Padaczka skroniowa – Charakterystyka, pielęgnacja i opieka

Padaczka skroniowa
Charakterystyka, pielęgnacja i opieka

Padaczka skroniowa (TLE) jest najczęstszym typem padaczki ogniskowej, zlokalizowanej w płatach skroniowych, które odpowiadają za funkcje takie jak pamięć krótkotrwała, emocje i rozumienie języka. Napady TLE najczęściej manifestują się jako napady ogniskowe z zaburzoną świadomością, obejmujące objawy takie jak déjà vu, lęk, automatyzmy (mlaskanie, ruchy żucia, pocieranie rąk) oraz zaburzenia świadomości. Patofizjologia często wiąże się ze stwardnieniem hipokampa lub bliznami w przyśrodkowej części płata skroniowego, a etiologia może obejmować urazy, stany zapalne lub inne uszkodzenia. Po napadzie obserwuje się często dezorientację, amnezję następczą oraz senność lub pobudzenie ponapadowe. Opieka pielęgniarska koncentruje się na zapewnieniu bezpieczeństwa, monitorowaniu funkcji życiowych, podawaniu leków przeciwpadaczkowych oraz edukacji pacjenta i rodziny, ze szczególnym uwzględnieniem rozpoznawania subtelnych napadów, zwłaszcza u niemowląt.

Wprowadzenie do padaczki skroniowej

Padaczka skroniowa (Temporal Lobe Epilepsy, TLE) jest najczęstszym typem padaczki ogniskowej, która rozpoczyna się w płatach skroniowych mózgu. Płaty skroniowe odpowiadają za przetwarzanie emocji, pamięć krótkotrwałą, interpretację dźwięków oraz rozumienie języka. ¹²³ Napady padaczkowe pochodzące z płatów skroniowych często wpływają na te funkcje, powodując charakterystyczne objawy, które mogą różnić się intensywnością – od bardzo subtelnych do gwałtownych. ⁴⁵

Padaczka skroniowa często jest związana z obecnością „blizny” w obszarze mózgu zwanym hipokampem lub stwardnieniem przyśrodkowej części płata skroniowego. Przyczyna TLE często pozostaje nieznana, ale może wynikać z urazu, stanu zapalnego lub innych uszkodzeń płata skroniowego. ⁶⁵

Objawy i przebieg napadów w padaczce skroniowej

Napady w padaczce skroniowej są często klasyfikowane jako napady ogniskowe z zaburzoną świadomością. Niektórzy pacjenci zachowują świadomość podczas napadu, podczas gdy inni, doświadczający bardziej intensywnych napadów, mogą wydawać się przytomni, ale nie reagują na otoczenie. ⁵⁷

Objawy napadu padaczki skroniowej obejmują:

Dziwne odczucia podczas napadu, takie jak radość, déjà vu lub strach ²⁴
Brak świadomości otaczających ludzi i przedmiotów ⁸
Wpatrywanie się ⁸
Mlaskanie wargami lub przełykanie ⁸
Powtarzające się ruchy żucia ⁸
Ruchy palców, takie jak skubanie ⁸
Powtarzające się ruchy, tzw. automatyzmy, jak pocieranie rąk ³⁹
Rzadziej obserwowane objawy, jak plucie iktalne (podczas napadu) ¹⁰

Po napadzie padaczki skroniowej pacjent może:

Być zdezorientowany i mieć problemy z mówieniem przez pewien czas ²¹¹
Nie być w stanie przypomnieć sobie, co działo się podczas napadu ⁸
Nie być świadomym, że miał napad ⁸
Być bardzo senny ⁸
Wykazywać pobudzenie ponapadowe, które może być łagodne lub znaczne ¹²

Opieka pielęgniarska podczas napadu padaczkowego

Opieka pielęgniarska podczas napadu padaczkowego powinna być szybka, dokładna i ukierunkowana na bezpieczeństwo. Personel medyczny musi znać i rozumieć protokoły postępowania w przypadku napadów padaczkowych obowiązujące w danej placówce. ¹³

Interwencje pielęgniarskie podczas napadu

Ogólne interwencje pielęgniarskie mające na celu zapewnienie bezpieczeństwa obejmują:

Pomoc pacjentowi w przyjęciu bezpiecznej pozycji, jeśli napad rozpoczyna się, gdy pacjent stoi lub siedzi ¹³
Zabezpieczenie drożności dróg oddechowych podczas napadu ¹⁴
Monitorowanie czynności życiowych pacjenta ¹³
Podawanie zleconych leków w celu kontroli i zatrzymania aktywności napadowej oraz monitorowanie działań niepożądanych ¹³
Rozpoznawanie i ocena objawów przedmiotowych i podmiotowych napadów ¹⁵

Należy zwrócić szczególną uwagę na subtelne napady padaczkowe, które mogą być łatwo przeoczone, zwłaszcza u noworodków i niemowląt, gdzie napady mogą manifestować się jako bezdech lub desaturacja. ¹⁶

Opieka po napadzie

Po napadzie padaczkowym pielęgniarka powinna:

