complete information for the management and care of patient suffering from epilepsy definition ,classification, types, pathophysiology ,clinical manifestation, diagnostic evaluation, medical management, nursing management, care provided to the patient suffering from epilepsy .

1. EPILEPSY
Submitted To:
Mrs. Mamta Toppo
Associate professor
College of Nursing
RIMS Ranchi
Submitted By:
Sachita Tiu
Roll No. 30
Basic Bsc nursing 3rd
year
RIMS ,Ranchi

2.  Introduction
 Definition
 Causes and risk factors
 Aura
 Classification
 Pathophysiology
 Clinical manifestation
 Diagnostic evaluation
 Medical management
 Surgical management
 Complication
 Prevention
 Diet
 Nursing responsibility
 Seizure first aid
 Health education
 Nursing diagnosis
 Nursing inetervention
 Summary
 New research
 Bibliography
CONTENT

3. INTRODUCTION
 Epilepsy is derived from the Greek word
Epilepsy which means take hold of or to seize.
 In 400BC Hippocrates described that EPILEPSY is disease of
brain.
 It is a brain disorder in which a person has repeated
seizure over time (epilepsy = 2-3 seizure).
 It is caused due to electrical disturbance in the nerve cell
which results in emit abnormal reoccurring uncontrolled
electric discharge.
 It is followed by loss of consciousness, excess muscle
movement, disturbance of behavior,mood,sensation etc.

4. DEFINITION
A neurological disorder marked by sudden recurrent
episode of sensory disturbance,loss of consciousness or
convulsions associated with abnormal electrical activity
in the brain.
Or
Epilepsy is the two or more unprovoked seizure.A
chronic non-communicable disease of the brain that
affect people of all ages.
-World health organization

5. Causes and risk factors
1. Traumatic brain injury
2. Abnormal brain development
3. Disturbance in nerve signal
4. Genetic influence
5. Infection such as meningitis,encephalitis, AIDS .
6. Brain tumor
7. Exposures to lead carbon monoxide and other poison.
8. Overdose of antidepressants and other drugs.

7. AURA
 An aura is a feeling, experience, or
movement that just seems different. It can
also be a warning that a seizure is going to
happen.

8. CLASSIFICATION
Focal/
partial
seizure
Distributed/
generalized
seizure

10. When an epileptic seizure starts in
one side of the brain, it’s called a focal
onset seizure or a focal seizure.
During a focal seizure, you stay fully aware
of what’s happening around you, even if you
can’t move or respond.
1. FOCAL SEIZURE

11. Simple Complex
Type

12. SIMPLE PARTIAL SEIZURE
 A simple partial seizure is a type
of seizure associated with epilepsy. It may
also be referred to as a focal seizure
 During a simple partial seizure, formerly
known as a focal seizure, the individual
remains aware.
 A simple partial seizure may involve sensory,
motor, psychic, or autonomic symptoms.

13. Complex partial seizure
• The persoon may loss consciousness for a period of time.
• It may result in altered consciousness,non purposeful
movement eg.walking in circulation, hand tubing etc.

14. 2.Generalized seizure
Generalized seizures are
characterized by the sudden onset
of abnormal electrical activity
involving both sides of the brain.
There are six different types of
generalized seizure.


15. Type of generalized seizure

16. Absence seizures: Historically
known as petit mal seizures, absence
seizures involve a short period of time
in which you lose a sense of
awareness or "space out." This type is
most common in children between the
ages of 4 and 14 and usually lasts 20
to 30 seconds

17. Tonic
seizures: These
seizures cause
your muscles to
suddenly stiffen,
which
can prompt you to
fall if you're
standing up. Tonic
seizures often
happen during
sleep and usually
involve a loss of
consciousness

18. Atonic seizures: When you
have an atonic seizure, your
muscles lose tone and control,
becoming limp, and you may
collapse. These are often referred
to as "drop seizures."

19. Myoclonic seizures: If you've
ever been asleep and suddenly woken
up because one of your muscles
suddenly jerked, you know what a
myoclonic seizure feels like. These
seizures involve sudden, quick jerks in
your arms or legs. You may have a
number in a row or just one on
occasion.

20. Clonic seizures:Similar to
myoclonic seizures, clonic seizures
involve sudden, jerky muscle
movement, only in this case, it's
repetitive. Usually, clonic seizures
are involved in a tonic-clonic
seizure.

21. Tonic-clonic seizures: Previously called
grand mal seizures, these seizures are the type
that most people associate with epilepsy. First,
in the tonic stage, your muscles stiffen, then you
lose consciousness and fall to the ground. Next
is the clonic stage, in which your arms and
sometimes your legs begin jerking or twitching
quickly and repeatedly. These seizures typically
last for a few minutes.

23. What is this seizure called?

24. PATHOPHYSIOLOGY

25. Clinical manifestation
Partial seizure
 Consciousness is fully preserved.
 Motor disturbance in any part of
body.
 Electric shock like feeling,tingling
 Hallucinations
 Change in skin colour, BP, heart rate,
pupil size
 Memory disturbance.
 Illusion of size , structured
hallucinations, fear, ,
irritability,depression.
 Aura may be present for short time.
Generalized seizure
 Temporary confusion
 Uncontrollable jerking
movement of arms and legs
 Loss of consciousness and
awareness.
 Involuntary changes in body
movement,function , sensation
or behavior.
 Dizziness, tightening of chest.

