Seizures Types

 

Seizure Types

  1. Partial (focal) Seizures

 

involves a limited portion of the brain

may start on one side of the brain and travel only a short distance before stopping

foci = start location of abnormal electrical activity

  • Simple partial seizures: small, local, limited focus but progress to a generalized seizure
  • Symptoms:
  • precise location – vague
  • auditory or visual hallucinations
  • smell or taste things not present
  • emotional experiences of joy, sorrow or grief
  • arms, legs or face may twitch

 

  • Complex partial (psychomotor or temporal lobe) seizures:
  • Show sensory, motor and autonomic symptoms with some degree of altered or impaired consciousness
  • Total loss of consciousness may not occur during a complex partial seizure
  • a brief period of somnolence or confusion may follow the seizure
  • some seizures are preceded by an aura that is often described as an unplesant odour or taste
  • Seizures may start with a blank stare, may fumble with or try to remove clothing
  • most pts will not pay attention to verbal commands
  • pts may act as if they are having a psychotic episode
  • After the seizure pts do not remember the incident

 

  1. Generalized Seizures

 

  • not localized to one area
  • travel throughout entire brain on both sides
  • the seizure is through to originate bilaterally and symmetrically within the brain

 

  • Absence (Petit mal) Seizures

 

  • most often occur in children
  • last only a few seconds
  • involve a loss or reduction of normal activity
  • Staring of transient loss of responsiveness are the most common signs
  • there may be slight motor activity with eyelid fluttering or myoclonic jerks
  • due to subtlety these seizures may go unnoticed or be mistaken for daydreaming or ADD.

 

  • Atonic Seizures

 

  • may be referred to as drop attacks
  • pt may stumble and fall for no apparent reason
  • Episodes are short lasting only a few seconds

 

  • Tonic-clonic seizures

 

  • seizures may be preceded by aura
  • some pts may perceive a warning sign described as a spiritual feeling, flash of light or special noise

Tonic Phase

  • Intense muscle contractions indicate the tonic phase
  • a hoarse cry may occur at the onset of a seizure due to air being forced out of the lungs
  • clients may temporarily lose bladder or bowel control
  • breathing may become shallow with moments of apnea

 

Clonic Phase

  • alternating contraction and relaxation of muscles
  • seizures usually last 1-2 minutes

Postical State

  • afterwards the pt becomes drowsy, disoriented and sleeps deeply

 

  1. Special Epileptic Syndromes

 

  • special epileptic seizures include the febrile seizures in infancy
  • reflex epilepsies
  • other forms of myoclonic epilepsies
  • Myoclonic epilepsies often accompany other neurological abnormalities or progressive symptoms

 

  • Febrile Seizures

 

  • typically cause tonic-clonic motor activities lasting 1-2 minutes
  • with rapid return of consciousness
  • Occur in conjunction with a rapid rise in body temperature
  • usually occur only once during any given illness
  • most likely to occur in the 3mo-5yr age group
  • preventing the onset of fever is the best way to control the seizures

 

  • Myoclonic Seizures

 

  • characterized by large, jerking body movements
  • major muscle groups contract quickly and pts appear unsteady and clumsy
  • Pt may fall from sitting position or drop whatever they are holding
  • Infantile spasms exemplify a type of generalized, myoclonic seizure
  • distinguished by short-lived muscle spasms involving the trunk and extremities
  • The spasms are often not identified as seizures by parents or healthcare providers because the movements are much like those the normal infantile Moro (startle) reflex

 

  • Status Seizures

 

  • medical emergency
  • occurs when a seizure is repeated continuously
  • can occur with any type of seizure
  • usually generalized tonic-clonic seizures are exhibited

characteristics:

  • generalized tonic-clonic seizures are prolonged or continuous
  • the time in breathing is affected by lengthened muscle contraction
  • may result in hypoglycemia, acidosis and hypothermia due to increased metabolic needs
  • lactic acid production and heat loss during contraction
  • carbon dioxide recension also leads to acidosis
  • if untreated, status eptilepticus can lead to brain damage and death
  • medical treatment involves IV administration of antiseizure medications and ensuring an open airway.

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