Seizure: Causes, Types, Treatment, and Nursing Management

Seizure: Causes, Types, Treatment, and Nursing Management

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Introduction of Seizure  

  • 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.

 

  1. Secondary seizures – 

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

 

  1. 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.

 

  1. 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.
  •  
  1. 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.

 

  1. 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.
  •  

 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.

 

  1. 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.

 

  1. 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.

 

  1. Nursing care during Seizures

  • Provide a comfortable position.
  • Clearance Airway.
  • Loose clothes.
  • Be prepared for suction.
  • Monitor seizure type and duration.
  •  
  1. 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.

Electrical activity changes in the brain

Seizure

What is the use of Anticonvulsant medication?

Seizure disorder.

Idiopathic Seizure is also known as

Epileptic seizure.

What is a Secondary Seizure?

A seizure occurs due to any pathological condition

What is Grand Mal Seizure?

A generalised tonic-clonic seizure is a – Grand Mal Seizure.

What is Aura?

A pre-monitoring phase of generalised tonic-clonic seizure – Aura.

In which phase of Seizure, does the patient takes an arching position?

Tonic phase.

Which phase of Seizure includes jerky movement?

Clonic phase.

What is a Drop attack Seizure?

Drop attack Seizure is a – Atonic seizure.

What is a petit Mal Seizure?

In Seizure disorder, petit Mal Seizure is a – Absence Seizure.

What is the most common seizure in children?

The most common seizure disorder in children – Absent Seizure.

Common drugs used in Seizure disorder?

Anticonvulsants

What is a partial Seizure?

A seizure occurs in a particular lobe of the brain

What is another name of Complex partial seizure?

Psychomotor Seizure

What is Common nursing action in Seizure disorder?

Most common nursing action in Seizure disorder – Seizure precautions

A common diagnostic procedure in seizure disorder

EEG

Which partial Seizure is associated with awareness

Simple partial Seizure

Seizure and epilepsy associated with

CNS disorder.

What is the Average duration of generalised tonic-clonic Seizure?

2 – 5 minutes.

What is the Other name for partial seizure?

Focal Seizure.

What is a Seizure?

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

What is the emergency treatment for seizures?

In emegency Condition two main medition are use midazolam and diazepam. midazolam – is given into the toung.

What are the first signs of a seizure?

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

What are the 5 causes of seizures?

Genetics
Fever
Hypoxaemia
Injury
Head trauma
Developmental disorder
Meningitis and encephalitis
Brain tumour
Metabolic changes

What does a seizure feel like?

In Seizure feel like A staring spell.

What happens when a person has a seizure?

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 faecal incontinence
Jerky muscles movement
Excessive salivation
Involuntary movement of arms and legs.

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