Seizure Objectives.docx - Seizures Obj Therapeutics 2 Final Exam 1 Describe the basic pathophysiology diagnosis and risk factors for seizures

Seizure Objectives.docx - Seizures Obj Therapeutics 2 Final...

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Seizures Obj Therapeutics 2 Final Exam 1.Describe the basic pathophysiology, diagnosis, and risk factors for seizures. Pathophysiology Abnormal electrical disturbance in brain - Occurs due to a neuron becoming hyperexcitable o Hyperexcitability occurs due to Excessive excitation (glutamate) Failure of inhibition (GABA) Alterations in voltage or ligand-gated K + , Na + , Ca 2+ , and Cl - channels These mechs are drug targets for maintenance tx of seizures - This spreads to other neurons (hypersyncronization) - Both are required for seizure to occur Diagnosis - History and clinical examination o Talk to eye witness, patient, to figure out what happened before, during, after the event - Radiologic evaluation o MRI, CT, both o To help determine if there are any structural abnormalities that could cause epilepsy - Laboratory evaluation o If there are any changes/anything under risk factors that could cause seizure Low blood glucose Liver function Abnormal electrolytes Acute ingestion of alcohol or drugs Toxicology screenings o Trying to get overall picture of what’s happening/what has happened to patient as it relates to the seizure - Electroencephalography (EEG) o Brain evaluation o If there are any electrical events that are occurring o Non-invasive test used to record electrical patterns in the brain Can be used to determine the area and type of seizure a person has Challenging bc most seizure self-terminate Can be used while a patient is seizing or if there are electrical disturbances If there is not electrical change during EEG, shows they are not actively seizing, does not rule them out for having a seizure disorder Risk Factors - History of febrile seizures (as an infant) - Perinatal injury or low birth weight - Focal neuronal injury (stroke) o Can be precipitating cause bc causes brain damage - Traumatic brain injury o Car accident Precipitating causes - Sleep disturbances o Poor sleep hygiene, lack of sleep - Hormonal changes o Seizure around menses, increase of seizure activity during menstrual cycle - Acute ingestion or withdrawal of alcohol or illicit drugs - Infection (meningitis, viral encephalitis)
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Seizures Obj Therapeutics 2 Final Exam - Physical/emotional stress - Medications - Withdrawal: from electrolyte imbalances or withdrawal from drugs o People with epilepsy at higher risk 2. Identify and differentiate seizure types, including clinical presentation and brain involvement. Focal/partial seizure Onset: localized, single hemisphere - Consciousness is NOT always impaired - Simple: without dyscognitive features o No loss of consciousness o Motor functions Involuntary twitching or jerking in one extremity o Autonomic symptoms Sweating, salivating, vomiting o Sensory symptoms Numbness, tingling, feeling of déjà vu, visual disturbance, hallucination, ringing/buzzing sound - Complex; with dyscognitive features o Loss of consciousness o Similar presentation as simple + LOC or awareness o Additional symptoms Not making sense while talking Lip smacking, picking at clothes Staring off into space
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