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Seizure

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An abnormal electrical discharge causing a surge of activity in the brain resulting in unusual sensations, uncontrollable muscle spasms, and/or loss of consciousness

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Causes

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Metabolic Disturbances Brain Trauma Birth Defects Brain Tumor Toxic Substances Increase in Pressure Infection

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How many types of seizures are there

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More than 30

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What are the two types of seizures

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Partial and Generalized

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Seizures are organized into two types by

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origination,presentation,duration

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Partial seizures

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Occurs on one side or one part of the brain

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60% of people suffer from which type of seizure

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Partial

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Simple Partial Seizure

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Clients remain conscious Experience feelings such as joy,anger,sadness, nausea, etc. Client can hear, see, smell, etc things that are not real These may last 30-60 seconds

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Complex Partial Seizure

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Client may experience loss of consciousness possibly going into a dreamlike state. May exhibit strange or repetitive behaviors called automatisms such as blinks, twitches or walking in circles. Client may continue the same action they started before the seizure Lasts anywhere from seconds to two minutes

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Generalized Seizures

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The result of abnormal activity in both sides of the brain and can develop from a partial seizure spreading from one hemisphere of the brain to the other hemisphere.

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Causes of Generalized Seizures

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Loss of consciousness Falls Major muscle spasms

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Types of Generalized Seizures

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Absent Atonic Myotonic Tonic Tonic-Clonic

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Absent GS

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More common in children than adults So brief they may go unnoticed and undiagnosed for months or years May occur up to 100 times a day no Aura Clients will seem to stare into space Usually last less than ten seconds but can last up to twenty Start and end Suddenly

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Atonic GS

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These are seizures where muscle tone disappears resulting in a fall or collapse.

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Atonic GS info

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Lasts up to a minute Starts and ends suddenly, afterwards consciousness is regained Results in a drop of the head, loss of posture or complete collapse. This is dangerous if the client falls, possibly sustaining injury to the face or head.

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Myloclonic GS

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Seizures characterized by jerk in part of the body, usually on both sides of the body at once, either upper body or lower body. Occasionally they will occur in just one arm or leg.

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Myloclonic GS info

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May resemble a twitch similar to a leg jerk just before falling asleep in a person who does not have epilepsy. Very sudden and brief. No aura or post-ictal period While a myoclonic seizure may be mild, a strong spasm may be enough to throw a small child to the floor causing injury.

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Tonic GS

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Characterized by a marked increase in the tone of the muscle. The client's muscles become rigid, generally those in the arms, legs and back. Remember the shape of the "T" as the body becoming straight and tight.

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Tonic GS info

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Clients remain conscious Breathing may decrease or stop resulting in cyanosis (turning blue) at the mouth, nail beds, or face. It is common for a client to become incontinent of bowel or bladder during a tonic seizure. May be preceded by an aura. Usually lasts less then 20 seconds. If lasting longer than 20 seconds breathing and respiratory status becomes extremely compromised. The tongue or inside of the mouth may be bitten. Breathing may sound noisy or become labored. Follow Seizure Precautions to keep client safe. Client may experience a post-ictal period of minutes to hours

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Clonic GS

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Referring to a marked contraction and relaxation of the muscles. The client's muscles repeatedly jerk on both sides including arms, legs and face. Remember the shape of the "C" as the body curling with each contraction

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Clonic GS info

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Rare Breathing does not stop Client may be incontinent during May be preceded by an aura. Lasts usually no more than a minute Client may experience a post-ictal period of minutes to hours.

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Tonic-Clonic GS

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Happens when Tonic and Clonic seizures alternate with one right after the other

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Tonic- Clonic GS info

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Sometimes called a Grand Mal Seizure or a Convulsion. Client may be incontinent during May be preceded by an aura Tonic phases last up to 20 seconds each and clonic phases up to 1 minute. The length of time the entire tonic-clonic seizure lasts determines its severity and treatment. may experience a post-ictal period of minutes to hours.

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Non-Epileptic Events

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Events that look like seizures even though a brain wave study would show no seizure activity and may occur in clients with true epileptic seizures

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Causes of Non-Epileptic Events

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Narcolepsy, Tourette syndrome, or a cardiac arrhythmia.

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Stages of a Seizure

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Aura Ictal Post Ictal

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Aura

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Before a seizure, a person may experience a warning or feeling that a seizure is coming

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Ictal

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The time at which a person is exhibiting symptoms of a seizure, from initiation to completion.

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Post Ictal

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Transition from a seizure back to baseline or normal state.

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Seizure treatment

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Medications Surgery Ketogenic Diet

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VNS

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Vagal Nerve Stimulation-Inserted by a doctor when medications are not enough to control seizures or the side effects of the medications are too much.The VNS generator can be programmed to deliver additional stimulation to the vagus nerve on demand. This is triggered by holding a special magnet near the implanted device, activating the stimulation outside of the programmed interval. For clients with auras, activating the VNS before the seizure occurs may prevent the seizure. For other clients, the VNS is activated at the onset of the seizure or as directed by the physician.

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VNS Therapy Magnet

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Using a VNS therapeutic magnet as prescribed may stop the seizure, shorten the seizure, decrease the intensity of the seizure, or improve the recovery period following the seizure. May be worn as a wrist band or belt clip.

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How to use VNS

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At the onset of a seizure or during a seizure, place the magnet over the chest area where the generator is implanted (generally the left chest area, below the collarbone). Swipe the magnet in a diagonal motion from sternum to shoulder. (DO NOT HOLD for longer than 2 seconds or the generator will shut off. Once the magnet is removed, however, the generator will restart on it's own.) Remove the magnet, which will start an extra dose of stimulation. The magnet can be used more then once during a seizure. Refer to the "HHA Care Plan Supplement: Vagus Nerve Stimulation for Seizures" for client specific instructions.

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Need to knows: before, during and after seizure

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Turn client on side Call Bayada and parent Immediately after seizure has occurred If seizure lasts longer than normal or there is anything unusual happening with client during or after seizure follow the emergency plan and call 911

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