Epilepsy

Subject: Medical and Surgical Nursing I (Theory)

Overview

To put it simply, epilepsy is a neurological illness that affects the central nervous system and causes seizures, which are characterized by aberrant behavior, symptoms, and feelings (including temporary loss of consciousness) caused by a disruption in the normal activity of nerve cells in the brain. Some of the symptoms include temporary bewilderment, staring spells, involuntary jerking motions of the arms and legs, loss of consciousness, and so on. About half of all people with epilepsy have no known trigger for their seizures. The diagnosis can be aided by a variety of imaging techniques, including CT scans, MRIs, and neurological exams. Most persons with epilepsy may eliminate their seizures entirely with just one anti-seizure drug, or anti-epileptic. While for others, medicine may help reduce both the frequency and severity of seizures. To stop the seizures, your doctor may recommend brain surgery to remove the faulty region.

Epilepsy is a neurological condition of the central nervous system that disrupts normal brain cell activity, leading to seizures characterized by altered states of consciousness, unusual behaviors, and other abnormalities.

There is a wide range of seizures' manifestations. During a seizure, some patients with epilepsy just look blankly for a few seconds, while others exhibit repetitive twitching of the arms or legs.

When doing potentially harmful tasks like driving or swimming, even minor seizures may necessitate treatment. Seizures can be reduced in frequency and severity, if not eliminated entirely, with the help of treatment, which often entails medication but may also include surgery.

Symptoms

Because epilepsy is caused by abnormal activity in brain cells, seizures can affect any process your brain coordinates. A seizure can produce symptoms such as:

  • Temporary confusion
  • A staring spell
  • Uncontrollable jerking movements of the arms and legs
  • Loss of consciousness or awareness
  • Psychic symptoms

Causes

About half of all people with epilepsy have no known trigger for their seizures. About half of those who suffer from epilepsy can find a specific cause for their episodes.

  1. Influence of genes:
     Depending on the sort of seizures a person has, there may be a genetic component to their epilepsy. The presence of a genetic factor is quite probable in such instances.
  2. Experiencing a blow to the head:
    Epilepsy can be triggered by a blow to the head, such as that sustained in a car crash or other stressful event.
  3. Disorders of the brain:
    Epilepsy can be triggered by any illness that causes brain damage, including brain tumors and strokes. In individuals over the age of 35, stroke is one of the most common triggers for epilepsy.
  4. Contagious illnesses:
    Epilepsy can be brought on by infectious disorders such as meningitis, AIDS, and viral encephalitis.
  5. An accident during pregnancy:
    Babies are vulnerable to brain injury before birth due to a number of reasons including maternal illness, malnutrition, and oxygen deprivation. The brain injury may cause epilepsy or cerebral palsy.
  6. Developmental disorder:
    Some forms of epilepsy have been linked to neurodevelopmental problems including autism and neurofibromatosis.

Tests and diagnosis

  1. Neurological examination:
    In order to diagnose your problem and identify the type of epilepsy you may have, your doctor may do tests of your behavior, motor ability, mental function, and other areas.
  2. Blood tests:
    Your doctor may draw blood to look for infections, genetic problems, or other conditions that could explain your seizures.
  3. Electroencephalogram (EEG):
    This is the gold standard for identifying epilepsy. Electrodes are pasted onto the scalp in this type of examination. All of your brain's electrical activity can be captured by the electrodes.
  4. Computerized tomography (CT) scan:
    In order to get cross-sectional pictures of your brain, X-rays are used in a CT scan. Seizures can be caused by a number of different brain disorders, and a CT scan can help rule out tumors, hemorrhages, and cysts.
  5. Magnetic resonance imaging (MRI):
    An MRI scan utilizes magnetic fields and radio waves to produce a high-resolution image of your brain.

