chronic neurologic problems Flashcards
primary headache
issues in the brain
secondary headache
headache d/t sinus infection, neck injury, etc
tension type HA
- bilateral, band like HA associated with neck pain and increased tone in the cervical and neck muscles
- constant, squeezing tightness
- cause: neurovascular factors: abnormal neuronal sensitivity
s/s of tension type HA
- no prodrome
- no n/v
- photophobia or phonophobia
- may occur intermittently
migraine HA
- recurring
- unilateral and bilateral throbbing pain
- triggers
- cause: neuronal hyperexcitability in the cerebral cortex, especially in the occipital cortex
s/s of migraine HA
- prodrome and aura
- steady, throbbing pain that is synchronous with the pulse
cluster HA
- repeated headaches that occur for weeks or months at a time, followed by periods of remission
- cause: dysfunctional of intracranial blood vessel
- trigeminal nerve is implicated
s/s of cluster HA
- sharp and stabbing
- intense pain lasting from a few mins to 3 hours
- pain usually located around the eye, radiating to the temple, forehead, cheek, nose, or gums
drug tx for tension type HA
- non opiod analgesics
- sedatives
- muscle relaxants
- tranquilizers
- ppx: depakote, topamax, elavil
drug tx for migraine HA
- aspirin, NSAIDs
- caffeine containing analgesics
- imitrex
- ppx: topamax, elavil, botox
drug tx for cluster HA
- 100% O2 6-8L/M for 10 mins
- triptans
- ppx: ergotamine
- nerve blocks
- deep brain stimulation
nursing mgmt of HA
- exercise, relaxation, socializing
- alternative pain mgmt
- massage and moist heat packs to the neck
- dietary counseling
- avoid smoking and smoke exposure
- avoid high altitudes or take ergotamine
seizure
paroxysmal, uncontrolled electrical discharge of neurons in the brain, interrupts normal function
epilepsy
condition in which a person has a spontaneous recurring sz caused by a chronic underlying condition
causes of sz in the first 6 months of life
- birth injury
- congenital defects
- infections
- inborn erros of metabolism
causes of sz from ages 2 to 20
- birth injury
- infection
- trauma
- genetic factors
causes of sz from ages 20-30
- trauma
- brain tumors
- vascular disorders
causes of sz after 50 years old
- stroke
- metastatic brain tumors
s/s of generalized sz
-loss of consciousness from few seconds to several minutes
s/s of tonic clonic seizure
- losing consciousness
- falling to the ground
- followed by stiffening of the body
- subsequent jerking of the extremities
- cyanosis, excessive salivation, tongue or cheek biting, incontinence
s/s of post-ictal tonic clonic seizure
- muscle soreness
- is tired
- no memory of seizure
s/s of typical absence sz
- usually only in children
- brief staring spell that lasts only a few seconds
- hyperventilation and flashing lights can precipitate these
s/s of atypical absence sz
- staring spell
- brief warnings
- peculiar behavior during the sz
- confusion after the sz
atonic sz
- either so stiff
- or sudden loss of muscle tone
simple focal sz
remain conscious but experience unusual feelings or sensations
complex focal sz
alteration/loss of consciousness, producing a dream like experience
complications of sz
- status epilepticus: constant sz -> brain exhaustion -> brain dead
- severe injury
- psychosocial problems
diagnostic studies for sz
- health hx
- EEG
- magnetoencephalography
- CBC, chem, LFTs, BUN/Cr, UA
- CT or MRI
- cerebral angiography
drug tx for tonic-clonic and focal sz
- dilantin
- neurontin
- keppra
drug tx for absence and myoclonic sz
- klonopin
- depakote
drug tx for status epilepticus
- ativan
- valium
surgery for sz
anterior temporal lobe resection
