SEIZURE

- is the physical findings or changes in behavior that occur after an episode of

abnormal electrical activity in the brain.
-Electrical activity caused by complex chemical changes that occur in nerve cells.
-It affects how a person appears or acts for a short time.
CLASSIFICATIONS

1. Partial Seizure
-Very subtle or unusual, may go unnoticed or be confused with other events.
-Occur in one small area of the brain and sometimes spread to other regions.
-When they spread, they become a (secondarily) generalised seizure.
-are produced (at least initially) by electrical impulses in a relatively small
part of the brain. The part of the brain generating the seizures is sometimes
called the focus.

o Simple partial seizures

-Short seizures often termed aura
-Patient remains alert

-No loss of awareness or consciousness; usually last less than minute

and include:
Sensory numbness,
Motor jerking of limb, twitching of face
Autonomic blushing, racing heart-rate
Psychic dj vu, hallucinations, anxiety or panic
o Complex Partial seizures
-Altered awareness and the person may not respond.
-Begin with a vacant stare, loss of expression or a vague, confused
appearance.
-Last from 30 seconds to 3 minutes
-Automatisms consist of involuntary but coordinated movements that
tend to be purposeless and repetitive. Common automatisms include
lip smacking, chewing, fidgeting, and walking
2. Generalised Seizure
- Seizure activity in the entire brain consciousness lost at the onset.
- Can occur following a simple or complex partial seizure.
-are produced by electrical impulses from throughout the entire brain
o Generalised tonic clonic seizures
-Most recognized seizures
-grand mal or convulsion with loss of consciousness , stiffening of
body then jerking of limbs.
-Lasts approximately two minutes or less.
o Absence Seizures
-Seizures which usually start in childhood
-Mistaken for daydreaming and inattentiveness
-Often a family history
-petit mal or staring or trance-like state
-Lasts from two to ten seconds and end up abruptly
-Children usually outgrow this seizure type by puberty
cause a short loss of consciousness (just a few seconds) with few or
no symptoms
-The patient, most often a child, typically interrupts an activity and
stares blankly
-These seizures begin and end abruptly and may occur several times a
day
-Patients are usually not aware that they are having a seizure, except
that they may be aware of "losing time."
o Myoclinic Seizures
-Very brief but intense muscle jerks usually involving the upper body.
-Mistaken for clumsiness often occur after awakening resulting in
dropping or spilling things.
-Can lead to a tonic clonic seizure

-consist of sporadic jerks, usually on both sides of the body

-Patients sometimes describe the jerks as brief electrical shocks
-When violent, these seizures may result in dropping or involuntarily
throwing objects
o Tonic Seizures
-Cause by a sudden, brief stiffening of the muscles of the whole body,
causing the person to become rigid and fall rapidly if standing.
-Recovery is swift, injuries can be sustained
-Can occur in sleep
-drop attack
o Atonic Seizure
-Sudden, brief loss of muscle tone of the body, particularly in the
arms and legs, which often results in a fall.
-Person will go limp and collapse, usually head first, so facial and
head injuries are common.
-drop attacks

Grand-mal seizure
o The most common and dramatic
o Patient loses consciousness and usually collapses
o During grand-mal seizures, injuries and accidents may occur, such as
tongue biting and urinary incontinence.
Clonic Seizure
o violent jerking
o 30 to 60 seconds
o repetitive, rhythmic jerks that involve both sides of the body at the
same time.
Postictal
o patient goes into a deep sleep
o after-seizure phase
Considerations

 Brief blackout followed by a period of confusion (the person cannot

remember for a short time)
Changes in behavior, such as picking at one's clothing
Drooling or frothing at the mouth
Eye movements
Grunting and snorting
Loss of bladder or bowel control
Mood changes, such as sudden anger, unexplainable fear, panic, joy, or
laughter
Shaking of the entire body
Sudden falling
Tasting a bitter or metallic flavor
Teeth clenching
Temporary stop in breathing
Uncontrollable muscle spasms with twitching and jerking limbs
The person may have warning symptoms before the attack, such as:

Fear or anxiety
Nausea
Vertigo (feeling as if you are spinning or moving)
Visual symptoms (such as flashing bright lights, spots, or wavy lines before
the eyes)

Causes

Abnormal levels of sodium or glucose in the blood

Brain infection, including meningitis
Brain injury that occurs to the baby during labor or childbirth
Brain problems that occur before birth (congenital brain defects)
Brain tumor (rare)
Drug abuse
Electric shock
Epilepsy
Fever (particularly in young children)
Head injury
Heart disease
Heat illness (heat intolerance)
High fever

NOTE: If seizures continue repeatedly after the underlying problem is

treated, the condition is called epilepsy.

Home Care

When a seizure occurs, the main goal is to protect the person from injury:
Try to prevent a fall. Lay the person on the ground in a safe area. Clear the
area of furniture or other sharp objects.
Cushion the person's head.
Loosen tight clothing, especially around the neck.
Turn the person on their side. If vomiting occurs, this helps make sure that
the vomit is not inhaled into the lungs.
Look for a medical ID bracelet with seizure instructions.
Stay with the person until he or she recovers, or until professional medical
help arrives.
Things friends and family members should not do:
Do not restrain (try to hold down) the person.
Do not place anything between the person's teeth during a seizure (including
your fingers).
Do not move the person unless they are in danger or near something
hazardous.
Do not try to make the person stop convulsing. They have no control over
the seizure and are not aware of what is happening at the time.
Do not give the person anything by mouth until the convulsions have
stopped and the person is fully awake and alert.
Do not start CPR unless the seizure has clearly stopped and the person is not
breathing or has no pulse.
In case:
If a baby or child has a seizure during a high fever, cool the child slowly
with lukewarm water. Do not place the child in a cold bath. You can give the
child acetaminophen (Tylenol) once he or she is awake, especially if the
child has had fever convulsions before.
When to Contact a Medical Professional

Call 911 or your local emergency number if:

This is the first time the person has had a seizure
A seizure lasts more than 2 to 5 minutes
The person does not awaken or have normal behavior after a seizure
Another seizure starts soon after a seizure ends
The person had a seizure in water
The person is pregnant, injured, or has diabetes
The person does not have a medical ID bracelet (instructions explaining
what to do)
There is anything different about this seizure compared to the person's usual
seizures
Report all seizures to the person's health care provider. The provider may
need to adjust or change the person's medicines.

What to Expect at Your Office Visit

Tests that may be ordered include:

Blood tests
CT scan of the head or MRI of the head
EEG (usually not in the emergency room)
Lumbar puncture (spinal tap)

Additional informations:
Focal seizure - (also called partial seizures and localized seizures) are
seizures which affect initially only one hemisphere of the brain.
Seizures normally last 30-45 seconds