Seizures (Epilepsy) Nursing NCLEX: Tonic-Clonic, Generalized, Focal, Symptoms

Seizures (epilepsy) in nursing - NCLEX review: learn about generalized vs focal (also called partial) seizures, as well as the different types and stages of seizures. Seizures occur when abnormal electrical signals are fired by neurons in the brain.

Generalized seizure types can include tonic-clonic seizures (formerly known as grand mal seizures), petit mal seizures, absence seizures, myoclonic seizures, tonic seizures, and clonic seizures.

Focal seizure types (formerly called partial seizures) can include the following: focal onset aware seizures (also called simple partial seizures) and focal impaired awareness (also called complex partial seizures).

Seizures can occurs in anyone (children and adults) due to a severe acute condition, such as a high fever, illness (especially central nervous system types), hypoglycemia, acidosis, alcohol withdraw etc. Once the condition is corrected the seizures tend to stop.

What is epilepsy? Epilepsy is when a patient experiences frequent seizure activity due to a chronic condition. This can be from a massive stroke, traumatic brain injury, congenital defect, effects of a central nervous system infection etc.

Types of generalized seizures:
Tonic-clonic (formerly called grand-mal): the patient loses consciousness and the patient may experience an aura (warning sign) before the seizure. Then the patient will experience: tonic episode: body stiffens (may bite the inside of the cheek or tongue, cry out, and experience apnea), and this is followed by the clonic episode, which is recurrent jerking of the extremities. The patient may have incontinence as well. The post ictus stage can take hours to days, and the patient may report feeling very tired, sore, have a headache etc.
Absence (petit-mal): most common in children. Hallmark is staring (patient may appear to be daydreaming). This type of seizure is very short and may go undetected by others. The post ictus stage is immediate recovery.
Atonic (drop attacks): this is complete loss of muscle tone. The patient will suddenly lose muscle tone and is at risk for head injury. Patients should be advised to wear a helmet with this type of seizure.
Myoclonic: this is jerking of the muscles. The patient is aware of their surrounding during this type of seizure.
In addition, patients can experience just a tonic or clonic seizure.

Focal (partial) seizures:
Focal Onset Aware (simple partial): the patient is AWARE of their surroundings during the seizure. The signs and symptoms vary due to the specific location of the brain being affected. For instance, some patients may experience vision changes if the occipital lobe is being affected. The seizure is very short and the post ictus stage is immediate. This is sometimes referred to as an aura, and can happen prior to a complex partial seizure (focal impaired awareness).
Focal Impaired Awareness (complex partial): this is different from the other type of focal seizure because the patient is NOT aware of their surroundings and will experience motor symptoms (automatisms). Automatisms are movements performed by the patient that they are don't know they are performing, such as hand rubbing, smacking of the lips, grasping for an object that isn't there.

Nursing interventions for seizures (watch the video for an in-depth review of the interventions): assess for risk factors and seizure history, helping the patient prep for the seizure by lying the patient on their side with a pillow under the head, initiate seizure precautions, educating about seizure triggers, timing the actual seizure and noting its characteristics, administering anti-seizure (AEDs) etc.

This lecture also includes information on the following nursing interventions and management:

-EEG scans for seizures
-Vagus nerve stimulation
-Anti-seizure (anti-epilepsy) medication

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[joshuacassatt]

Sarah, I have to take a moment to thank you from the bottom of my heart for your videos. Your in depth explanations, mnemonics and explanation of the Pathophysiology have taught me more than any textbook or lecture ever could. Your entire Pharmacology video series has been a true life saver for me this semester. I have the greatest admiration and respect for what you do. Your videos leave me feeling confident, competent and prepared come exam day. I feel engaged and truly enriched knowing that I walk away actually grasping and understanding the concepts at the end of your videos rather than just regurgitating information.

[vitomaunabotrompeta]

Just a patient here. To me, this is thus far the best get it together information I've had found on YouTube. That means it's serious. She knows what she's talking about and knows how to teach. My admiration and respect.
Absolutely very helpful. ☺

[hellostephoo]

I was on the verge of failing my critical care course but then I remembered your videos and took notes off your lectures & took your quizzes. Then studied them alongside the teachers PowerPoints. I went from my last exam 70% to this exam a 94%. You brought me up to a passing grade!! Thank you!!

[Courtney_]

Thank you for this information. I’m a 34 year adult and recently diagnosed with tonic-clonic seizures and I’ve gotten more information from this video than I did from the neurologist. Thank you.

[juliarehm]

I’m back as a New Grad! I’m starting on a pediatric neurology, neurosurgery, and plastic surgery unit. We are designated as a Level 4 Epilepsy Center.
Your videos teach the most important basics, including patho, diagnosis, and interventions, providing a great foundation. I don’t think I’ll ever quit watching your videos.

[loverlyroperos]

Hi Sarah., i would like to say THANK YOU so
Much for all your videos. I graduated from college for almost 10 yrs. i honestly forgot about a lot of things even simple medical terms. Reading books, reviewers were really struggle for me. Until i found your videos on youtube. I was really amazed that i easily understood and remembered your lectures even the pathophysiology. So i decided to watch all of your videos. It helped a lot. YOU helped me. I just recently PASS my nclex and i wanted to share this to you. i will be forever thankful to you. I recommended your channel to my friends and colleagues. Pls continue to be an inspiration and a blessing to everyone. Thank you again sarah and God bless.

