Seizure Disorders

Caring for Children in a Community

Program

2014-02-04

Seizures•Abnormal burst of electrical signals in the brain•When a person has more than one seizure, it is called a seizure disorder or epilepsy

SeizuresThe part of brain where erratic impulses occur affects where seizure occurs in body

Causes of Seizures• Problems with brain development before birth• Lack of oxygen or damage to

brain during/after birth• Brain injury • Brain infections • Metabolic conditions • Interruption in blood flow to the brain (e.g., stroke)• Brain tumor

Triggers for Seizures

• Missing a regular dosage of anti-seizure medication• Stress, excitement• Lack of sleep• Poor lifestyle habits • Illness, fever• Flickering lights • Hyperventilation• Extreme emotions • Heat, humidity• Hormonal changes

Types of Seizures

Generalized– Tonic clonic– Absence– Myoclonic– Atonic

Partial– Simple partial– Complex partial

Tonic Clonic Seizure(generalized)

•Suddenly loses consciousness•Body stiffens (tonic phase)•Body jerks repeatedly (clonic phase)•Skin may turn pale or blue/grey•May cry out•May have changes in breathing•May clench teeth•May bite tongue•May drool or have increased salivation•May lose bladder and bowel control•Will be confused and tired after the seizure

Responding to Tonic Clonic Seizure

During the seizure1. Note the time when you become aware of

the seizure.2. Put the child on the floor in a side-lying

position. Loosen tight clothing around the neck.

3. Keep the child safe. Move any harmful objects out of the child’s way.

4. Stay with the child.

After the seizure• Stay with the child.• Reassure and comfort the child. • Inform the parent/guardian that the seizure occurred.

Other Generalized Seizures

Absence• Brief• Stares blankly• May have eye blinking, fluttering or upward

rolling eyes• Loss of consciousness

Myoclonic• Brief• Sudden muscle jerks – may be mild or intense,

can affect one part or whole body• Occurs more frequently when falling asleep or

upon awakening, may occur in succession• No loss of consciousness• Recovers within seconds

Atonic• Brief• Sudden loss in muscle tone – if standing, may

fall to the ground• If loss of muscle tone is severe, dramatic loss of

muscle tone occurs• Loss of consciousness

Responding to Absence, Myoclonic & Atonic

Seizures

Wearing a helmet may be recommended for children with myoclonic and atonic seizures.

During the seizure1. Stay with the child.2. Keep the child safe. Move child if in

an unsafe place.

After the seizure• Check for injuries, if applicable.• Reassure and comfort the child.

Partial SeizuresSimple partial•Affects movement, sensations, emotions or autonomic functions

•May have jerking movements•May see or hear things that are not there•May appear sad, afraid, angry, laugh out loud.

•May experience loss of sensation, tingling, pain or nausea

•Awake & aware

Complex partial seizures •May begin with an aura (warning sign) •May stare or appear dazed•May make repeated motions (automatisms) •May appear dizzy, confused, anxious, scared, angry and experience abdominal pain or an unusual taste or odor. •May respond inappropriately•May be confused and tired after the seizure•Altered level of consciousness.

Complex Partial Seizures

During the seizure1. Note the time you become aware of

the seizure.2. Keep the child safe. Move child if in

an unsafe place. Guide child away from hazards.

After the seizure• Reassure and comfort the child. • Reorient to surroundings.

If the seizure progresses to a secondarily generalized seizure (partial seizures that spread throughout the brain to become a generalized), implement the response for tonic-clonic seizures.

Observing Seizures

•Length of the seizure•Time and date seizure occurred•Description of seizure activity observed. •Activities child was participating in •Exposure to possible triggers

• Seizure lasts longer than 5 minutes

• Repetitive seizures with no recovery in between

• Serious injury • Other medical concerns• Pregnant, diabetes

Emergency Situations

1. Activate 911/EMS. 2. Notify parent/guardian.

Do NOT leave child alone.

Treatment of Seizures

• Anti-seizure medication• Rescue medication• Surgery• Ketogenic diet• Vagus Nerve Stimulator

Anti-seizure Medication

• Most common treatment• Usually taken at home• Common side effects

– Drowsiness– Fatigue– Changes in attention span– Changes in appetite– Mood swings– Altered balance– Decreased coordination

Rescue Medication

• To stop seizure or prevent further seizures occurring in a cluster

• Lorazepam, Midazolam• Usually given after 5 minutes of

seizure activity– When to give rescue medication is

specific in health care plan– If you did NOT witness start of seizure,

administer rescue medication immediately

Administering Lorazepam

1. Place Lorazepam between inner cheek and gum. Massage cheek gently.

2. Activate 911∕EMS if seizure does not stop after specified amount of time (see health care plan).

3. Notify parent ∕ guardian.

4. Stay with child until EMS arrives.

Precautions

• Children should be allowed to enjoy a wide range of activities

• Some activities may require precautions

– Swimming– Climbing– Cycling– Bathing

Child specific information

• History of seizure activity• Typical length & frequency

of seizure(s)• Precautions, if any• Location of rescue

medication, if prescribed

Health Care Plans are located in child file and binder