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NB401 > Epilepsy and Stroke > Flashcards

Epilepsy and Stroke Flashcards

1
Q

What is Epilepsy?

A

A neurological condition which causes a person to have seizures when the electrical impulses in the brain become disrupted from their normal activity

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2
Q

What Causes a Seizure?

A
  • Electrical impulses are disrupted or too many are sent at once.
  • Neurones can sometimes send out an ‘abnormal’ message. For example, this abnormal message causes a larger-than-normal depolarisation. AAR making other neurones send out abnormal messages
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3
Q

Conditions in which a Signal Causes a Seizure (3) And Where in the Brain can the Signal Spread?

A
  • each neurone must be excited
  • They must be connected to many other neurones within just a few synapses
  • The message must be large enough to cause the other neurones to act in the same way
  • Under these conditions, the message can spread very quickly. If the unusual message causes disrupted activity, this may affect part of the brain (causing a partial seizure) or it can spread to affect the whole of the brain
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4
Q

Potential Causes to do with Neurones/Synapses/NT’s

A
  • Damaged neurones could change how they work and send signals
  • If there are too little or to many NT’s, this affects how the neurones can communicate, and could cause seizures
  • Some neurones have slower than normal ion channels, meaning messages are not ‘turned off’ as quickly as they would normally
  • Some neurones have different synaptic receptors that receive the NT’s, making it harder for the neurone to stop or ‘switch off’ the message, so the neurone continues to send the message even after it is not needed
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5
Q

What is Epileptic Focus?

A

The part of the brain where the disruption starts.

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6
Q

What Causes Epilepsy? (4)

A
  • Brain damage eg dmg caused by a stroke, head injury or infection
  • Brain tumours
  • Problems with brain development in the womb
  • Genetic factors
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7
Q

What Causes Epilepsy? (4)

A
  • Brain damage eg dmg caused by a stroke, head injury or infection
  • Brain tumours
  • Problems with brain development in the womb
  • Genetic factors
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8
Q

What are Petit Mal Seizures? Who Experience them and for How Long?

A
  • Partial seizures that tend to last a few seconds. The patient experiences an ‘absence’ (seem to be staring blankly into space).
  • More common in children than adults and often cease in teenage years
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9
Q

What are the Phases of a Grand Mal Seizure?

A

Tonic phase - stiffening of limbs & body
Clonic phase - twitching and jerking of body & limbs

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10
Q

Signs of a Patient in the Aura Stage

A
  • The start of a partial of complex seizure.
  • The person may experience abnormal sensations like a particular smell, vertigo, nausea, or anxiety.
  • If the person is familiar with having seizures, they may recognize the warning signs of a seizure about to begin
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11
Q

Signs of a Patient in the Tonic Stage (7)

A
  • Person loses consciousness and may fall.
  • Strong tonic spasms of the muscles can force air out of the lungs, resulting in a cry or moan
  • May be saliva or foam coming from the mouth.
  • If the person bites their tongue/cheek, blood maybe visible
  • Stiffness of the chest muscles may impair breathing,
  • Person’s face may look bluish or grey
  • May make gasping or gurgling sounds
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12
Q

Signs of a Patient in Clonic Stage

A
  • Jerking movements affect the face, arms and legs, becoming intense and rapid
  • After one to three minutes, jerking movements slow down and the body relaxes, sometimes including the bowel or bladder
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13
Q

What Happens During the Postictal Period?

A
  • After a seizure, the person may remain unconscious for several minutes as the brain recovers. They may appear to be sleeping.
  • Gradually the person regains awareness and may feel confused, exhausted, sore, sad or embarrassed
  • The person may not remember their seizure, and may have other memory loss
  • Occasionally, people may have abnormal or combative behaviour after a tonic-clonic seizure while the brain is recovering
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14
Q

What Bodily things are Affected by Seizures?

A
  • Both types of seizure reduced consciousness is present to a varying degree.
  • Respiration and oxygenation of the brain can also be affected in T/C seizures
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15
Q

Once a Seizure has Started, How Does it Stop?

A
  • There is no clear answer to this. For most people, when seizures start, they last for a certain length of time and then stop by themselves.
  • The brain may have a mechanism that recognises a seizure and releases chemicals that inhibit or stop the seizure from carrying on. This mechanism or substance is still unknown
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16
Q

How is Epilepsy Treated?

