Pseudo
Pseudo
Pseudo
II. Case
Ms. Veger, an 18 years-old young woman with an apparent history of seizure
disorder was taking antiepileptic medication. She presented to the emergency
department with a persistently low GCS of 3/15 after an episode of seizures. Her
mother reported that her daughter suddenly started shaking uncontrollably. The
assigned nurse noticed that Ms. Veger is weak and showing facial grimace and
irritation. Computed axial tomography (CT) of her brain was performed. The CT
was normal. After some time, the vital signs was performed which are T: 37.3, P:
110, R: 20, BP: 120/90 and returned to a low GCS of 3/15. Further review of the
case revealed a dissociative disorder and was suffering from pseudo--seizures.
III. Definition
Typical epileptic seizures occur when a sudden electrical disturbance in the nerve
cells in the brain causes the person to lose control of their body. The muscles in the
body may jerk or seize up uncontrollably, and the person may also lose
consciousness. Nonepileptic seizures are seizures that occur in someone who does
not have epilepsy.
While pseudoseizures are distinct from epileptic seizures, their symptoms are similar.
Symptoms of a pseudoseizure may include:
Pseudoseizures tend to result from mental health conditions and can often occur
because of severe psychological stress. The stress may be due to a single traumatic
event, or to an underlying chronic condition.
Pseudoseizures and their underlying causes can severely affect quality of life, so it is
essential that people receive a proper diagnosis and treatment.
There isn’t one treatment for pseudoseizures that will work for every person.
Determining the cause of the disorder is a significant part of treatment.
individual counseling
family counseling
behavioral therapy, such as relaxation therapy
cognitive behavioral therapy
eye movement desensitization and reprocessing (EMDR)
Counseling or therapy can occur at an inpatient facility or as outpatient. People who
can administer counseling are psychiatrists, psychologists, and social workers.
Studies show it’s not clear whether epilepsy medication can help this condition or not.
However, medication for mood disorders may be a viable treatment plan.
People with PNES are often misdiagnosed with epilepsy because a doctor isn’t
there to see the event happen. Psychiatrists and neurologists have to work together
to diagnose pseudoseizures. The best test to run is called a video EEG. During this
test, you’ll stay at a hospital or specialty care unit. You’ll be recorded on video and
monitored with an EEG, or electroencephalogram.
This brain scan will show if there’s any abnormality in the brain function during the
seizure. If the EEG comes back normal, you might have pseudoseizures. To confirm
this diagnosis, neurologists will also watch the video of your seizure. Many
neurologists also work with psychiatrists to confirm a diagnosis. A psychiatrist will talk
to you to help determine if there are psychological reasons that could be causing
your seizures.
IX. NCP
ASSESSMENT DIAGNOSIS OUTCOMES NURSING RATIONALE EVALUATION
INTERVENTIONS
Subjective: Risk of STG: Independent STG:
trauma
The patient related to After 8 hours Discuss - Enable After 8 hours of
reported that loss of of nursing seizure patients to nursing
her daughter large interventions, warning signs protect her interventions,
suddenly muscle patient will and usual self from patient was
started shaking coordinat demonstrate seizure injury able to
uncontrollably. ion behaviors, patterns. demonstrate
lifestyle behaviors,
Objective: changes to -Use of lifestyle
reduce risk Evaluate helmet may changes to
Weaknes
factors and need for provide reduce risk
protect self protective added factors and
Facial
from injury head gear protection for protect herself
grimace
patient during from injury.
Irritability seizure
activity.
Vital Signs
are: Explore - Lack of
with the sleep,
T: 37.3 flashing lights
patient various
P: 110/min and
stimuli that
R: 20/min prolonged
may
BP: 120/90 television
participate
seizure activity viewing may
For
increase brain
Significant
activity that
Glasgow
may cause or
Coma
trigger
Scale data
potential
showed a
seizure
low score
activity.
of 3/15