Epilepsy (Seizure)

Epilepsy (Seizure)

 

Definition:- 

  Seizure are an abnormal sudden excessive discharge of electrical activity within neurones of brain.

   Chronic seizure activity called epilepsy

Causes:-

- Brain tumor ( most common cause)

- Head trauma

- Infection (meningitis, Encephalitis)

- Birth Injuries

- Toxins, Hyperpyrexia and cerebral hypoxia

Type Of Epilepsy

It can divide into Two Groups

1) Generalized seizure

2) Partial or focal seizures

1) Generalized seizure

     These seizure result from excessive electrical discharge from both hemispheres of brain

Sub Types

a) Tonic-clonic seizure ( grand mal seizure )

b) Petit mal seizure ( absence seizure )

A) Tonic-clonic seizure

These types of seizures have three phase

I ) Aura :- signals of an upcoming restlessness hallucination and insomnia

ll ) Tonic :- Stiffening of muscles of arms and legs about 10-20 seconds and loss of consciousness

lll ) Clonic :- Jerking of extremities cast about 30-40 seconds

B) Petit mal seizure ( absence seizure )

  Brief period of altered consciousness lasting 5-30 seconds usually in childhood

   The patient shows a black facial expression that may be followed by movements such as repeated eye blinking or rolling and lips smacking

2) Partial or focal seizures

  It begins with focal or local discharge in one part of brain

  The most common type are

A) Simple Partial 

  When a patient remains awaken during a seizure episode the seizure said to be simple partial

  The shaking movements begins in thumb and progress up to the arm

B) Complex partial 

 If loss of consciousness occurs after a focal seizure the condition is said to be complex partial 

Sign and Symptoms

- Temporary confusion

- Loss of consciousness

- Jerking movements of arms and legs

- Dizziness

- Headache

- Visual Change

- Loss of memory

- Involuntary changes in body movement functions, sensation behaviour and awareness

Diagnosis

- History Collection

- Physical Examination

- Neurological Examination

- EEG 

- CT Scan and MRI

Manegement

A) Medical Manegement

Anti - Convulsant medication

- Phenytoin sodium

- Diazepam

- Valproic acid

- Carbamazepine 

B) Nursing Manegement

  Protect Patient from injury, if the patient is standing place the patient on floor or if on bed put up side rails

  Carefully observe and record details of events during seizures

  Maintain a patient airway

  Suction fluid for airway clearance

  Turn the patient head to side

  Remain with patient do not restrain

 Administer Intravenous anti-convulsant drugs

  Educate the patient and family members about life long medicines