Seizure Disorder: abnormal electric discharges from cerebral neurons

Characteristics: loss of consciousness, convulsive movements

Cause: Unknown, Secondary to trauma, anoxia, infection, stroke; Isolated seizures due to fever, electrolyte, or acid-base imbalance

Generalized: 1) Grand mal (tonic-clonic)- most common, generalized alternating muscle spasms and jerkiness

2) Petit mal (absence) - brief loss of consciousness (10 seconds or less), usually occurs in children

Partial: Psychomotor - repetitive behavior, chewing or swallowing motions, behavorial changes, motor seizures 

Action: Suppress abnormal neuron firing

Supress Na influx: Phenytoin (Dilantin)

Supress Ca influx: Valproic acid (Depakane, divalproex (Depakote)

Enhance action of GABA: Clonazepam (Klonopin), gabapentin (Neurontin)

Inhibit GABA degradation: Vigabatrin (Sabril)

Main one: Phenytoin (Dilantin)

Contraindications: pregnancy (teratogenic)

Therapeutic serum level: 10-20 mcg/mL

Side Effects/Adverse reactions: gingivitis, gingival hyperplasia, nystagmus(eye movement), HA, diplopia (double vision), dizziness, hyperglycemia

*Low therapeutic range - must monitor frequently

Phenytoin (Dilantin)

drug interactions: increased effects with cimetidine (Tagamet), decreased effects with folic acid, antacids, calcium, decreased effects of anticoagulants, antihistamines, dopamine, theophylline

Nursing Interventions: shake suspension well (5 min.), monitor serum drug levels, avoid CNS depressants, alcohol, monitor glucose in diabetics, warn of harmless pinkish red or brown urine

Two transmitters: dopamine (inhibitor)/acetylcholine (excitatory)

Pathophysiology: degeneration of dopaminergic neurons, imbalance of the neurotransmitters

Characteristics: tremors of head & neck, rigidty (increased muscle tone), bradykinesia (slow movement), lack of facial expression

Treatment: anticholinergics:block chollinergic receptors

anticholinergics interfere with glycoma: Benztropine (Cogentin), Trihexyphenidyl HCl (Artane)

Parasympatholytic: Benztropine (Cogentin), Trihexyphenidyl HCl (Artane)

Action: inhibit release of actylcholine (decrease tremors and rigidty

Dopaminergics: (help create dopamine) Cardidopa-levodopa (Sinemet)

Action: converted to dopamine, increases mobility

Side Effects: dry mouth, constipation, increased heartrate, urinary retention

Amantadine (Symmetrel), also antiviral drug for influenza

Can be taken alone or with a combination of drugs.

Early treatment as drug, tolerance develops.

Pathopysiology: progressive, degenerative disease

Characteristics: loss of memory, personality change, tendency to wonder, time disorientation

Donepril (Aricept), Rivastigmine (Exelon)

Action: allow more acetylcholine in neuron receptors, increase cognitive function

Side Effects: depression, dehydration, blurred vision, dysrhythmias

Nursing Interventions: monitor VS, provide safety, maintain consistency in care, monitor behavorial changes