Monitorować stan świadomości pacjenta ¹⁵
Ocenić funkcje neurologiczne ¹⁵
Dokumentować czas trwania, charakter i przebieg napadu ¹⁷
Zapewnić komfort i wsparcie emocjonalne pacjentowi ¹⁴
Monitorować ewentualne pobudzenie ponapadowe i podejmować działania mające na celu uspokojenie pacjenta ¹²

Diagnoza i ocena pielęgniarska u pacjentów z padaczką skroniową

Ocena pielęgniarska pacjenta z padaczką skroniową powinna obejmować kompleksową analizę stanu pacjenta. ¹⁸ Ważnymi elementami oceny są:

Szczegółowy wywiad dotyczący częstotliwości, charakteru i czasu trwania napadów ¹⁵
Identyfikacja czynników wyzwalających napady ¹⁵
Ocena skuteczności dotychczasowego leczenia farmakologicznego ¹
Ocena wpływu napadów na codzienne funkcjonowanie pacjenta ¹⁹
Ocena wiedzy pacjenta na temat choroby i leczenia ²⁰

Na podstawie zebranych danych, główne diagnozy pielęgniarskie u pacjenta z padaczką skroniową mogą obejmować:

Ryzyko urazu – pacjenci z napadami padaczkowymi są narażeni na urazy lub uduszenie z powodu utraty kontroli mięśniowej podczas napadów, co może prowadzić do upadków, urazów głowy i trudności w oddychaniu. ¹⁴
Ryzyko nieskutecznego oczyszczania dróg oddechowych – z powodu upośledzenia nerwowo-mięśniowego, które może powodować niedrożność dróg oddechowych przez język lub aspirację śliny/wymiocin. ¹⁴
Niska samoocena – pacjenci z padaczką mogą doświadczać niskiej samooceny z powodu piętna społecznego i błędnych przekonań związanych z chorobą. ¹⁴
Nieprzestrzeganie zaleceń – może wynikać z różnych czynników, w tym działań niepożądanych leków, zapominania, zaprzeczania chorobie, ograniczeń finansowych oraz przekonań kulturowych lub religijnych. ²⁰
Deficyt wiedzy – pacjenci mogą mieć niewystarczającą wiedzę o swojej chorobie z powodu błędnych przekonań, nieodpowiedniej edukacji lub ograniczonego dostępu do informacji. ²⁰

Metody leczenia i opieka pielęgniarska

Leczenie padaczki skroniowej ma na celu znalezienie najlepszej terapii, która zatrzyma napady przy jak najmniejszej liczbie działań niepożądanych. ²⁴ Dostępne metody leczenia obejmują:

Farmakoterapia

Leki przeciwpadaczkowe są podstawą leczenia padaczki skroniowej. ¹ Opieka pielęgniarska w zakresie farmakoterapii obejmuje:

Podawanie zleconych leków przeciwpadaczkowych zgodnie z zaleceniami ¹⁵
Monitorowanie skuteczności leków w kontrolowaniu napadów ¹⁵
Obserwacja i raportowanie działań niepożądanych, takich jak zmęczenie, przyrost masy ciała i zawroty głowy ⁸
Edukacja pacjenta na temat konieczności regularnego przyjmowania leków ²¹
Informowanie o potencjalnych interakcjach z innymi lekami ⁸

Należy pamiętać, że wielu pacjentów nie może w pełni kontrolować napadów wyłącznie za pomocą leków. W takich przypadkach lekarz może rozważyć inne metody leczenia. ²⁸

Leczenie chirurgiczne

Leczenie chirurgiczne może być rozważane, gdy leki przeciwpadaczkowe nie są skuteczne lub gdy przyczyną napadów jest guz. ¹²² Najczęstszym typem operacji jest lobektomia skroniowa (usunięcie części płata skroniowego). ²³

Istotne aspekty opieki pielęgniarskiej związane z leczeniem chirurgicznym:

Przygotowanie pacjenta do zabiegu, w tym edukacja przedoperacyjna ²⁴
Monitorowanie pacjenta pod kątem potencjalnych powikłań pooperacyjnych ²³
Wsparcie pacjenta w okresie rekonwalescencji ²⁵
Edukacja na temat oczekiwanych rezultatów i możliwych skutków ubocznych operacji ²³

Lobektomia skroniowa jest związana z wysokim wskaźnikiem powodzenia i niskim ryzykiem powikłań. Niektórzy pacjenci mogą zauważyć trudności z zapamiętywaniem słów lub rozpoznawaniem miejsc po operacji, ale te deficyty są zwykle niewielkie i przejściowe. ⁶²³

Neurostymulacja

Urządzenia neurostymulacyjne mogą być opcją, jeśli leki nie są skuteczne lub operacja nie jest bezpieczną opcją. ¹²² Rola pielęgniarki w opiece nad pacjentem z neurostymulatorem obejmuje:

Edukację pacjenta na temat działania urządzenia ²⁶
Monitorowanie skuteczności neurostymulacji w kontrolowaniu napadów ²²
Obserwację miejsca implantacji pod kątem potencjalnych powikłań ²²
Informowanie pacjenta o konieczności regularnych kontroli urządzenia ²⁵

Modyfikacja diety

Przestrzeganie diety ketogenicznej może poprawić kontrolę napadów. ⁴²⁷ Dieta ketogeniczna jest bogata w tłuszcze i bardzo uboga w węglowodany. Rola pielęgniarki w tym obszarze obejmuje:

