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Management of Seizures. Management of Seizures. Seizure management Introductions House keeping items Washrooms Breaks. Learning Objectives. Definition of a seizure/epilepsy. Facts about epilepsy. Cause of seizures. Common types and treatments of seizures.
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Management of Seizures • Seizure management • Introductions • House keeping items Washrooms Breaks
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.
Definition of a Seizure • A 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.
What is the difference between a seizure and epilepsy? “I’m not sure!”
Seizure versus Epilepsy • A 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.
Seizure versus Epilepsy • Many people with epilepsy have different types of seizures that can happen frequently. • Having one seizure does not mean you have epilepsy.
General Information • Most 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.
General Information • Seizures can last a few seconds or a few minutes. • Seizure may need medical attention if they last too long. • People cannot swallow their tongue
Causes of Seizures • Head trauma: car and sport accidents, falls, blows to the head. • Brain tumors and strokes • Poisoning: lead poisoning and drug withdrawal • Lack of oxygen to the brain for any reason the person can develop seizures.
Types of Seizures • Partial 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.
Partial Seizures • Simple 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).
Partial Seizures • Complex 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.
Complex Partial Seizures • Unresponsive 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.
Generalized 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.
Generalized Seizures • Include: • Absence Seizures- • Blank stare, beginning and ending abruptly. • Lasts a few seconds. • Looks like the child is “day dreaming”. • Most common in children.
Generalized Seizures • Myoclonic Seizures- • Sudden brief, massive muscle jerks. • Parts of /or the whole body may be involved. • May fall out of a chair.
Generalized Seizures • Tonic Clonic- • Loss of consciousness. • Sudden cry • Fall to the ground. • Stiffening and rhythmic jerking of muscles Altered or shallow breathing.
Generalized Seizures • May stop breathing temporarily. • Skin may turn a bluish color. • Possible loss of bowel and bladder. • Can last a few minutes.
Atonic Seizures (drop attacks)- • Sudden collapse and fall. • May recover after 10 seconds to a minute.
Status 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.
Treatment for Seizures • Medication • Surgery • Ketogenic Diet • Vagal Nerve Stimulator
Goals of Treatment • Decrease the frequency and severity. • Use the smallest amount of drug. • Suffer the fewest side effects • Improve the quality of life.
Medication • Most 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:
Side-Effects of Medications • Drowsiness • Irritability • Nausea • Skin rash • Visual impairment • Hyperactivity
Ketogenic Diet • High 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.
Surgery • Only 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.
Vagus Nerve Stimulator • Vagus 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
Vagus Nerve Stimulator http://www.epilepsy.com/epilepsy/vns
Documentation Why do we document seizures?
Documentation • Assists 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.
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.
Record • Loss 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?
First 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-putsomething 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
Seizure First Aid • Record: the seizure time or length • Describe the seizure: behavior before during and after the seizure • Notify: appropriate people, parents, others • Aspiration / choking
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