defined as cerebrospinal fluid pressure greater than 15 mm Hg.
Infections
Tumors
Stroke
Aneurysm
Epilepsy
Seizures
Hydrocephalus
Hypertensive brain injury
Hypoxemia
Meningitis
Due to etiological factors
Components of ICP is disturbed- brain tissue, CSF, blood volume
An increase in the volume of ANY ONE component must be accompanied by a reciprocal decrease in one of the other components.
When this volume-pressure relationship becomes unbalanced, ICP increases.
Sudden temporary change in PHYSICAL movement, SENSATION, BEHAVIOUR because of abnormal discharged of electrical impulses from nerve cells.
CLASSIFICATION
PARTIAL SEIZURE / FOCAL SEIZURE
>> Aimed to determine:
Type of seizure
Frequency
Severity
Aura
LOC
Dyspnea
Fixed and dilated pupil
Incontinence
Factors that precipitate them.
Developmental history taking (events of pregnancy and childbirth)
Questioned about illnesses or head injury
Focuses on Epilepsy Management for poeple wth Tuberous Sclerosis. Includes information on:
- Status Epilepticus
- Epilepsy Management
- First Aid Principles
- Seizure Management Planning
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
Author: Danielle Cassidy, Pharm.D., BCPS
Audience: Third year pharmacy students at University of Colorado School of Pharmacy
Background: describes common causes of seizures, differentiates dosing of antiepileptic drugs in pediatrics vs. adults, common risk factors associated with febrile seizures, treatment of febrile seizures, treatment of status epilepticus (inpatient & outpatient), & how to dispense/counsel parents on the administration of Diastat.
complete information for the management and care of patient suffering from epilepsy definition ,classification, types, pathophysiology ,clinical manifestation, diagnostic evaluation, medical management, nursing management, care provided to the patient suffering from epilepsy .
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness. If you have two or more seizures or a tendency to have recurrent seizures, you have epilepsy.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
2. Definition
A seizure is a sudden disruption of the brain's normal electrical
activity accompanied by altered consciousness and/or other
neurological and behavioural manifestations.
Epilepsy is a condition characterized by recurrent seizures that
may include repetitive muscle jerking called convulsions.
3. ETIOLOGY
Low oxygen during birth
Head injuries that occur during birth or from accidents during youth or adulthood
Brain tumours
Genetic conditions that result in brain injury, such as tuberous sclerosis
Infections such as meningitis or encephalitis
Stroke or any other type of damage to the brain
Abnormal levels of substances such as sodium or blood sugar
4. RISK FACTORS
Age - The onset of epilepsy is most common during early childhood and after age 60, but
the condition can occur at any age.
Family history
Head injuries - Head injuries are responsible for some cases of epilepsy.
Stroke and other vascular diseases - Stroke and other blood vessel (vascular) diseases
can lead to brain damage that may trigger epilepsy.
Brain infections - Infections such as meningitis, which causes inflammation in the brain or
spinal cord, can increase the risk.
Seizures in childhood - High fevers in childhood can sometimes be associated with
seizures.
6. Generalized seizure
Generalized Seizures
(Produced by the entire brain)
Symptoms
1. "Grand Mal" or Generalized tonic-clonic Unconsciousness, convulsions, muscle rigidity
2. Absence Brief loss of consciousness
3. Myoclonic Sporadic (isolated), jerking movements
4. Clonic Repetitive, jerking movements
5. Tonic Muscle stiffness, rigidity
6. Atonic Loss of muscle tone
7. Partial seizure
Partial Seizures
(Produced by a small area of the brain)
Symptoms
1. Simple(awareness is retained)
a. Simple Motor
b. Simple Sensory
c. Simple Psychological
a. Jerking, muscle rigidity, spasms, head-turning
b. Unusual sensations affecting either the vision,
hearing, smell taste, or touch
c. Memory or emotional disturbances
2. Complex(Impairment of awareness)
Automatisms such as lip smacking, chewing,
fidgeting, walking and other repetitive, involuntary
but coordinated movements
3. Partial seizure with secondary generalization
Symptoms that are initially associated with a
preservation of consciousness that then evolves into
a loss of consciousness and convulsions.
8. STATUS EPILEPTICUS (SE)
Is a life-threatening neurologic disorder defined as 30 minutes or
more of a continuous seizure, or two or more discrete seizures
without complete recovery of consciousness between seizures.
Two common forms of SE are generalized convulsive SE, involving
prolonged seizures, and nonconvulsive SE, involving changes in
behaviour, memory, affect, or level of consciousness.
9. Cont.…….
Treatment must begin immediately after diagnosis, because SE of
long duration is associated with an increase in neurologic morbidity
and seizures may become less responsive to medication with time.
