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NEURO > loss of consciousness > Flashcards

loss of consciousness Flashcards

1
Q

neurological causes of LOC

A
  • epileptic seizures
  • raised ICP - tumour, post fossa lesions, hydrocephalus is colloic cyst
  • SAH
  • Sleep disorders (narcolepsy, cataplexy)
  • basilar artery migraine
  • cerebrovascular disease
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2
Q

types of neurally mediated syncope

A
  • neurocardiogenic syncope
  • carotid sinus syncope
  • situation syncope (cough,micturution)
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3
Q

define syncope

A

transient loss of consciousness

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4
Q

classification of syncope

A

1) neurological
2) metabolic
3) psychiatric
4) cardiac

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5
Q

clinical signs and symptoms of neurocardiogenic syncope

A

may be preceded by prodromata such as nausea, diaphoresis, lightheadedness, blurred vision, headaches, palpitations, paraesthesia, and pallor

after recovery - washed out and tired feeling

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6
Q

carotid sinus syncope signs and symptoms

A

rotation or turning of the head or pressure on the carotid sinus (for example, carotid massage, shaving, tight collars or neckwear, or tumour compression)

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7
Q

cardiac syncope causes

A

cardiac arrhytmias

structural cardiopulmonary disease

  • AS
  • HOCM
  • PE
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8
Q

causes if orthosatic/postural hypotension

A

drugs - vasodialtors, antidepressants, L-dopa preparations

autonomic neuropathy

  • GBS
  • Diabetes
  • amyloid

neurodegenerative diseases
- MSA, PD

hypovolaemia - loss of blood, diuretic therapy, Addison’s disease

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9
Q

causes of LOC from metabolic disorders

A

hypoglycaemia

hyperventilation induced alkalosis

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10
Q

what is consciousness

A

wakefullness and awareness

depends on the sesnory input into the brain and the intrinsic activity of the reticular activating system, ascending reticular formation in the brainstem and its rostral connections, which maintain the cerebral cortex in an alter state

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11
Q

causes of short lived LOC

A 
Seizure
Vaso-vagal syncope
Neurocardiogenic syncope
Cardiac syncope
Hypoglycaemia
Dissociative or functional
Cataplexy
Head injury
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12
Q

typical pre-syncopal Sx

A

faint, hot, sweaty, muffled hearing, blurred vision, tinnitus, dizziness

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13
Q

temporal lobe epilepsy aura

A

déjà vu, jamais vu, olfactory and gustatory hallucinations

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14
Q

DD for seizures

A

Generalised tonic-clonic seizure with minor head injury
Generalised tonic-clonic seizure with significant head injury
Syncope with head injury and subsequent seizure with post ictal confusion caused by either the fit and/ or concussion
Acute intracranial event causing collapse or fit with head injury
Intracranial abnormality leading to seizure

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15
Q

what is narcolepsy

A

rare - tetrad of clinical features
-> daytime sleep attacks (10-20mins), irresistible, inappropriate

  • > cataplexy - loss of postural control and limb weakness w preserved consciousness provoked by emotional events
  • > sleep paralysis
  • > hypnagogic hallucinations - frightening visual hallucinations on falling asleep
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16
Q

Mx of narcolepsy

A

amphetamines but careful

modafinil

clomipramine relieves cataplexy no effect on narcoleptic attacks

17
Q

what is obstructive sleep apnoea

A

excessive daytime somnolence w partial upper airway obstruction - nocturnal apnoeic attacks

heavy snoring

Ix - pulse oximetry overnight

central sleep apnoea - apnoeic episodes occur without continuing respiratory effort

Mx CPAP

18
Q

most common/uncommon causes of transient LOC

A

syncope
seizures

UNCOMMON
hypoglycaemia
narcolepsy/cataplexy
hyperventilation
vertebrobasilar ischaemia
vertebrobasilar migraine
psychogenic or 'non-epileptic attacks'
19
Q

what is vasovagal syncope

A

fainting - caused by a sudden drop in BP resulting from peripheral vasodilation
reduction in CO -> vagal stimulation -> bradycardia

triggers - strong emotion, sudden intense pain, prolonged standing

20
Q

Prodromal Sx of vasovagal syncope

Sx

A

prodromal
light headed, gradual dimming of vision, ringing in the ears, salivation, sweating, N/V

Sx
pale, clammy

21
Q

what is situational syncope (micturition/cough)

A

micturtion -> men who get up during the night to pass urine -> vasodialtion, postural hypotension, bradycardia

NEURO (30 decks)

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