SEIZURE Disorders In Children

[This is my lecture for presentation >.....

Topics To DISCUSE

Definition
-Types of seizure
Diagnostic Evaluation
-Drugs
commonly used for the control of seizures
-Nursing assessment
Nursing Intervention
- Family Education & Health
Maintenance

Definition

Seizures ( also known as epileptic seizures and if
recurrent , epilepsy ) are thought to result from disturbances in the cells of
the brain that cause them to give off abnormal, recurrent , uncontrolled
electrical discharge They are relatively common in children. Being more
prevalent during the first 2 years than at any other time in life

-Types of seizure

A- Partial Seizures (seizures bgining locally )
1- Simple
; focal motor or sensory effect , no loss of consciousness
2- comlea :
congitive , psychosensory ,psychomotor , or affective
effect , brief loss of
cnscious

C- Status epilecticus ; prologed partial or generalized
seizures
without recovery between attackes : many completely
exhaust the
clint and lead
to death

Seizures (bilateral symmetric and without
local onset )
1- Absence (petit mal)
2- Myoclonic
3-Tonic-clonic (
Grand mal )

Diagnostic Evaluation

A- electroencephalogram
The EEG shows characteristic abnormalities during
seizures and with generalized seizures , between seizures as well .
B- laboratory studies
1- serum electrolytes (hyponatermia )
2- toxicology serum (drug overdose )
3- blood culture( fever ,CNS infection )
4- lumber puncture

Treatment

1- selection of the most effective drugs
depends on correct identification of the clinical seizure type .
2- A
desirable drug level ; is that will prevent seizure without producing
undesirable side effect.
3- dosages are adjusted according to blood level and
clinical sign.

4- Accurate timing
5- Enteric-coated tablet
6- symptoms may not be controlled 100%
7- Medication is often not discontinued
until 2to3years after last attack.
8- Weaning from mediation should always be gradual

Drug commonly used
PHENOBARBITAL (luminal )
Maentenance
dosage
3-8 mg /kg per day given qid or bd

PHENYTOIN (Dilantin )

Loding dose : 15mg/ kg
Mantenance ;4-7mg/kg
per day given qid or bd

ETHOSURIMEDE
Maintenance :20-40mg/kg
per day given qid by oral
DIAZEPAM (valium )
I/V dosage 0.2-0.3mg /kg
to maximum 10mg

rectal dosage 0.5mg/kg

TEGRATOL
20-30-MG/KG PER
day tid or
qid maximum
dose of 1000mg/d

Nursing Assessment

1-During seizure assess the following
A-any indication of difficulty in breathing

B- behavior before the seizure
D-type of movement observed
E- time seizure begin and ended
F- site where twitching or contraction began
G- movement of the eyes and change in pupil size h- color change , mouth (tongue bitten )

2- After seizure ,assess the following
A- degree of memory
for recent event
B- type of speech
C- coordination ,paralysis or
weakness
D- length of time the child is posited
E- papillary
reaction
F- vital signs

Nursing Intervention
A-Ensuring
safety during a seizure
1-use preventive measures
A- Remove hard toys
from the bed
B-pale the sides of the bed or side rails
C-have a suction
machine available
D-Have an emergency oxygen
2- Make sure the child can
be readily observed
3- during seizure monitor vital signs &assess
neurological status

During Seizure Take the Following Emergency
Action

A- clear the area around the child
B-Don’t restrain the child

C-without limiting the movement of the child loosen any tight clothing
,particularly around the neck
D- If vomiting occurs ,turn the child on one
side
E- place a small folded blanket under the head to prevent trauma

2-suction the vomits or saliva& administer oxygen
3- in an
infant or child,if the seizure seem to be the result of high fever cool the
child gradually , using taped water
4- After the seizure ,place the child in
a sideling position .

Family Education * Health maintenance

1-describe completely any examination , treatment
That the child is
receiving
2-Provide information regarding the disease
3-prepare the
parents for the fact that it may take several months of regulating drug dosage
before adequate control is obtained .
4- Teach the parents the factors that
may precipitate a seizure

THANK YOU

الأخت القديرة رشروشه
بارك الله فيكِ
جهد طيب يستحق الشكر والتحيه
SEIZURE Disorders In Children 18

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