Seizure / Epilepsy

Seizure / Epilepsy Seizures are one feature of epileptic syndrome. Seizure: a paroxysmal, uncontrolled electrical discharge of neurons in the brain that interrupts normal function. Epilepsy: spontaneously recurring seizures caused by a chronic underlying condition. Seizures are one feature of epileptic syndrome.

Specific Causes of Seizures Cerebrovascular disease Hypoxemia Fever (childhood) Head injury Hypertension Central nervous system infections Metabolic and toxic conditions Brain tumor Drug and alcohol withdrawal Allergies

Types of epilepsy Primary (idiopathic): unknown cause (genetic), needs Antiepileptic medications Secondary: the cause is known and the epilepsy is a symptom of another underlying condition such as brain tumor.

First aid of generalized seizures 1. Stay calm 2. Ease the victim to the floor, if possible. 3. Protect the head with a pad to prevent injury (from striking a hard surface). 4. Push aside any furniture that may injure the patient during the seizure 5. Monitor breathing 6. Loosen constrictive clothing.

6. Loosen constrictive clothing. 7 6. Loosen constrictive clothing. 7. Pay attention to the length of the seizure 8. Make the person as comfortable as possible 9. Keep on crowds away 10. Do not restrain the victim. 11. Do not put anything in the person's mouth.

12. Do not give the person water, pills, or food until fully alert 13 12. Do not give the person water, pills, or food until fully alert 13. Be sensitive and supportive, and ask others to do the same

When to call 911  If this is a first time  If the seizure lasts more than 5 minutes  If the person has one seizure after another  If the person is injured  If the seizure stops, but the person does not regain consciousness within 10-15 minutes.  If the person is not breathing correctly within one minute after the seizure.

Collaborative Care 1. Drug therapy Genenerally, seizures are self-limiting. So, they do not need urgent medical treatment except if status epilepticus (do not stop spontaneously), body injury, or first time. Main Treatment is meds (Anti-seizures) as cure is not possible. The goal of meds at prevention of attacks : to Stabilize nerve cell membranes and prevent spread of epileptic discharges. 70-80% of patients controlled with medication Serum levels of medication should be monitored (the goal is: Max seizure control with Min toxic side effects)

Prevention Wearing helmet, if risk for head injury General health habits (diet, exercise) Assist to identify events or situations precipitating seizures and avoidance, if possible Instruct to avoid excessive alcohol, fatigue, and loss of sleep A person with epilepsy should wear a medical-alert bracelet or necklace that gives the person's diagnosis, medications, telephone numbers of the doctor, and the person to call in case of an emergency

After the seizure Place the victim on his left side. Keep in mind there is a small risk of post-seizure vomiting, before the person is fully alert. Therefore, the person’s head should be turned so that any vomit will drain out of the mouth without being inhaled. Stay with the victim until he recovers (5 to 20 minutes).

4. Ask questions to determine if the victim knows his/her name, where he/she is, what time or day it is, and what happened. If the person is unable to answer these questions, telling him/her this information may help decrease confusion and orient him/her to their surroundings. 5. Let the victim know what happened during a seizure and allow him to talk about it, this may help make the seizures less scary.

6. Help the victim to meet his needs; may ask for a washcloth or tissue to wipe away any saliva that has come out of their mouths. Some persons may need to go to the bathroom. Others may want to lie down for a while. 7. Before you leave the person alone, be sure that he/she is able to answer the four W’s: who, what, when, and where.