Sunday, July 12, 2009

Seizures


After i did the above post about the seizure our daughter had, I suddenly thought...."wait a minute....you are a Registered Nurse - perhaps a post about seizures and basic first aid for them is in order.

All seizures signify abnormal electrical activity within the brain - an electrical storm if you will. For some people, they are often preceded by an "aura." An aura is an individualized set of warning signs someone may experience prior to a seizure. This is interesting stuff - see more here.

There are a few types of seizures:

1. Grand Mal - often referred to as "convulsions". This type of seizure is characterized by uncontrollable movement involving the entire body. There is often muscle rigidity and violent muscle contractions. This type is most often associated with epilepsy and febrile seizures (seizure related to fever). There is generally a loss of awareness during the event and post-seizure amnesia (they don't remember it).

2. Abscence seizures - also known as "petit mal" seizures. These can be difficult to detect. People having an abscence seizure appear to be staring into space. They are usually quite brief. In reading Medline plus, these are most common in people under 20, particularly kids ages 6-12. They can occur infrequently or hundreds of times a day, interfering with school functioning, etc.

3. Partial (focal) seizure - Can be "simple" or "complex". Simple partial seizures do not involve loss of awareness or memory, while complex partial seizures do. There are lots of symptoms and manifestations (see more here). Focused, non-voluntary, repetitive movement is often one.

What conditions can lead to seizures?
  • hypoglycemia
  • fever
  • head-injury
  • Spinal meningitis (inflammation of the membrane covering the brain) or other infections involving the central nervous system
  • stroke
  • cardiac events (due to inefficient pumping of the heart, the brain is deprived of oxygen)
  • epilepsy
  • electrolyte disturbances
  • exposure to certain drugs - like ecstasy
  • brain tumors
  • dementia
  • birth injury
  • kidney or liver failure
  • metabolic disorders
  • alcohol withdrawal in a consistent drinker
I think that about exhausts the list in my brain.

What are the long term consequences of seizures?

My understanding is that seizures do not hurt the brain, they are symbolic of an underlying problem - the brain's cry for help, so to speak. Though, as i nose around, there seems to be some debate about this. Here is an interesting article suggesting that seizures occuring during brain development have some long term effect on learning.

DISCLAIMER: I am not a medical doctor and the education posted here is intended to be a starting point for your own research.

Basic first aid for a seizure:
This is taken from the Epilepsy Foundation website @ www. epilepsyfoundation.org.

1. Try to stay calm - it only takes one person to start a panic. Be a voice of reassurance to those around you.
2. Don't restrain the seizing person in any way. You can, however, try to protect them by padding areas, etc. and removing any object that might be harmful.
3. Never put your fingers in their mouth!
4. Turn and maintain the person onto their side (left side preferably). This helps maintain their airway and prevent aspiration.
5. Do not leave the person unattended.
6. Be supportive as they wake up.

Do I need to call 911?
It is always safe to do so, but in someone with a known seizure disorder, generally is not necessary. If the victim turns blue, does not seem to arouse after the seizure, if the seizure is prolonged (more than 5 min), if you suspect an injury occurred during the course of the seizure, or if the seizure may be secondary to something else (see list above) - call 911!

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