Seizures Overview and Types

Seizures

• Seizures are episodes of abnormal brain activity causing motor, sensory, autonomic, or psychic disturbances.
• Seizures result from sudden, uncontrolled electrical discharges in cerebral neurons.
• Seizures are classified into partial and generalized types.
  • Partial seizures originate in one part of the brain.
    • Simple partial seizures: Consciousness remains intact.
    • Complex partial seizures: Consciousness is impaired.
  • Generalized seizures affect the entire brain.
• Seizure causes include cerebrovascular disease, hypoxemia, fever (especially in children), head injuries, hypertension, CNS infections, metabolic/toxic conditions, brain tumors, and drug/alcohol withdrawal.

Seizure Types - Generalized

• Tonic-Clonic: Characterized by muscle stiffness (tonic), followed by jerking movements (clonic). Can last 1-3 minutes.
• Tonic: Muscle stiffness.
• Clonic: Jerking movements.
• Absence: Brief staring spells resembling daydreaming. May not involve falling or jerking. Lasts 2-20 seconds.
• Myoclonic: Brief, shock-like jerks in muscles or a group of muscles. Often less than a few seconds and can occur in series.

Seizure Care Plan

• Observation: Document signs and symptoms before, during, and after a seizure.
• Patient safety: Take actions during a seizure to protect the patient from injury.
• Post-seizure care: Prevent complications after a seizure,
• Important actions: Stay calm. Protect the person from injury. Do not restrain the person. Do not put anything in the person’s mouth. Time the seizure.
• Post-seizure assessment: Describe what was observed. Calculate the duration. Identify events before the seizure; Assess for aura (warning signal). Document body parts affected and behavior. Note the level of consciousness. Observe whether the client slept after the seizure.

Interventions- Medications

• Anticonvulsants: Medications to prevent seizures.
  • Valproic acid: Commonly used in children.
  • Phenobarbital, Carbamazepine, Phenytoin (Dilantin): (Note: phenytoin can cause gum dysplasia as a side effect)
• Benzodiazepines: Used to control seizures. Examples include diazepam (Valium), lorazepam (Ativan), and clonazepam (Klonopin).
• Lamotrigine: Another anticonvulsant medication.

Status Epilepticus

• A series of generalized seizures without full recovery between episodes.
• Continuous seizures lasting at least 30 minutes, can occur with or without consciousness impairment.
• A medical emergency.
• Treatment goals: stop seizures, ensure cerebral oxygenation, maintain seizure-free state following treatment to prevent future seizures.
• Nurses must monitor respiratory and cardiac function.