Edukację pacjenta i rodziny na temat zasad diety ketogenicznej ²⁷
Monitorowanie wpływu diety na kontrolę napadów ⁴
Wsparcie pacjenta w przestrzeganiu zaleceń dietetycznych ²⁷
Obserwację potencjalnych działań niepożądanych związanych z dietą ⁴

Edukacja pacjenta i rodziny

Edukacja pacjenta i rodziny jest kluczowym elementem opieki nad osobami z padaczką skroniową. ²⁰ Główne obszary edukacji obejmują:

Zarządzanie leczeniem

Informowanie o konieczności regularnego przyjmowania leków ²¹
Edukacja na temat potencjalnych działań niepożądanych leków i kiedy należy skontaktować się z lekarzem ⁸
Nauczanie, jak monitorować i dokumentować napady ¹⁷
Informowanie o znaczeniu regularnych wizyt kontrolnych ¹⁵

Zasady postępowania podczas napadu

Edukacja rodziny i opiekunów na temat prawidłowego postępowania podczas napadu ²⁶²¹
Informowanie o tym, kiedy należy wezwać pomoc medyczną ¹⁹
Nauczanie technik zapewnienia bezpieczeństwa podczas napadu ¹³
Informowanie o potencjalnych urazach związanych z napadami i jak ich unikać ²⁸

Wsparcie psychologiczne

Zachęcanie do otwartej komunikacji na temat choroby w rodzinie ¹⁹²⁷
Informowanie o dostępnych grupach wsparcia ²⁸
Edukacja na temat wpływu stresu na częstotliwość napadów i technik radzenia sobie ze stresem ¹⁹
Wsparcie w radzeniu sobie z piętnem społecznym związanym z padaczką ¹⁴

Wsparcie zawodowe i społeczne

Informowanie o tym, jak rozmawiać o chorobie z pracodawcą i współpracownikami ¹⁹
Edukacja na temat potencjalnych ograniczeń zawodowych i rozwiązań adaptacyjnych ²⁸
Informowanie o prawach pacjenta w miejscu pracy ¹⁹
Wsparcie w integracji społecznej ²⁷

Ocena efektów opieki pielęgniarskiej

Cele opieki pielęgniarskiej u pacjenta z padaczką skroniową są osiągnięte, gdy:

Pacjent pozostaje bezpieczny podczas i po napadach ¹⁵
Częstotliwość i nasilenie napadów są zmniejszone dzięki odpowiedniemu zarządzaniu lekami ¹⁵
Pacjent i rodzina rozumieją chorobę i potrafią prawidłowo postępować podczas napadu ¹⁵
Pacjent regularnie przyjmuje leki zgodnie z zaleceniami ²⁰
Jakość życia pacjenta jest poprawiona ²²
Pacjent radzi sobie ze stresem związanym z chorobą ¹⁹
Pacjent skutecznie integruje się ze społeczeństwem i środowiskiem zawodowym ¹⁹

Nowe kierunki w leczeniu padaczki skroniowej

Badania nad nowymi metodami leczenia padaczki skroniowej stale się rozwijają. Jednym z obiecujących kierunków jest wykorzystanie aminokwasu D-seryny, który może blokować receptory odpowiedzialne za nadmierny napływ wapnia do neuronów, zapobiegając tym samym aktywności napadowej i śmierci neuronów. ²⁹

Innym ważnym obszarem badań jest identyfikacja specyficznych struktur mózgu zaangażowanych w generowanie napadów padaczkowych. Na przykład, badania wskazują na rolę fasciola cinereum (dalszego końca „ogona hipokampa”) w padaczce skroniowej opornej na leki. ²⁴²⁵

Rozwój spersonalizowanych podejść do leczenia, w tym możliwość monitorowania i przerywania aktywności napadowej w specyficznych regionach mózgu, może przynieść lepsze wyniki niż uniwersalne podejście. ²⁵

Wnioski

Padaczka skroniowa jest złożonym schorzeniem neurologicznym, które wymaga kompleksowej opieki pielęgniarskiej. Napady padaczkowe pochodzące z płatów skroniowych mogą znacząco wpływać na codzienne funkcjonowanie pacjenta, ale odpowiednie leczenie i opieka mogą pomóc w kontrolowaniu napadów i poprawie jakości życia. ¹³⁰

Rola pielęgniarki w opiece nad pacjentem z padaczką skroniową jest wieloaspektowa i obejmuje: zapewnienie bezpieczeństwa podczas napadu, edukację pacjenta i rodziny, wsparcie w zarządzaniu leczeniem oraz pomoc w radzeniu sobie z psychologicznymi i społecznymi aspektami choroby. ¹⁵³¹

Dzięki właściwej opiece pielęgniarskiej, pacjenci z padaczką skroniową mogą prowadzić normalne i satysfakcjonujące życie, mimo wyzwań związanych z tą chorobą. ²⁶²¹

