EPILEPSY

SUBMITTED BY

AXSA ALEX
FIRST YEAR MSC NURSING
SJCON
INTRODUCTION

 FOURTH MOST COMMON NEUROLOGICAL

DISORDER.
 AFFECT ALL AGE GROUP
 IT IS A SPECTRUM CONDITION WITH A
WIDE RANGE OF SEIZURE TYPE.
 CONTROL VARY FROM PERSON TO PERSON
ANATOMY-BRAIN

 FRONTOL LOBE
 PARIETAL LOBE
 OCCIPITAL LOBE
 TEMPORAL LOBE
PHYSIOLOGY OF BRAIN

 FRONTAL LOBE –THINKING,PLANNIUNG,ORGANISING,PROBLEM

SOLVING;EMOTIONS AND BEHAVIOURAL CONTROL,PERSONALITY
 MOTOR CORTEX-MOVEMENT
 SENSORY CORTEX-SENSATIONS
 OCCIPITAL LOBE-VISION
 TEMPORAL LOBE-MEMOERY UNDERSTANDING,LANGUAGE
 PARIETAL LOBE-PERCRPTION,ARITHEMETIC,SPELLING
DEFINITION

 A DISORDER IN WHICH NERVE CELL ACTIVITY IN THE BRAIN IS

DISTURBED,CAUSING SEIZURE.
 A SEIZURE IS A SUDDEN RUSH OF ELECTRICAL ACTIVITY IN BRAIN.
ETIOLOGY

 IDIOPATHIC
 BIRTH INJURY
 CONGENITAL DEFECTS INVOLVING CNS
 INFECTIONS
 GENETIC FACTORS
 BRAIN TUMORS
 VASCULAR DISEASE
 ALCOHOL,CAFFEINE,DRUGS
 SKIPPING MEALS
 HIGH FEVER
 GLIOSIS
 OVEREATING
PATHOPHYSIOLOGY

 DUE TO ETIOLOGICAL FACTORS

 SEIZURES HAS BEEN ATTRIBUTED TO GROUP OF ABNORMAL NEURONS
GET ACTIVATED
 SPONTANEOUS FIRING
 SPREAD TO WHOLE BRAIN(GENERALIZED)
 TISSUE SCARRING WHICH AFFECT NORMAL CHEMICAL AND STRUCTURE
OF BRAIN
 SPONTANEOUS FIRING
CLINICAL MANIFESTATION

 TEMPORARY CONFUSION
 JERKING MOVEMENT
 LOSS OF CONSCIOUSNESS
 PSYCHIC SYMPTOMS
 HEAD ACHE
 CHANGE IN SENSE OF SMELL,TASTE,TOUCH AND PAIN
 NAUSEA AND VOMITING
 DROWSINESS
 EPISODES OF BLINKING,CHEWING AT INAPROPRIATE TIMES
 CEREBRAL ANOXIA
 HYPONATREMIA
 HYPOGLYCEMIA
 HYPOCALCEMIA
 SLEEP DISTURBANCE
TYPES(INTERNATIONAL
CLASSIFICATION)
1. GENERALISED SEIZURE
 TONIC CLONIC SEIZURE
 ABSENCE SEIZURE
 MYOCLONIC SEIZURE
 TONIC SEIZURE
 ATONIC SEIZURE
 CLONIC SEIZURE
2 PARTIAL SEIZURE
 SIMPLE PARTIAL SEIZURE
 WITH MOTOR ,SENSORY,PSYCHIC SYMPTOMS
 NO IMPAIRMENT OF CONSCIOUSNESS
 COMPLEX PARTIAL SEIZURES
 IMPAIRMENT OF CONSCIOUSNESS
 WITH ACTION PERFORMING UNCONSIOUSLY
 PARTIAL SEIZURES EVOLVING TO SECONDARY GENERALIZED SEIZURE
3) UNCLASSIFIED EPILEPTIC SEIZURE
GENERALIZED SEIZURES