Treatments and drugs

To achieve the best seizure control possible with medication:

  1. Medication
    Most persons with epilepsy may eliminate their seizures entirely with just one anti-seizure drug, or anti-epileptic. While for others, medicine may help reduce both the frequency and severity of seizures.
    It might be difficult to choose the best drug and dose. When deciding what kind of medicine to give you, the doctor will take into account your current health status, the frequency of your seizures, and your age.
    Your doctor will likely start you on a single medicine at a low dose and progressively raise the dose until your seizures are under control.
    Anti-seizure medications may have some side effects. Mild side effects include:
    • Fatigue
    • Dizziness
    • Weight gain
    • Loss of bone density
    • Skin rashes
    • Loss of coordination
    • Speech problems
    • Memory and thinking problems
      Take medications exactly as prescribed. Never stop taking your medication without talking to your doctor. Notify your doctor immediately if you notice new or increased feelings of depression, suicidal thoughts, or unusual changes in your mood or behaviors.
  2. Surgery

    Most of the time, surgery is only an option if diagnostic tests reveal that your seizures originate in a localized part of the brain that does not affect your ability to speak, think, move, see, or hear normally. To stop the seizures, your doctor may recommend brain surgery to remove the faulty region.

  3. Therapies

    A vagus nerve stimulator, similar to a cardiac pacemaker, is implanted subcutaneously in the chest to stimulate the vagus nerve. The vagus nerve in the neck is the target of the stimulator's wires.

Nursing management

During seizure

  1. Remain calm.
  2. Keep a comfortable, harm free position.
  3. Loosen restrictive clothing, remove eyeglasses.
  4. Clear any hazard or hard object from the surrounding.
  5. Allow seizure to end without interference.
  6. Stay with them until they feel well again.

After seizure

  1. Check breathing, and keep in a lateral position.
  2. If no breathing, give rescue breathing,
  3. Remain with the child.
  4. Don't give food or liquid until fully alert and the swallowing reflex has returned.
  5. Check for any possible injuries on the head and other body part.
  6. Check if either tongue or lips have been bitten.

References
Things to remember
  • When nerve cell activity in your brain is disrupted, you have epilepsy, a condition of the central nervous system (neurological illness).
  • When doing potentially harmful tasks like driving or swimming, even minor seizures may necessitate treatment.
  • Contagious illnesses. Epilepsy can be brought on by infectious disorders such meningitis, AIDS, and viral encephalitis.
  • When diagnostic testing pinpoints the source of your seizures to a very minor,
  • Medications should never be stopped without first discussing this with a doctor.
  • Get rid of any sharp or dangerous objects lying about.
  • Hold off on feeding until the patient is completely awake and has regained swallowing reflexes.
Questions and Answers

In a seizure, which is a central nervous system disorder (also known as a neurological disorder) where your brain's nerve cell activity is disrupted, you may experience abnormal behavior, symptoms, and sensations, including losing consciousness.

Symptoms

Because epilepsy is caused by abnormal activity in brain cells, seizures can affect any process your brain coordinates. A seizure can produce symptoms such as:

  • Temporary confusion.
  • A staring spell.
  • Uncontrollable jerking movements of the arms and legs.
  • Loss of consciousness or awareness.
  • Psychic symptoms.

Causes

Epilepsy has no identifiable cause in about half of those with the condition. In about half the people with epilepsy, the condition may be traced to various factors.

  • Genetic influence: Some types of epilepsy, which are categorized by the type of seizure you experience, run in families. In these cases, it's likely that there's a genetic influence.
  • Head trauma: Head trauma that occurs due to a car accident or other traumatic injury can cause epilepsy.
  • Brain conditions: Brain conditions that result in damage to the brain, such as brain tumors or strokes, also can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35.
  • Infectious diseases: Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy.
  • Prenatal injury: Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies. This brain damage can result in epilepsy or cerebral palsy.
  • Developmental disorders: Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis.

Tests and Diagnosis

  • Neurological examination: Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have.
  • Blood tests: Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions which may be associated with seizures.
  • Electroencephalogram (EEG): This is the most common test used to diagnose epilepsy. In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain.
  • Computerized tomography (CT) scan: A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts.
  • Magnetic resonance imaging (MRI):  An MRI uses powerful magnets and radio waves to create a detailed view of your brain.

 

 

Nursing Management

During Seizure

  • Keep your cool.
  • Maintain a safe and comfortable position.
  • Wear less constrictive clothing and take off your glasses.
  • Remove any obstacles or hard objects from the area.
  • Permit the seizure to end on its own.
  • Stay by them until they recover their health.

After Seizure

  • Breathing control; maintain lateral posture.
  • If the youngster is not breathing, perform rescue breathing.
  • Food and fluids should wait until the patient is conscious and capable of swallowing again.
  • Check your head and other body parts for any probable injuries.
  • Verify if your tongue or lips have been bit.

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