Management of SeizuresManagement of Seizures

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Management of SeizuresManagement of SeizuresSeizure management

Introductions

House keeping items Washrooms Breaks

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Learning Objectives Learning Objectives Definition of a

seizure/epilepsy.Facts about

epilepsy.Cause of

seizures.Common types

and treatments of seizures.

Emergency care during a seizure.

Documenting a seizure.

5 new facts about seizures that participants can share with school and staff.

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What is a Seizure? Think What is a Seizure? Think Brain!Brain!

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Definition of a SeizureDefinition of a SeizureA brief abnormal disturbance of

electrical activity of the brain.

A seizure may be a brief staring spell, unusual movement of the body or limb, a change in awareness, or a convulsion.

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What is the difference between What is the difference between a seizure and epilepsy?a seizure and epilepsy?

“I’m not sure!”

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Seizure versus EpilepsySeizure versus EpilepsyA seizure may happen in a person

due to an illness, fever or a temporary medical condition( i.e. brain tumor).

After the illness is treated and resolved the seizure does not happen again.

Epilepsy is a ongoing series of seizures. The seizures can occur frequently without a known cause.

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Seizure versus EpilepsySeizure versus EpilepsyMany people with epilepsy have

different types of seizures that can happen frequently.

Having one seizure does not mean you have epilepsy.

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General InformationGeneral InformationMost of the people with epilepsy

can lead a normal life.Approximately 30,000 people in

Canada have epilepsy.Anyone can development

epilepsy at any age.Epilepsy is usually diagnosed in

childhood.

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General InformationGeneral InformationSeizures can last a few seconds

or a few minutes. Seizure may need medical

attention if they last too long.People cannot swallow their

tongue

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Causes of SeizuresCauses of SeizuresHead trauma: car and sport

accidents, falls, blows to the head.Brain tumors and strokesPoisoning: lead poisoning and drug

withdrawalLack of oxygen to the brain for any

reason the person can develop seizures.

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Types of SeizuresTypes of SeizuresPartial seizures: seizures that

involve part of the brain. Examples are simple partial or complex partial seizures.

Most common seizures.Non-convulsive.May spread to the whole brain.Consciousness can be impaired,

but not lost.

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Partial SeizuresPartial SeizuresSimple Partial Seizure:No loss of consciousness.Generally no warning.Person does not lose awareness of

environment.Jerking in one part of the body (ie

arm/leg).

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Partial SeizuresPartial SeizuresComplex Partial:Consciousness is impaired. May start with a blank stare.May see altered behavior like picking

at clothing, lip smacking or chewing.Person may be unaware of

surroundings.

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Complex Partial SeizuresComplex Partial SeizuresUnresponsive when spoken to.May walk about the room.Seizure may last a few minutes.Will be confused when the

seizure is over.No memory of what happened

during seizure.

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Generalized SeizuresGeneralized Seizures

Seizure affects the whole brain:Person loses consciousness.Can be convulsive or non-

convulsive.An aura could occur first.Can be detrimental to the health

of a person if continuous.

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Generalized SeizuresGeneralized SeizuresInclude:Absence Seizures-Blank stare, beginning and

ending abruptly.Lasts a few seconds. Looks like the child is “day

dreaming”.Most common in children.

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Generalized SeizuresGeneralized SeizuresMyoclonic Seizures-Sudden brief, massive muscle

jerks.Parts of /or the whole body may

be involved.May fall out of a chair.

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Generalized SeizuresGeneralized SeizuresTonic Clonic-Loss of consciousness.Sudden cry Fall to the ground.Stiffening and rhythmic jerking of

muscles Altered or shallow breathing.

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Generalized SeizuresGeneralized SeizuresMay stop breathing temporarily.Skin may turn a bluish color. Possible loss of bowel and

bladder.Can last a few minutes.

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Atonic Seizures (drop attacks)-

Sudden collapse and fall.May recover after 10 seconds to

a minute.

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Status EpilepticusStatus Epilepticus

Any seizure that lasts longer than 30 minutes with or without loss of consciousness.

May occur after stopping medications.

Can be life threatening if not treated immediately.

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Treatment for SeizuresTreatment for SeizuresMedicationSurgeryKetogenic DietVagal Nerve Stimulator

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Goals of TreatmentGoals of Treatment

Decrease the frequency and severity.

Use the smallest amount of drug.Suffer the fewest side effectsImprove the quality of life.

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MedicationMedicationMost common treatment.Many types of medications

available.Side-effect of drugs depend on

the drug and person.Epilepsy can be controlled with

medications.Common side-effects:

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Side-Effects of Side-Effects of MedicationsMedicationsDrowsinessIrritabilityNauseaSkin rashVisual impairmentHyperactivity

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Ketogenic DietKetogenic DietHigh fat, low carbohydrate, low

protein.Fluids are restricted.Burns body fat instead of glucose.Must have medical advice and

instruction.Risks: low blood sugar and weight

loss.Difficult to follow.

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SurgerySurgeryOnly possible if seizures occur in

a small part of the brain.Used as last resort.Cannot be done if speech or

memory will be affected.Results vary from partial to full

improvement.

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Vagus Nerve StimulatorVagus Nerve StimulatorVagus nerve stimulator (VNS) is

designed to prevent seizures.Works similar to heart

pacemakers.VNS sends mild electrical

impulses to the brain by way of the vagus nerve.

View following video on next slide re: VNS

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Vagus Nerve StimulatorVagus Nerve Stimulator

http://www.epilepsy.com/epilepsy/vns

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Documentation Documentation

Why do we document seizures?

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DocumentationDocumentationAssists in the diagnosis and

treatment of the disorder.Indicates changes in the pattern

or severity of seizures.Help the doctors evaluate the

treatment.Alerts the family to events that

may cause seizures.

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Record Record Date and time of the seizure.Any warning signs prior to the

seizure.Describe the body parts involved

and the progression. Type of movement (jerky,

rhythmic, rigid).Breathing changes and changes

in color.

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RecordRecordLoss of consciousness.Behavior after the seizure (i.e.

drowsiness, disorientation, recovery time.)

Loss of bladder or bowel control.Who needs to know about the

seizure?

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Management of SeizuresManagement of Seizures

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Seizure First AidSeizure First Aid

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First AidFirst Aid Position person, stay, and remain calm Wheelchair or side position only Never put them on their back Never leave a person during a seizure Call for help Protect Person-put something soft under their head

Do not restrain move objects out of thrashing range

Put nothing in the mouth

Loosen restrictive clothing

Offer reassurance following seizure

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Seizure First AidSeizure First AidRecord: the seizure time or

lengthDescribe the seizure: behavior

before during and after the seizure

Notify: appropriate people, parents, others

Aspiration / choking

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http://www.bcepilepsy.com/publications_and_resources/lecture-and-info-videos.aspx

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