NR 507 EDAPT MODULE WEEK 8 LATEST
UPDATED VERSION WITH 100% ACCURACY
Introduction to Convulsions
Convulsions are sudden involuntary muscle contractions that cause a series of rapid shaking or
jerking movements. These movements are a sign of potential underlying neurologic or mental
health conditions. Frequently, this symptom is associated with epileptic seizures. At other times,
they suggest nonepileptic seizures. Understanding the cause of convulsions and administering
appropriate treatment depends on the underlying cause. Treatment may involve medications to
control seizures, fever management, or other specific interventions targeted at the cause of the
convulsions.
Convulsions may be caused by fever (febrile seizures), infection (especially meningitis or
encephalitis), head injury, or a reaction to a drug or toxin.
Rhythmic coordinated muscle contractions followed by relaxation are consistent with a
generalized epileptic seizure.
The correct order of the phases of a seizure is as follows:
1. Prodromal phase
2. Aura phase
3. Ictus phase
4. Postictal phase
Convulsions
Convulsions have no specific pathology but rather a variety of potential causes. They are
considered more a symptom than a condition. A typical convulsion consists of rapid muscle
twitching or a broader extremity tremor. It can affect all muscle groups and include
unconsciousness, or it can be seen focally in one or more extremities, sometimes without a loss
of consciousness.
Convulsions can also result from other causes, including fever, infections affecting the brain
(e.g., meningitis or encephalitis), head injury, stroke, or a reaction to certain medications, drugs,
or toxins.
,Client safety is always the priority during the event. Details of the convulsion should be
recorded, including the movements and behaviors associated with it, to assist in determining
the cause. This includes the duration of the event, body parts included, and any injury that may
have been sustained. Details can inform a diagnosis. For example, eye closure during a
convulsion is a reliable sign of a psychogenic nonepileptic seizure.
A mental health issue may be the cause of a convulsion and must be treated with the respect
and dignity of any physical problem. According to Huff and Murr (2022), older terms like
psychogenic, hysterical, or pseudo-seizures should be replaced with psychogenic nonepileptic
spells (PNES), psychogenic nonepileptic episodes (PNEE), or psychogenic nonepileptic attacks.
Pathophysiology of Seizures
Seizures are defined as uncontrolled electrical activity in the brain caused by excessive neuron
discharges. This can be caused by neuronal injury, metabolic or chemical changes, medication
toxicities, or electrolyte imbalances. These could be considered arrhythmias of the brain. The
result is random depolarization of neurons in specific areas of the brain. Depending on the
location within the nervous system, these signals can activate motor neurons, thereby causing
intense contractions of various muscle groups potentially all over the body.
Random neuron depolarization may occur in a localized area of the brain, causing focal (or
isolated) symptoms.
Ischemia
Lack of oxygen to cerebral cell tissue may cause decreased pH (acidosis) and potential
electrolyte abnormalities leading to a seizure (e.g., during a cerebral vascular accident or
suffocation). During a seizure, more oxygen is consumed, leading to increased hypoxemia,
depletion of glucose, and an increase in lactic acid.
Electrolyte Abnormalities
The imbalance of sodium, potassium, and other electrolytes in the brain can lead to a decrease
in the action potential threshold, causing increased neuronal depolarization. When this
imbalance increases, seizures can occur.
The rapid correction of electrolytes can also cause uncontrolled electrical activity, as also occurs
in hyponatremia. This low sodium level, if corrected too quickly, can cause seizures even after
being corrected.
,Direct Trauma
Any injury directly to cerebral tissue can cause edema and changes in electrolytes and pH,
leading to seizures. It is common for clients who have experienced head trauma to require
medication to reduce seizure activity.
Neurotransmitter Abnormalities
Imbalances in neurotransmitters can lead to seizure activity. Because medications are often
used to increase or decrease neurotransmitter activity, toxicities can lead to seizure activity.
Serotonin syndrome, caused by medications that increase serotonin levels, has a potential
adverse reaction to seizures.
