Pharmaceutical Care 1 // 1D-PH

SEIZURES b. COMPLEX PARTIAL

- A sudden surge of electrical activity in  Start in a small area of the
the brain temporal or frontal lobe of the
- Usu. affects how a person appears or brain
acts for a short time  Quickly involve other areas of
- Partial and generalized the brain that affect alertness
and awareness
CAUSES  Can wipe out memories of
a. Vary by age of person events just before or after it
b. Without clear cause -> genetic  Symptoms are subtle ->
c. One-third of children with autism “daydreaming”
spectrum  May be tired or confused for
d. Infections about 15 minutes
e. Begin in people over 65  May not be fully normal for
f. Stroke (for seniors) hours
 Symptoms: lip smacking,
SYMPTOMS chewing, fidgeting, walking,
a. Confusion and other repetitive,
b. Unusual behavior involuntary but coordinated
c. Mood changes movements (impairment of
d. Drooling or frothing at the mouth awareness)
e. Eye movements
f. Grunting and snorting [Complex Partial] TREATMENT
g. Loss of bladder or bowel control  Time the seizure.
h. Shaking of the entire body  Speak calmly, don’t yell at the
i. Sudden falling patient.
j. Tasting a bitter or metallic flavor  Don’t grab or hold the patient.
k. Teeth clenching  Block hazards and
l. Temporary stop in breathing accompany the patient.
m. Uncontrollable muscle spasms
c. PARTIAL WITH SECONDARY
TYPES GENERALIZATION
1. PARTIAL/FOCAL
 Symptoms: Initially
- Electrical activity remains in a limited
associated with a
area of the brain
preservation of
- Affect initially only one hemisphere of
consciousness that then
the brain
evolves into a loss of
- Most common type of seizure in
consciousness and
people older than 65 who have blood
convulsions
vessel disease of the brain
- Simple and complex
2. GENERALIZED
- Widespread electrical discharge that
a. SIMPLE PARTIAL
involves both sides of the brain at
 Affect only a small region of once
the brain, often the temporal - Hereditary factors
lobes or hippocampi - Absence, myoclonic, tonic, clonic,
 Retain consciousness atonic, grand mal
 Starts suddenly and are very
brief, typically lasting 60-120 a. ABSENCE
seconds  Petit mal
 Three types of symptoms:  Short loss of consciousness
simple motor, simple sensory, (just a few seconds) with few
simple psychological or no symptoms
 Typically interrupts an activity
[Simple Partial] TREATMENT and stares blankly
 Keep other people and
 Not be aware of what they are
objects of the way until the
doing
seizure is over. The muscle
 Begin and end abruptly
contractions can cause the
person having the seizure to  May occur several times a
lash out and hurt themselves. day
Pharmaceutical Care 1 // 1D-PH
 Usu. not aware that they are
having a seizure, except that
they may be aware of “losing
time”
[Absence] TREATMENT
 Stay with the person
 Gently guide them away from
any danger
b. MYOCLONIC
 Muscle jerk
 Sporadic (isolated) jerks, usu.
on both sides of the body
 Jerking of a limb or part of a
limb
 “brief electrical shocks”
 Dropping or involuntarily
throwing objects (when
violent)
[Myoclonic] TREATMENT
 You don’t need to do anything
to help during the seizure
other than make sure that the
person has not hurt
themselves.
c. TONIC
 Stiffening of the muscles and
impaired consciousness
 Uncommon
 Occur without clonic jerking
 Often develop in childhood
 Often occur during sleep and
usu. involve all or most of the
brain, affecting both sides of
the body
 Last less than 20 seconds
 Postictal confusion
[Tonic] TREATMENT
 Reassure
 Seek medical help if injured
d. CLONIC
 “Clonus” – rapidly alternating
contraction and relaxation of
the muscle; repeated jerking
 Movements cannot be
stopped by restraining or
repositioning the arms and
legs
 Rare compared to tonic-clonic
seizures – which are much
more common to occur
 Rhythmic jerking movements
of the arms and legs,
sometimes on both sides of
the body
 Ended -> simply continue
what they are doing
 First aid is not a typical
requirement for this type of
seizure
e. ATONIC
 Drop seizures or akinetic
seizures
 Brief lapse in muscle tone that
are caused by temporary
alternations in brain function
 Less than 15 seconds
 All age groups but common in
children
 Eyelids may drop; head may
nod; person may drop things
and often fall to the ground
 Protective headgear is
sometimes used by children
and adults
 Resistant to drug therapy
[Atonic] TREATMENT
 Reassure
 Seek medical help if injured
f. GRAND MAL
 Generalized tonic-clonic
seizure
Two parts:
1. TONIC PHASE
 Initially stiffens and loses
consciousness, causing
them to fall to the ground
 Eyes roll back into their
head as the muscle
contract and back arches
 Chest muscles tighten ->
harder for the person to
breathe
 Lips and face may take on
a bluish blue
 Begin to make gargling
noises
 Lasts no longer than a
minute
2. CLONIC PHASE
 Muscles begin to spasm
and jerk
 Elbows, legs, and head
will flex then relax rapidly
at first
 Frequency of the spasm
will gradually subside until
they cease altogether
 Common for the person to
let out a deep sigh, after
which normal breathing
resumes after jerking
 Transition to post-seizure
period -> likely remain
Pharmaceutical Care 1 // 1D-PH

unconscious for a few

minutes or more
 Brain is extremely active
trying to stop the cells
from firing to bring the
seizure under control
 No treatment method for
any patient with a seizure
disorder

[Grand Mal] TREATMENT

 Medical therapy
 Nerve stimulation
 Dietary therapy
 Surgery