Epilepsy is a central nervous system (neurological) disorder characterized by abnormal brain activity, resulting in seizures or periods of unusual behaviour, sensations, and, in some cases, loss of awareness.
Epilepsy can affect anyone. Epilepsy affects men and women of all races, ethnicities, and ages.
The symptoms of a seizure can vary greatly. During an attack, some people with epilepsy stare blankly for a few seconds, while others twitch their arms or legs repeatedly. A single seizure does not imply that you have epilepsy. For an epilepsy diagnosis, at least two episodes without a known trigger that occur at least 24 hours apart are generally required.
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Most people with epilepsy can be controlled by medication or, in some cases, surgery. Some people require lifelong treatment to control their seizures, while others have their episodes resolved. Some children with epilepsy may outgrow their condition as they grow older.
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Seizures can affect any process your brain coordinates because epilepsy is caused by abnormal brain activity. Seizure symptoms and signs may include:
A spell of staring
Jerking movements of the arms and legs that are uncontrollable
Consciousness or awareness loss
Fear, anxiety, or a sense of déjà vu are psychological symptoms.
The symptoms vary according to the type of seizure. A person with epilepsy typically has the same kind of seizure each time so the symptoms will be similar from episode to episode.
Seizures are classified as either focal or generalized by doctors based on how and where the abnormal brain activity begins.
Seizures with a specific focus
Focal seizures occur when seizures appear to be caused by abnormal activity in only one area of your brain. These seizures are classified into two types:
Seizures with and without loss of consciousness. These seizures, formerly known as simple partial seizures, do not result in loss of consciousness. They may alter emotions or change things’ appearance, smell, feel, taste, or sound. Some people have déjà vu. This type of seizure may also cause involuntary jerking of a single body part, such as an arm or leg, and spontaneous sensory symptoms like tingling, dizziness, and flashing lights.
Seizures with focal awareness impairment. These seizures, formerly known as complex partial seizures, involve a change or loss of consciousness or awareness. This type of seizure may be a dream. You may stare into space and not usually respond to your surroundings during a focal episode with impaired cognition, or you may perform repetitive movements such as hand rubbing, chewing, swallowing, or walking in circles.
Symptoms of focal seizures can be mistaken for those of other neurological disorders such as migraine, narcolepsy, or mental illness. To distinguish epilepsy from other conditions, a thorough examination and testing are required.
Generalized seizures are seizures that appear to involve all areas of the brain. There are six types of generalized seizures.
Seizures caused by absence. Absence seizures, formerly known as petit mal seizures, are most common in children. They last 5-10 seconds and are distinguished by staring into space with or without subtle body movements such as eye blinking or lip smacking. These seizures can occur in clusters, up to 100 times per day, and cause a brief loss of consciousness.
Seizures with tonic jerks. Tonic seizures cause muscle stiffness and may impair consciousness. These seizures usually affect the muscles in your back, arms, and legs, and they can cause you to collapse.
Atonic seizures. Atonic seizures, also known as drop seizures, result in muscle control loss. Because this most commonly affects the legs, it frequently causes you to collapse or fall.
Seizures that occur in clusters. Repetitive or rhythmic jerking muscle movements characterize clonic episodes. Attacks typically affect the neck, face, and arms.
Seizures with myoclonic convulsions. Myoclonic seizures are brief jerks or twitches affecting the upper body, arms, and legs.
Seizures that are tonic-clonic in nature. Tonic-clonic seizures, also known as grand mal seizures in the past, are the most severe type of epileptic seizure. They can cause a sudden loss of consciousness and stiffening, twitching, and shaking of the body. They can sometimes cause bladder control problems or tongue biting.
When should you see a doctor?
Seek immediate medical attention if any of the following events occur:
The convulsion lasts more than five minutes.
After the seizure stops, neither breathing nor consciousness returns.
A second seizure immediately follows.
You have a high temperature.
You’re expecting a child.
You have diabetes.
During the attack, you injured yourself.
You continue to have episodes despite taking anti-seizure medication.
Seek medical attention if you are having your first seizure.
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In about half of those who have epilepsy, there is no known cause. In the other half, the condition can be attributed to several factors, including:
Genetic predisposition. Some types of epilepsy, which are classified based on the type of seizure or the part of the brain affected, run in families. In these cases, there is most likely a genetic component.
Some types of epilepsy have been linked to specific genes by researchers, but for most people, genes are only part of the cause of epilepsy. Particular genes may make a person more susceptible to environmental factors that cause seizures.
Trauma to the head. Epilepsy can be caused by head trauma from a car accident or another traumatic injury.
Abnormalities in the brain. Epilepsy can be caused by brain abnormalities such as brain tumours or vascular malformations such as arteriovenous malformations (AVMs) and cavernous malformations. Stroke is the most common cause of epilepsy in adults over 35.
