Medical Surgical Seizures #7

Question

The nurse is caring for an 8-year-old client who is diagnosed with epilepsy following an abnormal electroencephalogram (EEG). The parents are voicing disbelief in the diagnosis and indicate they never witnessed a seizure. Which of these types of seizure will the nurse provide instruction for the parents?

Answers

  1. Jacksonian seizures
    • Rationale:

      This answer is not correct because Jacksonian seizures involve focal abnormal movements that usually begin in distal muscles and progress to other adjacent muscles (motor seizures). They last around 20-30 seconds and would be noticeable by the parents.

  2. Petit mal seizures
    • Rationale:

      This answer is correct because petit mal seizures are also called absence seizures since they may be observed only as a brief staring occurrence. They may last only 10 seconds or less; however, they are likely to develop into tonic-clonic later, so medical management is necessary. They usually are found between 3 and 15 years of age.

  3. Grand mal seizures
    • Rationale:

      This answer is not correct because grand mal seizures are noticeable and the body may stiffen, jerk, shake, and loss of consciousness occurs. Petit mal seizures are brief seizures with sudden inattentiveness that lasts no longer than 20 seconds.

  4. Myoclonic seizures
    • Rationale:

      This answer is not correct because myoclonic seizures occur with sudden muscle jerking as if shocked by electrical current, so the parents would have observed this type. Petit mal seizures do not last very long and can be missed.

Overview

The vacant stare symptom of petit mal seizures are barely noticeable, since the seizures only last no longer than 20 seconds. Sometimes it is mistaken for inattentiveness and there also is no postictal period.

Explanation

Learning Outcomes

Petit mal seizures have a characteristic vacant stare that is barely noticeable, since it only lasts no longer than 20 seconds. Sometimes it is mistaken for inattentiveness and there is no postictal period. EEG is the test used to diagnose petit male seizures. The drug of choice for children with petit mal seizures is ethosuximide due to its safety in children, since other antiepileptic medications may increase the risk of suicidal thoughts. Evidence-based practice has shown that a ketogenic diet also improves seizure control along with the appropriate medications. Lamotrigine is also an antiepileptic drug with less side effects, but has been shown to be less effective at preventing petit male seizures in children.

Test Taking Tip

The word “petit” means petty or minor. The parents were shocked and did not notice their child was having seizures. These word parts can direct the student to choosing the correct answer.

Video Rationale