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 Generalized tonic-clonic (grand mal) seizure

 May be preceded by an aura such as a peculiar sensation or
dizziness; then sudden onset of seizure with loss of
 Rigid muscle contraction in tonic phase which clenched jaw
and hands; eyes open with pupils dilated; lasts 30 to 60
 Rhythmic, jerky contraction and relaxation of all muscles in
clonic phase with incontinence and frothing at the lips; may
bite tongue or cheek, lasts several minutes.
 Sleeping or dazed post-ictal state for up to several hours.
 Loss of contact with environment for
5 to 30 seconds.
 Appears to be day dreaming or may
roll eyes, nod head, move hands, or
smack lips.
 Resumes activity and is not aware of
 Seen in children or infants, caused by cerebral pathology,
often with mental retardation.
 Infantile spasms usually disappear by age 4, but child may
develop other types of seizures.
 Brief, sudden, forceful contractions of the muscles of the
trunk, neck, and extremities.
 Extensor type – infant extends head, spreads arms out,
bend body backward in “spread eagle” position.
 Mixed flexor and extensor types may occur in clusters or
 May cause children to drop or throw something.
 Infant may cry out, grunt, grimace, laugh, or appear
fearful during an attack.
 Rhythmic twitching of muscle group, usually
hand or face.
 May spread to involve entire limb, other
extremities and face on that side, known as
jacksonian seizure.

 Numbness and tingling in a part of the body.

 May also be visual, taste, auditory, or olfactory
 Partial psychomotor (temporal lobe) seizure
 May be aura of abdominal discomfort or bad odor
or taste.
 Auditory or visual hallucinations, déjà vu feeling,
or sense of fear or anxiety.
 Repetitive purposeless movements (automatisms)
may occur, such as picking at clothes, smacking
lips, chewing, and grimacing.
 Lasts seconds to minutes.
 Complex partial seizures – begin as
partial seizures and progress to
impairment of consciousness or
impaired consciousness at onset.
 Febrile seizure
 Generalized tonic-clonic seizure with fever
over 101.8 degrees Fahrenheit.
 Occurs in children younger than age 5.
 Treatment is to decrease temperature,
treat source of fever, and control seizure.
 Long-term treatment to prevent recurrent
seizures with fever is controversial.

 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 person’s neck.
 Turn the person on his or her side. If vomiting occurs, this
helps make sure that the vomit is not inhaled into the
 Look for a medical I.D. bracelet with seizure instructions.
 Stay with the person until he or she recovers, or until you
have professional medical help. Meanwhile, monitor the
person’s vital signs (pulse, rate of breathing).

 Antiepileptic drugs (AEDs) may be used singly

or in combination to increase effectiveness,
treat mixed seizure types, and reduce adverse
 A wide variety of adverse reactions may occur,
including hepatic and renal dysfunction, vision
disturbances, drowsiness, ataxia, anemia,
leukopenia, thrombocytopenia, psychotic
symptoms, skin rash, stomach upset, and
idiosyncratic reactions.

 Surgical treatment of brain tumor or

hematoma may relieve seizures caused by
 Temporal lobectomy, extratemporal
resection, corpus callosotomy, or
hemispherectomy may be necessary in
medically intractable seizure disorders.