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Materiały źródłowe

#1 Temporal Lobe Epilepsy (TLE): Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/17778-temporal-lobe-seizures
Temporal lobe epilepsy is a seizure-causing condition that starts in your temporal lobe. A healthcare provider may recommend medications or surgery to manage seizures. Temporal lobe epilepsy is the most common type of focal epilepsy. Seizures are the main symptom of TLE. A healthcare provider can help you manage them and other issues that this condition can cause. Treatment for temporal lobe epilepsy may include: Antiseizure medications, Epilepsy surgery, Neurostimulation. Your healthcare provider might try one or more medications and different dosages to find what works best for you. Your healthcare provider may consider surgery if antiseizure medications aren’t successful or if a tumor causes epilepsy symptoms. A temporal lobectomy (removal of part of your temporal lobe) is the most common type of surgery. Neurostimulation devices may be an option if medications aren’t successful or surgery isn’t a safe option. A healthcare provider can help you treat TLE to prevent complications. You might not realize how important your temporal lobes are until they’re not working at 100%. Temporal lobe epilepsy (TLE) may affect their functioning over time. But a healthcare provider can help you manage TLE seizures to prevent complications.
#2 Temporal lobe seizure | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/temporal-lobe-seizure
Temporal lobe seizures begin in the temporal lobes of the brain. These areas process emotions and are important for short-term memory. Symptoms of a temporal lobe seizure often affect these functions. Some people have odd feelings during the seizure, such as joy, deja vu or fear. […] Temporal lobe seizures are treated with medicine. Some people who don’t respond to medicine may have surgery. […] After a temporal lobe seizure, you may: Be confused and have trouble speaking for a time. Be unable to recall what happened during the seizure. Be unaware of having had a seizure. Be very sleepy. […] Seizure treatment aims to find the best therapy to stop your seizures with the fewest side effects. […] Many medicines treat temporal lobe seizures. But many people can’t manage seizures fully with medicines alone. Side effects are common. They can include tiredness, weight gain and dizziness.
#3 Types of Epilepsy & Seizure Disorders | NYU Langone Health
https://nyulangone.org/conditions/epilepsy-seizure-disorders/types
Temporal lobe seizures, a category of focal seizures, are the most common type of epilepsy. The temporal lobe is located beneath the temples, on either side of the head. It is responsible for memory, emotions, interpreting sound, and understanding language. […] Seizures in the temporal lobe vary in intensity. They may be so mild people barely notice them. For example, a person may notice an odd feeling in the stomach or say that something smells funny. At other times a person may feel consumed by feelings of fear, anxiety, or a sense of dÃ©jÃ vu or loss of reality. […] People with temporal lobe seizures tend to perform repetitive movements, called automatisms, during complex partial seizures. These may include lip smacking and rubbing their hands together.
#4 Temporal lobe seizure | Health Library | Memorial Health System
https://www.mhsystem.org/health-library/con-20378199/
Temporal lobe seizures begin in the temporal lobes of the brain. These areas process emotions and are important for short-term memory. Symptoms of a temporal lobe seizure often affect these functions. Some people have odd feelings during the seizure, such as joy, deja vu or fear. […] Temporal lobe seizures are treated with medicine. Some people who don’t respond to medicine may have surgery. […] After a temporal lobe seizure, you may be confused and have trouble speaking for a time. […] Seizure treatment aims to find the best therapy to stop your seizures with the fewest side effects. […] Many medicines treat temporal lobe seizures. But many people can’t manage seizures fully with medicines alone. […] Following a ketogenic diet can improve seizure management. […] Epilepsy surgery is a procedure to reduce seizures and improve the quality of life of people who have epilepsy.
#5 Mayo Clinic Health Library – Temporal lobe seizure | Swiss Medical Network
https://www.swissmedical.net/en/healtcare-library/con-20378199
Temporal lobe seizures begin in the temporal lobes of the brain. These areas process emotions and are important for short-term memory. Symptoms of a temporal lobe seizure often affect these functions. Some people have odd feelings during the seizure, such as joy, deja vu or fear. […] Temporal lobe seizures are sometimes called focal seizures with impaired awareness. Some people are aware of what’s going on during the seizure. People who have more-intense seizures might look awake but won’t respond to what’s around them. Their lips and hands may make motions over and over. […] The cause of temporal lobe seizures often isn’t known. But it may stem from a scar in the temporal lobe. Temporal lobe seizures are treated with medicine. Some people who don’t respond to medicine may have surgery.
#6 UC Davis Department of Neurology – Epilepsy FAQs
https://health.ucdavis.edu/neurology/subspecialties/epilepsy_faqs.html
The most common epilepsy in adults for which surgery is performed is temporal lobe epilepsy (complex-partial seizures, psychomotor epilepsy). Many of these patients have had febrile convulsions as a child. In temporal lobe epilepsy, the seizures often start with an aura. The onset of convulsions might begin with a strange sensation in the stomach, a feeling of fear, dj vu or hallucinations. During seizures, patients might lick their lips, move their limbs repetitively or hold them in unusual postures. Patients will not act or respond normally during these episodes. They could remain partially conscious or lose total consciousness. […] Temporal lobe epilepsy is most commonly associated with a „scar” in a region of the brain called the hippocampus, or mesial temporal sclerosis. Seizures stop in more than 70 percent of patients when this lesion is removed. Some of these patients can stop medications after a couple years. Another 10 to 20 percent of patients can improve from surgery but will continue to have some seizures. Some patients might not improve significantly. Some patients might notice difficulty remembering words or recognizing places after the surgery, but these deficits are minor and often transient. The risk of serious complication following surgery is less than 2 percent. Patients with intractable epilepsy should be identified, referred and evaluated for epilepsy surgery early. If not, years of recurrent seizures can cause harmful effects and should be avoided. Two years is the recommended limit for ineffective drug therapy.
