CANSINO, Gianelei Vianne F.

BSN III-L3 Type of Seizure Specific Type Description People may experience unusual sensations such as uncontrollable jerky motions of a body part, sight or hearing impairment, sudden sweating or flushing, nausea, and feelings of fear. Only a finger or hand may shake, or mouth may jerk uncontrollably A person may talk unintelligibly, may be dizzy May experience unusual or unpleasant sights, sounds, odors, or tastes Without loss of consciousness A.K.A. Temporal lobe epilepsy or Psychomotor seizure Lasts for only one or two minutes Person either remains motionless or moves automatically but inappropriately for time and place May experience emotions of fear, anger, elation, or irritability The person does not remember the episode when it is over. May be preceded by an aura (a warning sensation characterized by feelings of fear, abdominal discomfort, dizziness, or strange odors and sensations Usually less than 20 seconds. Muscle tone is greatly increased and the body, arms, or legs make sudden stiffening movements. Consciousness is usually preserved. Most often occur during sleep and usually involve all or most of the brain, affecting both sides of the body. If the person is standing when the seizure starts, he or she often will fall. Person feels tired after seizure. Consist of rhythmic jerking movements of the arms and legs, sometimes on both sides of the body. Not followed by a period of tiredness or confusion Nursing Management Keep the bed in a low position with side rails up, and use padded side rails as needed. Observe and document the following: a. Date, time of onset, duration b. Activity at time of onset c. Level of consciousness (confused, dazed, excited, unconscious) d. Presence of aura (if known) e. Movements Safety measures should be taken if there is an indication that the person is experiencing an aura before the onset of a seizure. Observe and document the following: a. Date, time of onset, duration b. Activity at time of onset c. Level of consciousness (confused, dazed, excited, unconscious) d. Presence of aura (if known) e. Movements Stay with the client Protect patient from injury Promote patent airway. Observe and document the following: a. Date, time of onset, duration b. Activity at time of onset c. Level of consciousness (confused, dazed, excited, unconscious) d. Presence of aura (if known) e. Movements Stay with the client Let patient lie down on floor Do not restrain movement

1. Partial Seizures

a. Simple Partial Seizures

b. Complex Partial Seizures

2. Generalized Seizures

a. Tonic Seizures

b. Clonic Sezures

CANSINO, Gianelei Vianne F. BSN III-L3 Protect patient from injury Promote patent airway. Observe and document the following: a. Date, time of onset, duration b. Activity at time of onset c. Level of consciousness (confused, dazed, excited, unconscious) d. Presence of aura (if known) e. Movements Protect patient from injury Observe and document the following: a. Date, time of onset, duration b. Activity at time of onset c. Level of consciousness (confused, dazed, excited, unconscious) d. Presence of aura (if known) e. Movements Stay with the client Let patient lie down on floor Do not restrain movement Protect patient from injury Promote patent airway Loosen clothing Do not try to force inserting a tongue blade Observe and document the following: a. Date, time of onset, duration b. Activity at time of onset c. Level of consciousness (confused, dazed, excited, unconscious) d. Presence of aura (if known) e. Movements

c. Atonic Seizures

Usually lasts less than 15 seconds Muscles suddenly lose strength The eyelids may drop, the head may nod, and the person may drop things and often falls to the ground. A.K.A. "drop attacks" or "drop seizures." The person usually remains conscious.

d. Tonic-Clonic Seizures

a.k.a. Grand mal seizure Generally lasts 1 to 3 minutes The tonic phase comes first: - All the muscles stiffen. - Air being forced past the vocal cords causes a cry or groan. - The person loses consciousness and falls to the floor. - The tongue or cheek may be bitten, so bloody saliva may come from the mouth. - The person may turn a bit blue in the face. Clonic phase: - The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees. - After a few minutes, the jerking slows and stops. - Bladder or bowel control sometimes is lost as the body relaxes.

CANSINO, Gianelei Vianne F. BSN III-L3 Consciousness returns slowly, and the person may be drowsy, confused, agitated, or depressed. A.K.A. Myoclonic or Petit mal seizure Characterized by a sudden, momentary loss or impairment of consciousness. Overt symptoms are often as slight as an upward staring of the eyes, a staggering gait, or a twitching of the facial muscles. No aura occurs Person often resumes activity without realizing that the seizure has occurred. -

e. Absence Seizures

Protect patient from injury Observe and document the following: a. Date, time of onset, duration b. Activity at time of onset c. Level of consciousness (confused, dazed, excited, unconscious) d. Movements

References: Smeltzer, S.(2010). Brunner and Suddarths Textbook of Medical-Surgical Nursing. Volume 2. http://ddsn.sc.gov/providers/manualsandguidelines/Documents/HealthCareGuidelines/NursingMgmtSeizures.pdf http://www.epilepsy.com/epilepsy/types_seizures http://www.webmd.com/epilepsy/guide/types-of-seizures-their-symptoms Microsoft Encarta 2009. 1993-2008 Microsoft Corporation