Anndy Prastya

Department of Emergency Nursing

Stikes Majapahit Mojokerto
Episodes of uncoordinated electrical activity in
brain
Signs/symptoms depend on area involved
Epileps
yactivity
Tendency to have repeated episodes of seizure
Seizure Types
 Grand mal (major motor)
 Petit mal (absence)
 Focal motor (simple partial)
 Psychomotor (complex
partial)
Grand Mal Seizure
 Aura
 Sensation coming before convulsion
 Patient may recognize as sign of
impending
seizure
 May help locate origin of seizure in brain
Grand Mal Seizure
 Convulsion
 Loss of consciousness
 Tonic phase - rigidity
 Clonic phase - rhythmic jerking,
incontinence, ineffective breathing
Grand Mal Seizure
 Post-ictal Phase
 Exhaustion

Drowsiness
 Headache
 Possible
hemiparesis
(Todd’s
paralysis)
Petit Mal Seizure
 Loss of consciousness
 No loss of postural tone
 More common in
children
Focal Motor Seizure
 Rhythmic jerking of limb, one side of
body
 No loss of consciousness
Psychomotor Seizure
 Loss of consciousness
 Sterotyped movements (automatisms)
 May look purposeful, but aren’t
 Lip smacking, movements of hands
 May be called in as “drunk”, “O.D.”,
“psych patient”
Generalized Seizure Management
 During seizure
 Remove from potential harm
 Do not forcibly restrain
 Roll on left side
 Avoid putting anything in
mouth
Generalized Seizure Management
 After seizure
ends
 Assess ABC’s
 Clear airway

Most common cause of

seizure deaths is post-
ictal airway loss
Generalized Seizure Management
 Assist breathing if ventilation
inadequate
 High concentration O2 - immediately!!
Generalized Seizure Management
• Obtain history/physical

•  Trauma that could have caused, been caused by

seizure
•  Anti-seizure medications
• Neuro/vital signs every 5 minutes

•  If patient ventilating adequately, transport on

left side
Seizures
 Anything that injures brain can cause seizures
(AEIOU/TIPS)
• A – Alcohol • T- Trauma
• E – Epilepsy • I - Infections
• I – Insulin • P - Psychiatric
• O – Opiates • P - Poisons
• U – Urea • S - Shock
 Do not assume seizures are due to idiopathic
epilepsy
until proven otherwise
Status Epilepticus
 > 2 seizures without
intervening
conscious period
 Immediate Life Threat
 Management
 Secure airway
 Assist breathing with O2
 Transport
 Request ALS intercept
Thanks…