Infections. Meningitis, HIV, viral encephalitis, and parasitic infections can cause epilepsy.
Prenatal harm. Babies are vulnerable to brain damage before birth, which can be caused by various factors such as a mother’s infection, poor nutrition, or oxygen deficiency. Epilepsy or cerebral palsy can result from brain damage.
Disorders of development. Epilepsy is sometimes linked to developmental disorders such as autism.
Certain factors may increase your chances of developing epilepsy:
Age. Epilepsy is most common in children and older adults, but it can strike anyone at any age.
A family tree. If you have a family history of epilepsy, you may be more likely to develop a seizure disorder.
Injuries to the head. Head injuries cause some cases of epilepsy. Wearing a seat belt while driving and a helmet while bicycling, skiing, riding a motorcycle, or participating in other activities with a high risk of head injury can reduce your risk.
Stroke, as well as other vascular diseases. Stroke and other blood vessel (vascular) diseases can cause brain damage, resulting in epilepsy. You can reduce your risk of these diseases by limiting your alcohol consumption, avoiding cigarettes, eating a healthy diet, and exercising regularly.
Dementia. In older adults, dementia can increase the risk of epilepsy.
Infections of the brain. Conditions that cause inflammation in your brain or spinal cord, such as meningitis, can raise your risk.
Childhood seizures. Seizures are sometimes associated with high fevers in children. Children with episodes due to high fevers are unlikely to develop epilepsy; if a child has a prolonged fever-related seizure, another nervous system condition, or a family history of epilepsy, the risk of epilepsy increases.
Having a seizure at the wrong time can result in dangerous situations for you or others.
Falling. You could injure your head or break a bone if you fall during a seizure.
Drowning. Because of the possibility of having a seizure while in the water, people with epilepsy are 13-19 times more likely than the general population to drown while swimming or bathing.
Car mishaps. A seizure that causes loss of awareness or control can be dangerous if you’re driving or operating machinery.
Many states have driver’s license restrictions based on a driver’s ability to control seizures and impose a minimum amount of time that a driver must be seizure-free before being allowed to drive, which can range from months to years.
Complications from pregnancy. Seizures during pregnancy endanger both the mother and the baby, and certain anti-epileptic medications raise the risk of congenital disabilities. If you have epilepsy and want to become pregnant, consult your doctor as you plan your pregnancy.
Most epileptic women can become pregnant and have healthy babies. You will be closely monitored throughout your pregnancy, and your medications may need to be adjusted. It would help if you collaborated with your doctor to plan your pregnancy.
Problems with emotional health. People with epilepsy are more likely to suffer from psychological issues, particularly depression, anxiety, and suicidal thoughts and behaviours. Problems may arise due to difficulties managing the condition or medication side effects, but even people with well-controlled epilepsy are at risk.
Other life-threatening complications of epilepsy are uncommon, but they can occur, including:
The condition is known as status epilepticus. This condition occurs when you are in a continuous seizure state for more than five minutes or if you have frequent recurrent seizures without regaining full consciousness in between them. People with status epilepticus are at a higher risk of permanent brain damage and death.
In epilepsy, sudden unexpected death occurs (SUDEP). People who have epilepsy are also at risk of dying suddenly and unexpectedly. The cause is unknown, but some research suggests that it could be caused by heart or respiratory problems.
People with frequent tonic-clonic seizures or whose seizures are not controlled by medication may be more vulnerable to SUDEP. SUDEP kills about 1% of people with epilepsy. It is most common in people who have severe epilepsy that isn’t responding to treatment.
Module 02 Assignment – Seizure Case Study
Module 02 Assignment – Seizure Case Study
Module 02 Content
Competency: Describe appropriate nursing interventions for clients with neurological diseases.
Scenario: Peter is a 22-year-old male with a history of seizures. He is usually compliant with his medications, but he has been out of work for over a month and cannot afford his prescribed anti-seizure medication. Today, Peter was standing in line at a grocery store and suddenly fell, thrashing about on the floor. You witnessed the event unfold. As a nurse, you immediately offer your assistance.
Please refer to the scenario above and answer the following questions.
What would be the priority nursing intervention to care for Peter? Please explain the rationale for your response.
Bystanders insist that you place something in his mouth to keep him from biting or swallowing his tongue. Is this an appropriate action? Why or why not?
You have asked someone to call 911. What do you anticipate reporting to the emergency medical personnel when they arrive? Please explain the rationale for your response.
Peter remains a little groggy after the seizure ends. You explain that the ambulance is on its way and that you will stay with him until it arrives. Peter asks you to help him up off of the floor. Is this an appropriate action at this time? Why or why not?
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