Seizures, absence

Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times per day, causing periods of inattention. Absence seizures usually begin between ages 4 and 12. Their first sign may be deteriorating schoolwork and behavior. The cause of these seizures is unknown.

Absence seizures occur without warning. The patient suddenly stops all purposeful activity and stares blankly ahead, as if he were daydreaming. Absence seizures may produce automatisms, such as repetitive lip smacking, or mild clonic or myoclonic movements, including mild jerking of the eyelids. The patient may drop an object that he's holding, and muscle relaxation may cause him to drop his head or arms or to slump. After the attack, the patient resumes activity, typically unaware of the episode.

Absence status, a rare form of absence seizure, occurs as a prolonged absence seizure or as repeated episodes of these seizures. Usually not life-threatening, it occurs most commonly in patients who have previously experienced absence seizures.

History and physical examination

If you suspect a patient is having an absence seizure, evaluate its occurrence and duration by reciting a series of numbers and then asking him to repeat them after the attack ends. If the patient has had an absence seizure, he can't do this. Alternatively, if the seizures are occurring within minutes of each other, ask the patient to count for about 5 minutes. He'll stop counting during a seizure and resume when it's over. Look for accompanying automatisms. Find out if the family has noticed a change in behavior or deteriorating schoolwork.

Next, perform a complete neurologic examination.

Medical causes

Idiopathic epilepsy.Some forms of absence seizure are accompanied by learning disabilities.

Other causes

Drugs.Drugs that lower the threshold for seizures, such as alcohol, cocaine, penicillin in high doses, isoniazid, and phenothiazines may trigger seizures in patients with preexisting epilepsy.

Nursing considerations

▪ Administer an anticonvulsant, as ordered.

▪ Assess neurologic status, noting episodes of possible absence seizures.

Patient teaching

▪ Teach the patient and family about the condition and its treatments.

▪ Explain signs and symptoms that require immediate attention.

▪ Emphasize the importance of follow-up medical care.

▪ Discuss the need to wear medical identification.

Book Source Details

• Book Title: Nursing: Interpreting Signs and Symptoms
• Author(s): Springhouse
• Year of Publication: 2007
• Copyright Details: Nursing: Interpreting Signs and Symptoms, Copyright © 2007 Lippincott Williams & Wilkins.

Other Book Chapters Related to Convulsions

Read excerpts from these other book chapters related to Convulsions:

Copyright Details: Nursing: Interpreting Signs and Symptoms, Copyright © 2008 Williams & Wilkins.

More About Causes of Convulsions

• Back to symptom: Convulsions: Introduction (review 559 causes)
• Next Book Extract About Convulsions: Seizures, complex partial (Nursing: Interpreting Signs and Symptoms)
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More About This Book: Title: Nursing: Interpreting Signs and Symptoms Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2007 ISBN: 1-58255-668-7

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