May be preceded by an aura such as a peculiar sensation or dizziness; then sudden onset of seizure with loss of consciousness. Rigid muscle contraction in tonic phase which clenched jaw and hands; eyes open with pupils dilated; lasts 30 to 60 seconds. Rhythmic, jerky contraction and relaxation of all muscles in clonic phase with incontinence and frothing at the lips; may bite tongue or cheek, lasts several minutes. Sleeping or dazed post-ictal state for up to several hours. ABSENCE ( PETIT MAL) SEIZURE Loss of contact with environment for 5 to 30 seconds. Appears to be day dreaming or may roll eyes, nod head, move hands, or smack lips. Resumes activity and is not aware of seizure. MYOCLONIC SEIZURE (INFANTILE SPASM) Seen in children or infants, caused by cerebral pathology, often with mental retardation. Infantile spasms usually disappear by age 4, but child may develop other types of seizures. Brief, sudden, forceful contractions of the muscles of the trunk, neck, and extremities. Extensor type – infant extends head, spreads arms out, bend body backward in “spread eagle” position. Mixed flexor and extensor types may occur in clusters or alternate. May cause children to drop or throw something. Infant may cry out, grunt, grimace, laugh, or appear fearful during an attack. PARTIAL (FOCAL) MOTOR SEIZURE Rhythmic twitching of muscle group, usually hand or face. May spread to involve entire limb, other extremities and face on that side, known as jacksonian seizure. PARTIAL (FOCAL) SOMATOSENSORY SEIZURE
Numbness and tingling in a part of the body.
May also be visual, taste, auditory, or olfactory sensation. Partial psychomotor (temporal lobe) seizure May be aura of abdominal discomfort or bad odor or taste. Auditory or visual hallucinations, déjà vu feeling, or sense of fear or anxiety. Repetitive purposeless movements (automatisms) may occur, such as picking at clothes, smacking lips, chewing, and grimacing. Lasts seconds to minutes. Complex partial seizures – begin as partial seizures and progress to impairment of consciousness or impaired consciousness at onset. Febrile seizure Generalized tonic-clonic seizure with fever over 101.8 degrees Fahrenheit. Occurs in children younger than age 5. Treatment is to decrease temperature, treat source of fever, and control seizure. Long-term treatment to prevent recurrent seizures with fever is controversial. THERAPEUTIC INTERVENTION
When a seizure occurs, the main goal is to protect the
person from injury. Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other sharp objects. Cushion the person’s head. Loosen tight clothing, especially around the person’s neck. Turn the person on his or her side. If vomiting occurs, this helps make sure that the vomit is not inhaled into the lungs. Look for a medical I.D. bracelet with seizure instructions. Stay with the person until he or she recovers, or until you have professional medical help. Meanwhile, monitor the person’s vital signs (pulse, rate of breathing). PHARMACOLOGIC INTERVENTIONS
Antiepileptic drugs (AEDs) may be used singly
or in combination to increase effectiveness, treat mixed seizure types, and reduce adverse effects. A wide variety of adverse reactions may occur, including hepatic and renal dysfunction, vision disturbances, drowsiness, ataxia, anemia, leukopenia, thrombocytopenia, psychotic symptoms, skin rash, stomach upset, and idiosyncratic reactions. SURGICAL INTERVENTIONS:
Surgical treatment of brain tumor or
hematoma may relieve seizures caused by these. Temporal lobectomy, extratemporal resection, corpus callosotomy, or hemispherectomy may be necessary in medically intractable seizure disorders.