Epilepsy - Short Note
Write a short note on Epilepsy
Definition
Is a group of syndromes characterized by recurring seizures. The most common syndromes are those with generalized seizures and those with partial-onset seizures.
Epilepsy - primary (idiopathic) - secondary when the cause is known and the epilepsy is symptom of another underlying condition such as a brain tumor, cerebrovascular accident
Generalized called Grand mal
Petimal
La absence attacks
Sensory epilepsy
Nursing Care During a Seizure
Privacy
Ease the patient to the floor
Protect the head with a pad
Loosen constrictive clothing
Remove nearby furniture
If in bed remove pillows and raise rails
Prevent tongue bite by an airway or mouth gag
Do not try to pry open the jaws
Do not restrain the movements : the strong muscle action may cause injuries like fractures
If possible put the patient into 3/4 prone position to prevent fall back of tongue and to facilitate drainage of saliva/mucus
Nursing Care After Seizure
Keep pt on one side
Keep airway patent
If pt is agitated persuade calmly and restrain gently
Educate patient and family regarding protecting the patient from injuries and aspiration
Improve coping mechanisms
Excemtion from peer activities and school activites as needed
Treat psycological problems due to neglect/over protection by the family.
Manage status epilepticus
Oral hygiene, gum massage, daily flossing, regular dental care
Home instructions given in writing
Instructed to avoid bathing in a tub or pond
to avoid alcohol, hypoglycemia etc
to develop regular sleeping patterns
to use the services of Epilepsy Foundation
Clinical Manifestations
Range from a simple staring to prolonged convulsive movements with loss of consciousness.
Simple partial : only a finger or hand may shake or the hand may shake or the mouth may twitch uncontrollably.
Talk is unintelligible
Dizziness
Unusual or unpleasant sights, sounds, odors, or tastes but without loss of consciousness
Epileptic cry
Incontinence of urint and stools
Convulsions last for a minute or two
Post ictal confusion or coma or long sleep
Noisy breathing
Head ache, sore muscle, fatigue and depression
Investigations
MRI
EEG
Telemetry and computerized eauipment to monitor electrical brain activity
Video recording of the seizure
Single photon emission computed tomography (SPECT)
Prevention
Congenital fetal anomaly to be guarded against in pts taking drugs
Delivery may increase the risk of epileptic fits.
Head injuries prevented
Medical Management
Carbamazepint (Tegretol)
Clonazepam
Ethosuximide
Felbamate
Gabapentin (Neurotonin)
Lamorrigine (Lamictal)
Oxacarbazepine (Trileptal)
Phenobarbital (Luminol)
Phenytoin (Dilantin)
Topiramate (Topamax)
Valproate
Zonisamide
