Phone: (513) 721-2905
Toll Free: (877) 804-2241
Email: tom.koprowski@cincinnatiepilepsy.org
Website: www.cincinnatiepilepsy.org
 Improve
Recognition of Seizures
 Review
Appropriate Response to Seizures
 Review
Administration of Rescue Medications
A
seizure is a brief interruption in the normal
functioning of the brain that takes the form
of a massive release of electrical energy (like
an electrical storm).
 This release of electrical energy and its
outward manifestation is what is called a
seizure.
 Epilepsy
is defined as a neurological disorder
that is characterized by recurrent seizures
that occur on an unpredictable basis.
 The onset of these seizures can occur
without warning at any time in a person’s
life.
3
million Americans are diagnosed with
epilepsy.
 200,000 new cases of seizures and epilepsy
occur each year.
 Epilepsy strikes most often in the young
(under age 2) and the old (over 65 years),
although it can develop at any age.
 326,000 school age children (15 and under)
are affected by epilepsy; 90,000 of these
children have severe seizures.
 570,000 adults over 65 years develop
epilepsy.
Symptomatic seizures can be linked to a direct
cause, including:
 Head trauma
 Lack of oxygen during birth
 Abnormal brain tissue (ex: tumors or tubers)
 Genetic conditions (such as tuberous sclerosis)
 Lead poisoning
 Brain malformations
 Brain infections (ex: meningitis or encephalitis)
 Stroke
 High Fever
 In
70% of the cases of epilepsy, the cause
cannot be determined.
 The remaining 30% have identifiable causes.
 Generalized
Seizures involve the whole
brain. They include:




Tonic-Clonic
Absence
Atonic
Myoclonic
 Partial
Seizures involve a specific area of the
brain. They include:


Simple
Complex
 Symptoms










of a tonic-clonic seizure include:
Loss of consciousness
Falling
Rigidity
Convulsions
Shallow breathing
Drooling
Occasionally, skin may turn blue
Possible loss of bladder of bowel control
Usually followed by confusion, tiredness and
emotional upset
Usually lasts 1-3 minutes
 Symptoms




of an absence seizure include:
Pause in activity with a blank stare
Brief lapse of awareness
Usually lasts 1-10 seconds
May be confused with behavioral issues
 Symptoms



Altered awareness
Blank stare or dazed look
Automatisms:






of complex seizures include:
Picking at clothes
Lip smacking
Chewing
Garbled speech
Clumsy or disoriented movements
Aimless walking



Picking things up
Often lasts 1 to 3 minutes
Often followed by:




Tiredness
Headache
Emotional upset
May be confused with other behaviors
 Assess
individual’s needs and gather
information
 Customize
 Teach
a seizure action plan
family, friends and co-workers
interventions and tailor interventions as
needed

Medically defined as 30 minutes of uninterrupted
seizure activity and may include:
One prolonged seizure
 Multiple seizures without recovery to baseline

Is a “MEDICAL EMERGENCY” and requires
immediate action to stop the seizure activity
 Every person’s seizure action plan should clearly
define what constitutes a seizure emergency and
have a detailed emergency plan response
 Discrete Status Epilepticus

First time seizure
 Convulsive seizure lasting more than 5 minutes
 Repeated seizures without regaining
consciousness
 Individual has diabetes or is pregnant
 Seizure occurs in water or injury is suspected
 Parents/Guardians request an emergency
evaluation
 If individual is not breathing after a convulsive
seizure
 Non-convulsive seizure lasting more than 5
minutes beyond the normal duration for that
individual

Follow seizure emergency definition and protocol as defined by
healthcare provider in seizure action plan
 Sometimes
AEDs are prescribed for patients
who tend to have seizure clusters or status
epilepticus
 Several of these include:



Ativan ® (generic: lorazepam)
Versed ® (generic: midazolam); now available in
a nasal spray
Diastat ® (generic: diazepam); dispensed as a
rectal gel
 Remove
plastic cap from vial
 Twist the blunted needle into syringe
 Holding vial upside down insert the needle
into stopper and withdraw prescribed
amount of medication
 Remove needle and replace with MAD®
atomizer.
 The child’s head may be in any position
 Place the tip of the atomizer into the nostril
and press the plunger until ½ of the
midazolam has been atomized, and then
atomize the remainder into the other nostril.
895 Central Ave., Suite 550
Cincinnati, OH 45202
Phone: (513) 721-2905
Toll Free: (877) 804-2241
Fax: (513) 721-0799
Email: tom.koprowski@cincinnatiepilepsy.org
Website: www.cincinnatiepilepsy.org