Epilepsy

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					Epilepsy

         or
Seizures
      By Melissa VanDyke
What is Epilepsy?????
   A transitory disturbance in consciousness or in
    motor, sensory, or autonomic, function with or
    without a loss of consciousness. Associated with
    paroxysmal, uncontrolled electrical discharges in
    the neurons of the brain that result in the sudden,
    violent, involuntary contraction of a group of
    muscles.
   Seizures are classified
   according to the varied
   features of the attack :
Generalized tonicclonic
(grand mal)
Absence (petit mal)
Psychomotor
(automatisms)
Jacksonian (focal)
Miscellaneous seizures
(myoclonic and
akinetic)
    Reasons seizures occur:
   Variety of reasons including hypoglycemia,
    infection, electrolyte imbalance, alcohol,
    barbiturate with-drawl, water intoxication,
    stroke, approximately 70% of patients with
    epilepsy a cause hasn’t been determined

There is excessive
neuronal discharge
which results in a tonic
convulsion. Seizures are
followed by a rest
period of variable
lengths (postictal
period)
        Assessment:
   Aura preceding a seizure is important to consider. Aura
    occurs in about 50% of all patients with tonic-clonic
    seizures. Aura is a sensation, as of light or warmth that
    may precede an attack of an epileptic seizure.
   Epileptic aura may be psychic, sensory with olfactory,
    visual, auditory, or taste hallucinations.
   Assessing the number of seizures occurring within a
    specific time period, any behaviors noted and injuries
    suffered
   Character of the seizure should be described as completely
    as possible including duration, patients movements, if the
    patient was incontinent, and cries or sounds that were
    made and the level of alertness.
          Diagnostics:
   Usually diagnosed thru a complete history and physical
    assessment.
   An electroencephalogram (EEG) is usually used to make a
    diagnosis of epilepsy. An EEG measures the electrical activity
    of the brain and certain abnormalities may be seen in patients
    with epilepsy.
       How to manage Epilepsy:
   Anti-seizure drugs, therapy is aimed at prevention of the
    seizures because cure is not possible
   Drugs generally act by stabilizing nerve cell membranes and
    preventing spread of the epileptic discharge blood levels may
    be checked to provide an accurate check on the therapeutic
    level of medication
   70% of patients with seizures use meds to control them
   If medication is not effective surgical removal of the brain
    tissue where the seizures occur will be done
       How does effect daily
       living?????
   Patients are encouraged not to drive operate
    machinery or swim until epilepsy is controlled
   Adequate rest and good nutrition
   NO ALCOHOL!!!!!!!!!
   Patients receiving longterm phenytoin (Dilantin)
    should be encouraged to use good oral hygiene
    because of side effects of edematous and
    enlarged gums.
   Patient should wear a medical-alert bracelet
Nursing Interventions:

    Care during a seizure:
     – Protection from aspiration
     – If patient is sitting or standing they should be
       lowered to the floor
     – NEVER LEAVE THE PATIENT ALONE!!!!
     – Support the head if possible turn the head to the
       side to maintain airway
     – Do not restrain patient, and NEVER NEVER
       NEVER EVER PRY OPEN THE JAW!!!
     Interventions con’t:
   Nurse should carefully observe and
    record details of the seizure because
    the diagnosis and subsequent tx often
    rests solely on seizure discription
   All aspects of the seizure when did it
    occur, how long did each episode last,
    what happened after the seizure.
And the Prognosis Is…….
   Most patients with seizures are able to
    control them with meds. And can lead
    a normal life.
   And with most seizure disorders the
    number and intensity usually stay the
    same.

				
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posted:8/20/2011
language:English
pages:12