KWAME NKRUMAH UNIVERSITY OF

SCIENCE & TECHNOLOGY

Medical nursing
NURSING III
EPILEPSY
Joana Kyei –Dompim
Department of nursing
joankyeidompim@gmail.com
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Brainstorming & TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
EPILEPSY (SEIZURE DISORDER)
• Epilepsy is a disorder of brain in which a fit occurs more than twice in a person
because of abnormal electrical discharge between certain brain cells.
• A sudden loss of consciousness which is often accompanied by repeated jerky
movements called convulsions.

•These attacks are sometimes called fits or seizures. A single seizure may occur for
no known reason. Some seizures are caused by a pathologic condition of the brain,
such as a tumor. In this case, once the underlying problem is treated, the patient is
often asymptomatic.

•Epilepsy is due to disturbance in the electrical activity of the brain that may result
in a change in level of consciousness (LOC), motor or sensory ability, and/or
behavior.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Def. cont
• Epilepsy Is caused by a transient, excessive and abnormal discharge of nerve
cells.
• The abnormal discharge may involve a small part of brain only ( partial or focal
seizure) or much more extensive area in both hemispheres (generalized
seizures).
• It can start at any age, In majority of the cases, it starts in childhood and
adolescence
• Tumors more likely after 40 years
• Those who suffer from Head trauma, CNS infections may occur at any age.
 KWAME NKRUMAH UNIVERSITY OF
CAUSES SCIENCE & TECHNOLOGY

1. Primary( idiopathic) epilepsy:-

- Unknown genetic or biochemical predisposition

2. Secondary epilepsy:-
- Intracranial Tumor
-Cerebro -vascular disease
-Arteriovenous malformation
-Trauma ( birth injury, depressed fracture, penetrating wound)
 KWAME NKRUMAH UNIVERSITY OF
CAUSES SCIENCE & TECHNOLOGY
• The most common causes of seizure disorder during the fist 6 months of life are severe
birth injury, congenital defects involving the central nervous system
(CNS), infections, and inborn errors of metabolism.
• In people between 2 and 20 years of age, the primary causes are birth
injury, infection, trauma, and genetic factors.
• In individuals between 20 and 30 years of age, seizure disorder usually occurs
as the result of structural lesions, such as trauma, brain tumors, or vascular disease.
• After 50 years of age, the primary causes of seizure disorders are stroke and metastatic
brain tumors. However, nearly 30% of all epilepsy cases are idiopathic, called
idiopathic generalized epilepsy (IGE), meaning they are not attributable to a specific
cause
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
CAUSES CONT. & TECHNOLOGY

• Infection ( meningitis, encephalitis)

• Inborn errors of metabolism
• Anoxia
• Hypoglycemia
• Drugs
• Drug withdrawal
• Alcohol withdrawal
 KWAME NKRUMAH UNIVERSITY OF
PATHOPHYSIOLOGY
SCIENCE OF SEIZURES
& TECHNOLOGY
• The etiology of recurring seizures (epilepsy) has long been attributed to a group of
abnormal neurons (seizure focus) that seem to undergo spontaneous firing. This firing
spreads by physiologic pathways to involve adjacent or distant areas of the
brain.
• If this activity spreads to involve the whole brain, a generalized seizure occurs. The
factor that causes this abnormal firing is not clear. Any stimulus that causes the cell
membrane of the neuron to depolarize induces a tendency for spontaneous
firing.
• Scar tissue (gliosis) is often found in the area of the brain from which the epileptic
activity arises. Scarring is believed to interfere with the normal chemical and structural
environment of the brain neurons, making them more likely to fie abnormally.
In addition to neuronal alterations, changes in the function of astrocytes may play
several key roles in recurring seizures. Activation of astrocytes by hyperactive neurons is
one of the crucial factors that predispose neurons nearby to the generation
of an epileptic discharge.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
CLASSIFICATION OF SEIZURES
• The International Classification of Epileptic Seizures recognizes three broad
categories of seizure disorders:
• Generalized Seizures
• Partial Seizures
• Unclassified Seizures
 KWAME
CLASSIFICATION NKRUMAH
OF SEIZURES UNIVERSITY
BASED OF AND
ON CLINICAL
SCIENCE & TECHNOLOGY
ELECTROENCEPHALOGRAPHIC MANIFESTATIONS OF
SEIZURES,
 KWAME NKRUMAH UNIVERSITY OF
PROGRESS OFSCIENCE
SEIZURES
& TECHNOLOGY
• Depending on the type, a seizure may progress through several phases:
• (1) The prodromal phase, with signs or activity that precede a seizure
• (2) the aural phase, with a sensory warning
• (3) the ictal phase, with full seizure
• (4) the postictal phase, the period of recovery after the seizure
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE &
PHASES OF SEIZURES TECHNOLOGY

