• Seizure is also called – convulsion and fits.
• Seizure is an episode of neural dysfunction.
• Seizure disorder is the result when the brain’s electrical activity is disrupted.
• Epilepsy is a CNS disorder in which brain activity becomes abnormal and causes seizures disorder.

Definition of Seizure

• Seizure is a central nervous system (CNS) disorder in which sudden, uncontrolled electrical disturbance in the brain.
• Seizures change the electrical activity of the brain.

Types of seizures  

1. Primary seizures
2. Secondary seizures
3. Generalized seizures
4. Partial (focal) seizures.

1. Primary seizures –

• Also known as an epileptic seizure and idiopathic seizure.
• Primary seizures occur without any cause.

2. Secondary seizures – 

• Seizures occur due to any pathological cause –
• For example – Head injury, CVA, Brain tumour, meningitis, fever, spinal cord injury etc.

3. Generalized seizures

• Generalized seizures involve both hemispheres as well as deeper brain structures.
• Hereditary factors are essential.
• Generalized seizures begin with a widespread electrical discharge.

Generalized seizures types –

1. Generalised tonic-clonic seizures
2. Generalised tonic seizure
3. Myoclonic seizure
4. Atonic seizure
5. Absent seizure.

1. Generalised tonic-clonic seizure  

• Also known as Grand Mal seizures.
• Patient’s loss of consciousness is quickly followed by a sudden fall to ground.
• Average duration 2 to 5 minute.

Stages/type of Generalised tonic-clonic seizure-

Generalized tonic-clonic seizure has 4 types/stages

1. Aura
2. Tonic
3. Clonic
4. Relaxation.

1. Aura –

• Pre-monitoring phase and warning phase.
• This phase gives direction that something big is about to happen.
• In these phases, patients feel that something is going to happen and feel discomfort.

2. Tonic –

• Tonic phase includes tonic contraction of muscles and loss of consciousness.
• The body of the patient forms an arched shape.
• Duration 30 second
• Cessation of respiration due to spasm of respiratory muscles.
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3. Clonic –

• clonic phase includes Jerky movements and tremors in all over the body.
• Duration 60 – 90 seconds.
• Clonic phase is a dangerous phase including the tongue bite and froth from mouth.

4. Relaxation –

• Stop Jerky movement and seizures.
• The patient goes to deep sleep.

B. Generalised tonic seizure  

• In such a condition, suddenly muscles stiffness of the patient, cause the patient to fall backwards.

C.  Myoclonic seizure

• Repeated jerking movement of patients.

D.  Atonic seizure

• Also known drop attack seizure.
• In this type of seizure, suddenly the muscle tone of the patient relaxes, causing the patient to fall forward.
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 E.  Absent seizure 

• Absence seizure also called – petit Mal seizure. 
• Absent seizures occur within the brain but are externally absent.
• Absent seizures mainly occur in children.
• Absent seizures last from 5 to 10 seconds.

5. Partial seizures 

• Also called focal seizures.
• Partial seizures are limited in a particular hemisphere/ lobe of the brain.

Partial seizures are divided into 2 types –

1. Simple partial seizure
2. Complex partial seizure.

1. Simple partial seizure

• Simple partial seizure associated with awareness.
• Include alteration in motor function, sensory function.
• Recurrent muscles contractions.

2. Complex partial seizures

• Also called psychomotor seizures.
• Seizures discharge in the temporal lobe of the brain.
• Seizures are associated without awareness.
• Loss of consciousness contact with environments.

Cause of seizure

• Idiopathic
• Genetics
• Fever
• Hypoxaemia
• Injury
• Head trauma
• Developmental disorder
• Meningitis and encephalitis
• Brain tumour
• Metabolic changes
• Degenerative brain disorder
• CVA
• Toxicity in pregnancy
• Hyperglycaemia
• Hypocalcaemia
• Allergic disorder
• Age
• Brain stroke
• Dementia.

Sign/Symptom of seizure

Clinical manifestation

• Altered level of consciousness
• Loss of muscles tone and movement
• Loss of sensory and motor function
• Rigid and arching body in tonic phase
• Tongue bite
• Fixed Jaw
• Disturbance in autonomic functions
• Fracture
• Head injury
• Urine and fecal incontinence
• Jerky muscles movement
• Excessive salivation
• Involuntary movement of arms and legs.

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Diagnostic examination  of seizure

• History collection and physical examination.
• EEG ( electroencephalography )
• CT scan and MRI
• Skull X-Ray
• Lumbar puncture
• Neurological test
• ABG analysis
• Blood culture test.

Medical management of Seizures-

• Manage patient seizure and cause.
• Anticonvulsant antiepileptic drugs –
• Phenytoin sodium
• Diazepam
• Midazolam
• Valproate
• IV administration
• Calcium channel blockers
• Oxygen therapy administer
• Seizure precautions.

Surgical management of Seizure 

• Vagal nerve stimulation therapy.
• Destroying minute area of the brain.

Nursing management

1. Nursing care before seizure –

• Nurses monitor vital signs and maintain patient airways.
• Administer prescribed drugs.
• To prevent injury.
• Provide seizure precautions –
• Side rails up
• Pillow under heads
• Side-lying positions
• Suction available
• Provide privacy
• Loose tight clothes
• Don’t put anything in mouth
• Remove hazards.

2. Nursing care during Seizures

• Provide a comfortable position.
• Clearance Airway.
• Loose clothes.
• Be prepared for suction.
• Monitor seizure type and duration.
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3. Nursing care after seizures

• Assist the patient in behaviour after a seizure.
• Do not live alone.
• Keep the patient on one side to prevent aspiration.
• Monitor patient vital signs and any injury.
• Perform neurological check-ups.
• Encourage the patient to wear a medical alert bracelet.
• Educate about follow-up care

FAQ.