Begin treatment with supportive care; ensuring sufficient
oxygenation is essential. If seizures do not terminate on their own,
administer antiepileptic medication
10. Causes of SE
Fever
Pre-existing epilepsy
Genetic predisposition
Cerebral palsy
Stroke or brain insults, such as prior or acute head trauma, CNS infection, and cerebrovascular
disease including arterial ischemic stroke or intracranial haemorrhage
Progressive neurologic disorders such as brain tumour or neurodegenerative disease
Hypoxic-ischemic encephalopathy
Metabolic and electrolyte disturbances (e.g., hypoglycaemia, hyponatremia, hypernatremia,
hypercalcemia)
Drug intoxication (alcohol, cocaine, theophylline, tricyclic antidepressants, amphetamines, insulin)
Acute withdrawal of AEDs
Progressive neurologic disorders such as brain tumours or neurodegenerative diseases
11. IMMEDIATE CARE
Verify diagnosis
Obtain brief history focusing on known convulsive disorders, medication usage, and
any recent medication changes, drug allergies, alcohol or substance misuse, recent
acute illness, chronic disease, or previous brain injury.
Initiate supportive care
Assess and secure airway and oxygenation; insert nasal airway or intubate if necessary.
Administer 100% oxygen
Monitor pulse, blood pressure, respiration, and temperature
Secure intravenous access in large vein
12. CONT…..
Send blood for complete blood count, serum electrolytes, calcium, magnesium,
blood urea nitrogen, liver function tests, glucose, and antiepileptic drug levels,
clotting studies, and toxic drug screen
Check arterial blood gases
Begin isotonic saline at a low infusion rate
Give 50 mL of 50% glucose intravenously if hypoglycemia is suspected, or
prophylactically if glucose levels cannot be determined
13. SIGNS AND SYMPTOMS
Generalized absence seizures
Staring
The child suddenly stops what she is doing
A few seconds of unresponsiveness (usually less than 10 seconds, but it can be
up to 20 seconds) that can be confused with daydreaming
No response when you touch your child
The child is alert immediately after the seizure
The child may have many seizures per day
Repetitive blinking
Eyes rolling up
Head bobbing
14. Generalized myoclonic seizures
One or many brief jerks, which may involve the whole body or a
single arm or leg
In juvenile myoclonic epilepsy, these jerks often occur upon
waking
The child remains conscious
15. Generalized atonic seizures
Sudden loss of muscle tone
The child goes limp and falls straight to the ground
The child remains conscious or has a brief loss of consciousness
Eyelids droop, head nods
Jerking
The seizure usually lasts less than 15 seconds, although some may
last several minutes
The child quickly becomes conscious and alert again after the seizure
16. Generalized tonic-clonic seizures
The child cries out or groans loudly
The child loses consciousness and falls down
Heart rate and blood pressure rise
Sweating
Tremor
In the tonic phase, the child is rigid, her teeth clench, her lips may
turn blue because blood is being sent to protect her internal organs,
and saliva or foam may drip from her mouth; she may appear to stop
breathing because her muscles, including her breathing muscles, are
stiff
17. Cont.........
In the clonic phase, the child resumes shallow breathing; her arms and
legs jerk quickly and rhythmically; her pupils contract and dilate
At the end of the clonic phase, the child relaxes and may lose control
of her bowel or bladder
Following the seizure, the child regains consciousness slowly and may
appear drowsy, confused, anxious, or depressed.
18. Simple partial seizures
Motor seizures
Brief muscle contractions (twitching, jerking, or stiffening), often
beginning in the face, finger, or toe on one side of the body.
Twitching or jerking spreads to other parts of the body on the same
side near the initial site.
Other motor seizures may involve movement of the eye and head.
The seizure begins the same way each time.
The child remains conscious.
19. Cont……..
Sensory seizures
Seeing something that is not there, such as shapes or flashing lights, or
seeing something as larger or smaller than usual
Hearing or smelling something that is not there
Feeling of pins and needles or numbness in part of the body
The child remains conscious
20. Cont……..
Autonomic seizures
Changes in heart rate
Changes in breathing
Sweating
Goose bumps
Flushing or pallor
The child remains conscious
Strange or unpleasant sensation in the stomach, chest, or head
Changes in heart rate
Changes in breathing
Sweating
Goose bumps
Flushing or pallor
The child remains conscious
21. Complex partial seizures
Warning sign such as a feeling of fear or nausea
Loss of awareness
Confusion after the seizure
Loss of memory about events just before or after the seizure
Loss of awareness
Blank stare
Walking or running
Automatisms such as mouth movements, picking at air or clothing, repeating words
or phrases
Confusion after the seizure
Loss of memory about events just before or after the seizure
22. DIAGNOSIS
Blood tests (such as blood sugar, complete blood count, electrolytes and
liver and kidney function tests)
Electroencephalography (EEG), a test that records electrical activity in
the child’s brain
Brain imaging tests including CT, MRI and PET scans to look for any scar
tissue, tumors or brain malformations that may be causing seizures
Spinal tap (lumbar puncture) to see if there is an infection or other
problem
PET /SPECT-Radioisotopes, radioactive materials injected into the vein
and traced with either PET or SPECT with to detect areas of brain
epileptic foci.
