NEURO-Siezure Concussion Flashcards
What is the result of aberrant electrical activity in the brain d/t metabolic, traumatic, infections, tumors, meds/drugs, congenital defects?
Seizures
What is the disease characterized by the presence of recurrent seizures?
Epilepsy
What detects synchronous firing throughout multiple regions of the brain → disrupts normal brain activity
EEG Normal brain activity 1. activity different places 2. activity different times 3. Does not tell simple vs complex 4. Always need PT HPI
What are the theories behind seizures?
● Altered membrane permeability/ ion dysfnx- disruption of ions across cell membrane, d/t genetic mutations
● Changes in neuronal excitability/ion channel activity → would ultimately change the membrane permeability
● Neurotransmitter imbalance- acetylcholine excess or γ-aminobutyric acid GABA inhibitory decreased
EEG show a seizure begin in a specific of one cerebral hemisphere. Name this classification
Focal/Partial seizures
Simple: no impairment of consciousness or awareness 1 hemisphere
Complex: Consciousness impaired; 1 hemisphere
Parital seizure activity that spread across the brain & becomes generalized?
Jacksonian march” - manifest up to 120 seconds
Focal/Partial
● MC type is temporal lobe
● MC is complex partial
What are Partial Seizure DDX? What diagnosis tools help differeinate?
● Movement disorders, ● Migraine HA, ● sleep disorders, ●syncope, ●behavioral and psych issues can mimic ● 2nd to brain injury, thorough PMH
For any make sure to get:
○ EEG
○ Laboratory evaluation
○ Imaging
Did trial of AED use for treatment have good outcomes?
Partial Seizure: Treatment
● AED
● TX started after second unprovoked seizure- epilepsy ● Type and origins are important
● LTC YEARS
● RX impair cognition
● Surgical if epileptic established via testing/imaging
EEG shows widespread synchronized electrical activity on both hemispheres
Generalized- travel all over brain
Absence Myoclonic Tonic clonic Tonic Atonic
MC- young children
What are tips to get a good PMH?
difficult to obtain d/t associated with amnesia
● Need solid history of period- ictal and the post-ictal period
● Look for triggers
What trigger lower seizure threshold?
fever,
menstruation,
stress,
sleep issues
Ms. Emily has nonconvulsive: very short episodes of conscious detachment, that last 10s-100s times per day
AKA petit mal seizures,
children and cease in adulthood
Children school failure
blank stare, and unresponsiveness,
Motion-lip smacking, mild clonic motion eyelids
INC/DEC postural tone-autonomic phenomena.
resume normal activity immediately.
Ms. Jenna had a sudden loss of muscle tone leading to slackening of the jaw, drooping of the limbs, and falling to the ground.
Atonic
AKA drop attacks
Mr. Tim had brief involuntary muscle contractions, involving bilateral jerking of muscles, to face, trunk, and legs.
Myoclonic
induced by stimuli of cerebral origin.
Ms. Emma has PMH of tonic contraction of the muscles with extension of the extremities and immediate loss of consciousness. What type is this seizure?
AKA GRAND Mal most common major motor seizure. vague warning/ focal seizure Incontinence of bladder and bowel Cyanosis contraction of airway and respiratory muscles. clonic phase-rhythmic bilateral contraction and relaxation of the extremities. Tonic- extensor MSK, followed by falling end of the clonic phase-unconscious until the RAS begins to function again. 60 to 90 seconds.
