1. Chapter 19

2. Seizure  Sudden onset of random, continuing discharges of electrical activity in the brain  Can be gross muscle contraction to just staring spells  Usually accompanied by altered mental status  Only last 2-3 minutes

3.  Not a disease, but caused by underlying defect, injury, or disease  Epilepsy-chronic brain disorder 125,000 cases each year

4. Figure 19-1a A generalized tonic-clonic, or grand mal, seizure is a sign of abnormal release of electrical impulses in the brain: (a) aura.

5. Figure 19-1b A generalized tonic-clonic, or grand mal, seizure is a sign of abnormal release of electrical impulses in the brain: (b) loss of consciousness followed by tonic phase.

6. Figure 19-1c A generalized tonic-clonic, or grand mal, seizure is a sign of abnormal release of electrical impulses in the brain: (c) clonic phase.

7. Figure 19-1d A generalized tonic-clonic, or grand mal, seizure is a sign of abnormal release of electrical impulses in the brain: (d) postictal phase.

8. Status Epilepticus  Generalized seizure lasting more than 5 minutes  Direct medical emergency  Aggressive airway management  Can cause permanent brain damage

10. Signs & Symptoms  Aura  Loss of consciousness  Tonic phase-muscle rigidity  Hypertonic phase-extreme muscle rigidity  Clonic phase-convulsion  Postictal state

11. Simple Partial Seizure  AKA focal motor seizure or Jacksonian motor seizure  Involves one cerebral hemisphere  Jerky movement generally one area

12. Complex Partial Seizure  Psychomotor or temporal lobe seizure  Involves one hemisphere  Starts with blank stare  Will be awake but unaware of surroundings  Clumsy & lack of direction  Mumbles or repeats words

13. Absence (Petit Mal) Seizure  Most common in children  Characterized by blank stare  Lasts only a few seconds Rapid eye blinking Chewing Lack of attention

14. Febrile Seizure  High fever  Most common 6 months to 6 years

15. Assessment  Scene size up  Primary  Secondary Convulsions Rigid muscular contraction Bitten tongue Excessive saliva Urinary or bowel incontinence Chewing movement, smacking lips, wringing hands, or some other repetitive movement Localized twitching of muscles Visual hallucination Olfactory hallucination

16. Emergency Medical Care  Position patient  Maintain airway  Suction  Assist ventilations  Prevent injury  Maintain O 2 therapy  Transport  Reassess

17. Treatment Figure 19-2 Protect the seizing patient from injury by moving furniture and objects away.

18. Syncope  Fainting  Temporary lack of blood flow to brain  Often confused as a seizure  Vasodilation throughout body Vasovagel faint