Case Study

(Seizure Disorder)
Prepared By: Tiongson, Elena Marie R. Valondo, Jennylyn Vallejo, Lynette Varilla, Krisren (Group 6)

Submitted to: Ms. Louuie Marrie Carag RN, MSN

and congenital neurodegenerative disorders. These seizures are called a ³seizure disorder´ or ³epilepsy.Seizure Disorder Introduction Also known as convulsions. . metabolic disorders (hypocalcemia. drug toxicity. There are two basic types of seizures: Epileptic: These seizures have no apparent cause (or trigger) and occur repeatedly. In children. They are thought to result from abnormal. circulating disorders. hypoglycemia or hyperglycemia. anoxia). a fever can trigger a nonepileptic seizure. cranial surgery. It is a sudden alteration in normal brain activity that cause distinct changes in behavior and body function. Predisposing factors include head or brain trauma. central nervous system infection. epileptic seizures. tumors. recurrent. drug withdrawal states (alcohol. epilepsy. barbiturates). and if recurrent.´ Nonepileptic: These seizures are triggered (provoked) by a disorder or another condition that irritates the brain. hyponatremia. uncontrolled electric discharges of neurons in the brain.

lasting from a few seconds to a few minutes. people may have a headache. After age 25: A head injury. sore muscles. and loss of muscle or bladder control. a birth defect. brief episodes of unresponsiveness. certain drugs. such as the following: y y y y Abnormal smells or tastes Butterflies in the stomach A feeling of déjà vu An intense feeling that a seizure is about to begin Almost all seizures are relatively brief. However. If the seizures recur without such triggers. infections. such as abnormal blood levels of sugar (glucose). calcium. confusion. causing a seizure. vitamin B6. seizures are preceded by unusual sensations (called aura). Conditions that irritate the brain²such as injuries. When a seizure stops. confusion. can trigger one or more seizures. stroke. magnesium. y y Seizures with no identifiable cause are called idiopathic. Seizures do not occur once the fever or abnormality resolves. People with a seizure disorder . loss of consciousness. and profound fatigue. or a hereditary metabolic abnormality or brain disorder. These after-effects are called the postictal state. a low level of oxygen in the blood. Alcohol withdrawal (caused by suddenly stopping drinking) is a common cause of seizures. Most people who have a seizure disorder look and behave normally between seizures. one side of the body is weak.Signs and Symptoms In about 20% of people who have a seizure disorder. the cause is unknown. and the weakness lasts longer than the seizure (a disorder called Todd's paralysis). unusual sensations. or a very low level of sugar in the blood²can trigger a single seizure whether a person has a seizure disorder or not. the cause is unknown. the cause is likely to be an injury during birth. Most seizures last 1 to 2 minutes. sleep deprivation. or tumor may damage the brain. 2 to 14 years: Often. A single seizure that results from such a stimulus is called a provoked seizure (and thus is a nonepileptic seizure). or sodium. Other possible symptoms include numbness or tingling in a specific body part. In some people. Pathophysiology y Before age 2: High fevers or temporary metabolic abnormalities. in about half of people in this age group. fever²or that deprive the brain of oxygen or fuel²such as abnormal heart rhythms.

calcium. or sodium Underactive parathyroid gland Vitamin B6 deficiency (in newborns) Inadequate oxygen supply to the brain Abnormal heart rhythms Carbon monoxide poisoning Near drowning Near suffocation Stroke Vasculitis . or even touching certain parts of the body. seizures are triggered by repetitive sounds. Avoiding these conditions can help prevent seizures. Causes of Seizures Cause High fever Examples Heatstroke Infections Brain infections Abscess AIDS Malaria Meningitis Rabies Syphilis Tetanus Toxoplasmosis Viral encephalitis Metabolic disorders High blood levels of sugar or sodium Kidney or liver failure Low blood levels of sugar. video games. flashing lights. magnesium. Rarely.are more likely to have a seizure when they are under excess physical or emotional stress or deprived of sleep. In such cases. the disorder is called reflex epilepsy.

leukopenia. locates epileptic focus. ataxia. 2. and toxicity screen determine the cause of first seizure. Medical Management 1. stomach upset. and idiosyncratic reactions. treat mixed seizure types. intensity. and duration. Temporal lobectomy. CT scanning or MRI identifies lesion that may cause of seizure. 6. . Surgical treatment of brain tumor or hematoma may relieve seizures caused by these.Diagnostic Procedure 1. Antiepileptic drugs (AEDs) may be used singly or in combination to increase effectiveness. anemia. glucose. Single photon emission CT scanning (SPECT) or positron emission tomography (PET) identifies seizure foci. including hepatic and renal dysfunction. helps classify seizure type. 2. EEG. corpus callosotomy. skin rash. vision disturbances. 3. spread. with or without video monitoring. 5. or hemispherectomy may be necessary in medically intractable seizure disorders. extratemporal resection. Neuropsychological studies evaluate for behavioral disturbances. Lumbar puncture and blood cultures may be necessary if fever is present. drowsiness. and reduce adverse effects. thrombocytopenia. Serum electrolytes. A wide variety of adverse reactions may occur. 2. psychotic symptoms. Surgical Management 1. 4.

including prodromal signs. 2. Encourage the patient to determine existence of triggering factors for seizures. seizure behavior. 12. Do not put anything in the patient¶s mouth during seizure. 14. 15. and visual examinations. 10. Do not restrain the patient during seizure. 6. 11. Provide safe environment by padding side rails and removing clutter. Monitor complete blood count. Place the bed in low position. 7. 13. 3. mental activity. 8.Nursing Management 1. including exercise. . medical check ups. Place the patient on side during a seizure to prevent aspiration. and nutritious diet. lack of sleep. and liver function studies for toxicity caused by medications. Monitor the entire seizure event. Provide oxygen during the seizure if the patient becomes cyanotic. and emotional stress. 5. Remind the family the importance of following medication regimen and maintaining regular laboratory testing. 9. Teach stress reduction techniques that will fit into the patient¶s lifestyle. and postictal state. urinalysis. Tell the patient to avoid alcohol because it interferes with metabolism of AEDs and adds to sedation. Encourage patient to follow a moderate lifestyle routine. Protect the patient¶s head during the seizure. 4. Maintain a patent airway until the patient is fully awake after a seizure. such as skipped meals.

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