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Neuro Nursing-Seizure Disorder

Neuro Nursing-Seizure Disorder

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Published by Belinda Josephine M
Understanding about Seizure Disorder,Nursing Care
Understanding about Seizure Disorder,Nursing Care

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Published by: Belinda Josephine M on Apr 28, 2010
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02/06/2013

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Neuro nursing: seizuredisorders
Learning Objectives
Define seizure & epilepsy(seizure disorders)
Seizure and Epilepsy:Correcting Misconceptions
List the types of seizuredisorders
Aetiology of seizure disorders
Brief pathophysiology of seizure(how seizure happen)
Clinical manifestations of seizure disorders
Radiologic and laboratoryinvestigations
Medical and surgicalmanagement for seizuredisorders
Nursing management of seizuredisorders
Seizure defined….
Sudden episode of abnormalmotor, sensory, autonomic orpsychic activity or a combination of these resulting from the excessiveelectrical discharges from cerebralneurons
o
(Hickey, 2003)
Seizure = sudden attack, alsoknown as convulsion
Also known as convulsion(comesfrom convulse) = violent,involuntary contraction/spasm of muscles
Epilepsy (seizure disorders)defined…
Greek word, comes from the word‘epilambaneim’ meaning to seize/attack
Epilepsy is an adjective (descriptiveword), also known as seizuredisorder
Defined as chronic disorder of abnormal recurring, excessive, self-terminating electrical dischargesfrom neurons.
Characterized by recurring seizureswith changes in behaviour
Facts about Seizures & Epilepsy
A common chronic disorder morecommon than Parkinson’s disease,Alzheimer’s disease, cancer.
Epilepsy or seizure is NOT adisease
Seizures & epilepsy are notinfectious!
History about Epilepsy…
People have looked at epilepsydifferently than most other medicalproblems.
Epilepsy has been fraught withsocial stigmas, even till today.
Ancient Greeks knew about thecondition that led to a suddenattack upon the unfortunate.
Seizures manifest in unusualbehaviours mystified observerswho considered this illness ascoming from another world(possessed / attacked by spirits /demons).
Hippocrates (400 B.C) referredepilepsy as ‘sacred disease’, toemphasize the general public’ssuperstitious view of this condition.
In 1873, English
neurologist JohnHughlings Jackson explainedepilepsy
as “a sudden, excessive,
 
and rapid discharge of gray matterof some part of the brain” thatwould correspond to the patient’sexperience
Correcting misconceptions aboutseizure & epilepsy…
Seizure & epilepsy affect people of all ages, races & ethnicbackgrounds
People who have had seizurebefore does not mean they haveepilepsy
Isolated seizure episodes can occurin healthy people due to variousreasons
Epilepsy is not a mental illness
People with seizure or epilepsy canlead a normal life.
Epilepsy & seizures can becontrolled if patients are compliantto their medication
 Types of Seizure Disorders
Partial Seizures
Result from firing of excessiveelectrical discharges within aparticular brain region or focus &will manifest focal symptoms e.g.excessive electrical discharges infrontal region cause involuntarymovements (movements thatcannot be controlled).
E.g. finger / mouth / leg jerkuncontrollably.
Simple partial seizure; no LOC
Complex partial seizure; with LOC /impaired consciousness
Partial Seizures
Simple Partial Seizure
With motor symptoms
With special sensory /somatosensory symptoms
With autonomic symptoms
Compound symptoms (consistof any 2 / more symptoms)
Refer additional notes provided for further information on types of seizure disorders& its clinical manifestations
Partial Seizure
Complex Partial Seizure
With impairment of consciousness only
With cognitive impairment
With affective symptoms
With psychosensory symptoms
With psychomotor symptoms(automatisms)
Compound symptoms
Generalized Seizures
Generalized seizures probablybegin in the thalamus, othersubcortical structures, deeperbrain structures (basal ganglia,thalamus, upper brainstem)
Usually affect both brainhemispheres – usually patienthave whole body jerksuncontrollably (clonic) & go intospasm (tonic).
 Too confused with all theseterms?Let’s look at what do all theseterms mean…
Aetiologic Factors for Epilepsy(Seizure Disorders)
Genetic / Hereditary
Cerebrovascular disease(e.g. stroke)
 
Hypoxemia includingvascular insufficiency
Fever (during childhood-nottreated)
Head injury
Hypertension e.g.preeclampsia, eclampsia
CNS infection e.g.meningitis, encephalitis
Metabolic & toxic conditionse.g. renal failure,eletrolytes imbalance (Na
+
,
+
, Ca
2+
), hypoglycaemia,pesticides poisoning
Perinatal neurological injury
Multiple sclerosis
Brain tumour
Drug & alcohol withdrawal
Severe allergies
Brief Pathophysiology toSeizure
Clinical Manifestations of Seizure
Depends on the location of thedischarging neurons
Initial part of seizure (the startof seizure) tells about the partof brain where seizure originate
Simple partial seizure;
No loss of consciousness (
o
LOC)
Finger / hand may jerk, mouth jerk uncontrollably.
 Talk unintelligibly, dizzy,experience unusual sights,odours, tastes.
Complex partial seizures;
Remains motionless / movesautomatically butinappropriate to time / place
Experience excessiveemotions of fear, anger,elation / irritability
Sometimes will have the‘blank stare’ & unable toprovide appropriateresponse to questions whenasked during seizure attack
Post- seizure / post-ictally;does not remember theseizure experience
Generalized seizures(alsoknown as grand mal);
Involve both side of brainhemispheres – both sides of body to react
Intense rigidity of bodyoccur alternate with musclerelaxation (tonic =contraction & relaxation)
Epileptic cry
Chewing of tongue / injureoral mucosa
Urinary & fecal incontinence
After 1-2 minutes post-ictal,patient relaxes & lies indeep coma, breathingnoisily using abdominalmuscle.
Post-ictal; confused, hard toarouse, sleep for hours, maycomplain of headache, soremuscles, fatigue &depression
Some with uncontrolledseizures & poor familysupport can be depressive &suicidal.
Diagnostic Tools for DiagnosingSeizure / Epilepsy

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