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نسخة نسخة Seizures
نسخة نسخة Seizures
نسخة نسخة Seizures
seizure
Academic Year 2023
Semester 2nd
Program: Nursing
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Index:
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Introduction:
Although seizure and epilepsy is one of the most prevalent and severe neurologic disorders, our
knowledge of its intricate pathophysiology and, consequently, the rationale for much of its therapy,
is still limited. In order to introduce neuroscientists to areas that might be subject to scientific
inquiry, this article addresses the clinical features of seizures and epilepsy. The definitions of
seizures and epilepsy, a review of diagnostic techniques, a discussion of numerous clinical
syndromes, and elements of differential diagnosis,
The following article gives for neurologist and nurses a general understanding of seizures and
epilepsy. Our discussion of processes, epileptogenesis, and therapeutic strategies is wide in scope
rather than clinically specific, and we pose concerns that may be of interest to basic scientists.
Numerous sources (Engel and Pedley 2008; Duchowny et al. 2012; Engel 2013) provide additional
details on differential diagnosis, pharmacological dosages, and clinical care.
Before classifying seizures and epilepsy, we first define seizures and epilepsy.
genetics and pathophysiology. The need of a precise historical account of an incident that may have
been a seizure is then discussed, along with the proper application of ancillary/confirmative testing
such the electroencephalogram (EEG), neuroimaging, and genetic analyses. With the aid of these
techniques, a physician is able to distinguish epilepsy from a variety of clinical illnesses that
resemble seizures but are pathophysiologically unrelated to epilepsy.
è Definition:
Seizures are episodes of abnormal motor, sensory, autonomic, or psychic activity (or a
combination of these) that result from sudden excessive discharge from cerebral neurons.A part
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or all of the brain may be involved. The two primary categories of seizures recognized
internationally are generalized seizures, which include electrical discharges throughout the
entire brain, and partial seizures, which start in one specific area of the brain.. While
consciousness is reduced during a complex partial seizure, it is intact during a simple partial
seizure. The term "unclassified seizures" refers to seizures with insufficient data. One region of
the brain's nerve cells have an electrical disruption (dysrhythmia) that results in aberrant,
recurrent, uncontrolled electrical discharges
This increased neuronal discharge manifests as the typical seizure.There may also be associated
loss of awareness, excessive movement, loss of muscular tone, and behavioral, emotional,
sensory, and perceptual problems.
Only with symptoms of awareness impairment, compound forms, cognitive symptoms, affective
symptoms, psychosensory symptoms, psychomotor symptoms (automatisms), and psychomotor
symptoms
Tonic -clonic seizures ,Tonic seizures, Clonic seizures, Absence petit mal seizures, Atonic
seizures, Myoclonic seizures bilaterally massive epileptic Unclassified seizures
epilepsy :
A category of diseases known as epilepsy are characterized by unprovoked, recurrent seizures.
Specific clinical characteristic patterns serve as a classification system for epileptic disorders.
At least two unprovoked seizures that happen more than 24 hours apart are considered epilepsy
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Causes:
Seizure causes can be categorized as idiopathic (genetic, developmental abnormalities), acquired, or
a variety of other causes.
Acquired seizure causes include cerebral vascular disease, hypoxia of any kind, including vascular
insufficiency, fever in children, head injury, hypertension, and infections of the central nervous
system.toxic and metabolic situations (such as exposure to viruses, hyponatremia, hypocalcemia,
hypoglycemia, and renal failure), aging of the brain, drug and alcohol withdrawal, Allergies
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Diagnostic examination (lab results)
Epileptic seizures range substantially in scientiic
phenomenology and might markedly have an effect on the
affected person's pleasant of life. As healing interventions
cognizance on discount or removal of seizures, the correct
documentation of seizure incidence is essential. However,
affected person self-assessment as compared with goal
assessment through video-electroencephalography (EEG) tracking or long-time period ambulatory
EEG discovered that sufferers ile fewer than 50% in their seizures, on average, and that
documentation accuracy varies extensively over time. For properly scientiic exercise in epilepsy,
novel and viable seizure detection strategies for ambulatory long-time period use are needed.