A seizure does not equal a diagnosis of epilepsy. A seizure syndrome is confirmed by the
presence of documented seizures on an electroencephalogram (EEG) or magnetic resonance
imaging (MRI). According to the International Leagues Against Epilepsy (2022), criteria for
diagnosing epilepsy include the following:
• two or more unprovoked (or reflex) seizures occurring more than 24 hours apart
• one unprovoked (or reflex) seizure and a probability of further seizures similar to the
general recurrence risk (at least 60%) after two unprovoked seizures occurring over the
next 10 years
• diagnosis of a seizure syndrome
Types of Seizures
Seizures are defined by the location and symptoms experienced. Types of seizures include
generalized or focal (partial), which are further classified by the characteristics of the seizure.
Focal seizures (partial seizures)
Types of partial seizures include the following:
• Simple partial seizures: The individual remains conscious and aware during the seizure.
Symptoms involve twitching or sensory changes (such as taste, smell, or visual
disturbances).
, • Complex partial seizures: These involve a change or loss of consciousness. Individuals
may seem dazed and confused, perform repetitive actions, and not remember the
seizure afterward.
Generalized Seizures
Types of generalized seizures include the following:
• Absence seizures (petit mal): Brief, sudden lapses in attention or staring spells that
might be mistaken for daydreaming. These are more common in children.
• Tonic seizures: Muscles in the body become stiff, especially in the extremities, leading to
a fall if the person is standing.
• Clonic seizures: Repetitive, rhythmic jerks that involve both sides of the body.
• Tonic-clonic seizures (grand mal): Characterized by a sudden loss of consciousness, body
stiffening and shaking, and sometimes loss of bladder control or biting the tongue.
• Atonic seizures (drop): Loss of muscle control, causing the person to collapse suddenly.
• Myoclonic seizures: Sudden brief jerks or twitches of the arms and legs.
One area of the brain experiences uncontrolled neuronal firing in focal seizures. Generalized
seizures include a large part of the brain.
Etiology of Seizures
Seizure etiology varies and is essential for effectively diagnosing, treating, and managing seizure
disorders. The etiology can include the following:
• Genetic inheritance: Seizure disorders like epilepsy appear to be inherited in some
families.
• Structural brain abnormalities: Space occupying tumors or blood outside the vascular
space can cause an increased possibility of seizure activity, as seen in a traumatic brain
injury.
• Metabolic imbalances: Elevated or reduced electrolyte levels like sodium or glucose may
lead to seizures. Seizures may also arise when electrolyte imbalances are too rapidly
treated.
UPDATED VERSION WITH 100% ACCURACY
Introduction to Convulsions
Convulsions are sudden involuntary muscle contractions that cause a series of rapid shaking or
jerking movements. These movements are a sign of potential underlying neurologic or mental
health conditions. Frequently, this symptom is associated with epileptic seizures. At other times,
they suggest nonepileptic seizures. Understanding the cause of convulsions and administering
appropriate treatment depends on the underlying cause. Treatment may involve medications to
control seizures, fever management, or other specific interventions targeted at the cause of the
convulsions.
Convulsions may be caused by fever (febrile seizures), infection (especially meningitis or
encephalitis), head injury, or a reaction to a drug or toxin.
Rhythmic coordinated muscle contractions followed by relaxation are consistent with a
generalized epileptic seizure.
The correct order of the phases of a seizure is as follows:
1. Prodromal phase
2. Aura phase
3. Ictus phase
4. Postictal phase
Convulsions
Convulsions have no specific pathology but rather a variety of potential causes. They are
considered more a symptom than a condition. A typical convulsion consists of rapid muscle
twitching or a broader extremity tremor. It can affect all muscle groups and include
unconsciousness, or it can be seen focally in one or more extremities, sometimes without a loss
of consciousness.
Convulsions can also result from other causes, including fever, infections affecting the brain
(e.g., meningitis or encephalitis), head injury, stroke, or a reaction to certain medications, drugs,
or toxins.
,Client safety is always the priority during the event. Details of the convulsion should be
recorded, including the movements and behaviors associated with it, to assist in determining
the cause. This includes the duration of the event, body parts included, and any injury that may
have been sustained. Details can inform a diagnosis. For example, eye closure during a
convulsion is a reliable sign of a psychogenic nonepileptic seizure.
A mental health issue may be the cause of a convulsion and must be treated with the respect
and dignity of any physical problem. According to Huff and Murr (2022), older terms like
psychogenic, hysterical, or pseudo-seizures should be replaced with psychogenic nonepileptic
spells (PNES), psychogenic nonepileptic episodes (PNEE), or psychogenic nonepileptic attacks.
