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Pediatric Seizures Allison Krickl
Edgewood College School of Nursing
Definitions Seizures are abnormal, excessive electrical discharges of neurons within the brain caused by a disease process.
They are classified according to their type and etiology.
Epilepsy is chronic, recurring, and diagnosed after all possible etiologies for the seizures have been ruled out.
(Sommer, et al., 2013).
Incidence/Etiology About 4% of children will have at least 1 seizure by the age of 15 with half of those episodes being febrile seizures.
Seizures in children have many different causes. Nonrecurring (Acute) Seizures. Recurrent (Chronic) Seizures.
(Hockenberry & Wilson, 2013)
Seizure Classifications Generalized seizures: involve both hemispheres of the brain without local onset.
Partial seizures: have local onset and involve a relatively small location in the brain.
Unclassified epileptic seizures
(Hockenberry & Wilson, 2013)
Generalized Seizures Tonic-‐clonic seizure (previously referred to as grand mal) Tonic phase (10-‐20 seconds) Clonic phase (time varies) Postictal state
Absence seizure (previously referred to as petit mal)
Myoclonic seizure
Atonic and Akinetic Seizures (also known as drop attacks)
Infantile Spasms (Sommer, et al., 2013).
Partial Seizures Simple partial seizures with motor signs
Aversive seizure Rolandic seizure
Simple partial seizures with sensory signs
Complex partial seizures
(Sommer, et al., 2013).
Diagnostic Procedures Electroencephalogram (EEG)
Magnetic resonance imaging (MRI)
Lumbar puncture (LP)
Computed tomography (CT) scan
(Sommer, et al., 2013).
Management Nursing Care
Seizure Precautions During a Seizure Postseizure
Drug Therapy
Ketogenic Diet
Vagal Nerve Stimulation
Surgical Therapy
(Hockenberry & Wilson, 2013) & (Sommer, et al., 2013).
Complications Status epilepticus: prolonged seizure activity that lasts longer than 30 min or continuous seizure activity in which the client does not enter a postictal state.
Developmental delays
(Hockenberry & Wilson, 2013).
Febrile Seizures Febrile seizures affect approximately 2%-‐5% of children between the ages of 6-‐60 months.
Febrile seizures are classified as simple or complex. Simple febrile seizures. Complex febrile seizures.
The cause of febrile seizures is still uncertain.
Treatment
(Hockenberry & Wilson, 2013).
Background “Religious beliefs about causes and treatment of epilepsy-‐South Asian culture” Muslim, Sikh, and Hindu patients in the UK Religious beliefs Treatments Implications
(Ismail, et al., 2005).
Review of Topic “An overview of epilepsy in children and young people” Parent’s experience Treatment
Antiepileptic Drugs Diet Vagus nerve stimulation
Surgery Emotional Issues
(Solomon & McHale, 2012).
Review of Topic “Seizure precautions for pediatric bedside nurses”
(Clore, 2010)
Expert Interview Meghan S. Furstenberg-‐Knauff: Nurse Practitioner at the UW Pediatric Neurology Clinic/Pediatric Epilepsy & Ketogenic Diet Clinic. Communication with Families Treatments
Ketogenic Diet Vagus Nerve Stimulation
Role of Clinic RNs Epilepsy vs. Febrile Seizures Safety First!
A nurse is caring for a child who has absence seizures. Which of the following findings can the nurse expect? (Select all that apply)
A. Loss of consciousness
B. Appearance of daydreaming
C. Dropping held objects
D. Falling to the floor
E. Having a piercing cry
(Sommer, et al., 2013).
A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for the nurse to take?
A. Maintain a side-‐lying position
B. Monitor vital signs
C. Reorient the child to the environment
D. Assess for injuries
(Sommer, et al., 2013).
A nurse is providing teaching to the parent of a child who is to have an electroencephalogram (EEG). Which of the following should be included in the teaching?
A. “Decaffeinated beverages should be offered on the morning of the procedure”
B. “Do not wash your child’s hair the night before the procedure.”
C. “Withhold all foods the morning of the procedure.”
D. “Give your child an analgesic the night before the procedure.”
(Sommer, et al., 2013).
A nurse is teaching a group of parents about the risk factors for seizures. Which of the following should be included in the teaching? (Select all that apply)
A. Febrile episodes
B. Hypoglycemia
C. Sodium imbalances
D. Low serum lead levels
E. Presence of diphtheria
(Sommer, et al., 2013).
A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following should not be included in the discussion?
A. Vagal nerve stimulation
B. Additional antiepileptic medications
C. Corpus callosotomy
D. Focal resection
E. Radiation therapy
(Sommer, et al., 2013).
Conclusion Communication
Education
Emotional Issues
Treatment options Ketogenic diet research
References Hockenberry, M. J., & Wilson, D. (2013). Wong’s essentials of pediatric nursing (9th ed.). St. Louis, MO: Elsevier Mosby.
Ismail, H., Wright, J., Rhodes, P., & Small, N. (2005). Religious beliefs about causes and treatment of epilepsy. British Journal of General Practice, 55 (510), 26-‐31.
Solomon, N. & McHale K. (2012). An overview of epilepsy in children and young people. Nursing Children and Young People, 24 (6), 28-‐35.
Sommer, S., Johnson, J., Roberts, K., Redding, S. R., Churchill, L., Elkins, C. B., & Roland, P. (2013). RN nursing care of children (9.0 ed.). Assessment Technologies Institute, LLC.
Thomen Clore, E. (2010). Seizure precautions for pediatric bedside nurses. Pediatric Nursing, 36 (4), 191-‐194.
