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36 Cards in this Set
- Front
- Back
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seizure definition
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time limited paroxysmal events resulting from abnormal, involuntary, rhythmic neuronal discharges in brain
-NOT predictable; INVOLUNTARY events |
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how long do seizures usually last?
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short
< 5 mints, last 60-80 secs |
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epilepsy definition
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spontaneous recurrence of 2 or more unprovoked seizures
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provoked causes of seizures
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hypoglycemia, hyper glycemia
hyponatremia, hypocalcemia stroke, drugs, alcohol withdrawal infection, tumors, head traume meds that lower seizure threshold |
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how do you treat provoked seizures?
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treat the provoking factor
(metabolic, trauma, infection, stroke, meds) |
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How do you treat unprovoked seizures?
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antiepileptic medications
(there isn't anything identifiable that is provoking the seizure) |
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What are the 2 classes called that epilepsy is divided into?
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partial and generalized
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generalized seizures
-definition |
electrical disturbance sweeps through whole brain at once
-cause LOC, falls, convulsions, massive muscle spasms |
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partial seizures
-definition |
disturbance occur in just 1 part of brain (focal)
-affects whatever physical or mental activity the damaged area controls |
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simple partial seizures
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consciousness is NOT impaired
-only 1 area of brain involved -has motor, sensory, autonomic, psychic SS |
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complex partial seizures
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consciousness is impaired
features same as simple partial-only 1 area is affected |
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What are the types of generalized seizures?
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tonic-clonic
absence seizures (petit mal) myoclonic seizures tonic clonic atonic atypical absence infantile spasms |
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Absence seizures
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petit mal
SS: staring unresponsive, twitching muscles -blinking, automatisms (repetitive purposeless movements, lip smacking) -lasts 1-10 seconds |
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What is the onset for absence seizures?
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abrupt onset & termination
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atypical absence seizures
-onset? characteristics? |
gradual onset & termination
-last longer & has more motor involvement |
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tonic seizures SS
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stiffening of muscles of body
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clonic seizures SS
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repeated jerking movements bilaterally
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myoclonic seizures SS
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brief lightening (shock like muscle jerks)
-generally upper body |
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primary generalized tonic-clonic seizures
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grand mal
-have tonic phase, clonic phast, tongue biting & incontinence -followed by unresponsive/confusion |
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Status epilepticus
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repeated seizures w/o recovering consciousness between them
-last >30 minutes |
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what is the most common cause of status epilepticus?
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noncompliance with antiepileptic drugs (AEP)
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How do you manage status epilepticus?
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if hypoglycemic, give sugar (always give thiamine w/it)
then lorazepam then if doesn't work, give phenytoin/fosphenytoin |
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EEG (electroencephalogram)
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repeated EEG to confirm diagnosis (esp for partial seizures)
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video EEGs
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pt admitted to hospital
-pts may need to withdraw or add meds in pt w/difficult to treat epilepsy -or before surgery |
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CT
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usually is first test ordered w/first time seizures
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MRI
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recommend for children w/1 seizures; under 1 yrs
and unexplained sig mental or motor problems |
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advanced imaging techniques
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detect abnormalities in brain activity (PET)
-locate damaged or scarred location sin brain from partial seizures -findings help to determine if pt good candidate for surgery |
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SPECT single photon emission computer tomography
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help decide if surgery should be performed
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What are ways to treat refractory epilepsy?
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epilepsy surgery
vagus nerve stimulation ketogenic diet |
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lesionectomy
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remove lesion/surrounding brain tissue
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temporal resections
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remove temporal lobe & part of brain assoc w/feelings, memory, emotions (hippocampus)
-may experience post op speech & memory problems |
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extra-temporal resection
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remove some or all of frontal lobe
-frontal lobe: regulate movement, planning, judgement, personality |
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Hemispherectomy
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remove brain tissue restricted to pts w/severe epilepsy & abnormal discharges that extend from one side of brain to the other
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Corpus callostomy
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cutting NERVE fibers connecting sides of brain
-no removal of brain tissue -mostly done on children w/frequent falls from seizures |
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multiple subpial transection
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used to control spread of seizures that originate in or affect brain responsible for
-complex thought & reasoning |
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Ketogenic diet
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high fat, low protein, low carb diet
-forces body to create ketones w/seizure suppressing properties |
