CNS Disorders (Seizures)

What are the Two Main parts of the CNS?

Brain and Spinal Cord (Central) Cranial/Spinal Nerves and ANS (Peripheral)

Function of the CNS

To control motor, sensory, autonomic, cognitive, and behavioral activities

__________ receive sensory messages and _________ ___________ send those signals to the brain

Dendrites, Synaptic Terminals

3 Excitatory Neurotransmitters

Acetylcholine, Norepinephrine, Enkephalin Endorphin

3 Inhibitory Neurotransmitters

Serotonin, Dopamine, Gamma-Aminobutyric Acid

Acetylcholine Action

Major parasympathetic nervous system transmitter

Norepinephrine Action

Major SNS transmitter responsible for mood and overall activity

Enkephalin Endorphin Action

Responsible for pleasurable sensation and inhibiting pain transmission

Serotonin Action

Controls mood and sleep and inhibits pain pathways

Dopamine Action

Controls behavior and fine movements

What parts make up the PNS?

Cranial nerves, spinal nerves, ANS

What are Spinal Nerves called?

Dermatomes

The _______ root of a spinal nerve receives sensory from body to brain and the _______ root sends motor from brain to body

Dorsal, ventral

What is the Function of the ANS?

To regulate the activities of internal organs and maintain/regulate homeostasis

The SNS is responsible for _________ responses

Excitatory

The Parasympathetic Nervous System is responsible for _________ functions

Visceral (Abdominal)

What is a Seizure?

An abrupt, abnormal, excessive, and uncontrolled electrical discharge of neurons within the brain that can cause alterations in the LOC and/or changes in motor/sensory ability and/or behavior

What is a Provoked Seizure?

A single seizure caused by an acute, reversible condition like low BS or fever

What is Epilepsy?

Unprovoked (chronic) seizure disorder characterized by at least 2 seizures 24 hours apart or 1 seizure with high probability of recurring

What is a Status Epilepticus Seizure?

Repeated seizure activity over a 30 minute period or a seizure lasting more than 5 minutes

Common Seizure Causes

Allergies, brain tumor, CVD (stroke), CNS infection (meningitis), drug withdrawal, fever, genetic predisposition, head injury, HTN, hypoxemia, metabolic disorders, toxins (pesticides)

Common Seizure Triggers

Increased physical activity, excess stress, hyperventilation, overwhelming fatigue, ETOH ingestion, excessive caffeine, flashing lights, substances (cocaine, aerosol, glue products)

Focal Onset seizures affect _____ side of the brain

1

Generalized Onset seizures affect ______ sides of the brain

Both

T or F: Focal onset seizures are non-emergencies that should be rode out and Generalized onset seizures are emergencies

T

Two Types of Focal Onset Seizures

Complex and Simple

Two Types of Generalized Onset Seizures

Tonic and Clonic

What is a Focal Complex Seizure?

A seizure where you blackout or lose consciousness

What is a Focal Simple Seizure?

A seizure where you maintain consciousness

What is a Tonic-Clonic Seizure?

A seizure that is a combination of muscle stiffness and rhythmic jerking

Nursing Interventions During Seizure

Protect their privacy, position client safely, have suction ready, turn client to side, loosen restrictive clothing, don’t restrain them, don’t open or insert anything in mouth, document onset/duration/findings of seizure

Nursing Interventions After Seizure

Maintain side-lying position, check vitals, assess for injuries, perform neuro check, allow them to rest, reorient/calm client, determine if aura was experienced, document findings

What Diagnostics are done for Seizures?

EEG, MRI, CAT scan, blood tests (for drug level)

What is the Post-Seizure period called?

Post-ictal period

What is an Aura?

A sensation that occurs before an episode that indicates one will occur

What should people with Chronic Epilepsy do to maintain their disorder?

Keep a journal, identify aura, see neurologist, have family/friends know how to care for seizures

T or F: People who have seizure disorders are not allowed to drive

T

Seizure Medications

Diazepam or Lorazepam (IV push)

Phenytoin or Fosphenytoin (IV infusion)

Keppra Infusion

Seizure medications are __________ until the desired effect is achieved

Titrated

T or F: Seizure medications carry the risk of having MANY interactions so it’s important for patients to tell their provider all of the medications they’re on

T

What 2 Seizure Medications can be given Rectally?

Valium and Ativan

T or F: Ativan must be diluted before pushing IV

T