Seizure Triggering Factors and Types
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Questions and Answers

What type of generalized seizure involves both stiffening of muscles and rhythmic jerking of extremities?

  • Tonic seizure
  • Myoclonic seizure
  • Tonic-clonic seizure (correct)
  • Atonic seizure

Which seizure type is characterized by brief jerking or stiffening of the extremities?

  • Clonic seizure
  • Focal seizure
  • Myoclonic seizure (correct)
  • Atonic seizure

What is a common manifestation during the clonic phase of a tonic-clonic seizure?

  • Rhythmic jerking of extremities (correct)
  • Muscle tone loss
  • Loss of consciousness
  • Aura

Which of the following is NOT a characteristic of a tonic seizure?

<p>Duration exceeding 30 seconds (C)</p> Signup and view all the answers

What occurs during the postictal phase following a tonic-clonic seizure?

<p>Confusion and sleepiness (D)</p> Signup and view all the answers

Which type of seizure has a loss of consciousness without notable motor activity?

<p>Absence seizure (B)</p> Signup and view all the answers

What duration describes an absence seizure?

<p>10 to 30 seconds (B)</p> Signup and view all the answers

Which of the following describes an atonic seizure?

<p>Loss of muscle tone leading to falls (C)</p> Signup and view all the answers

Which of the following factors is a common trigger for seizures?

<p>Excessive stress (D)</p> Signup and view all the answers

Generalized seizures involve which of the following?

<p>Both cerebral hemispheres (B)</p> Signup and view all the answers

What distinguishes complex partial seizures from simple partial seizures?

<p>Automatisms are present in complex partial seizures. (A)</p> Signup and view all the answers

Which statement accurately describes a simple partial seizure?

<p>The individual remains aware throughout the event. (A)</p> Signup and view all the answers

What types of sensations might a person experience during a simple partial seizure?

<p>Unusual sensations and a sense of déjà vu. (D)</p> Signup and view all the answers

Which of the following is NOT a feature of complex partial seizures?

<p>Unilateral abnormal extremity movements. (B)</p> Signup and view all the answers

During which type of partial seizure may a person exhibit behaviors they are not aware of?

<p>Complex partial seizure. (B)</p> Signup and view all the answers

What is the primary focus of nursing care during a seizure?

<p>Protect the client’s privacy and prevent injury (B)</p> Signup and view all the answers

Which action is appropriate after a seizure has occurred?

<p>Perform neurological checks and check vital signs (B)</p> Signup and view all the answers

What should be avoided during a seizure to prevent injury?

<p>Inserting items into the airway (B)</p> Signup and view all the answers

What is the primary goal when administering antiepileptic drugs?

<p>To control seizure activity using one medication (B)</p> Signup and view all the answers

Why is it essential to educate clients about taking antiepileptic medications consistently?

<p>To prevent the potential development of tolerance (A)</p> Signup and view all the answers

What position should a client be placed in after a seizure?

<p>Side-lying position to prevent aspiration (C)</p> Signup and view all the answers

What common side effect should clients be monitored for when on antiepileptic medications?

<p>Oral gum overgrowth (A)</p> Signup and view all the answers

Which factor can potentially trigger seizures in clients?

<p>Fatigue and sleep deprivation (B)</p> Signup and view all the answers

What should be done regarding the monitoring of antiepileptic drug levels?

<p>Conduct routine blood tests on a scheduled basis (C)</p> Signup and view all the answers

What is a potential consequence of developing tolerance to antiseizure medications over time?

<p>Increased intensity of seizures (A)</p> Signup and view all the answers

What is the purpose of initiating a social services referral for a client with seizure activity?

<p>To enhance medication adherence by providing financial assistance. (D)</p> Signup and view all the answers

What specific type of seizures is vagal nerve stimulation used to treat?

<p>Focal seizures (A)</p> Signup and view all the answers

What should clients avoid to prevent complications while using a vagal nerve stimulator?

<p>Using microwave ovens (A)</p> Signup and view all the answers

Which statement is correct regarding responsive neurostimulation systems (RNS)?

<p>They interrupt seizure activity in the brain. (B)</p> Signup and view all the answers

What is a characteristic of laser interstitial thermal therapy (LiTT)?

