Question | Answer |
Seizures | - Abnormal electrical discharge in part or all of brain
- Altered state of cerebral function |
Epilepsy seizure triggers | Flashlights
Odor
Fatigue
Hypoglycemia
Fever
Constipation
Hormonal changes |
Generalized seizures | Involves activation of both hemispheres - most common type |
Simple partial seizures | - No loss of consciousness |
Simple partial seizures | - Recurrent muscle contractions on one part of body
- Abnormal sensations or hallucinations
- Tachycardia, flushing, hypotension, hypertension |
Complex partial seizures | - Impaired consciousness
- Automatisms- repetitive, non-purposeful activity (I.e. Lip smacking)
- May be preceded by aura
- Amnesia afterwards |
Absence seizure (petit mal) | - In children:
- Sudden brief cessation of all motor activity lasting 5-10 sec
- Blank stare
- Unresponsive
- Occasional or up to 100 times a day |
Tonic-clinic (grand mal) | - May begin with aura
- Seizure begins with loss of consciousness; falling to floor |
Tonic phase | - Muscle contractions, rigid muscles, legs and arms extended (opisthotonos)
- Jaw clenched; incontinence and breathing cessation, cyanosis
- Lasting 15 sec - up to one minute |
Clonic phase | - Alternating contraction/relaxation in extremities; hyperventilation
- Eyes roll back, patient froths at mouth
- May last longer
- Entire seizure lasts 60-90 seconds |
Postictal phase | - Slowly regains consciousness
- Headache, muscle ache, fatigue, amnesia
- May sleep several hours after
- Check for possible injury (biting tongue, fractures, head injury |
Status epilepticcus | Prolonged or repetitive seizures with only short periods in between (5 min) |
Status epilepticcus | - Effect is hypoxia, acidosis, hypoglycemia, hyperthermia
- IV push (Ativan or diazepam (Valium); repeat 10 min if needed
- May be followed with phenytoin (Dilantin) slow IVPB for longer control |
Anti epileptic drugs (AEDs) pg 1366-67 | - May have to use combination of medications to achieve goal
- Type of medication based upon type of seizures |
Phenobarbital | Given for extreme sedation |
Phenytoin (Dilantin) | Several undesired side effects
- Gingival hyperplasia - use soft toothbrush and floss
- Demineralization of bones - maintain calcium levels |
General side effects of AEDs | -Blurred vision
- Nystagmus (rapid eye movement)
- Slurred speech
- Confusion/cognitive slowing
- Ataxia (impaired coordination) |
Teachings for epileptics | - Periodic lab for therapeutic levels
- Do not discontinue
- Wear medic-alert tag
- Avoid hazardous activities |
Driving privileges re-instated | Seizure-free for 2 years and letter for physician |
How long does migraine headaches last? | 4-72 hours |
Migraine headache triggers | - Stess, excitement, fatigue, rapid blood sugar changes
- Foods: chocolate, aged cheese, alcohol, artificial sweeteners, MSG, caffeine
- Menstrual cycle, hypertension, fever |
Prophylactic daily medications | - Beta blockers
- Calcium channel blockers
- Tricyclics antidepressants or SSRI antidepressants |
Abortive medications (stops migraine) | - Sumatriptan (Imitrex) binds with serotonin receptors: oral, SQ, nasal spray
- Ergotamine - causes vasoconstriction ( caution with coronary disease/HTN, limited amount allowed; report chest pain) |