 LEADS TO LOSS OF CONSCIOUNESS

 CONVULSIVE OR NON CONVULSIVE
 BOTH HEMISPHERE INVOLVED

TYPES
ABSENCE SEIZURE
 SUDDEN LAPSES
 LASTING FEW SECONDS
 SEEN-CHILDHOOD,ADOLOSCENT


MYOCLONIC SEIZURE
 SUDDEN UNCONTOLLABLE JERKING MOVEMENT
 CLIENT MAY FALL
 OCCURS MORNING
 UNCONSCIOUS AND CONFUSED
CLONIC SEIZURE
 CAUSES MUSCLE CONTRACTION AND RELAXATION
 LAST FEW MINIUTES
TONIC SEIZURE
INCREASE IN MUSCLE TONE
LOSS OF CONSCIOUSNESS
30 sec TO SEVERAL MINUTES
TONIC CLONIC SEIZURES
 GRANDMAL SEIZURE
 A AURA MAY OR MAYNOT PRESENT
 SUDDEN LOSS OF CONSCIOUSNESS
 CYNOSIS
ATONIC SEIZURE
 SUDDEN LOSS OF MUSCLE TONE
 POST ICTAL CONFUSION
PARTIAL SEIZURES

SIMPLE PARTIAL SEIZURES

 REMAINS CONSCIOUS
 UNUSUAL SENSATION BEFORE OCCURING
 OFFENSIVE SMELL PERCEPTION
 ONE SIDED MOVEMENT OF EXTIMITY
 AUTNOMIC CHANGES
COMPLEX PARTIAL SEIZURE
 LOSS OF UNCONSCIOUSNESS
 BACKOUT 1-3 min
 TEMPORAL LOBE SEIZURE
UNCLASSIFIED SEIZURES
 IDIOPATHIC
 ACCOUNT FOR ABOUT HALF OF ALL SEIZURE
PHASES

 AURA- ALTERATION IN SMELL,TASTE,VISUAL

PERCEPTION,HEARING,EMOTIONAL STATE
 ICTUS-SEIZURE OCCURS.
 POST ICTAL STATE- DROWSINESS AND CONFUSION
DIAGNOSTIC EVALUATION

 HISTORY COLLECTION
 PHYSICAL EXAMINATION
 EEG
 MRI
 LONG TERM VEDIO EEG MONITERING
MANAGEMENT

GOAL
 TO PREVENT INJURY
 TO PROVIDE ADEQUATE OXYGENATION
 TO MAINTAIN NUTRITIONAL STATUS
NON PHARMACOLOGICAL MANAGEMENT

 ELIMINATE PRECIPITATING FACTORS

 REHABLITATION
 AVOID ALCHOL AND SMOKING
 REST AND SLEEP
 MINIMIZE STRESS
 OXYGEN AND SUCTION KEEP READY
 AVOID COUNTER DRUGS
 MEDICAL ALERT BRACELET
 HEATH EDUCATION TO FAMILY
PHARMACOLOGICAL MANAGEMENT

 ANTI CONVULSANT DRUGS

PHENYTOIN-BLOCK SODIUM CHANNEL,CARBAMAZEPINE

 LOCOSAMIDE ,RUFENAMIDE-SLOW INACTIVATION OF SODIUM
 PHENOBARBITOL
 .CALCIUM CHANNEL BLOCKERS- VALPORATE
SURGICAL MANAGENENT

 LEISONECTOMY
 LOBECTOMY
 MULTIPLE SUBPIAL TRANSECTION
 CORPUS CALLOSTOMY
NURSING DIAGNOSIS

 INEFFECTIVE BREATHING PATTERN RELATED TO NEUROMUSCULAR

IMPAIREMENT.
 INEFFECTIVE CEREBRAL PERFUSION RELATED TO IRRITATION IN NERVES
 RISK FOR INJURY RELATED TO SEIZURE ACTIVITY
 INEFFECTIVE COPING RELATED TO PERCIEVED LOSS OF CONTROL
 IMBALANCED NUTRITION LESS THAN BODY REQUIREMENT RELATED TO
LESS INTAKE OF FOOD.
COMPLICATIONS

 STATUS EPLILEPTICUS
 MEMORYLOSS
 VIOLENT BEHAVIOUR
 ASPIRATION
 FRACTURES-SKULL/VERTEBRAE
 PULMONARY EDEMA
 MI
 CARDIAC ARRYTHMIAS
 PYROMANIA
SUMMARY
THANK YOU