1. Epilepsy

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).