<p>It applies heat via a laser probe to ablate tissue. (C)</p> Signup and view all the answers

Which procedure is typically done before conventional surgical procedures for seizures?

<p>Discontinuation of antiepileptic drugs. (D)</p> Signup and view all the answers

What role does the disability office play for a school-age child with seizure activity?

<p>Develops an Individualized Education Program (IEP). (C)</p> Signup and view all the answers

What is a common misconception regarding seizure-related discrimination?

<p>Discrimination is only illegal in specific states. (D)</p> Signup and view all the answers

What is the primary function of the vagal nerve stimulator device?

<p>To stimulate the brain via vagus nerve stimulation. (A)</p> Signup and view all the answers

Which of the following actions can clients with a vagal nerve stimulator take during a seizure?

<p>Hold a magnet over the device. (C)</p> Signup and view all the answers

What does the intracarotid amobarbital (Wada) test primarily assess?

<p>Impact on language or memory (B)</p> Signup and view all the answers

What is the purpose of a partial corpus callosotomy?

<p>To reduce the severity of seizures (A)</p> Signup and view all the answers

What potential complication might arise from surgical procedures on the brain?

<p>Loss of cerebral function (B)</p> Signup and view all the answers

Which nursing action is essential for a client with seizures?

<p>Educate about the importance of medical identification tags (A)</p> Signup and view all the answers

What aspect of antiepileptic drug (AED) management is critical for clients?

<p>Monitoring levels to maintain therapeutic range (D)</p> Signup and view all the answers

Which is a potential limitation for individuals with a history of seizures regarding driving?

<p>State laws that may restrict or limit driving (B)</p> Signup and view all the answers

How can an individual's seizures impact the effectiveness of oral contraceptives?

<p>They can decrease the effectiveness of oral contraceptives (A)</p> Signup and view all the answers

What kind of testing can evaluate if visuospatial function is affected?

<p>Neuropsychological testing (B)</p> Signup and view all the answers

In performing a brain procedure, which of these factors must be significant in decision-making?

<p>Potential impact on vital brain function (A)</p> Signup and view all the answers

What should clients with a history of seizures be educated about regarding their condition?

<p>Monitor AED levels and drug interactions (A)</p> Signup and view all the answers

What defines status epilepticus?

<p>Repeated seizures without full recovery within 30 minutes (B)</p> Signup and view all the answers

Which is a complication of status epilepticus?

<p>Continued assault on neuronal tissue (C)</p> Signup and view all the answers

Which nursing action is NOT a priority for managing status epilepticus?

<p>Administer oral antiepileptic medication (B)</p> Signup and view all the answers

What is one of the primary risk factors for Sudden Unexpected Death in Epilepsy (SUDEP)?

<p>Multiple antiepileptic medications (C)</p> Signup and view all the answers

Which nursing action is important for the prevention of SUDEP?

<p>Promote sleep hygiene (C)</p> Signup and view all the answers

What percentage of SUDEP cases occur during sleep?

<p>Between 40 to 60% (B)</p> Signup and view all the answers

Which of the following is a non-pharmacological intervention for managing seizure activity?

<p>Using seizure alert devices (D)</p> Signup and view all the answers

Why is it important for clients to keep a journal of their seizure activity?

<p>To identify and avoid potential seizure triggers (C)</p> Signup and view all the answers

Which of the following is NOT a potential consequence of status epilepticus?

<p>Increased neuronal recovery time (A)</p> Signup and view all the answers

What is a common emergency medication used in the treatment of status epilepticus?

<p>Phenytoin (C)</p> Signup and view all the answers

Flashcards

Generalized Seizure

A seizure involving both brain hemispheres.

Tonic-Clonic Seizure

A seizure with stiffening (tonic) and jerking (clonic) phases.

Tonic Seizure

Seizure with stiffening of muscles & loss of consciousness.

Clonic Seizure

Seizure with rhythmic jerking only.

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Myoclonic Seizure

Brief jerking or stiffening of extremities.

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Atonic/Akinetic Seizure

Loss of muscle tone, often leading to falling.