[shevelsimms]

Being the visual learner that I am your videos are extremely helpful. watch them more than I read nursing books and when I do read books in summary it is basically the same thing. Thanks much.

[taylorblackwell]

From an epileptic diagnosed at 18, with grand mal seizures, I usually skip the 1st phase, mine are set off by stress/lack of sleep, I enter the "aura" stage 1st, which I can feel for hours or a whole day before a seizure, it makes my brain feel "off", like I'm not all there, I never lose my bowls or vomit during my seizures, and unless I really knock myself out, I can recover thoughts within minutes, so yes, every epileptic is different! Ty for making this video to help ppl understand

[damariso.]

It's true, I have had several generalized tonic-clonic seizures and I always get an aura a few minutes or seconds before it happens. Thank God my family and friends are always around and know what to do. Usually now its to the point that when I get to the aura state I am able to relax myself and prevent the seizure all together :) My seizures are idiopathic but I have faith the will go away all together.

[jodihafner]

This was god sent! What a Wonderfully educational video for us first timers!🙏🏼 My daughter (17), has always suffered from Absent seizers since she was 4-years old but just recently (July 1, 2021) she had her 1st Grand-Mal (Tonic-Clonic) and was found face down, unconscious, and jerking in my mothers driveway! SCARIEST DAY OF MY LIFE! She also suffers from autism and a learning disability. So this is now added to our list of huge concerns. She has her 1st appointment Aug.30th to go over everything and possibly adjusting her current seizer meds. I pray we can control these with proper medication adjustments, because as of now I have not slept a full night, and my poor baby wants her independence back!!🙏🏼😔 She already knew she probably wouldn’t ever be able to drive, but we were so excited that she was just coming up on 6-months (absent) seizer free, then this!!☹️ I also have her starting counseling, because her stress and depression levels have since sky rocketed.
Sorry so long, but just wanted to say “Thank you, Thank you THANK-YOU!!🥰🙏🏼

[marzm]

Just Passed my NCLEX RN :) Thank you Nurse Sara for helping me through LVN School and RN School and helping me pass NCLEX. I pray Jesus Blesses you and your family. Thank you so much. You helped me to really learn the content. I could not have done it without you. I spent so much time reviewing your videos even my children and husband know you lol.

[rosa]

My 90 years old uncle has twice today. He is good now. Thank you for sharing and very helpful. ❤❤❤

[NaturallyWavy]

Hi Sarah!! I hope you still remember me haha but I wanted to come on here and tell you I found out today I passed my NCLEX and am officially an RN!! I have to thank you for supplying these awesome videos to us because they helped me SO much throughout nursing school and while I was studying for the NCLEX! I will always recommend you and appreciate the hard work, detail and time you put into these videos! 😊 God Bless!

[ironice]

Just had a patient like this recently. This video helped me get short minute clues to look for while i was preppring my work for the day

[Mystical_Dreams]

Five months ago I hit my head on the corner edge of my desk. I was extremely stressed out from college. I lost a lot of sleep trying to complete my algebra assignments throughout the semester and the last few hours after graduation . The accident kept me in the hospital ICU for a few days after I remembered the last thing I did before the seizure. I had my head scanned and the hospital radiology found a blood clot that had to be removed through IV and widening my veins to flush it out. This video is very informative! I am taking Keppra and I haven't had any seizures. I still have memory loss and still recovering from mild traumatic brain injury.

[jenniferclark]

I’ve had epilepsy since I was born, I’m now 67, I have had over the years different types of epilepsy, so I recognise many, from people telling me, Now I main.y have Tonic colonic, and it’s mainly under control 🙏. But this Doctor has explained so much THANKYOU I’ve saved this video, as I’m most likely to forget watching it . This could help my family, and many other families across the world again a huge THANKYOU ❤️👍

[GoodVibesNewlevel]

I am not a nurse but my daughter has been diagnosed with absence seizures. You gave a thorough presentation that helped me greatly. Thank you.

[sallyhasiak]

What a fantastic video for seizures!! I've had Epilepsy since I was 10 years old. I have both Tonic-Clonic and Focal aka partial. I'm going on the Keto diet. From what I heard it's a miracle for seizures. Lately I've been having Cluster seizures and it's been going on for days. Eventually I'm probably going to end up in the hospital.Thank you so much for this very in-depth video!

[daciaalmquist]

YOU ARE SAVING MY LIFE IN NURSING SCHOOL DURING COVID-19!!!! I am unable to load my teachers lectures due to the kiddos being home and the internet bandwidth being used up. You are such an amazing teacher. Thank you for all that you do!

[xtropicalsunrise]

This video is incredibly insightful & easy to understand. I watched this video because I suffer from epilepsy and wanted to know more about the specifics of the disease. Sarah does a great job in explaining WHY seizures occur and how people can help other when they are having a seizure. Thank you!!