26. DIAGNOSTIC EVALUATION
1. Physical examination
2. Neurological and behavioral
examination
3. Blood test
4. Lumber puncher
5. EEG
6. CT
7. MRI
8. PET
9. Neuropsychological test

27. MEDICAL MANAGEMENT
1. Carbamazepine
1600mg/day
2. Phenytoin
3. Clonazepam 20mg/day
4. Valporic acid
15mg/kg/day
5. Ethosuximide1000mg/day

28. SURGICAL MANAGEMENT
 Temporal Lobectomy
 Extra temporal
resection
 Corpus callostomy
 Hemispherectomy
 Vagus nerve
stimulation.

29. COMPLICATION
 Hematoma
 Hemorrhage
 Aseptic meningitis
 Infection
 Deep vein thrombosis
 Dysphasia
Death

30. PREVENTION
1. Prevent traumatic brain injury (wear helmet
& seat belt.
2. Get adequate sleep at night.
3. Stay away from alcohol and drugs.
4. Minimize screen timing (TV
/phone/computer).
5. Manage stress
6. Practice meditation,relaxation
technique,yoga and deep breathing exercise
to decrease anxiety and depression.
7. Keep away from bright light and other visual
stimuli.

32. DIET
MANAGEMENT
Ketogenic diet is
preferred.
It means food rich in:-
1. Fat
2. Low carbohydrates
3. Normal protein
4. Vitamin
5. Calcium reach food

33. NURSING RESPONSIBILITY
 Move harmful object out of the way,cushion the head and protect the person
from falling.
 Side rails should be padded to prevent injury.
 Lossen ties , scarves and other neckware.
 Don’t put anything in person mouth.
 The individual should not be restrained because this may increase the risk of
injury.
 Oral airway and suction should be redily available.
 Make sure the airway is clear and the person is breathing.

34. NURSING DIAGNOSIS
 Risk for injury related to loss of consciousness during
seizure activity and post physical weakness.
 Ineffective airway clearance related to blockage of the
tongue,enditrachial, increase secration of saliva.
 Ineffective breathing pattern related to neuromuscular
impairment, dyspea and apnea
 Risk for ineffective cerebral tissue perfusion related to
decreased oxygen supply to the brain.
 Ineffective self -health management related to drug
therapy and life style adjustment.

35. NURSING
INTERVENTION

36. Risk for injury releated to loss of
consciousness during seizure activity and
post physical weakness.
 Remove potentially harmful object from the environment.
 Keep sucction, ambulance bag ,oral or nasopharyngeal airway
and oxygenation if needed.
 Use padded side rails to prevent injury during a seizure.
 Instruct patient to carry medic ID card to provide information in
case of emergency.
 Remain with the patient during seizure to protect from injury.
 Monitor neurological status to identify any deficits resulting
from seizure.
 Record seizure characteristics: body part involved,motor
activity and seizure progression.

37. Ineffective airway clearance related to
blockage of the tongue,
endotracheal,incresed secretion of saliva.
 Auscultate breathing sound every 1 to 4 hours.
 Monitor respiratory pattern including :rate
,depth, and efforts.
 Monitor blood gas values and pulse oxygen
saturation levels as available.
 Provide proper position ,elevate head of the bed
up to 30-45degree.

38. Ineffective breathing pattern releated to
neuromuscular impairment,dyspnea and
apnea .
 Monitor respiratory and oxygenation status to
determine presence and extent of breathing problem
and to initiate appreciate intervention.
 Provide side line position to maximize ventilation
potential and decrease risk of aspiration.
 Perform endotracheal or nasotracheal suctioning to
maintain airway.
 Loosen clothing to prevent restricted breathing.
 Maintain oxygenation and prevent hypoxia.

39. Risk for ineffective cerebral tissue perfusion
releated to decrease oxygen supply to the
brain
Maintain head of the bed flat or
less than 30 degree.

40. Inefficient self health management releated
to drug therapy and lifestyle adjustment.
 Assess the patient’s current level of knowledge
related to specific disease process to establish
learning needs.
 Discuss life style changes.
 Discussion therapy/ treatment option and
describe rationale behind management so that
the patient and family can make lifestyle
modification to manage a chronic disease.

42. HEALTH EDUCATION
 Safty education and first aid training
 Medication information and seizure reduction plan
 Social and mental health education.
 Counselling to patient and family members.
 Take mediation exactly as directed,skipPing dozes can
affect the way your body handles the mediation which
would cause to have a seizure
 Don’t drink alcohol or use any mediation without talking
with your health care first.
 Wear a medic alert identity card

43. Summary
Epilepsy is a neurological disorder
caused by the electrical disturbance
in the brain.This electrical disturbance
causes episode called as seizure.It can
occurred in any age group.I t is
classified into two parts : Focal and
generalized seizure.

44. NEW RESEARCH

46. BIBLIOGRAPHY
1. PV A Textbooks of medical surgical nursing Page no
353-356.
2. Brunnars And suddarth Text book of medical
surgical nursing.twelve edition page no.290-295
3. www.Wikipedia.org
4. www.Slideshare.net.in
5. www.Healthline.com
6. www.researchgate.com

47. THaNk You☺️