Epilepsies 
Definition
Group of syndromes characterized by periodic seizures.
Epileptic syndromes are categorised by specific trends of
symptoms, involving age of onset, family history, and seizure type.
Epilepsy can be primary (idiopathic)
or secondary, when the cause is known and the epilepsy
is a symptom of another underlying condition such as a brain tumour
Pathophysiology
neurons of the brain carry messages from the body
occurs through discharges of electrochemical energy that sweep through them.
These impulses occur in surges
if a neuron has to perform a duty
at times these nerve cells proceed firing after a duty is completed.
at the time of undesirable discharges, parts of the body
controlled by the errant cells may function intermittently.
Resultant dysfunction ranges from normal to
incapacitating and causes unconsciousness
When the occurrence of uncontrolled, abnormal discharges are seen repeatedly,
an individual has: epileptic syndrome
Epilepsy does not affect intellectual level. individuals with
epilepsy without other CNS disorders has the same
intelligence as the overall population.
Epilepsy is not a mental condition or disorder
Clinical manifestations
Abdominal breathing
Noisy breaths
Muscles sores
Sleeping for hours
Mood swings
Deep coma
Difficulty in arousing & confusion
Fatigue
headache
Diagnostic tests
electroencephalogram (EEG)
Single photon emission computed tomography (SPECT)
biochemical, hematologic, and serologic studies.
MRI
Pharmacologic therapy
carbamazepine (Tegretol)
clonazepam (Klonopin)
ethosuximide (Zarontin)
felbamate (Felbatol)
gabapentin (Neurotonin)
lamotrigine (Lamictal)
levetiracetam (Keppra)
oxacarbazepine (Trileptal)
phenobarbital (Luminal)
phenytoin (Dilantin)
primidone (Mysoline)
tiagabine (Gabitril)
topiramate (Topamax)
valproate (Depakote, Depakene)
zonisamide (Zonegran, Excegran
Nursing Care During a Seizure
Screen and Provide privacy and protect the patient.
lower the patient to the floor, if possible.
Provide head protection: a pad to prevent injury (from reaching a
hard surface abruptly).
Loosen tight clothes
Remove any furniture that can injure the patient during the seizure.
If the patient is in bed, take away pillows and raise side rails.
prevent the tongue or cheek from being bitten by putting .
an oral airway during a seizure with aura
Do not try to open jaws that are compressed in a spasm to put anything.
Broken teeth and injury to the lips and tongue can occur
No means should be made to restrain the patient during the seizure
since muscular contractions are strong restraints can lead to injury.
Position patient properly and suction saliva and mucous is available
Nursing Care After the Seizure
Place the patient on one side for aspiration prevention.
ensure patent airway exist.
expect period of confusion after a grand mal seizure.
A short difficulty in breathing period may occur
during or immediately after a general seizure.
orientate patient again, after waking up, to the environment.
Restrain the patient If he becomes agitated after a seizure (postictal),
use calm persuasion and gentle restraints