INTRODUCTION Seizure "Seizure" is a general term that refers to a sudden malfunction in the brain that causes someone to collapse

, convulse, or have another temporary disturbance of normal brain function, often with a loss or change in consciousness. Seizure may be brought by excessive electrolyte imbalances because brain is considered to be the most sensitive part of the body during fluid and electrolyte shifting thus, alteration of electrolyte and fluid levels may initiate the occurrence of this. Symptoms may vary depending on the part of the brain involved, but often include unusual sensations, uncontrollable muscle spasms, and loss of consciousness. When seizures occur more than once or over and over, it may indicate the ongoing condition epilepsy. In older clients about 10% or more have standard fainting spells (also called syncope), which is often associated with a brief seizure or seizure-like spell. A person may stiffen or even twitch or convulse a few times. Fortunately, this rarely indicates epilepsy. Most adults recover very quickly (seconds to minutes) and don't require specialized treatment. Currently, 1.5 million elderly people reside in nursing homes, therefore as many as 150,000 elderly patients in nursing homes may be taking AEDs. The widespread prevalence of epilepsy in this population indicates a need to educate the physicians who treat them. Upon completing t his program, physicians will be able to discuss the epidemiology of epilepsy in the elderly, review the means by which seizures are produced and presented in geriatric patients to better understand which treatment is most appropriate, and discuss the special considerations that must be addressed regarding drug interactions in these patients as well as new data regarding the safety and tolerability of pharmacologic and nonpharmacologic treatments in this population. Types of Seizure: a. Generalized seizure  Absence seizures are brief episodes of staring. (Although the name looks like a regular English word, your neurologist may pronounce it ab-SAWNTZ.) Another name for them is petit mal (PET-ee mahl). During the seizure, awareness and responsiveness are impaired. People who have them usually don't realize when they've had one. There is no warning before a seizure, and the person is completely alert immediately afterward.  Myoclonic (MY-o-KLON-ik) seizures are brief, shock-like jerks of a muscle or a group of muscles. "Myo" means muscle and "clonus" (KLOH-nus)  means rapidly alternating contraction and relaxation—jerking or twitching—of a muscle.  Muscle "tone" is the muscle's normal tension. "Atonic" (a-TON-ik) means "without tone," so in an atonic seizure, muscles suddenly lose strength. The eyelids may droop, the head may nod, and the person may drop things and often falls to the ground. These seizures are also called "drop attacks" or "drop seizures." The person usually remains conscious.  Muscle "tone" is the muscle's normal tension at rest. In a "tonic" seizure, the tone is greatly increased and the body, arms, or legs make sudden stiffening movements. Consciousness is usually preserved. Tonic seizures most often occur during sleep and usually involve all or most of the brain, affecting both sides of the body. If the person is standing when the seizure starts, he or she often will fall.  "Clonus" (KLOH-nus) means rapidly alternating contraction and relaxation of a muscle -- in other words, repeated jerking. The movements cannot be stopped by restraining or

They quickly involve other areas of the brain that affect alertness and awareness. The person may turn a bit blue in the face.  Complex Partial seizures. Bladder or bowel control sometimes is lost as the body relaxes. bending and relaxing at the elbows. . Much more common are tonic-clonic seizures." An older term for them is "grand mal. confused. the jerking slows and stops." If the symptoms are subtle. After a few minutes. This type is what most people think of when they hear the word "seizure. however. so bloody saliva may come from the mouth. Sometimes tonic-clonic seizures start with jerking alone. in which the jerking is preceded by stiffening (the "tonic" part).) Partial Seizures  Simple partial seizures entails motor. in reality "nobody's home. b. agitated. hips. they combine the characteristics of tonic seizures and clonic seizures. These seizures usually start in a small area of the temporal lobe or frontal lobe of the brain. The person loses consciousness and falls to the floor. Clonic (KLON-ik) seizures are rare. and the person may be drowsy. or depressed. The tonic phase comes first: All the muscles stiffen." As implied by the name. The tongue or cheek may be bitten. autoimmune and even psychic malfunctioning. After the tonic phase comes the clonic phase: The arms and usually the legs begin to jerk rapidly and rhythmically. Consciousness returns slowly. sensory. other people may think the person is just daydreaming.repositioning the arms or legs. These are called clonic-tonic-clonic seizures!  Tonic-clonic seizure. So even though the person's eyes are open and they may make movements that seem to have a purpose. Air being forced past the vocal cords causes a cry or groan. and knees.

She also helps her mother in doing household chores. . SOCIAL HISTORY – Lifestyle The patient is currently on her 5th grade. the patient spends her time playing and watching television. ayaw nyang magtake ng gamot nya”. they have a family history of hypertension on her paternal side. as verbalized by her uncle. She has good appetite and is able to do activities like doing household chores. This prompted her mother to bring her to the hospital.NURSING HEALTH HISTORY  According to the mother. the patient doesn’t have allergy to any foods and drugs. as verbalized by the mother. she had seizure attack (1 episode) which lasted for 30 seconds. FAMILY HEALTH HISTORY  According to the patient. Few hours prior to her admission. “Matigas ang ulo nya. When asked to do something. she easily forgets the instructions given to her.  Prior to admission. “Mababa ang IQ nya”. During weekends. She already had previous hospitalization due to her seizure attacks when she was in Grade 3. the patient had an irregular intake of her maintenance dose of phenobarbital. She was given phenobarbital as her maintenance.

friends. her sleep hour has increased. No difficulties experienced with her senses before and during hospitalization.  During hospitalization.  During hospitalization. She also eats her snacks in the morning and in the afternoon. Activity-Exercise Pattern Sleep-Rest Pattern  Before hospitalization. she sleeps 8-10 hours a day. Her mother answers it for her. in moderate amount and has straw colored urine. She has a good relationship with her children. Cognitive-Perceptual She doesn't respond well to questions asked on her. She easily gets hungry and is fond of having meat as her food preference. she easily gets asleep. Elimination Pattern  She urinates 5 to 6 times a day. She takes phenobarbital as her maintenance to prevent her seizure attacks. Sexual-reproductive she lives with her mother. She eats three times a day but in small amount. She usually sleeps at 8 pm and wakes up at 6 am. Every time she lay down. Conflicts arise between them but they manage to resolve them easily.GORDONS Health Perception Nutritional / Metabolic Pattern  Before hospitalization. She drinks 7-8 glasses of water a day. she eats three times a day with adequate amount and no food preferences. place and person. She has no difficulty in urinating and moves her bowel regularly. She sleeps at 8pm and wakes up at 8 am. Role-Relationship  Her family is intact and close with each other. Although she is oriented to time. . her appetite was slightly decreased. neighbors and relatives.

PHYSICAL ASSESSMENT .

LAB EXAMS .

DRUG STUDY .

NURSING CARE PLAN .