#7 Types of Epilepsy & Seizure Disorders in Children | NYU Langone Health
https://nyulangone.org/conditions/epilepsy-seizure-disorders-in-children/types
Temporal lobe seizures are the most common type of epilepsy in both children and adults. The temporal lobe is located beneath the temples, on either side of the head. It is responsible for memory, emotions, interpreting sounds, and understanding language. […] Seizures in the temporal lobe vary in intensity. Sometimes they are so mild children barely notice them, or they notice only an odd sensation in the stomach or a funny smell. At other times a child may feel consumed by feelings of fear and anxiety or a sense of dj vu or loss of reality. […] People with temporal lobe seizures tend to perform repetitive movements during seizures. These are called automatisms and may include lip smacking and rubbing the hands together.
#8 Mayo Clinic Health Library – Temporal lobe seizure | Swiss Medical Network
https://www.swissmedical.net/en/healtcare-library/con-20378199
Symptoms of a temporal lobe seizure include: Not being aware of the people and things around you. Staring. Lip smacking. Swallowing or chewing over and over. Finger movements, such as picking motions. […] After a temporal lobe seizure, you may: Be confused and have trouble speaking for a time. Be unable to recall what happened during the seizure. Be unaware of having had a seizure. Be very sleepy. […] Seizure treatment aims to find the best therapy to stop your seizures with the fewest side effects. […] Many medicines treat temporal lobe seizures. But many people can’t manage seizures fully with medicines alone. Side effects are common. They can include tiredness, weight gain and dizziness. […] Discuss possible side effects with your healthcare professional when thinking about treatments. Also ask what effect your seizure medicines may have on other medicines you take.
#9 Temporal Lobe Epilepsy – Southeast OB/GYN
https://seobgynpc.com/womens-health/health-library?DOCHWID=d23740266
Temporal lobe epilepsy involves the portions of the brain that control emotions and memory. The temporal lobes are located on each side of the head just above the ears at the temples. Temporal lobe epilepsy can cause both partial and generalized seizures. […] Temporal lobe seizures cause behaviors such as smacking of the lips or rubbing the hands together. Other features of the seizures may include emotional or thought disturbances and hallucinations involving sounds, smells, or tastes. […] Treatment with medicine controls seizures in many people who have temporal lobe epilepsy. A type of brain surgery called anterior temporal lobectomy is another treatment option for people with this type of epilepsy.
#10
https://aesnet.org/abstractslisting/ictal-spitting-as-a-clinical-manifestation-of-left-temporal-lobe-seizures–report-of-three-cases
Ictal spitting is considered to be a rare event in epileptic seizures, being most frequently observed in patients with temporal lobe epilepsy (TLE). […] Ictal spitting may, however, be observed in seizures originating in the dominant temporal lobe. […] Spitting is an uncommon automatism in temporal lobe seizures. […] As we have shown in this work, it should not be considered a lateralizing sign to nondominant temporal lobe, since it may occur as a clinical manifestation of seizures originating in the left temporal lobe.
#11 Focal seizures – Epilepsy Action
https://www.epilepsy.org.uk/info/seizures/focal-seizures
If you have been diagnosed with temporal lobe epilepsy it means you have seizures starting in one or other of the temporal lobes. The temporal lobe is responsible for things like memory, hearing and understanding language. […] Seizures starting in the temporal lobes are usually, but not always, focal impaired awareness seizures. You might start the seizure being aware of whats happening, and then lose awareness as the seizures goes on. […] After a temporal lobe seizure you are likely to be confused or may find it hard to speak for a short time.
#12 JLE – Epileptic Disorders – Determinants of postictal agitation and recovery after tonic-clonic seizures in generalized and focal epilepsy
https://www.jle.com/en/revues/epd/e-docs/determinants_of_postictal_agitation_and_recovery_after_tonic_clonic_seizures_in_generalized_and_focal_epilepsy_321320/article.phtml?tab=videos
Marked postictal agitation in a 47-year-old man with right temporal lobe epilepsy. He interferes with nursing care, tries to remove equipment, repeatedly attempts to get out of bed. He continues to be agitated despite repeated attempts to calm him. […] Mild postictal agitation in a 32-year-old woman with right frontal lobe epilepsy. She is agitated, attempting to remove nasal canula but calms down after efforts by nurses and family. She does not attempt to leave the bed. […] No postictal agitation in a 27-year-old woman with frontal lobe epilepsy. She remains calm in the postictal period.
#13 Seizure | Nursing Diagnosis, Care Plans, and More – Nursing Student Assistance
https://allnurses.com/seizure-nursing-diagnosis-care-plans-t750479/
As a nurse, you must develop a seizure nursing diagnosis care plan tailored to your patient’s specific needs to address and prevent seizure activity. […] Therefore, seizure care must be swift, accurate, and safety-focused. […] It’s critical to know that the symptoms may vary from seizure to seizure in the same patient and from one type to another. […] As a nurse, seizure prevention and management are integral to your practice. […] Knowing and understanding your facility’s seizure protocols is essential. Always work fast to secure a safe environment and monitor the patient during the seizure. […] General nursing interventions you can use to ensure safety include: Assist the patient to the floor if they are standing or sitting when the seizure happens to ensure safety. […] Administer ordered medications to control and stop seizure activity and monitor for side effects.
