1. EPELIPSY

2. DIFFERENCE BETWEEN SEIZURE AND EPILEPSY A seizure is a brief, temporary disturbance in the electrical activity of the brain Epilepsy is a disorder characterized by recurring seizures (also known as “seizure disorder”)

3. KEY FCTORS  Seizures are abrupt, uncontrolled electrical brain discharges that cause alterations in level of consciousness and changes in motor and sensory behavior.  Epilepsy can be idiopathic ) 70 %) or secondary (30%)  It is not associated with alterations in intellectual capabilities.  Seizures are classified as neurologic emergencies.  Sustained untreated seizures can result in hypoxia, cardiac dysrhythmias, and lactic acidosis.

4. A SEIZURE MAY APPEAR AS: A sudden cry and fall, followed by  Convulsive movements of all limbs  Shallow/interrupted breathing - cyanosis  Loss of bowel/bladder control  Slow return to consciousness, post-seizure confusion and/or fatigue

5. RISK FACTORS  Genetic predisposition  Acute febrile state/ febrile convulsion in kids  Head trauma  Cerebral edema  Abrupt cessation of antiepileptic drugs (AEDs)  Infection; meningitis  Metabolic disorder (for example, hypoglycemia)  Exposure to toxins  Brain tumor, CVA  Hypoxia  Acute drug and alcohol withdrawal  Fluid and electrolyte imbalances  Complication of diabetes or pregnancy

6. TRIGGERING FACTORS  Increased physical activity.  Stress, illness  Reading  Fatigue.  Alcohol, and Caffeine.  Flash light, lack of Sleep  Some chemicals, dehydration  Sun light & Hot water Menstruation

7. TYPES OF EPILEPSY  1. Generalized; involve the whole brain & loss of consciousness  Partial; involve part of the brain, may / may not involve loss of consciousness

13. DIAGNOSTIC PROCEDURES AND NURSING INTERVENTIONS  Electroencephalogram (EEG)  Blood and urine tests,  magnetic resonance imaging (MRI),  computed tomography imaging (CT),  positron emission tomography (PET) scan,  cerebrospinal fluid (CSF) analysis,  skull x-ray,  Electrolyte profile and drug screen

14. ASSESS/MONITOR  Airway patency  Aspiration  Injury post seizure  If client experienced an aura (warning sensation); possible indication of the origin of seizure  Possible trigger factors (for example, fatigue)

15. NANDA NURSING DIAGNOSES  Risk for injury  Risk for impaired spontaneous ventilation  Risk for ineffective tissue perfusion (cerebral)

16. TREATMENT GOALS IN EPILEPSY  Help person with epilepsy lead full and productive life  Eliminate seizures without producing side effects  Tailor treatment to needs of individuals/special populations :Women, Children, Elderly, Hepatic or renal failure and other diseases

17. NURSING INTERVENTIONS  Protect the client from injury.  Maintain a patent airway.  Be prepared to suction.  Turn the client to the side (??).  Loosen clothing.  Do not attempt to restrain the client.

18. NURSING INTERVENTIONS  Do not attempt to open jaw during seizure activity. Do not use padded tongue blades.  Administer oxygen as prescribed.  Administer prescribed medications  Document onset and duration of seizure and client findings/ observations prior to during, and following the seizure (level of consciousness, apnea, cyanosis, motor activity, incontinence).

19. POST SEIZURE  Maintain the client in a side-lying position to prevent aspiration and to facilitate drainage of oral secretions.  Check vital signs.  Perform neurological checks.  Reorient and calm the client  Institute seizure precautions.  Provide client education regarding seizure management:  The importance of monitoring AED levels and maintaining therapeutic medication levels.  Possible drug interactions (for example, decreased effectiveness of oral contraceptives).  Encourage the client to wear a medical alert bracelet (necklace) at all times.

20. SEIZURE PRECAUTIONS  Standby oxygen, airway, and suctioning equipment  IV access (medication administration during seizure)  Side rails in up position and bed in lowest position

21. POTENTIALLY DANGEROUS RESPONSES TO SEIZURE  Don’t restrain person  Don’t put anything in the person’s mouth  Don’t try to hold down or restrain the person  Don’t attempt to give oral antiseizure medication  Don’t keep the person on their back face up

22. COMPLICATIONS AND NURSING IMPLICATIONS  Aspiration  Turn the client to side, suction as needed.  Status Epilepticus  Establish airway,  provide oxygen,  ensure IV access,  perform EKG monitoring,and  monitor ABG results.  As prescribed, administer diazepam (Valium) or and a by a continuous infusion of phenytoin (Dilantin ).