Seizures/Convulsive Disorders

• Seizures


  Are sudden, excessive, disorderly electrical discharges of neurons.
• A seizure is an abnormal burst of electrical activity that occurs within the brain.
• Epilepsy is a chronic neurological condition characterized by recurrent unprovoked seizures.
• Seizures: Pathophysiology

  Cerebral hypoxia - decreased electrical impulse - compensation - action-potential - electrical impulse increase - hyperexcitation = decreased LOC and muscle rigidity or spasm
• Seizures: Types

  1. Grand-mal (generalized): tonic clonic
  2. Petit mal (absent): blank stare
  3. Jacksonian: myoclonous (extremities rigid); aware
• Seizure: Diagnostic Procedure

  Electroencephalogram
• Seizures: Management

  Before:

  1. Seizure Precaution - safety

  • raise side rails
  • decrease stimulation - dim light; no visitors
  • hypoxia - adequate oxygen
• Seizures: Management

  Before: Pharma

  1. Phenytoin

  • WOF: Gingival Hyperplasia - oral care

  2. Carbamazepine

  • WOF: Agranulocytosis (decreased WBC)

  3. Valproic Acid
• Seizures: Management

  During

  1. Time the seizure (3 to 5 minutes = brain damage)
  2. Position: Side lying (to prevent aspiration)
  3. O2 support
  4. Do not put anything in the mouth
  5. DOC: Diazepam
• Seizures: Management

  After

  1. Re-orient (PPT)