Headache & seizures Flashcards
What is a headache?
- called cephalgia
two types: primary and secondary - causes significant discomfort and can interfere with activities and lifestyles
What is a primary headache?
no known organic cause and includes migraine, tension headache, and cluster headache
What is a secondary headache?
symptom with an organic cause such as a brain tumour or aneurysm
What is some headache triggers?
stress, anxiety, time of day, routine, sleep, body tension, weather, exercise, activity level, mood, behaviour, diet, emotions, thoughts
What are the four main classifications of headache?
- tension-type
- migraine
- cluster
- sinus
What is a sinus headache?
pain is usually behind the forehead and/or cheekbones
What is a cluster headache?
pain is in and around one eye
- rare, repeated headaches that occur for months or weeks with periods of remission
- most severe forms
- sharp, stabbing, intense pain around eyes radiating to temple, forehead, cheek, nose or gums
What is a tension headache?
bilateral pain, band-like squeezing the head
- not brought on by physical activity
- most common, mild or moderate
- massage and heat packs can help
What is a migraine?
pain, nausea, and visual changes are typical of classic form
What is the etiology and pathophysiology of tension-type headaches?
Result of sustained and painful contraction of scalp and neck muscles
What is the S&S of tension-type headache?
Pressure or tightness, mild to moderate, bilateral, worsens with physical activity, photophobia, phonophobia
What is the diagnostic test used for a tension-type headache?
- hx
- electromyography
- resistance while moving head
What is the etiology and pathophysiology of a migraine?
- family hx
- reoccurring, unilateral or bilateral throbbing pain
- triggering event or factor
- vascular, muscular, and biochemical factors are involved
- exact cause is unknown
What is an aura in a migraine?
preceded factor before a migraine
-sensory dysfunction, motor dysfunction, dizziness, confusion, and even loss of consciousness
What is the four phases in a migraine?
- prodrome
- aura
- headache
- recovery
What are the S&S for a migraine?
Generalized edema, irritability, pallor, nausea, vomiting, sweating
- steady, throbbing pain that matches with the pulse
- people like to “hibernate”
What is a diagnostic test for migraines?
- no specific test
- diagnosis is made from test
- neurological and diagnostic examinations are normal
What kind of medications can be used for headaches?
prophylactic medications
What is a seizure?
- neurological disorder that affects the brain
- Paroxysmal, uncontrolled electrical discharge of neurons in brain interrupting normal function
What is the etiology and pathophysiology for a seizure by age?
6 mth or less: birth injury, birth defects, infections inborn errors of metabolism
2-20: birth injury, infection, trauma, genetic factors
20-30: structural lesions
50+: cerebrovascular lesions, metastatic brain tumours
- abnormal firing is unclear
What is the two major classes of a seizure?
- generalized
- partial
What is a partial seizure?
begin in one part of the brain
What is a general seizure?
involve the whole brain
What are the two types of partial seizures?
- simple partial
- complex partial
What is a simple partial seizure?
consciousness remains intact
What is a complex partial seizure?
impairment of consciousness
- has an aura
What are the four types of general seizures?
- tonic-clonic(grand mal)
- typical absence (petit mal)
- myoclonic
- atonic
What is a tonic-clonic seizure?
tonic phase: Patient falls - muscles contract and consciousness is lost. horse cry at start, chest muscle contract
than convulsions
clonic phase: muscles relax and air rushes into the body causing vigorous jerky movements. frothing at mouth(could be red if they bite their tongue)
- no memory of seizure, sore muscles, and feel abnormal for days
What is a typical absence seizure?
- most common in children and adolescents
- precipitated by hyperventilation and flashing lights
- staring spell for couple seconds and usually goes unnoticed
- eyes may blink rapidly or turn upwards for a moment
- brief loss of conscience
What is a myoclonic seizure?
- There is no loss of consciousness
- Often associated with single or repetitive jerking motions of the muscles (myoclonus).
- Myoclonic seizures are primarily observed in young children and infants. They are rarer in adults
What is an atonic seizure?
- Often called drop attacks/seizures.
- Characterized by sudden loss of muscle tone, resulting in an inability to sit or stand.
- Usually rare in adults.
What is status epilepticus?
generalized seizures that occur without full recovery of consciousness between attacks; continuous clinical or electrical seizures lasting at least 30 minutes, even without impairment of consciousness
- CALL 911 if does not stop within 5-10 mina
- can cause severe brain damage and even loss of life
What is the diagnostic studies for a seizure?
- health hx
- EEG
-CBC, serum chemistries, liver and kidney function, UA to rule out metabolic disorders - CT or MRI in new onset seizure to rule out structural lesion
- Cerebral angiography, SPECT, MRS, MRA, and PET in selected situations
What is the collaborative care for a seizure?
- Drug therapy aimed at prevention
- Primary drugs for treatment of generalized tonic-clonic and partial seizures
- Status epilepticus treated with IV lorazepam (Ativan) and diazepam (Valium)
- Antiseizure drugs should not be discontinued abruptly, as this can precipitate seizures
- Side effects include diplopia, drowsiness, ataxia, and mental slowing
What are some possible medications for a seizure?
antiseizure, Ativan, valium
- carbamazepine (Tegretol)
- clonazepam (Rivotril)
- phenobarbital (Luminal)
- phenytoin (Dilantin)
- valproic acid (Depakene)
What is the long term effect of dilantin?
gingival hyperplasia (swollen and tender gums)
