A 22-year-old client suffered from his first tonic-clonic seizure. Upon awakening, the client asks the nurse, “What caused me to have a seizure? Which of the following would the nurse include in the primary cause of tonic-clonic seizures in adults more than 20 years?
A. Electrolyte imbalance
B. Head trauma
C. Epilepsy
D. Congenital defect
Correct Answer: B. Head trauma
Trauma is one of the primary causes of brain damage and seizure activity in adults. Other common causes of seizure activity in adults include neoplasms, withdrawal from drugs and alcohol, and vascular disease. Common causes of emergency department visits after seizures are alcohol and drugs, head injury, and epilepsy.
Option A: Decreased sodium in the blood is a rare cause of seizures, especially among adults. Acute symptomatic seizures- secondary to ischemic or hemorrhagic strokes, extra-axial hemorrhage, traumatic brain injury, hypoxic-ischemic injury, acute medical illness, metabolic derangements, substance abuse- can manifest as tonic-clonic seizures without the inherent tendency to recurrent seizures, whereas epileptic seizures recur without proximate provoking factors.
Option C: The most common cause of seizure is epilepsy. However, not every person who has a seizure has epilepsy. The etiology of most of the generalized tonic-clonic seizures is underlying epilepsy from genetic causes (previously categorized as idiopathic). Besides genetic generalized epilepsy, tonic-clonic seizures can be secondary to epilepsy due to structural, infectious, metabolic, or immune-related pathologies.
Option D: Congenital defects do not cause seizures among adults. Seizures account for 1 to 2 percent of all emergency visits in the U.S. Seizures are reported to occur about 11% of people in the United States during their lifetime. Acute symptomatic seizures tend to occur more frequently in males than females in a ratio of 1.85 to 1, with a lifetime risk of 5.0% in males and 2.7% in females.