Prodromal
• The attack or fit occurs suddenly at any place or time.
• The patient falls down and loses awareness of his surroundings
• Convulsion proceeds as follows:
Aura
• Is a warning signal prior to onset of seizures e.g sensation of peculiar test or smell, spots
before eyes, dizziness and feeling of weakness.
 KWAME NKRUMAH UNIVERSITY OF
Phases cont SCIENCE & TECHNOLOGY

Epileptic cry:
Patient loses consciousness with an epileptic cry, it is caused by spasm of thoracic
and abdominal muscles expelling air through the glottis.
Tonic stage:
Patient falls to the ground with all his muscle in an increased tone with
rigidity. The skin become pale and cyanotic, the respiration ceases. Pupil dilated
and fixed. It lasts for 10-30 sec.
.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Cont .,
• Clonic stage:
Is characterized by rhythmic, jerking
movements that follow the tonic
stage.it usually start at one place and
become generalized, including the
muscle of the face. There is frothing at
the mouth and
incontinence of urine and faeces.
Duration is approximately 1-5 min.
 KWAME NKRUMAH UNIVERSITY OF
TYPES OF GENERALISED SEIZURES
SCIENCE & TECHNOLOGY
• The tonic-clonic seizure
• The most common generalized seizure is the generalized tonic-clonic (formerly
known as grand mal) seizure. Tonic-clonic seizure is characterized by losing
consciousness and falling to the ground if the patient is upright, followed by
stiffening of the body (tonic phase) for 10 to 20 seconds and subsequent jerking
of the extremities (clonic phase) for another 30 to 40 seconds.
• Cyanosis, excessive salivation, tongue or cheek biting, and incontinence may
accompany the seizure. In the postictal phase the patient usually has muscle
soreness, is tired, and may sleep for several hours. Some patients may not feel
normal for several hours or days after a seizure. The patient has no memory of
the seizure.
 KWAME NKRUMAH UNIVERSITY OF
TYPES OF GENERALISED SEIZURES
SCIENCE & TECHNOLOGY
• Typical Absence Seizures. Or The absence seizure (formerly called petit mal)
usually occurs only in children and rarely continues beyond adolescence.
• This type of seizure may cease altogether as the child matures, or it may evolve
into another type of seizure.
• The typical clinical manifestation is a brief staring spell resembling “daydreaming”
that lasts only a few seconds, so it often goes unnoticed. When untreated, the
seizures may occur up to 100 times a day.
• The electroencephalogram (EEG) demonstrates a 3-Hz (cycles per second) spike-
and-wave pattern that is unique to this type of seizure. Hyperventilation and
flshing lights can precipitate absence seizures.
 KWAME NKRUMAH UNIVERSITY OF
TYPES OF GENERALISED SEIZURES
SCIENCE & TECHNOLOGY
• Atypical Absence Seizures is another type of generalized seizure which is
characterized by a staring spell accompanied by other signs and symptoms,
including brief warnings, peculiar behavior during the seizure, or confusion after
the seizure.
• It is longer lasting than a typical absence seizure and may be associated with loss
of postural tone.
 KWAME NKRUMAH UNIVERSITY OF
OTHER TYPESSCIENCE
OF GENERALISED SEIZURES
& TECHNOLOGY
Other generalized seizures are myoclonic, atonic, tonic, and clonic seizures.
• A myoclonic seizure is characterized by a sudden, excessive jerk of the body or
extremities. The jerk may be forceful enough to hurl the person to the ground.
These seizures are brief and may occur in clusters.
• An atonic (“drop attack”) seizure involves either a tonic episode or a paroxysmal
loss of muscle tone and begins suddenly with the person falling to the ground.
Consciousness usually returns by the time the person hits the ground, and
normal activity can be resumed immediately. Patients with this type of seizure
are at a great risk of head injury and often have to wear protective helmets.
 KWAME NKRUMAH UNIVERSITY OF
OTHER TYPESSCIENCE
OF GENERALISED SEIZURES
& TECHNOLOGY
• A tonic seizure involves a sudden onset of maintained increased tone in the
extensor muscles. These patients often fall.
• Clonic seizures begin with loss of consciousness and sudden loss of muscle tone,
followed by limb jerking that may or may not be symmetric
 KWAME NKRUMAH UNIVERSITY OF
PARTIAL SEIZURES
SCIENCE & TECHNOLOGY
• This is also called focal or local seizures and it begin in a part of one cerebral
hemisphere.
They are further subdivided into two main classes:
1. complex partial seizures (the person has a change or loss of consciousness)

