Seizure Disorders PDF

Seizure Disorders Uncontrolled neurons firing in the brain Random activity neuron activity Caused by increased activation or decrease inhibition of neurons across neuronal pathway Epilepsy When cause is irreversible or requires chronic treatment Neurological disorder...

Seizure Disorders Uncontrolled neurons firing in the brain Random activity neuron activity Caused by increased activation or decrease inhibition of neurons across neuronal pathway Epilepsy When cause is irreversible or requires chronic treatment Neurological disorder characterized by recurrent episodes of abnormal brain activity Seizures are unprovoked and familial genetic link Diagnose with at least two unprovoked seizures occur more than 24 hours and one unprovoked seizure with a likelihood in the next 10 years Gamma-aminobutyric(GABA) Inhibitory neurons that maybe defective or influenced by other mechanism Causes neuron to depolarize in disorganized manner Electroencephalogram (EEG) Shows electrical activity in brain during seizure SEIZURE causes: A change in permeability of neuronal membrane affect sodium and calcium channels Neurotransmitter imbalance - a defect of inhibitory neuron Reduced ability of neurons to exercise inhibitory control by GABA Excitatory of ability of neurons to exercise inhibitory control Seizures Often acute and symptomatic caused by health problem like fever, injury,hypoxia Acute seizure Causes Immediately after brain injury Infection within the neurological system like meningitis Electrolyte imbalances( common with hyponatremia) Severe hypoglycemia(especially after insulin) Withdrawal from drugs or alcohol Brain hemorrhage or tumor Toxins and medications Hypoxia Triggers of Epileptic Seizures Triggered by external or internal factors Includes loud noise or bright flashing lights, biochemical stimuli such as stress, change in medication or hyperventilation(alkalosis) Aura- sensory warning like a smell or visual hallucinations before the seizure starts Characteristics of Seizure Disorder Last from seconds to minutes Unconscious and disoriented  Seizures may repeat moment later Intense muscle activity Loss of sensory functions Respirations may impaired or airway blockage Repeated seizures cause by hypoxia, hypotensions, acidosis, hypoglycemia Injuries associated with loss of consciousness Diagnostic and Testing Electroencephalogram (EEG)- seizure must occuring while testing CT SCAN, MRI Positron Emission (PET) scans- use a small amount dose of radioactive material to detect brain abnormalities Single-Photon Emission Computerized Tomography(SPECT)- 3D map of blood flow during brain activity Focal Seizures Start in one small area of the brain and affect on or more parts of the body, but not the entire body. Client is usually conscious but may not be aware Simple focal seizures- affect small are of brain and a twitch in an extremity or change in sensation Complex Focal Seizures- muscle or nerve reaction, but causes a person to be confused or disoriented. No loss of consciousness Secondary Generalized Seizures- start as a focal seizure the spreads to both sides of brain and become a generalized seizure Generalized Seizures Occur both sides of the brain and affect the entire body. Client loses consciousness and is not aware until seizure is done. Post-ictal period- period of confusion after seizure is complete Absence seizure- called petit mal seizures and can go unnoticed. Person may stare and become unresponsive for a short period of time. Loss of Consciousness, not always atonicity. No muscle activity is noted. Tonic-Clonic seizures- sudden cyclic and tightening and loosening of all major muscle groups. Also known as grand mal seizures or convulsions. Loss of consciousness and resulting injury. All extremities tighten. Response to Seizures; Protect and support the person’s airway and breathing Protect from injury Start timing seizure and stay with person TREATMENT Acute symptomatic seizures Address underlying cause Correction of sodium level in hyponatremia or correction of glucose levels in hypoglycemia Anti-seizures or benzodiazepine Status epilepticus- seizure a long period of time which require emergency care Chronic Epilepsy Management Triggers help to identify and avoid situations in which seizures have a higher risk of occurring Anti-seizure medications take daily Driving is restricted Aspects of Seizure Disorders Environmental- due to toxins and chemical ingestion Lifestyle- drug and alcohol use, brain injury Genetics and congenital birth defects- Age- older adults have worse complication Seizures Prevention Close diabetes and insulin Avoid medication Wear protective equipment Understand seizure triggers