Status Epilepticus

Status Epilepticus powerpoint presentation

1. STATUS

EPILEPTICUS

2. SEIZURE
Seizures
sudden, excessive, disorderly electrical
discharges of the neurons.
EFFECTS OF SEIZURE: alteration in
the following
 mental status
 LOC
 sensory and speciual senses
 motor funtion

3. TYPES OF SEIZURE

GRAND MAL
most common type of seizure
The phases are as
follows:

5. PETIT MAL (Absence Seizure or Little Sickness)
onot preceeded by AURA
o little or no toni-clonic
o charac blank facial expression, automatism like lip-chewing,
cheek smacking
o regain of consciousness as rapid as it was lot for 10-20secs
o usually occurs during childhood and adolescence
JACKSONIAN / FOCAL SEIZURE
o common for patients with organic brain lesion like frontal
lobe tumor
o aura is present(numbness, tingling, crawling feeling)
o charac by tonic-clonic movements of group muscle e.g.
Hands, foot, or face then it proceeds toi grand mal seizure
FEBRILE SEIZURE
o this is common for children <5yo, when temp. is rising
PSYCHOMOTOR SEIZURE
o aura is present (hallucinations or illusion)
o charac by mental clouding (being out of touch with the
envt)
o appears intoxicated
o the client may commit violent or antisocial acts, e.g. Going
naked public, running

6. STATUS
EPILEPTICUS

7. STATUS
EPILEPTICUS
(ACUTE PROLONGED SEIZURE ACTIVITY)
IS A SERIES OF GENERALIZED SEIZURE THAT
OCCUR WITHOUT FULL RECOVERY OF
CONSCIOUSNESS BETWEEN ATTACKS
THE TERM HAS BEEN BROADENED TO INCLUDE
CONTINUOUS CLINICAL OR ELECTRICAL SEIZURES
LASTING AT LEAST 30 MINUTES, EVEN WITHOUT
IMPAIRMENT OF CONSCIOUSNESS.
A seizure is a sudden disruption of the brain's
normal electrical activity, which can cause a loss of
consciousness and make the body twitch and jerk. This
condition is a medical emergency.

8. CAUSES
not taking anticonvulsant medication
also caused by an underlying condition, such
as meningitis, sepsis, encephalitis, brain
tumor, head trauma, extremely high fever, low
glucose levels, or exposure to toxins.

9. SymptomS
The characteristic symptom of status
epilepticus is seizures occurring so frequently
that they appear to be one continuous seizure.
These seizures include severe muscle
contractions and difficulty breathing.
Permanent damage can occur to the brain and
heart if treatment is not immediate. A
person's symptoms can range from simply
appearing dazed to the more serious muscle
contractions, spasms, and loss of
consciousness. The specific symptoms depend
on the underlying type of seizure.

10. TWO CATEGORIES OF STATUS EPILEPTICUS
CONVULSIVE
Epilepsia partialis continua is a variant it involve an hour, day
or even week-long jerking. It is a consequence of vascular
disease, tumor or encepalitis and drug resistant.
NONCONVULSIVE
Complex Partial Status Epilepticus CPSE and absence status
epilepticus are rare forms of the condition which are marked
by nonconvulsive seizures. In the case of CPSE, the seizure is
confined to a small area of the brain, normally the temporal
lobe. But the latter, absence status epilepticus, is marked by a
generalised seizure affecting the whole brain, and an EEG is
needed to differentiate between the two conditions. This
results in episodes characterized by a long-lasting stupor,
staring and unresponsiveness.

11. HOW IT IS DIAGNOSED?
Status epilepticus is diagnosed according to its
characteristics symptoms. The doctor will order test to look
for the cause of the seizures. This may include
 blood test
 ECG to check for an abnormal heart rhythm
 EEG to check electrical activity in the brain
 MRI or CT scan to check for braing tumord or
signs of damage to the brain tissue.

12. Nursing Diagnosis
High Risk for Injury r/t Seizure
Activity
Individual Coping r/t perceive
social stigma, potential changes
in employment

13. MEDICATIONS
 diazepam (Valium)
this will stop motor movement
 Phenytoin (Dilatin)
 Phenobarbital (Barbita)
 Paraldehyde
 Thiopentahl sodium (Pentotal sodium)
 General anesthesia may also be used as a treatment of last
resort to stop seizure activity

14. NURSING INTERVENTION
PREVENTING INJURY
IMPROVING COPING MECHANISMS
PROVIDING PATIENT AND FAMILY EDUCATION
MONITORING AND MANAGING POTENTIAL COMPLICATIONS
TEACHING PATIENTS SELF-CARE
REDUCING FEARS OF SEIZURE

15. PREVENTING INJURY

injury prevention for the patient with seizure is a PRIORITY.

 patient should be placed on the floor and remove any
obstructive items
 patient should never be forced into a position
 pad side rails
 do not attempt to pry open jaws that are clenched in a spasm
to insert anything.
 if possible place the patient on one side with head flexed
forward,
back

16. PATIENT
EDUCACTION

TAKE MEDICATION AT REGULAR BASIS
 AVOID ALCOHOL. Lowers seizure threshold
 ADEQUATE REST
 WELL-BALANCED DIET
 AVOID DRIVING, OPERATING MACHINES,
SWIMMING UNTIL SEIZURES ARE WELL
CONTROLLED.
 LIVE AN ACTIVE LIFE

17. REDUCING FEARS OF SEIZURE

Fear that a seizure may occur
unexpectedly can be reduced by the
patients adherence to the prescribed
treatment regimen. Cooperation of the
patient and family and their trust in the
prescribed regimen are essential for
control of seizures
Periodic monitoring is necessary to
ensure the adequacy of the treatment
regimen and to prevent the side effects.
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18. IMPROVING COPING MECHANISMS
it has been noted that the social,
psychological, and behavioral problems
frequently accompanying the attack can be
more handicap than the actual seizure.
Counselling assists the individual and
family to understand the condition and the
limitations imposed by it. Social and
recreational opportunities are good for
mental health . Nurses can improve the
quality of life for patients with the disorder
by educating them and their family about the
symptom and also the management.
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19. PROVIDING PATIENT AND
FAMILY EDUCATION
Ongoing education and encouragement
should be given to patients to enable them
to overcome these feelings. The patient and
family should be educated about the
medications as well as care during a
seizure.
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perhaps the most valuable facets are
education and efforts to modify the
attitudes of the patient and family toward
the disorder.

20. MONITORING AND MANAGING
POTENTIAL COMPLICATIONS
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Patients should have plan to have
serum drug levels drawn at regular
intervals. The patient and family
are instructed about the side effects
and are given specific guidelines to
assess and report signs and
symptoms indicating medication
overdose.

21. TEACHING PATIENTS
SELF CARE
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Like thorough oral hygiene after
each meal, gum massage, daily
flossing, and regular dental care
The patient is also instructed to
inform all health care providers of the
medication being taken because of
the possibility of drug interactions. An
individualized comprehensive
teaching plan is needed to assist the
patient and family to adjust to this
chronic disorder.

22. thank you and God Bless Us
Always
Presented by: Dave Jay S.
Manriquez RN.