23. TREATMENT
Principles of Treatment
Treatment should be started with a single conventional AED
(monotherapy).
The dose should be slowly built up until seizure control is achieved or side
effects occur.
If the initial treatment is ineffective or poorly tolerated then monotherapy
using another AED can be tried
The dose of the second drug is slowly increased until adequate or
maximum tolerated dose is reached.
The first drug is then tapered off slowly.
Combination therapy (polytherapy or adjunctive or “add-on “therapy) can
be considered when two attempts at monotherapy with AEDs have not
resulted in seizure freedom.
24. CONT……..
Phenytoin (PHT), phenobarbitone (PB), carbamazepine (CBZ),
oxcarbazepine (OXC) and valproate (VPA) are usually called
“conventional” or “first-line drugs”.
The other AEDs are called “new "or “second-line drugs”.
It is preferable to use a conventional AED as the initial drug since those
are less expensive and the side effects with long-term use are well-
known.
25. SURGERY
Epilepsy surgery may be resective or nonresective.
Resective surgery includes lesionectomy (resection of the lesion and the
surrounding epileptogenic area), amygdalohippocampectomy with or
without temporal lobe resection, multilobar resection and
hemispherectomy.
Non resective surgery includes multiple subpial transections corpus
colostomy and vagus nerve stimulation (VNS)
26. Ketogenic Diet in Epilepsy
High fat and low protein/carbohydrate diet given with/without a
restricted fluid intake to maintain ketosis.
It can be used in all children above the age of 1 year with drug-resistant
epilepsy.
Adverse effects include GI disturbances, acidosis, increased
susceptibility to infections, drowsiness, weight loss, nutritional
deficiencies and rarely, renal calculi and pancreatitis.
In failures it should be discontinued after in 3-6 months.
In responders, it should be continued for 2-3 year.
27. IN TONIC-CLONIC SEIZURE
DURING SEIZURE
Remain calm
Time the seizure episode
If child is standing or seated, ease the child down to the floor
Place pillow/ folded blanket below the child’s head.
Loosen restrictive clothing
Remove eye glasses
Clear area of any hazards or hard object
Allow seizure to end without any interference
If vomiting occurs, turn the head of the child to one side.
Do not attempt to restrain the child.
Do not put anything in child’s mouth.
Do not give any fluids or liquids.
28. After seizure
Time the post ictal period
Check the breathing. Check the position of head and tongue. Reposition if head
is hyperextended
If child is not breathing give rescue breathing and call for emergency medical
service.
Keep child on side
Remain with child
Do not give food or liquid until fully alert and swallowing reflex has returned.
Check head and body for possible injury
Check inside of mouth to see if tongue or lips have been bitten.
29. In complex partial seizure
DURING THE SEIZURE
Do not restrain
Remove harmful object from area
Redirect to safe area
Do not agitate; instead talk in calm reassuring manner
Do not expect child to follow instruction
Watch to see if seizure generalize.
30. PROGNOSIS
Prognosis for children with seizure depend on the etiology, type of
seizure, age of onset, family and medical history. Risk factors
associated with recurrence of epilepsy include:
Adolescent age and older
Family history of epilepsy
Frequent seizure on antiepileptic medication
Multiple antiepileptic therapy
Abnormal EEG
Seizure result from past injury/ insult.
31. NURSING DIAGNOSIS
1. Risk for Injury related to uncontrolled seizure activity (balance disorder).
2 .Ineffective airway clearance related to blockage of the tongue, endotracheal tube,
increased secretion of saliva.
3. Social isolation related to low-self against the disease state, and the bad stigma
against epilepsy in the community.
4. Ineffective breathing pattern related to dyspnoea and apnoea.
5. Activity intolerance related to decreased cardiac output, tachycardia.
6. Impaired sensory perception related to disturbances in nerve sensory organs of
perception.
7. Anxiety related to lack of knowledge about the disease.
8. Risk for Ineffective cerebral Tissue Perfusion related to decreased oxygen supply to
the brain.