Pathophysiology of Seizures
Seizures are defined as uncontrolled electrical activity in the brain caused by excessive neuron
discharges. This can be caused by neuronal injury, metabolic or chemical changes, medication
toxicities, or electrolyte imbalances. These could be considered arrhythmias of the brain. The
result is random depolarization of neurons in specific areas of the brain. Depending on the
location within the nervous system, these signals can activate motor neurons, thereby causing
intense contractions of various muscle groups potentially all over the body.
Random neuron depolarization may occur in a localized area of the brain, causing focal (or
isolated) symptoms.
Ischemia
Lack of oxygen to cerebral cell tissue may cause decreased pH (acidosis) and potential
electrolyte abnormalities leading to a seizure (e.g., during a cerebral vascular accident or
suffocation). During a seizure, more oxygen is consumed, leading to increased hypoxemia,
depletion of glucose, and an increase in lactic acid.
Electrolyte Abnormalities
The imbalance of sodium, potassium, and other electrolytes in the brain can lead to a decrease
in the action potential threshold, causing increased neuronal depolarization. When this
imbalance increases, seizures can occur.
The rapid correction of electrolytes can also cause uncontrolled electrical activity, as also occurs
in hyponatremia. This low sodium level, if corrected too quickly, can cause seizures even after
being corrected.
,Direct Trauma
Any injury directly to cerebral tissue can cause edema and changes in electrolytes and pH,
leading to seizures. It is common for clients who have experienced head trauma to require
medication to reduce seizure activity.
Neurotransmitter Abnormalities
Imbalances in neurotransmitters can lead to seizure activity. Because medications are often
used to increase or decrease neurotransmitter activity, toxicities can lead to seizure activity.
Serotonin syndrome, caused by medications that increase serotonin levels, has a potential
adverse reaction to seizures.
A seizure does not equal a diagnosis of epilepsy. A seizure syndrome is confirmed by the
presence of documented seizures on an electroencephalogram (EEG) or magnetic resonance
imaging (MRI). According to the International Leagues Against Epilepsy (2022), criteria for
diagnosing epilepsy include the following:
• two or more unprovoked (or reflex) seizures occurring more than 24 hours apart
• one unprovoked (or reflex) seizure and a probability of further seizures similar to the
general recurrence risk (at least 60%) after two unprovoked seizures occurring over the
next 10 years
• diagnosis of a seizure syndrome
Types of Seizures
Seizures are defined by the location and symptoms experienced. Types of seizures include
generalized or focal (partial), which are further classified by the characteristics of the seizure.
Focal seizures (partial seizures)
Types of partial seizures include the following:
• Simple partial seizures: The individual remains conscious and aware during the seizure.
Symptoms involve twitching or sensory changes (such as taste, smell, or visual
disturbances).
, • Complex partial seizures: These involve a change or loss of consciousness. Individuals
may seem dazed and confused, perform repetitive actions, and not remember the
seizure afterward.
Generalized Seizures
Types of generalized seizures include the following:
• Absence seizures (petit mal): Brief, sudden lapses in attention or staring spells that
might be mistaken for daydreaming. These are more common in children.
• Tonic seizures: Muscles in the body become stiff, especially in the extremities, leading to
a fall if the person is standing.
• Clonic seizures: Repetitive, rhythmic jerks that involve both sides of the body.
• Tonic-clonic seizures (grand mal): Characterized by a sudden loss of consciousness, body
stiffening and shaking, and sometimes loss of bladder control or biting the tongue.
• Atonic seizures (drop): Loss of muscle control, causing the person to collapse suddenly.
• Myoclonic seizures: Sudden brief jerks or twitches of the arms and legs.
One area of the brain experiences uncontrolled neuronal firing in focal seizures. Generalized
seizures include a large part of the brain.
Etiology of Seizures
Seizure etiology varies and is essential for effectively diagnosing, treating, and managing seizure
disorders. The etiology can include the following:
• Genetic inheritance: Seizure disorders like epilepsy appear to be inherited in some
families.
• Structural brain abnormalities: Space occupying tumors or blood outside the vascular
space can cause an increased possibility of seizure activity, as seen in a traumatic brain
injury.
• Metabolic imbalances: Elevated or reduced electrolyte levels like sodium or glucose may
lead to seizures. Seizures may also arise when electrolyte imbalances are too rapidly
treated.