A
  • The main treatment is epilepsy medicines. Sometimes called anti-epileptic drugs or AEDs. They don’t cure epilepsy but can stop or reduce the number of seizures.
  • Many find that their seizures stop with the 1st or 2nd medicine they try. Others try a few medicines before finding one that works. Some need to take 2 or more epilepsy medicines together.
  • If epilepsy medicine doesn’t work, their doctor might suggest other treatments; Including brain surgery, vagus nerve stimulation, a ketogenic diet (sometimes used for children)
17
Q

Common Epilepsy Drugs

A

Phenytoin* Carbamazepine* Lamotrigine* Levetiracetam* Sodium valproate* Pregabalin* Gabapentin* Oxcarbazepine* Topiramate

18
Q

3 Rescue Medicines

A
  • idazolam (buccal administration) (patient has)
  • Diazepam (rectal administration)
  • Diazamuls (IV administration)
19
Q

How do Diazemuls work?

A
  • Diazemuls injection contains the active ingredient diazepam, w a type of medicine called a benzodiazepine
  • Diazepam works by acting on GABA receptors in the brain. This causes the release of a NT called GABA
  • GABA acts as a natural ‘nerve-calming’ agent, keeping the nerve activity in the brain in balance, inducing sleepiness, reducing anxiety and relaxing muscles
20
Q

What is a stroke?

A
  • A stroke is a brain attack
  • Occurs when the blood supply to part of the brain is cut off, killing brain cells.
  • This will effect body function and can change how you think/feel.
  • The specific effects of a stroke depend on where it takes place in the brain, and how large the damaged area is
21
Q

What are the 3 Types of Strokes?

A
  • Ischaemic strokes
  • Haemorrhagic strokes
  • Transient ischaemic attacks
22
Q

What are the Risk Factors of Strokes?

A
  • Age - as we age, our arteries become harder and narrower and more likely to become blocked.
  • Medical conditions - Atrial fibrillation can increase risk of stroke
  • Lifestyle factors - Smoking, excessive drinking, lack of exercise
  • Trauma - can also lead to stroke as a secondary injury.
23
Q

What is a Ischaemic Stroke Caused by?

A

A blockage cutting off the blood supply to the brain. The most common type of stroke.

24
Q

What is Haemorrhagic Stroke Caused by?

A

Bleeding in or around the brain.

25
Q

What is a Transient Ischaemic Attack Caused by?

A
  • Also called TIA or a mini-stroke.
  • The symptoms only last for a short amount of time. This is because the blockage that stops the blood getting to your brain is temporary
26
Q

Positives and Negatives to the FAST acronym

A

Positive - slurred speech and facial droop are the most commonly known signs of stroke
Negative - Some strokes present differently so can be missed as a result, particularly if the area of the brain affected is the cerebellum. Known as a posterior stroke

27
Q

Signs and Symptoms of Posterior Stroke (12)

A
  • Uncoordinated movements of the limbs or trunk
  • Difficulty walking, including problems with balance
  • Tremors
  • Vertigo - feeling of spinning or whirling when you are not moving
  • Nausea and vomiting
  • Intense headache
  • Speech problems and difficulty swallowing
  • Problems sensing pain and temperature
  • Difficulty hearing
  • Problems with vision, like eyes move rapidly or difficulty controlling eye movement
  • Problems with eyes, like small pupils or droopy eyelids
  • Loss of consciousne
28
Q

Names of Tests for Posterior Stroke (5)

A
  • Gait
  • Rombergs Test
  • Tremor
  • Tone
  • Co-ordination
29
Q

What is the Gait and Rombergs Test?

A

Gait - walking normally/abnormally?
Rombergs - Patient stands with eyes closed. Any swaying? Loss of balance?

30
Q

What are the Tremor and Tone Tests?

A

Tremor - Check for a resting tremor in the hands by placing a piece of paper on the patient’s outstretched hands
Tone - arms (shoulder/elbow/wrist)

31
Q

What is a Coordination Test?

A
  • Dysdiadochokinesis Test - Palm to back of hand etc
  • Finger to nose
  • Heel to shin
  • Peripheral vision fields

NB401 (14 decks)

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