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Absence Seizure

Brief loss of consciousness, no major activity.

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Focal Seizure

Seizure affecting only one brain hemisphere.

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Aura

A sensation that may signal a coming seizure, like a change in vision, smell, hearing or emotion.

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Postictal Phase

Period of confusion and sleepiness after a seizure.

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Complex Partial Seizure

A focal seizure with loss of consciousness and automatic behaviors like lip smacking or picking clothes.

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Simple Partial Seizure

A focal seizure with no loss of consciousness, but unusual sensations or movements.

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Automatisms

Behaviors that happen automatically during a complex partial seizure, like lip smacking or picking clothes.

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Amnesia

Memory loss experienced before or after a complex partial seizure.

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Patient-centered care during a seizure

Protecting the patient from injury and providing a safe environment during a seizure.

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Positioning a patient during a seizure

Turning the patient to the side to maintain a clear airway and reduce the risk of aspiration.

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What NOT to do during a seizure

Avoid restraining the patient, opening the jaw, or inserting anything in the airway.

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Post-seizure care

Monitoring for injuries, checking vital signs, and providing comfort and reassurance.

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Antiepileptic drugs (AEDs)

Medications used to control seizures; often require regular blood tests to monitor effectiveness and prevent side effects.

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Therapeutic levels of AEDs

Specific blood levels of the medication that are needed for proper seizure control.

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Importance of consistent AED dosage

Taking AEDs at the same time every day improves their effectiveness.

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Possible effects of long-term AED use

Tolerance or sensitivity may develop over time, requiring adjustments in medication dosage.

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Common adverse effects of AEDs

Some AEDs can cause side effects like gum overgrowth, which can be minimized by good oral hygiene and dental visits.

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Client education regarding AEDs

Providing information on taking medications as prescribed, recognizing potential side effects, and managing potential interactions with food and other medications.

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Social Services Referral for Medication

If a client's ability to afford medication affects their adherence to treatment, refer them to social services for assistance.

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Vocational Evaluation for Epilepsy

If seizures impact a client's employment, refer them to social agencies for financial support and a vocational evaluation to explore alternative career options.

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IEP for School-Age Children with Epilepsy

For school-age children with epilepsy, report their condition to the disability office for specialized interventions or an Individualized Education Program (IEP).

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Vagal Nerve Stimulation (VNS)

A device implanted in the chest to stimulate the vagus nerve, which can reduce seizures in some people with epilepsy.

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VNS for Focal Seizures

Vagal nerve stimulation is specifically used to treat focal seizures, not generalized seizures.

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Magnet Activation of VNS

Clients with a VNS can activate it by holding a magnet over the device at the onset of a seizure, which may reduce its severity.

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Responsive Neurostimulation System (RNS)

A device implanted in the brain that can detect and interrupt seizures in people with focal seizures who haven't responded to other treatments.

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Laser Interstitial Thermal Therapy (LiTT)

A less invasive surgical procedure for epilepsy that uses heat to destroy the areas of the brain where seizures start.

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Conventional Epilepsy Surgery

Surgical procedures such as focal resection or temporal lobe resection are options for people whose seizures cannot be controlled with medication alone.

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EEG Monitoring Before Epilepsy Surgery

Before epilepsy surgery, anti-epileptic drugs are stopped, and electroencephalogram (EEG) monitoring is used to identify the specific areas of seizure activity in the brain.

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Corpus Callosotomy

Surgical procedure that severs the corpus callosum, preventing neuronal discharges across hemispheres and reducing the severity and frequency of seizures.

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Wada Test

A test where one hemisphere of the brain is temporarily anesthetized to assess the impact on speech and memory, often used before brain surgery.

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Neuropsychological Testing

Evaluates cognitive functions like memory, language, and visuospatial abilities, helping to determine the impact of potential brain surgery.

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Seizure Management Education

Involves providing clients with information on seizure control methods, medication management, and potential complications.

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AED Levels

Refer to the amount of antiepileptic drugs present in the blood, requiring regular monitoring to ensure therapeutic levels are maintained.

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Medication Interactions

Possible effects of AEDs on other medications, such as reduced effectiveness of oral contraceptives.

