Epilepsy (Seizure Disorders)

Etiology and Pathophysiology

Abnormal discharge of electric impulses by the nerve cells in the brain from idiopathic or secondary causes resulting in the typhical manifestation of seizure. Onset of idiopathic epilepsy generally before age 30. Other conditions associated with seizures include brain tumor, CVA, hypoglycemia and head trauma.

Types of Seizures
a. Partial Seizure ( seizures beginning locally) i. Simple: focal motor or sensory effect; no loss of consciousness. ii. Complex: cognitive, psychosensory, psychomotor or affective effect; brief loss of consciousness.

b. Generalized seizures (bilaterally symmetric and without local onset) i. Absence(petit mal): brief transient loss of consciousness with or without minor motor movements of eyes, head or extremities. ii. Myoclonic brief transient rigidity or jerking of extremities , singly or in groups. iii. Tonic-clonic (grand mal)

aura, loss of consciousness,rigidity followed by tonic and clonic movements, interruptions of respirations, loss of bladder and bowel control. c. Status epilepticus prolonged partial or generalized seizures without recovery between attacts ; may completely exhaust the client and lead to death.

Signs and Symptoms

1. Subjective Aura or warning sensation such as seeing spots or feeling dizzy often precedes a tonic-clonic seizure. Loss of consciousness during seizure Lethargy after follows return to consciousness(postictal phase) Dyspnea

2. Objective: Pupils become fixed and dilated Often the client cries out as a seizure begins or as air is exhaled forcefully. Tonic and clonic movements of the muscles Incontinence Abnormal EEG

Therapeutic interventions
Anticonvulsant therapy continued throughout life. Sedatives (phenobarbital) used to reduce emotional stress Neurosurgery is sometimes indicated if seizures are caused by tumors, abscess or vascular problems.