2. simple partial seizures. (the person remains conscious

In addition, some partial seizures can become generalized tonic-clonic, tonic, or

clonic seizures. Partial seizures are most often seen in adults and generally are less
responsive to medical treatment when compared with other types
 KWAME NKRUMAH UNIVERSITY OF
PARTIAL SEIZURES
SCIENCE & TECHNOLOGY
• In a simple focal seizure, patientsremain conscious but experience unusual
feelings or sensations that can take many forms. Thy may experience sudden and
unexplainable feelings of joy, anger, sadness, or nausea. They also may hear,
smell, taste, see, or feel things that are not real.
• In a complex focal seizure, patients have a loss of consciousness or an alteration
in their consciousness, producing a dreamlike experience.
• They display strange behavior such as lip smacking and automatisms (repetitive
movements that may not be appropriate).
• Patients may continue an activity started before the seizure, such as counting out
change or picking items from a grocery shelf, but after the seizure they do not
remember the activity performed during the seizure.
• Other automatisms are less organized, such as picking at clothing, fumbling with
objects (real or imaginary), or simply walking away. These seizures usually last
 KWAME NKRUMAH UNIVERSITY OF
PARTIAL SEIZURES CONT
SCIENCE & TECHNOLOGY
• Complex partial seizures are most common among older adults. These seizures are
difficult to diagnose because symptoms appear similar to dementia, psychosis, or
other neurobehavioral disorders, especially in the postictal stage (after the
seizure).
• New-onset seizures in older adults are typically associated with conditions such
as hypertension, cardiac disease, diabetes mellitus, stroke, dementia, and recent
brain injury
 KWAME NKRUMAH UNIVERSITY OF
PARTIAL SEIZURES
SCIENECONT
& TECHNOLOGY
• The patient with a simple partial seizure remains conscious throughout the
episode. He or she often reports an aura (unusual sensation) before the seizure
takes place.
• This may consist of a “déjà vu” (already seen) phenomenon, perception of an
offensive smell, or sudden onset of pain. During the seizure, the patient may have
one-sided movement of an extremity, experience unusual sensations, or have
autonomic symptoms.
• Autonomic changes include a change in heart rate, skin flushing, and epigastric
discomfort. Unclassified, or idiopathic, seizures account for about half of all
seizure activity. They occur for no known reason and do not fit into the
generalized or partial classifications.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE &
Causes and risk factorsTECHNOLOGY

• Primary or idiopathic epilepsy is not associated with any identifiable brain lesion or
other specific cause; however, genetic factors most likely play a role in its development.
• Secondary seizures result from an underlying brain lesion, most commonly a tumor or
trauma. They may also be caused by:
• • Metabolic disorders
• • Acute alcohol withdrawal
• • Electrolyte disturbances (e.g., hyperkalemia, water intoxication, hypoglycemia) • High
fever
• • Stroke
• • Head injury
• • Substance abuse
• • Heart disease
 KWAME NKRUMAH UNIVERSITY OF
Risk Factors SCIENCE & TECHNOLOGY
Seizures resulting from these problems are not considered epilepsy. Various risk
factors can trigger a seizure, such as
1. increased physical activity
2. emotional stress
3. excessive fatigue
4. alcohol or caffeine consumption,
5. certain foods or chemicals.
 KWAME NKRUMAH UNIVERSITY OF
Diagnosis and hx taking
SCIENCE & TECHNOLOGY
Diagnosis is based on the history and physical examination. A variety of diagnostic
tests are performed to rule out other causes of seizure activity and to confirm the
diagnosis of epilepsy. Typical diagnostic tests include an
• Electroencephalogram (EEG)
• Computed tomography (CT) scan
• MRI, or positron emission tomography (PET) scan.
• Magnetoencephalography.
• Transcranial doppler ultrasonography.
Laboratory studies are performed to identify metabolic or other disorders that may
cause or contribute to seizure activities
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
NONSURGICAL MANAGEMENT.
• Removing or treating the underlying condition or cause of the seizure manages
secondary epilepsy and seizures that are not considered epileptic. In most cases,
primary epilepsy is successfully managed through drug therapy
• Most seizures can be completely or almost completely controlled through the
administration of antiepileptic drugs (AEDs), sometimes referred to as
anticonvulsants, for specific types of seizures.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Drug MANAGEMENT. & TECHNOLOGY

