Reducing Fear of Seizures
Fear that a seizure may occur unexpectedly can be reduced by the patient's adherence to
the prescribed treatment regimen. Cooperation of the patient and family and their trust
in the prescribed regimen are essential for control of seizures. The nurse emphasizes
that the prescribed antiseizure medication must be taken on a continuing basis and that
drug dependence or addiction does not occur. Periodic monitoring is necessary to
ensure the adequacy of the treatment regimen, to prevent side effects, and to monitor
for drug resistance (Rho et al., 2004).
In an effort to control seizures, factors that may precipitate them are identified, such as
emotional disturbances, new environmental stressors, onset of menstruation in female
patients, or fever (Rho et al., 2004). The patient is encouraged to follow a regular and
moderate routine in lifestyle, diet (avoiding excessive stimulants), exercise, and rest
(sleep deprivation may lower the seizure threshold). Moderate activity is therapeutic,
but excessive exercise should be avoided. An additional dietary intervention, referred to
as the ketogenic diet, may be helpful for control of seizures in some patients (Stafstrom
& Rho, 2004). This high-protein, low-carbohydrate diet is most effective in children
whose seizures have not been controlled with two antiepileptic medications, but it is
sometimes used for adults who have had poor seizure control (Stafstrom & Rho, 2004).
Photic stimulation (bright flickering lights, television viewing) may precipitate
seizures; wearing dark glasses or covering one eye may be preventive. Tension states
(anxiety, frustration) induce seizures in some patients. Classes in stress management
may be of value. Because seizures are known to occur with alcohol intake, alcoholic
beverages should be avoided.
Improving Coping Mechanisms
The social, psychological, and behavioral problems that frequently accompany epilepsy
can be more of a disability than the actual seizures. Epilepsy may be accompanied by
feelings of stigmatization, alienation, depression, and uncertainty. The patient must
cope with the constant fear of a seizure and the psychological consequences (Rho et al.,
2004). Children with epilepsy may be ostracized and excluded from school and peer
activities. These problems are compounded during adolescence and add to the
challenges of dating, not being able to drive, and feeling different from other people.
Adults face these problems in addition to the burden of finding employment, concerns
about relationships and childbearing, insurance problems, and legal barriers. Alcohol
abuse may complicate matters. Family reactions may vary from outright rejection of the
person with epilepsy to overprotection. As a result, many people with epilepsy have
psychological and behavioral problems.
Counseling assists the patient and family to understand the condition and the
limitations it imposes. Social and recreational opportunities are necessary for good
mental health. Nurses can improve the quality of life for patients with epilepsy by
teaching them and their families about symptoms and their management (Bader &
Littlejohns, 2004).
Providing Patient and Family Education
Perhaps the most valuable facets of care contributed by the nurse to the person with
epilepsy are education and efforts to modify the attitudes of the patient and family
toward the disorder. The person who experiences seizures may consider every seizure a
potential source of humiliation and shame. This may result in anxiety, depression,
hostility, and secrecy on the part of the patient and family. Ongoing education and
encouragement should be given to patients to enable them to overcome these reactions.
The patient with epilepsy should carry an emergency medical identification card or