#14 Seizure | Nursing Diagnosis, Care Plans, and More – Nursing Student Assistance
https://allnurses.com/seizure-nursing-diagnosis-care-plans-t750479/
Now that you understand the basics of seizure management, you can begin developing nursing care plans for seizure care. […] Maintaining a patent airway during a seizure is crucial. […] The Epilepsy Foundation reports that statistics about seizure-related injuries aren’t readily available because many aren’t reported or recorded. […] Arming the patient with knowledge about their seizure condition is the best way to reduce the risk of long-term and life-threatening sequelae. […] Nearly one million adults 55 or older and 470,000 children live with seizures. […] Seizure patients may experience a seizure type that causes muscular rigidity and jerky movements, resulting in a fall. […] Seizures may cause disorientation, leading to acute confusion.
#14 5 Nursing Diagnosis for Seizures Nursing Care Plans – Nurseslabs
https://nurseslabs.com/seizure-disorder-nursing-care-plans/
Clients with seizure disorders are at risk for trauma or suffocation due to the loss of muscle control during seizures, which can lead to falls, head injuries, and difficulty breathing. Additionally, seizures can occur during sleep, putting the client at risk of suffocation from airway obstruction or aspiration. […] Clients with seizure disorders is at risk for ineffective airway clearance due to neuromuscular impairment, which can cause the tongue to obstruct the airway or result in the aspiration of saliva or vomit. Additionally, tracheobronchial obstruction can occur due to increased secretions and decreased muscle tone during a seizure, further increasing the risk of airway obstruction. […] Clients with seizure disorders may experience low self-esteem due to the social stigma and misconceptions surrounding the disorder, as well as the limitations and disruptions it can cause in their daily lives.
#15 5 Nursing Diagnosis for Seizures Nursing Care Plans – Nurseslabs
https://nurseslabs.com/seizure-disorder-nursing-care-plans/
Use this nursing care plan and management guide to help care for patients with seizure disorders. Learn about the nursing assessment, nursing interventions, goals and nursing diagnosis for seizure disorders in this guide. […] The nursing care plan goals for clients with seizure disorders include ensuring safety during and after seizures, preventing injury, and minimizing the frequency and severity of seizures through appropriate medication management and client education. The plan should also include regular monitoring of seizure activity and side effects of medication, as well as addressing any psychological or social impacts of the disorder. […] The following are the nursing priorities for patients with seizure disorders: Recognize and assess signs and symptoms of seizures. Ensure immediate safety of the individual during a seizure episode. Administer first aid, if necessary, to prevent injury during seizures. Monitor seizure frequency, duration, and triggers. Administer prescribed anti-seizure medications as directed. Educate patients and caregivers on seizure management, including medication adherence, seizure precautions, and lifestyle modifications. Offer emotional support and counseling to patients and families to cope with the impact of seizure disorder. Coordinate care and referrals to specialists, such as neurologists or epileptologists. Schedule regular follow-up appointments to monitor seizure control, adjust medications if needed, and address any concerns or changes in symptoms.
#16
https://aesnet.org/abstractslisting/apneic-seizures-in-neonates-and-infants–subtle-seizures-of-temporal-lobe-origin
Apnea is a common event in babies and occurs for multiple reasons. […] The clinical seizures may be subtle and easily overlooked, and video-EEG may be required to demonstrate them. […] In all four, V-EEGs were performed for evaluation of apneic spells and demonstrated an ictal basis. Subtle clinical seizures accompanying the desaturation and apnea in the neonates were identified on review of the video and had been overlooked by the intensive care nursing staff. […] All four patients had temporal lobe-based seizures. […] All three neonates had sufficiently subtle seizures as to have been overlooked by intensive care nursing staff, and the apnea/desaturations were detected at or near the end of the seizures in 2/3 instances. […] When apnea is reported in a neonate or infant, a seizure should be considered if there is not another obvious explanation. […] The temporal lobe/limbic system is most often involved in apneic seizures in the neonate and infant, and this helps explain the subtle nature of the seizures. […] V-EEG is a useful modality to determine the ictal nature of apnea in neonates and infants.
#17 Temporal lobe seizure | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/temporal-lobe-seizure
Talk with your supervisor about your seizures and how they affect you. Discuss what you need your supervisor or co-workers to do if you have a seizure at work. […] Sometimes seizures need medical help right away. There isn’t always time to prepare for an appointment. […] Write down what you remember about the seizure. Include when and where it happened, symptoms you had, and how long it lasted, if you know.
#18 Seizure Disorders (Epilepsy) Nursing Care Management – Nurseslabs
https://nurseslabs.com/seizure-disorders/
Seizure disorders, also known as epilepsy, are a complex and diverse group of neurological conditions that demand specialized nursing care and support. […] Nursing care for a child with a seizure disorder includes the following: […] Nursing assessment includes: […] Based on the assessment data, the major nursing diagnoses are: […] The major nursing goals for a child with a seizure disorder are: […] Nursing interventions for a child with seizure disorder include the following: […] Goals are met as evidenced by: […] Documentation in a child with seizure disorder include:
