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    Tonic - Clonic Seizures Marco, Carmela Dawn M.

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    Christian Dave Marco
    Tonic-clonic seizures, also known as grand mal seizures, consist of four stages: 1) a prodromal period with symptoms like dizziness, 2) an aura where the person may experience smells or visions, 3) a tonic phase where the body stiffens and a clonic phase with jerking motions, and 4) a postictal period where the person sleeps for 1-4 hours. Treatment involves daily anticonvulsant medications like valproic acid, carbamazepine, or phenytoin sodium to prevent seizures, as well as a ketogenic diet high in fat and low in carbs.

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    Tonic - Clonic Seizures Marco, Carmela Dawn M.

    Uploaded by

    Christian Dave Marco
    132 views14 pages
    Tonic-clonic seizures, also known as grand mal seizures, consist of four stages: 1) a prodromal period with symptoms like dizziness, 2) an aura where the person may experience smells or visions, 3) a tonic phase where the body stiffens and a clonic phase with jerking motions, and 4) a postictal period where the person sleeps for 1-4 hours. Treatment involves daily anticonvulsant medications like valproic acid, carbamazepine, or phenytoin sodium to prevent seizures, as well as a ketogenic diet high in fat and low in carbs.

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    Tonic-clonic seizures, also known as grand mal seizures, consist of four stages: 1) a prodromal period with symptoms like dizziness, 2) an aura where the person may experience smells or visions, 3) a tonic phase where the body stiffens and a clonic phase with jerking motions, and 4) a postictal period where the person sleeps for 1-4 hours. Treatment involves daily anticonvulsant medications like valproic acid, carbamazepine, or phenytoin sodium to prevent seizures, as well as a ketogenic diet high in fat and low in carbs.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    132 views14 pages

    Tonic - Clonic Seizures Marco, Carmela Dawn M.

    Uploaded by

    Christian Dave Marco
    Tonic-clonic seizures, also known as grand mal seizures, consist of four stages: 1) a prodromal period with symptoms like dizziness, 2) an aura where the person may experience smells or visions, 3) a tonic phase where the body stiffens and a clonic phase with jerking motions, and 4) a postictal period where the person sleeps for 1-4 hours. Treatment involves daily anticonvulsant medications like valproic acid, carbamazepine, or phenytoin sodium to prevent seizures, as well as a ketogenic diet high in fat and low in carbs.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
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    Tonic Clonic Seizures

    Marco, Carmela Dawn M. BSN II - 3

    Tonic Clonic Seizures


    Also known as Grand mal Seizure Generalized seizures consisting of four stages:
    1.

    2.
    3. 4.

    Prodromal Period Aura Tonic- Clonic Stage Postictal Stage

    Not all four stages occur with every seizure

    Tonic Clonic Seizures

    Four Stages: I. Prodromal Period


    1. Prodromal Period

    Manifestations:
    Drowsiness Dizziness Malaise Lack of coordination Tension

    Parents may observe simply that the child is not himself School- Age Children May able to predict from vague preliminary feelings when they are going to have seizure

    Four Stages: II. Aura


    2. Aura May reflect the portion of the brain in which seizure originates Manifestations:

    Smelling unpleasant odors Denotes activity in medial portion of the temporal lobe Seeing flashing lights Suggests occipital area Repeated hallucinations Arise from the temporal lobe Numbness of the an extremity Relates to the opposite parietal lobe

    Four Stages: II. Aura

    Cheshire- cat grin Relates to the frontal lobe

    Young Children

    Unable to describe or understand an aura

    Expected Actions During Onset:


    May scream in fright Run to their parents

    Note exactly what symptoms the child experiences during the onset

    It may help to localize the involvement of brain portion

    Four Stages: III. Tonic Clonic Stage


    3. Tonic Clonic Stage

    Tonic Stage

    It lasts only about 20 seconds


    Manifestations:
    All muscles of the body contract Child falls on the ground Extremities stiffen Face distorts May experience hypoxia and become cyanotic Due to contraction of respiratory muscles

    Four Stages: III. Tonic Clonic Stage

    Collection of saliva in the mouth Due to contraction of the throat and prevent swallowing Child might bite the tongue Due to contraction of the jaw Guttural Cry Due to initially contraction of the chest muscle and air pushed through the glottis

    Clonic Stage

    It usually lasts about 20-30 seconds Manifestations:

    Quick, Jerky Motions

    Muscles of the body rapidly contract and relax

    Four Stages: III. Tonic Clonic Stage


    May blow bubbles or foamy saliva Incontinent of stool and urine If the child bite his tongue when his jaw spasmed shut

    Presence of blood in the mouth

    Four Stages: IV. Postictal Period


    4. Postictal Period
    The child falls into a sound sleep He will sleep soundly for 1 to 4 hours and will rouse only to painful stimuli When the child awakens, expect:

    Severe headache No memory of the occurring seizure

    Tonic Clonic Seizures


    Seizures may occur at night When the child wake up in the morning expect:

    Blood on the pillow

    Due to bitten tongue

    Bed wet with urine Considered possibility of nocturnal seizures

    Persistent Bedwetting

    Abnormal EEG patterns

    Therapeutic Management:

    Daily administration of Anticonvulsant

    Valproic Acid (Depakene)

    Care should be taken when giving this medication to very young children and clients with liver disorders Due to hepatoxicity for possible adverse reaction

    Carbamazepine (Tergetol)

    Used to control this type of seizure that have not responded to other anticonvulsant therapy Avoid drinking grapefruit juice May cause toxicity

    Therapeutic Management:

    Phenobarbital

    Inexpensive anticonvulsant that lowers the seizure threshold Drowsiness and Sleepiness
    To prevent this type of seizure Non-toxic side effects Painless Hypertrophy of the gums

    Phenytoin Sodium (Dilantin)


    Unless the gum hypertrophy is extensive, it is not sufficient reason to discontinue the medication.

    Prescription of Ketogenic Diet


    High in fat and low in protein and carbohydrate To causes an increased level of ketones Decrease tonic- clonic seizure activity

    References:

    Maternal and Child Health Nursing Volume 2; Adele Pillitteri Pharmacology www.youtube.com

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