• Drug therapy is the major component of management. The health care provider
introduces one antiepileptic drug (AED) at a time to achieve seizure control. If the
chosen drug is not effective, the dosage may be increased or another drug
introduced.
• At times, seizure control is achieved only through a combination of drugs. The
dosages are adjusted to achieve therapeutic blood levels without causing major
side effects.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Drug MANAGEMENT. & TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
Drug MANAGEMENT.
SCIENCE & TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Drug MANAGEMENT. & TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
MANAGEMENT.
SCIENCE & TECHNOLOGY
• Emphasize that drugs must not be stopped even if the seizures have stopped.
• Discontinuing these drugs can lead to the recurrence of seizures or the life-
threatening complication of status epilepticus
• A balanced diet, proper rest, and stress-reduction techniques usually minimize
the risk for breakthrough seizures. Encourage the patient to keep a seizure diary
to determine whether there are factors that tend to be associated with seizure
activity
• Patients who work in occupations in which a seizure might cause serious harm to
themselves or others (e.g., construction workers, operators of dangerous
equipment, pilots) may need other employment.
• They may need to decrease or modify strenuous or potentially dangerous
physical activity to avoid harm, although this varies with each person
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Seizure MANAGEMENT.& TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Seizure MANAGEMENT.& TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Seizure MANAGEMENT.& TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE &
What Triggers seizuresTECHNOLOGY

• Emotion stress
• Alcohol or alcohol withdrawal
• Infection
• Pyrexia
• Flickering light
• Noise
• Loud music
• Withdrawal of medication
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Status epilepticus Definitions
• Status epilepticus is a medical emergency and is a prolonged seizure lasting longer
than 5 minutes or repeated seizures over the course of 30
minutes.
• Is a state of continuous seizure activity or a condition in which seizures recur in rapid
succession without return to consciousness between seizures.

• It is a potential complication of all types of seizures and occurs with any type of
seizure
• Seizures lasting longer than 10 minutes can cause death! Common causes of status
epilepticus include:
• Sudden withdrawal from antiepileptic drugs
• Infection
• Acute alcohol or drug withdrawal
• Head trauma
• Cerebral edema
• Metabolic disturbances
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Epidemiology & TECHNOLOGY

• Sex: affects males and females equally.

• Age: Status epilepticus occurs in all age groups but more frequently at the extremes of
age. In the elderly have an increased incidence of status epilepticus secondary to
ischaemic CNS insults.
• Mortality/Morbidity:
Mortality rate could be as high as 20%
• Death often is related to an underlying cause of brain injury.
• Mortality rate is highest in elderly patients with hypoxic or ischaemic central nervous
system (CNS) insults.
• further harm to the patient occurs when muscle breaks down and myoglobin
accumulates in the kidneys, which can lead to renal failure and electrolyte imbalance.
This is especially likely in the older adult.
 KWAME NKRUMAH UNIVERSITY OF
Causes SCIENCE & TECHNOLOGY

• Exacerbation of an idiopathic • CNS inflammatory processes

seizure disorder. • CNS lupus
• First onset of a seizure disorder • Medications
(usually a diagnosis of exclusion). • Cyclosporine
• Toxic or metabolic causes • Mepiridine
• Ciprofloxacin
• Stroke
• Cerebral infarction
• embolic
• Subarachnoid hemorrhage
• Hypoxic injury
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Causes Cont & TECHNOLOGY
• Tumours • Electrolyte abnormalities eg,
• Trauma • Hyponatremia
• Hypernatremia
• Drugs e.g.; • Hypercalcemia
• alcohol withdrawal • Hepatic encephalopathy
• Cocaine • Uraemic encephalopathy
• Theophylline
• Infectious etiology eg
• Isoniazid
• Meningitis
• brain abscess
• Encephalitis
• HIV
• Schistosomiasis (metastatic)
 KWAME NKRUMAH UNIVERSITY OF
History SCIENCE & TECHNOLOGY