#19 Temporal lobe seizure | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/temporal-lobe-seizure
Discuss possible side effects with your healthcare professional when thinking about treatments. […] When antiseizure medicines don’t work, there are other treatments, including: Surgery. Epilepsy surgery is a procedure to reduce seizures and improve the quality of life of people who have epilepsy. […] You also might not be able to have surgery if your healthcare team can’t find where the seizures start. […] It’s helpful to know what to do if you see someone having a seizure. If you’re at risk of having seizures in the future, give this information to family, friends and co-workers. […] Stress due to living with a seizure condition can affect your mental health. Talk with your healthcare professional about your feelings. Look for ways to find help. […] Your family can provide much-needed support. Tell them what you know about your seizures. Let them know they can ask you questions. Ask them about their worries.
#20 5 Nursing Diagnosis for Seizures Nursing Care Plans – Nurseslabs
https://nurseslabs.com/seizure-disorder-nursing-care-plans/
Nonadherence in clients with seizure disorders may be due to various factors, including medication side effects, forgetfulness, denial of the condition, financial constraints, and cultural or religious beliefs. However, nonadherence can lead to suboptimal seizure control, increased risk of injury, and poor quality of life, making it essential for nurses to address and mitigate these factors through effective client education, counseling, and support. […] Clients with seizure disorders may have deficient knowledge about their condition due to misconceptions, inadequate education, or limited access to information. This can lead to difficulties in managing their disorder, making informed decisions about their care, and effectively communicating their needs and concerns with healthcare providers, potentially resulting in suboptimal treatment outcomes.
#21 Temporal Lobe Epilepsy | Rady Children’s Hospital
https://www.rchsd.org/health-article/temporal-lobe-epilepsy
Kids with temporal lobe epilepsy can lead a normal life. To help your child: […] Make sure your child takes medicines as prescribed. […] It’s important to keep your child safe during a seizure. Make sure that other adults and caregivers (family members, babysitters, teachers, coaches, etc.) know what to do if one happens. […] Often, temporal lobe epilepsy is a lifelong condition. When it’s time, help your child move to adult health care.
#22 Temporal Lobe Epilepsy: Symptoms, Causes, Treatment, Outlook
https://resources.healthgrades.com/right-care/epilepsy/temporal-lobe-epilepsy
Temporal lobe epilepsy (TLE) is a condition marked by seizures that start in the temporal lobes of your brain. Medications can sometimes successfully stop the seizures. In cases in which medications are not successful, there are surgical options or nerve stimulators. […] Treatment begins with medications and changes in diet. If these methods do not manage seizure activity, your care team may recommend surgical procedures or deep brain stimulation. […] Your healthcare professional may try one or more medications and will possibly change your dosing to try to find a regimen that can stop your seizures. […] If two different medication regimens do not stop your seizures, you may be a candidate for surgery. A second reason for surgery is if a tumor is causing seizures. […] If medications do not work or stop working and you are not a candidate for surgery, another option is a nerve stimulator. […] The key to managing TLE is to decrease the number of seizures you have. Repeated seizures can cause memory problems and increase the chance of anxiety and lower quality of life. […] If medication or surgery do not stop seizures, nerve stimulation implants may help.
#23 Temporal Lobe Epilepsy Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City
https://www.neurosurgery.columbia.edu/patient-care/conditions/temporal-lobe-epilepsy
When the initiation point of recurrent seizures can be traced to the temporal lobe, it is known as temporal lobe epilepsy. […] Temporal lobe epilepsy is a condition that often is amenable to surgery. Because the seizures are localized and have an identifiable source in the brain, the removal of all or part of the temporal lobe, called a temporal lobectomy, often can stop the seizures entirely. […] Temporal lobectomy is the most common epilepsy surgery and is associated with high success rates and low complication rates. […] Some physicians still consider temporal lobectomy an extreme procedure, citing the risks of side effects, including loss of memory, visual disturbances, and emotional change, associated with the removal of brain tissue. However, such side effects are minimized by careful patient selection and a battery of neurological tests that indicate where resection can be made to minimize effects on neurological function. […] Experts state that the portion of the brain being removed already is behaving abnormally, and therefore its removal does not usually have a profound detrimental effect on brain function.
#24 Stanford Medicine-led study identifies novel target for epilepsy treatment | News Center
https://med.stanford.edu/news/all-news/2024/04/epilepsy-treatment.html
Removing part of the brain’s temporal lobe is the only treatment available to the millions of people with a form of epilepsy that medications often don’t alleviate. […] Our findings suggest that all patients with drug-resistant temporal lobe epilepsy should have depth electrodes placed in the fasciola cinereum as part of the surgery planning process. […] Before performing the surgery, physicians need to identify the brain tissue responsible for seizure activity. […] The idea to record from the fasciola cinereum – the far tip of the sea horse’s tail – in patients with epilepsy undergoing sEEG for surgical planning first formed about three years ago. […] The fasciola cinereum contributed recorded seizures in all six patients, including some episodes in which the head and body regions of the hippocampus were quiet.
