Disorders of the nervous system (p 263)

Question 1

Disorders

Answer 1

Epilepsy
Stroke
Meningococcal disease
Cauda equina syndrome
Paralysis
Coma

Question 2

Epilepsy ( convulsions)

Answer 2

Recurrent unprovoked convulsions ( seizures, fits) due to neurological conditions.

Question 3

Convulsions categories

Answer 3

1. Partial ( focal) convulsion
   - originating from temporal or frontal lobes.
   Partial (focal) convulsions are split into two sub- types:
   *simple partial - “ butterflies” in stomach, fear, illusions, hallucinations.
   *complex partial - altered LOC, pt chewing, lip- smacking and fiddling with their hands.
2. Generalised:
   a) tonic clinic - consist of two phases:
   *tonic - stiffness, jaw clench,
   *clonic- regular jerking movements.

b) absence convulsions ( day dreaming).

Question 4

Febrile convulsions

Answer 4

Febrile Convulsions are not considered to be epileptic.
- provoked by sudden increase in temperature.

• most common in group 6 months to 6 years old.

Question 5

Status epilepticus

Answer 5

• generalised convulsion lasting for more than 30 minutes, or
• a series of convulsions, where the pt does not become
  fully conscious between convulsions, lasting more than 30 minutes.

Question 6

Post ictal phase

Answer 6

period after tonic clonic, characterized by a period of uresponsiveness, gradual return of Consciousness pt likely to be
drowsy and disorientated. It can last 15 muntes to an hour or longer.Headaches are common

Question 7

Buccal midazolam pt own

Answer 7

Buccal midazolam is benzodiazepine drug such as diazepam
Onset 5 min.
Used for generalised convulsions lasting more than 5 min
- administration: between cheek and gum
Side effects:
Respiratory depression
Hypotension
Drowsiness
Muscle weakness
Slurred speech

Question 8

Management of convulsions p264

Answer 8

Airway
Np if required
O2 15 l non rebreather mask
Administer pt own buccal midazolam
If convulsions continues for next 10 min, i futher dose.

Question 9

Management of convulsions p264

Answer 9

Airway
Np if required
O2 15 l non rebreather mask
Administer pt own buccal midazolam
If convulsions continues for next 10 min, i futher dose.