This document provides information on seizures and epilepsy, including: - Definitions and classifications of seizure types such as generalized absence seizures, myoclonic seizures, generalized tonic-clonic seizures, and partial seizures. - Causes, pathophysiology, diagnostic findings, medical management, and nursing care for seizures, status epilepticus, and epilepsy. - Descriptions of diagnostic tests like EEG, CT, MRI, and information on anticonvulsant medications and surgical treatment options. - Guidelines for nursing management including seizure control and safety, medication administration, lifestyle modifications, education, and promoting independent living.

1. S E I Z U R E Dr. Anthony P. Toledo MSNET2 D I S O R D E R

2. DEFINITION Involuntary muscle contractions caused by abnormal discharged of electrical impulses from nerve cells Seizure

20. Seizure

24. E P I L E P T I C U S S T A T U S

27. PATHOPHYSIOLOGY Status Epilepticus The exact pathophysiology of why seizure evolves into status is complex and not fully understood

33. E P I L E P S Y

37. Epilepsy Causes of newly diagnosed cases of epilepsy. Despite growing knowledge of causes, 70% of cases are of unknown cause. (from Hauser, 1990)

38. Epilepsy

39. Epilepsy

40. Epilepsy

41. Epilepsy

42. Epilepsy

50. H E A D A C H E

52. COMMON LOCATIONS OF HEADACHE PAIN Headache

53. Headache The brain itself is not sensitive to pain, because it lacks pain-sensitive nerve fibers. Several areas of the head can hurt, including a network of nerves which extend over the scalp and certain nerves in the face, mouth and throat. The meninges and the blood vessels do not have pain receptors. Headache often results from traction to or irritation of the meninges and blood vessels. The muscle of the head may similarly sensitive to pain PATHOPHYSIOLOGY

54. Headache TYPES OF HEADACHE

55. Headache TYPES OF HEADACHE

56. Headache TYPES OF HEADACHE

57. Headache TYPES OF HEADACHE

59. Headache TYPES OF HEADACHE

60. Headache TYPES OF SURGICAL PROCEDURES

61. Headache

66. Headache CAUSE AND SYMTOMS CAUSE SYMTOMS dilatation of blood vessels a. nausea and vomiting b. chills c. fatigue d. irritability e. sweating f. edema

67. Headache CAUSE AND SYMTOMS

75. Headache TREATMENT (cont’d) chocolate, nuts, onions, cow’s milk, wheat, egg, orange, benzoic acid, cheese, tomato AVOID FOODS LIKE:

80. Headache D. CRANIAL ARTERITIS Cause of headache in older population, reaching its greatest incidence in those older than 70 years old TYPES OF HEADACHE 1. Primary headache (cont’d)

89. A L T E R E D LEVEL OF CONSCIOUSNESS CONSCIOUSNESS

105. I N T R A C R A N I A L I N C R E A S E D P R E S S U R E

106. Increased Intracranial Pressure Is the result of the amount of brain tissue, blood, and cerebrospinal fluid (CSF) within the skull at any one time. The volume and pressure of these three components are usually in a state of equilibrium. Because there is limited space for expansion within the skull, an increase in any of these components causes a change in the volume of the others by displacing or shifting CSF, increasing the absorption of CSF, or decreasing cerebral blood volume. The normal ICP is 10 to 20 mm Hg. Although elevated ICP is most commonly associated with head injury, an elevated pressure may be seen secondary to brain tumors, subarachnoid hemorrhage, and toxic and vital encephathies. Increased ICP from any cause affects cerebral perfusion and produces distortion and shifts of brain tissue

107. CLINIICAL MANIFESTATION Increased Intracranial Pressure When ICP increases to the point where the brain’s ability to adjust has reached its limits, neural function is impaired. Increased ICP is manifested by changes in level of consciousness and abnormal respiratory and vasomotor responses.

110. MEDICAL MANAGEMENT Increased Intracranial Pressure Increased ICP is a true emergency and must be treated promptly. Immediate management involves decreasing cerebral edema, lowering the volume of CSF, and decreasing blood volume while maintaining cerebral perfusion.

113. NURSING MANAGEMENT Increased Intracranial Pressure NURSING ALERT! Changes in vital signs may be a late sign of increased ICP. As ICP increases, pulse rate and respiratory rate decreased, and blood pressure and temperature rise. Observe for widening pulse pressure, bradycardia, and respiratory irregularity: Cheyne-Storked breathing and ataxic breathing (Cushing’s triad). Widened pulse pressure is a serious development. Immediate surgical intervention is indicated if the major circulation begins to decrease as a result of brain compression.

116. PLANNING OF GOALS Increased Intracranial Pressure The major goals of the patient may include adequate cerebral tissue perfusion through reduction of ICP, normal respiration, patent airways, restored fluid balance, normal urine and bowel elimination, absence of infection, and absence of complications.

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