#25 Stanford Medicine-led study identifies novel target for epilepsy treatment | News Center
https://med.stanford.edu/news/all-news/2024/04/epilepsy-treatment.html
The patient underwent a second surgical ablation that removed almost all of the fasciola cinereum, and the frequency of the seizures decreased by 83%, from one to two each month to once every three months. […] The results of our study do not challenge the importance of ablating the amygdala and anterior hippocampus but suggest considering a second ablation targeting the posterior hippocampal tail for the patients whose seizures recur. […] The findings from this study suggest that a more personalized approach that also allows the device to monitor and interrupt seizure activity in the posterior hippocampal tail region might be more beneficial to patients. […] Knowing which patients have seizures involving the fasciola cinereum would let us target it with either ablation or neurostimulation and help us treat patients better than a one-size-fits all approach.
#26 Temporal Lobe Epilepsy (for Parents) – Humana – Louisiana
https://kidshealth.org/HumanaLouisiana/en/parents/temporal-lobe-epilepsy.html
Kids with temporal lobe epilepsy can lead a normal life. […] It’s important to keep your child safe during a seizure. Make sure that other adults and caregivers (family members, babysitters, teachers, coaches, etc.) know what to do if one happens. […] Seizures usually get better with medicine. If medicines don’t control the seizures, doctors may recommend surgery or neurostimulation (using a device that sends electrical stimulation to the brain to stop seizures). In many cases, epilepsy surgery can lead to very good results for patients with temporal lobe epilepsy.
#27 Mayo Clinic Health Library – Temporal lobe seizure | Swiss Medical Network
https://www.swissmedical.net/en/healtcare-library/con-20378199
Following a ketogenic diet can improve seizure management. A ketogenic diet is high in fat and very low in carbohydrates. […] When antiseizure medicines don’t work, there are other treatments, including: Surgery. Epilepsy surgery is a procedure to reduce seizures and improve the quality of life of people who have epilepsy. […] Seizures can affect your mental health. Talk with your healthcare professional about your feelings. Look for ways to find help. […] Your family can provide much-needed support. Tell them what you know about your seizures. Let them know they can ask you questions. Ask them about their worries.
#28 Temporal lobe seizure | Health Library | Memorial Health System
https://www.mhsystem.org/health-library/con-20378199/
When antiseizure medicines don’t work, there are other treatments, including surgery. […] Talk with your healthcare professional about the risks of antiseizure medicines, including the risk of health conditions present at birth. […] Most often, seizures don’t result in serious injury. But injury is possible if you have recurrent seizures. […] It’s helpful to know what to do if you see someone having a seizure. […] Stress due to living with a seizure condition can affect your mental health. […] Your family can provide much-needed support. […] Talk with your supervisor about your seizures and how they affect you. […] Reach out to family and friends. […] A healthcare professional is likely to ask you questions, such as: Can you describe your seizure episode?
#29 Azthena logo with the word Azthena
https://www.news-medical.net/news/20201014/Amino-acid-produced-by-the-brain-could-prevent-temporal-lobe-epileptic-seizure.aspx
Temporal lobe epileptic seizures are debilitating and can cause lasting damage in patients, including neuronal death and loss of neuron function. […] The research team also found that the amino acid D-serine blocks these receptors to prevent excess levels of calcium from reaching neurons, thereby preventing seizure activity and neuronal death. […] Kumar’s research points to neuroinflammation as the cause for diminished D-serine levels in the entorhinal cortex of the brain. D-serine is typically produced by glial cells, but neuroinflammation experienced as part of TLE causes cellular and molecular changes in the brain that can prevent it from being produced. […] The next step in exploring D-serine as a viable therapy is investigating potential administration techniques. […] TLE often results from an injury such as a concussion or other traumatic brain injury. When administered to the appropriate region, D-serine has been shown to work in preventing the secondary effects of such an injury. […] The important thing is that we’ve outlined the basic bread-and-butter mechanisms of why D-serine works. What we’ve established is the discovery of the receptors, discovery of the antagonist for these receptors (D-serine), how it works and how to prevent the emergence of TLE.
#30
https://www.wkhs.com/health-resources/wk-health-library/disease-condition-information/a-z/temporal-lobe-seizure
This type of seizure begins in one of the temporal lobes of the brain. Temporal lobe seizures can severely impact your daily life. […] Treatment options depend on the severity of your seizures and how often you have them. Your healthcare provider can create a care plan that is right for your needs.
#31 Effective Documentation & Coding for Temporal Lobe Epilepsy
https://www.outsourcestrategies.com/blog/document-code-temporal-lobe-epilepsy/
Temporal Lobe Epilepsy (TLE) is characterized by seizures originating in the temporal lobes of the brain. […] Treatment for Temporal Lobe Epilepsy seizures may involve medications and surgery in complex cases. […] Comprehensive documentation should include detailed symptoms, diagnostic tests, and treatment plans. […] Accurate documentation and coding of temporal lobe epilepsy are essential for effective neurology medical billing. By adhering to best practices and utilizing the expertise of medical billing specialists, healthcare providers can streamline reimbursement processes and enhance patient care. Proper coding not only ensures compliance but also maximizes financial efficiency in neurology practices.