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Post Midterm Patho > Encephalitis / Seizures > Flashcards

Encephalitis / Seizures Flashcards

1
Q
  1. What does encephalon mean?

2. What does parenchyma mean?

A
  1. The brain

2. Functional tissue in any organ

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2
Q

What is encephalitis?

A

Inflammation of parenchyma of the brain and spinal chord

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3
Q

What is encephalitis usually d/t: viral or bacterial infection?

Explain why? (to do with mode of action)

A

Typically viral infection

Bacteria and Virus mode of action = different. Virus cells enter the host cells in order to replicate, so would be inside the cells of the tissue in the brain causing inflammation

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4
Q

What are the 2 most common viruses that can lead to encephalitis? (2)

A
  1. Herpes Simplex 1 Virus

2. Arbovirus

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5
Q

Explain what arbovirus is spread by. Provide an example.

A

Spread by arthopods (have skeleton and is a classification of insect)
Ex. Tick

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6
Q

What is the pathophysiology of Encephalitis?

A
  • Localized necrosis and hemorrhage of the neurons in the brain/spinal chord –> becomes generalized –> edema (swelling within the brain tissue itself)
  • Cell bodies degenerate
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7
Q

Is encephalitis a predictable course? Why or why not?

A

Not a predictable course d/t to the various parts of the brain that can be damage, the location that is damaged may have different specialized function

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8
Q

Can you predict the progression of encephalitis?

A

Nope!

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9
Q

What are the Manifestations of Encephalitis? (6)

A
  1. Neuro disturbances
  2. Fever
  3. Headache
  4. Meninges could be affected
  5. Nuchal Rigidity
  6. Sever neurological impairment
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10
Q

What do the neuro disturbances include? (3)

A
  1. lethargy
  2. seizures
  3. coma
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11
Q

Explain what are the 2 severe neurological impairments that can occur are?

A
  1. Dementia

2. Seizures

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12
Q

What is the more severe form of encephalitis from (which virus?)

A

Herpes Simplex 1 Virus = more aggressive

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13
Q

Since Encephalitis that comes from Herpes Simplex 1 virus is more aggressive, what sort of treatment does it require? Through which route of administration?

A

Antiviral Medications

IV

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14
Q

What is the mortality rate of patients who suffer from encephalitis?

A

~30%

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15
Q

Define seizure:

What does this cause to happen?

A

Acute onset, uncontrolled neuronal discharge

- alteration in behaviour and movements

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16
Q

Define epilepsy:

A

recurrent seizures

17
Q

The etiology of seizures fall under 2 different types. Name each type.

A
  1. Provoked (2 degree)

1. Unprovoked (1st degree)

18
Q

The provoked form a seizure involves an underlying cause. What could these underlying causes be? (4)

A
  1. CNS insult
  2. Febrile
  3. Metabolic Related
  4. Electrolyte Imbalance
19
Q

What is an example of CNS insult?

A

Infection (ex. Encephalitis)

20
Q

What age group is a febrile seizure most common in?

A

Kids

21
Q

Explain how metabolic related seizures can occur (2)

A
  1. Hypoglycemic coma

2. Hypoxia

22
Q

What is the etiology of unprovoked seizures? Is there a link to genetics?

A

Idiopathic

Yes there is a link to genetics

23
Q
  1. What is the treatment for the Arbovirus encephalitis?

2. What is the treatment for the Herpes Simplex 1 encephalitis?

A
  1. It is self limiting (monitor for complications, treat the symptoms)
  2. IV antivirals
24
Q

Explain how the electrolyte imbalance could provoke a seizure to occur?

A

Change in the resting membrane potential

25
Q

Seizures are classified into 2 categories.

What are they?

A
  1. Generalized seziure

2. Parital Seizure

26
Q

A generalized seizure involves one or both of the hemispheres?

A

Both

27
Q

A partial seizure can be further classified into what two subcategories?
1.
2.
Explain what the LOC is for each?

A
  1. Simple partial (no LOC)

2. Complex partial (LOC)

28
Q

What is the Patho for seizures? Explain from top to bottom.

A

“Epileptogenic focus”, therefore hypersensitivity of the cells in the cerebral cortex and hippocampus –> acute, uncontrolled increased neronal dishcarge –> increased frequenzy and amplitude caused –> spreads –> inhibitory neurons blocked, therefore abnormal muscle movements and possible loss of conciousness.

THEN

Eventually inhibitory neurons will be able to control and inhibit the neuronal discharge, as this is happening intermittent relaxation and contraction is occurring until the seizure ends.

The seizure ends when the epileptogenic cells are inhibitted.

Lastly, the CNS will become depressed (ictal Phase)

29
Q

Define what the Ictal phase is in a seizure?

A

The ictal phase is the phase when the CNS system becomes depressed after a seizure has occured

30
Q

Why do complications occur d/t a seizure?

A

The brain is requiring more ATP since it is working harder

31
Q

Since the brain in a seizure is requiring more ATP, it requires what 2 elements?

A

Oxygen and glucose

32
Q

Without the increase of Oxygen and glucose, you can have what 2 things occuring?

A
  1. Inadequate perfusion to the brain

2. Hypoxia in the skeletal muscles, therefore anaerobic metabolism is initiated

33
Q

What is a byproduct of anaerobic metabolism? What can this lead to? Which leads to what if this is prolonged?

A

Lactic acid.
Lactic acidosis
Brain damage

34
Q

What do you Dx a seixure on? (3)

A
  1. Hx
  2. Neuro exam (cranial nerves, reflex, PERLA)
  3. Underlying cause (EEG, labs, scans)
35
Q

The treatment for a seizure involves 3 processes.

  1. During =
  2. Stat after =
  3. Later on= (3)
A
  1. Prevent injury (move objects away from the patient)
  2. Preserve brain function
    1. Underlying cause (avoid the trigger)
    2. Anticonvulsant drugs
    3. Sx if the drugs are not working
36
Q

Can the meninges be affected in encephalitis?

A

Yes mam they can. Similiar how to meningitis other parts of the brain other than the meningies can be affected

37
Q

What are the names of two anticonvulasant drugs? (also given after a stroke to prevent a seizure from occuring)

A

Phenytoin and Levitiracetam

Post Midterm Patho (16 decks)

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