• systemic or CNS neoplasms

• Infections
• Metabolic disorders
• Toxic ingestions
• Alcohol cessation
• As an initial presentation of a seizure disorder.
• Noncompliance with medications
• Injuries
• Fall
• involvement in a motor vehicle accident
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Physical characteristics
• Rhythmic tonic-clonic activity is present.
• Consciousness is impaired.
• Sometimes, status epilepticus may present as a persistent tonic seizure.
• Suspect subtle status epilepticus in any patient who does not regain
consciousness within 20-30 minutes of cessation of generalized seizure activity.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Physical characteristics CONT
• At times all motor activity may be absent.
• Associated injuries that may be present in patients with seizures
include
• tongue lacerations
• shoulder dislocations
• head trauma
• facial trauma.
• Fractures
• Defecation
• Urination
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Investigations & TECHNOLOGY
• Clinical information should guide the ordering of laboratory tests.
• The most useful diagnostic tools are an accurate and comprehensive description
of the seizures and the patient’s health history
• Status epilepticus should prompt a search for the etiology of status or potentially
reversible conditions.
• The EEG is a useful diagnostic adjuvant to the history, but only if it shows
abnormalities.
• Magnetoencephalography may be done in conjunction with the EEG.
• CT OR MRI
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE &
Laboratory studiesTECHNOLOGY

• RBS
• FBC
• Blood culture
• Electrolytes, BUN, Creatinine, Na and Calcium (especially in malignancy).
• Liver function test
• Serum levels of antiepileptic drugs
• Urine levels of drugs
• Arterial blood gas analysis
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Treatment & TECHNOLOGY
• The goal of treatment in patients with epileptic seizures is to achieve a seizures free
status without adverse effects. This goal is accomplished by in more than 60% of
patients who require treatment with anticonvulsants.
• Nasopharyngeal airway placement is sufficient for some patients, particularly if the
seizures are stopped and the patient is awakening. For other patients, endotracheal
intubation is necessary. At times, rapid sequence induction, with neuromuscular
paralysis, is necessary.
• The principle of drug therapy is to begin with a single drug based on the patient’s
age and weight; type, frequency, and cause of seizure; and then increase the dosage
until seizures are controlled or toxic side effects occur.

• If seizure control is not achieved with a single drug, the drug dosage or timing of
administration may be changed or a second drug may be added. About one third of
patients require a combination regimen for adequate control
•
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Treatment cont.
• The drugs most commonly used are lorazepam (Ativan) and diazepam (Valium).
• Because these are short-acting drugs, their administration is followed with long
acting drugs such as phenytoin or phenobarbital

• Initiate rapid glucose determination and correction.

