1 Epileptic Case Study 2 Questions 1. Explain what the stages of a tonic/clonic seizure. Tonic-clonic seizures typically begin with the patient experiencing a simple partial seizure or an aura. After that the patient begins to experience the tonic activity which may cause strong tonic muscle spasms, foaming at the mouth, and impaired breathing. Hopkins medicine shares that the next stage is the clonic activity including, “Jerking movements affect the face, arms and legs, becoming intense and rapid. After one to three minutes, the jerking movements slow down and the body relaxes” (2021). Lastly the person may remain unconscious for a couple of minutes after waking they may experience exhaustion, confusion, and memory loss. 2. What should you not do when suffering from tonic-clonic seizures? When a person suffers from a seizure it is important to remain calm and help them. The CDC states, do not hold the person down, do not put anything in the person’s mouth, Do not try to give mouth-to-mouth breaths, do not offer the person water or food until he or she is fully alert. (2022). Instead the person witnessing the seizure should help turn the person on their side and help them prevent any head injuries. 3. What should you do after a tonic-clonic seizure? If this is the person's first tonic-clonic seizure, or it lasts longer than five minutes then one would call 911. The Epilepsy Foundation says this, try to keep the person in a safe place, don't give water, pills or food to swallow until the person is awake, stay with the person until they are fully alert and oriented, ask a series of questions that require more than a yes or no answer, have witnesses tell the person who had a seizure what happened and how long it lasted. (Shafer RN MN & Sirven MD , 2017) 4. What is an EEG test for seizure? An EEG is a test that detects abnormalities in brain waves or in the electrical activity of the brain. Johns Hopkins Medicine shares, “During the procedure, electrodes consisting of small metal discs with thin wires are pasted onto your scalp. The electrodes detect tiny electrical charges that result from the activity of your brain cells.” (2021). This activity is then transmitted on to a monitor for the doctor to make their diagnosis. 5. What is the drug of choice for tonic-clonic seizure? The drug of choice for tonic-clonic seizures is valproic acid. Medscape shares, “Considered the drug of first choice for primary generalized epilepsy, valproate has a very wide spectrum and is effective in most seizure types, including myoclonic seizures.” (Ko MD, 2023). This medication is also a drug of choice because it can be prescribed once a day when it is the extended-release formulation. 6. What type of seizure is status epilepticus? Status epilepticus is a seizure that lasts longer than 5 minutes or recurrent seizure activity without recovery between seizures. Many people that have tonic-clonic seizures regain consciousness within 15 to 20 minutes. It is important to note the difference between a 3 regular tonic-clonic seizure and status epilepticus. The Epilepsy Foundation shares this to help educate, “The active part (rhythmic shaking) of a tonic-clonic seizure lasts 5 minutes or longer. A person goes into a repeated tonic-clonic seizures without recovering consciousness for a period of longer than 5 minutes.” (Singh MD & Osman MD, 2023). 4 Works Cited Centers for Disease Control and Prevention. (2022, January 2). Seizure first aid. Centers for Disease Control and Prevention. https://www.cdc.gov/epilepsy/about/first-aid.htm Electroencephalogram (EEG). Johns Hopkins Medicine. (2021a, August 8). https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/electroencephalog ram-eeg#:~:text=An%20EEG%20is%20a%20test,activity%20of%20your%20brain%20c ells. Johns Hopkins School of Medicine . (2021, August 8). Tonic-clonic (Grand Mal) seizures. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/epilepsy/tonic-clonic-gr and-mal-seizures#:~:text=Tonic%2Dclonic%20seizures%20involve%20both,to%20the% 20tonic%2Dclonic%20seizure. Ko MD, D. (2023, June 13). Generalized tonic-clonic seizures medication. Anticonvulsant Agents. https://emedicine.medscape.com/article/1184608-medication?0=reg#1 Shafer RN MN, P., & Sirven MD , J. (2017, September 2). First aid for tonic-clonic seizures. Epilepsy Foundation. https://www.epilepsy.com/recognition/adapting-plans/first-aid-tonic-clonic Singh MD, R. (2023, May 12). What is status epilepticus?: Emergency seizures & treatment. Epilepsy Foundation. https://www.epilepsy.com/complications-risks/emergencies/status-epilepticus