Generalised tonic-clonic seizures can already be detected reliably through techniques that depend on
movement recording (eg, loor electromyography). However, the automated detection of different
seizure types, consisting of complicated partial seizures, would require multimodal methods that
integrate the size of ictal autonomic alterations (eg, coronary heart rate) and of feature motion
patterns (eg, accelerometry). Innovative and viable gear for computerized seizure detection are in all
likelihood to boost each tracking of the inal results of a remedy in a affected person and scientiic
studiesin epilepsy.
Medical management:
In convulsive reputation epilepticus (SE), accomplishing seizure manage inside the first 1–
2 hours after onset is a substantial determinant of outcome. Treatment is likewise much more
likely to paintings and be fee powerful the sooner it's far given. Initial first useful resource
measures have to be followed via way of means of setting up intravenous get right of entry to
if viable and administering thiamine and glucose if required. Calling for assist will assist green
management, and additionally the capability for video-recording the events. This may be
carried out as a exceptional hobbies research to tell later management, furnished ok steps to
guard statistics are taken. There is excessive excellent proof helping using benzodiazepines for
preliminary treatment. Midazolam (buccal, intranasal or intramuscular) has the maximum
proof in which there's no intravenous get right of entry to, with the realistic blessings of
management outweighing the marginally slower onset of action. Either lorazepam or diazepam
are appropriate IV agents. Speed of management and ok preliminary dosing are in all
likelihood greater essential than preference of drug. Although simplest phenytoin (and its
prodrug fosphenytoin) and phenobarbitone are certified for mounted SE, a now giant frame of
proof and worldwide consensus helps the application of each levetiracetam and valproate as
alternatives in mounted reputation. Both additionally
have the benefit of being nicely tolerated as
protection treatme.
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Nursing intervention:
Nursing interventions for seizure :
1-Keep sharp objects away from the patient during the seizure
Complications:
Any age group might be affected by seizures. They may pose a life-threatening situation if
untreated. Its difficulties include, among others:
Kids have trouble learning , permanently harm the brain , pneumonia due to aspiration , mental
health problems , problems with pregnancy , injuries sustained from falls, loss of orientation, and
cuts while performing normal tasks like driving or climbing stairs. Kidney damage is one of the
most prevalent side effects of medications
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Conclusion:
Seizure under-reporting has been proven in numerous studies5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16,
17, 18 with unique designs and settings, and this locating represents a irst-rate project for scientiic
studies into epilepsy. Overall, best approximately 50% of seizures are suggested via way of means
of sufferers and under-reporting is greater common for complicated partial seizures or seizures
taking place throughout the night. Lack of attention that a seizure has took place seems to be the
number one reason for under-reporting.
Chemotherapy has very harmful side effects but can treat cancer cells that have spread throughout
the body. These therapies are
still in use today, albeit
they might not be the only
ones.
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Reference
1-Brunner & Suddarth’s textbook of medical-surgical nursing. 12th ed. Page (1881)
Causes :
https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-
20365711
Physical examination ( signs and symptoms) :
American College of Emergency Physicians Clinical Policies Committee, Clinical
Policies Subcommittee on Seizures. Clinical policy: critical issues in the evaluation
and management of adult patients presenting to the emergency department with
seizures. Ann Emerg Med. 2018;43:605-25
Diagnostic studies:
RD Nass et al. The role of postictal laboratory blood analyses in the diagnosis and
prognosis of seizures
Medical management:
Acute systemic complications of convulsive status epilepticus-a systematic review
Crit Care Med, 46 (2018), pp. 138-145
Association of time to treatment with short-term outcomes for pediatric patients with
refractory convulsive status epilepticus
JAMA Neurol, 75 (2018), pp. 410-418
Nursing intervention:
NANDA international nursing Diagnoses: Definition & classification 2021-2023
Conclusion:
Automated seizure prediction Epilepsy & Behavior, Volume 88, 2018, pp. 251-261
The future of seizure detection The Lancet Neurology, Volume 17, Issue 3, 2018, pp.
200-202