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Seizures
| Question | Answer |
|---|---|
| What are some of the causes for seizures? | Tumor, acidosis, hypogycemia, hypoxia, extracranial disorders, alcohol and or barbituate withdrawls |
| How many seizures does a pt have to have to be an epileptic? | 2 or more |
| At what point is epilepsy high? | First year of life and elderly years |
| When do epileptic seizures decline and plateau? | childhood and adolescence and adulthood |
| Who are more at risk for seizures? | Males, African Americans |
| When the whole brain is involved, what type of seizure is it? | A generalized seizure |
| What are Astrocytes? | New meds focusing on decreasing glutamate |
| What order do the phases of a seizure occur?> | prodromal phase, aura phase, Ictal phase, Postictal phase |
| When adults come in w a seizure, how are they treated? | As if they have a tumor |
| What is the cardio drug used for seizures? | Lidocaine |
| what is gliosis? | scar tissue |
| What phase is missing in a generalized seizure? | phase 2, aural phase |
| What does tonic/clonic mean? | Stiffening and jerking of body |
| What is a tonic clonic seizure aka? | grand mal (generalized) |
| What happens during a grand mal seizure? | fall down, tonic-clonic, cyanosis, eyes blinking, drooling, LOC, loss of bladder and bowel control |
| What type of seizures are common in children? | absence seizure (petite mal) generalized |
| What are the characteristics of a petite mal? | eyes flutter upward for 3-20 seconds, vacant stare and lack of response |
| If a child has a absence, petite mal seizure, will they always have them? | May disappear at puberty or develop into another type of seizure |
| Which seizures are brought on by strobe lights? | Atypical Absence seizures |
| Which type of seizure is characterized by sudden very brief jerk of the body? | Myoclonic |
| Which type of seizure is characterized by falling, loss of muscle tone, LOC with regain of consciousness by the time they hit the floor? | Akinetic AKA atonic AKA astatic seizure |
| What is the primary difference between generalized and partial seizures? | generalized= whole brain is involved, partial= specific region of cortex, however, may spread and end up involving entire brain |
| How do simple and complex partial seizures differ? | simple=no LOC, complex=LOC |
| What are the different types of simple partial seizures? | Motor – convulsion in the upper extremity Somatosensory – numbness & tingling in the affected area Automatic – epigastric sensations, pallor, sweating, flushing, tachycardia Psychic – aura, subjective sensation Auditory-ringing or hiss, visual-flashes |
| What are automatisms? | lip-smacking, picking, patting, chewing, picking |
| What type of seizure have automatisms? | complex petite mal |
| How is status epilepticus classified? | persists >30 mins or repeatedly without return to consciousness between seizures |
| Which takes more energy? A persistent seizure or repeated without regaining consciousness? | repeated without regaining consciousness |
| What are possible complications from seizures? | insufficient ventliation, hypoxemia, brain damage, hyperthermia, cardiac arrythmias, systemic acidosis, injury |
| Psychologically, how can a seizure disorder affect a patient? | social stigma |
| When looking for a seizure, what are some other disorders that are ruled out? | metabolic disorders, brain lesions |
| What is the acronym for seizure management? | "CAN DO" C-be calm, A-void injury, N-note the time the seizure starts, D-dont try to restrain them or put anything in their mouth, O-do not obstruct the airway (May need O2 and suction after) |
| Which meds are use tonic-clonic, generalized seizures and partial seizures? | Dilantin, Tegretol, phenobarbitual, Depakote |
| Which meds are used for absence/akinetic & myoclonic | Zarotonin, Depakote, Klonopin |
| What are the second generation drugs for seizures? | Neurontin, Topamax, and Lyrica as an add on drug |
| What are some of the neurological SE from anti-seizure meds? | decreased LOC, ataxia, diplopia, slow cognitive function and alertness |
| What are some of the Idiosyncratic effects outside the CNS | skin rash, gingival hyperplasia, blood dyscrasias, liver, & kidney problems, decreased labidio, ED |
| At what point may a seizure med may be discontinued? | May consider discontinuing medications if the person is seizure-free for 2 years (no epilepsy waves on EEG) |
| When are surgical options considered? | When drug therapy doesn't work |
| What are the surgical options? | removal of the epileptic focus, multiple sub-pial transection (a series of cuts to isolate sections), separate 2 hemispheres to prevent spread of actvity |
| What type of implant may be permanently inserted? | Vagal nerve simulator that delivers intermittent electrical stimulation to the brain to reduce frequency and intensity of seizures (desynchronize) |
| What are some alternative therapies? | Biofeedback using EEG and relaxation Alternative therapy Ketogenic diet |
| What are patient teaching priorities? | Do not operate a motor vehicle or dangerous machinery (even kitchen knife), Take meds, Use a microwave for cooking, non-contact sports with supervision, Swim with the presence of lifeguard; shower instead of taking a bath, Medical alert bracelet |
Created by:
brebre273
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