• Establish IV access, ideally in a large vein.
• IV administration is the preferred route for anticonvulsant administration because it allows
therapeutic tissue levels to be attained more rapidly.
• Establish cardiac and other hemodynamics monitoring.
• Iv Thiamine 100mg followed by 50mls of 50% dextrose
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
Medications & TECHNOLOGY
. BENZODIAZEPINES
• Lorazepam (Ativan)
• 0.1 mg/kg at 2mg/min not exceeding 4mg or
• Diazepam (Valium)
• 0.2 mg/kg at 5mg/min up to 10mg
• Plus maintainance anticonvulsants
2. PHENYTOIN
• Phenytoin sodium
• Fosphenytoin (Cerebyx),
• Beware of the side effects of Phenytoin.
• Bradycardia
• Heart block
• Monitor BP, pulse rate and rhythm.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Refractory status epilepticus
This is Failure to respond to optimal benzodiazepine and phenytoin loading.
• Third-line drugs
1. Phenobarbital
2. Midazolam
3. Propofol
4. Pentobarbital
5. Lidocaine
Sometimes continuous infusion of benzodiazepine (diazepam)
 KWAME NKRUMAH UNIVERSITY OF
Treament cont .
SCIENCE & TECHNOLOGY
• General principle is to maximize the dosage of each drug before adding an
additional agent.
• Special consideration of Isoniazid
• Isoniazid (INH) toxicity may present with
• profound acidosis
• Seizures
• Coma
• Give Pyridoxine (Vitamin B6)
• Specific antidote for managing INH-induced seizures.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Vagal nerve stimulation:
• Vagal nerve stimulation: Vagal nerve stimulation (VNS) may be performed for
control of continuous simple or complex partial seizures.
• vns is a palliative technique that involves surgical implantation of a stimulating
device. It is currently indicated for patient older than 12 years with medically
partial seizure that are not treated surgically.
• Vns may have improved efficacy over time. Children should be carefully
monitored for the site of infection after vns implantation
• Patients experience a change in voice quality, which signifies that the vagus nerve
has beenstimulated. They usually report a relief in intensity and duration of
seizures and an improved quality of life.
• OTHER SURGICAL TREATMENT
• Lobectomy
• lesionectomy
• partial corpus callosotomy may be used to treat tonic-clonic or atonic seizures
 KWAME NKRUMAH UNIVERSITY OF
SURGICAL TREATMENT SCIENCE & TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Activity modifications
• The major problem for patients with seizures in the unpredictability of the next
seizure. Clinicians should discuss the following types of seizures precautions with
patients who have epileptic seizures:
• Ascending heights
• Driving
• working with fire or cooking
• using power tools or
• dangerous items
• taking unsupervised baths
• swimming
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Nursing management
• Assessment:
• history, including prenatal, birth, and developmental history, family history, age
at seizure onset, history of all
illness and traumas.
•Determine whether the patient has an aura before an
epileptic seizure, which may indicate the origin of seizure.
•Observe and assess neurological condition.
•Assess vitals and neurological signs continuously.
•Assess effect of epilepsy on lifestyle.
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
Nursing management
• Assessment:
• history, including prenatal, birth, and developmental history, family history, age
at seizure onset, history of all
illness and traumas.
•Determine whether the patient has an aura before an
epileptic seizure, which may indicate the origin of seizure.
•Observe and assess neurological condition.
•Assess vitals and neurological signs continuously.
•Assess effect of epilepsy on lifestyle.
KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE & TECHNOLOGY
HEALTH EDUCATION CONT
• Anticonvulsant therapy compliance
• Alcohol abstinence.
• Stress the importance of regular medical attention for medication adjustment.
• The importance of follow-up visits to adjust medications and for further medical
workup and care
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE
COMPLICATIONS & TECHNOLOGY

• Hyperthermia
• Acidosis
• Hypotension/hypertension
• Respiratory failure
• Rhabdomyolysis
• Aspiration
• Fractures
• Suicide ( sudden unexplained or unexpected death in epilepsy (SUDEP)
• ineffective coping methods
 KWAME NKRUMAH UNIVERSITY OF
SCIENCE &
NURSING DIAGNOSISTECHNOLOGY

• Risk for injury related to seizure activity.

• Fear related to possibility of having seizures.
• Ineffective coping related to stress imposed by epilepsy.
• Deficit knowledge about epilepsy and its control.
• Planning and goal
- Prevention of injury.
-Control of seizures.
-Achievement of psychosocial adjustment.
-Acquisition of knowledge.
-Absence of complications.
 KWAME NKRUMAH UNIVERSITY OF
READING AND GROUP
SCIENCE ASSIGNMENT
& TECHNOLOGY
• PARKINSON DISEASE ( GROUP 1 )
• ALZHEIMERS DISEASE ( GROUP 2 )
• HUNTINGTON DISEASE ( GROUP 3 )
• MULTIPLE SCLEROSIS ( GROUP 4 )
• GUILLAIN-BARRÉ SYNDROME ( GROUP 5 )
• MYASTHENIA GRAVIS ( GROUP 6 )
• BRAIN ABSCESS ( GROUP 7)
• ENCEPHALITIS ( GROUP 8 )
• RABIES ( GROUP 9 )
• BOTULISM ( GROUP 10)
SUBMISION DATE ( 23TH FEBRUARY 2023)
 KWAME NKRUMAH UNIVERSITY OF
References SCIENCE & TECHNOLOGY

Hinkle, J. Brunner, L.S. & Suddarth, D.S (2014). Textbook of medical surgical
nursing.13th ed. Lippincott, New York.
Burke, K.M; LeMone, P (2006). Medical-Surgical nursing care. 2nd ed. Upper
Saddle River, New Jersey: Pearson Education, Inc.
Le Hemone, & P. & Brake, K.M. (2000).Medical- surgical: critical thinking in
client care: New Jersey: Prentice Hall Inc.
Marion, J. (2001). Nursing diagnoses, outcomes and interventions. St Louis,
Mosby.
Mosby (2009) Mosby Pocket Dictionary of Medicine, Nursing and Health
Profession. 6th ed. St. Louis: Elsevier Health Sciences
Smeltzer, S., Bare, B., Hinkle, J., & Cheever, K. (2010). Brunner and Suddarth’s