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Medical Identification Tag

A crucial accessory for individuals with seizure disorders, providing emergency contact information and medical history.

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Driving Laws for Seizure History

Some states impose restrictions or limitations on driving for individuals with a recent history of seizures.

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Morbidity Risks of Corpus Callosotomy

Includes potential complications like infection, loss of cerebral function, and limited effectiveness in preventing seizures.

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AED Dosage Consistency

Taking AEDs at the same time every day is crucial for maintaining a stable therapeutic level and maximizing the effectiveness of the medication.

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Status epilepticus

A prolonged seizure lasting more than 5 minutes or repeated seizures without full recovery within 30 minutes.

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Complications of status epilepticus

Reduced oxygen levels, brain dysfunction, and damage to neuronal tissue due to prolonged seizure activity.

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Treatment for status epilepticus

Immediate medical intervention is vital to prevent permanent brain damage and death. It includes maintaining an airway, oxygen administration, IV access, ECG monitoring, and administering medications like diazepam, lorazepam, phenytoin, or fosphenytoin.

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Sudden Unexpected Death in Epilepsy (SUDEP)

The sudden, unexplained death of a person with epilepsy who otherwise appears healthy, with no other known cause.

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Risk factors for SUDEP

Commonly occurs between ages 15-40, long seizures, seizure clusters, multiple AEDs, non-adherence to AEDs, brain lesions, and possible cardiac/respiratory abnormalities like post-ictal apnea.

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Nursing actions to prevent SUDEP

Educating on seizure alert devices, encouraging seizure journals, avoiding seizure triggers, promoting adherence to medications, and emphasizing good sleep hygiene.

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Why is good sleep hygiene important for epilepsy patients?

Between 40-60% of SUDEP cases occur during sleep.

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What are seizure alert devices used for?

To detect the onset of a seizure and potentially provide warning or assistance to the patient.

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How do you encourage seizure journal keeping?

It helps track patterns and identify potential triggers.

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What are some ways to avoid seizure triggers?

Identifying and avoiding specific factors that can induce seizures, such as flashing lights, stress, lack of sleep, or certain foods.

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Study Notes

Seizure Triggering Factors

  • Increased physical activity
  • Excessive stress
  • Hyperventilation
  • Overwhelming fatigue
  • Acute alcohol ingestion
  • Excessive caffeine intake
  • Exposure to flashing lights
  • Substances like cocaine, aerosols, and inhaled glue products
  • Illness

Seizure Types: Generalized Seizures

  • Involve both cerebral hemispheres
  • Can begin with an aura (altered vision, smell, hearing, or feelings)
  • Five types:
    • Tonic-clonic:
      • Tonic phase (muscle stiffening, loss of consciousness, few seconds)
      • Clonic phase (rhythmic jerking, 1-2 minutes)
      • Breathing stops/irregular, cyanosis possible, cheek/tongue biting, incontinence
      • Postictal phase (confusion, sleepiness)
    • Tonic:
      • Only tonic phase experienced
      • Sudden loss of consciousness, increased muscle tone, autonomic manifestations (arrhythmia, apnea, vomiting, incontinence, salivation)
      • Generally lasts less than 30 seconds (some sources say several minutes)
    • Clonic:
      • Only clonic phase experienced (rhythmic jerking)
      • Muscles contract and relax
      • Can last several minutes
    • Myoclonic:
      • Brief jerking or stiffening of extremities (symmetrical or asymmetrical)
      • Lasts seconds
    • Atonic/Akinetic:
      • Loss of muscle tone for a few seconds
      • Often results in falling
      • Followed by confusion
    • Absence:
      • Loss of consciousness (10-30 seconds)
      • No or mild symmetrical activity (e.g., blinking.)
      • Can occur hundreds of times daily
      • Rare in adults, usually stops during adolescence

Seizure Types: Focal Seizures

  • Involve only one cerebral hemisphere
  • Two types:
    • Partial/focal/local: (specific information not provided)

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This quiz explores the various triggering factors of seizures and the different types of generalized seizures. You will learn about specific causes such as stress and physical activity, as well as the features of tonic-clonic and tonic seizures. Test your knowledge on this vital topic related to epilepsy.

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