2. Care for patient with Brain
Disorders
BY
DR. Fatma Abbas Salem

3. Care for patient with seizures
 Definition:
Seizures are episodes of abnormal motor,
sensory, autonomic, or psychic activity or a
combination of these that result from
sudden excessive discharge from cerebral
neurons (Hickey 2009).

4. Care for patient with seizures
 The international classification
 Partial seizures that begin in
one part of the brain.
 Generalized seizures that
involve electrical discharges in
the whole brain.

5. Causes
a. Idiopathic (genetic, developmental defects)
b. Acquired seizures include:
1. Cerebral anoxia.
2.Cerebro vascular disease.
3.Fever (childhood).
4.Head injury.
5. Hypertension.

6. Causes
6. Central nervous system infections.
7. Metabolic and toxic conditions (renalfailure,
hypornatremia, hypo calcemia, hypoglycemia,
pesticide, exposure)
8. Brain tumor.
9. Drug and alcohol withdrawal.
10. Allergies.

7. CLINICAL COURSE
 Aura epileptic cry, loss of
consciousness, fall, tonic & clonic
convulsions and incontinence -
postical confusion – headache &
sleep.

8. Medical Management
Major anticonvulsive
medications as.
 Carbamazepine (Tegretol)
 Clonazepam(Klonopin)
 Lamotrigine (Lamicatal)
 Phenol barbital (Luminal)
 Phenytoin (Dilantin)

9. Surgical treatment.
 Indicated for patients whose epilepsy
results from intracranial tumors,
abscesses, cysts or vascular anomalies.

10. Nursing management
 Assessment:
A major responsibility of the nurse is to observe
and record the sequence of signs. The natural of
the seizure usually indicates the type of
treatment that is required (AANN, 2007)
1. Description of circum stances before the seizure
(visual, auditory, or olfactory stimuli, tactile stimuli,
emotional or psychological disturbances sleep,
hyperventilation).
2. The occurrence of an aura.
3. The first thing the patient does in the seizure where
the movements or the stiffness begins, the position
of the head at the beginning of the seizure.

11. Nursing ASSESSMENT
4. The type of movements in the part of the
body involved.
5. The areas of the body involved.
6. The size of both pupils and whether the
eyes are open.
7. Whether the eyes or head turned to one
side.
8. The presence or absence of automatisms
(involuntary motor activity, such as lip

12. NURSING ASSESSMENT
9. Incontinence of urine or stool.
10.Duration of each phase of the seizure.
11.Unconsciousness if present and its duration.
12. Any obvious paralysis or weakness of arms or
legs after seizure.
13. Inability to speak after the seizure.
14. Whether or not the patient the patient sleeps
afterward.
15. Cognitive statues (Confused or not confused)
after the seizure.

13. Care during seizure
1. Provide privacy and protect the
patient from curious on lookers.
2. Ease the patient to the floor if
possible.
3. Protect the head with a pad to
prevent injury from striking a hard
surface.
4. Loosen constrictive clothing.
5. Push aside any furniture that may

14. Care during seizure
6. If the patient is in bed, remove pillows and
raise side rails.
7. IF an aura precedes the seizure, insert an
oral air way to reduce the possibility of the
patient's biting the tongue or cheek.
8. Do not attempt to pry open jaws that are
clenched in a spasm or to insert anything.

15. Care during seizure
9. No attempt should be made to restrain
the patient during the seizure, because
muscular contractions are story and
restrain can produce injury.
10. If possible, place the patient on one side
with head flexed forward which allows the
tongue to fall forward and facilitates
drainage of saliva and mucous. If suction
is available use it if necessary to clear
secretions.

16. Nursing care after the seizure
1. Keep the patient on one side to prevent
aspiration.
2. Make sure the airway is patent.
3. There is usually a period of confusion after a
grand mal seizure.
4. The patient on awaking should be reoriented
to the environment.
5. If the patient becomes agitated after a seizure
(postictal use persuasion and gentle restrain
to assist him or her to stay calm.)
1.