Neurologic Disorders Flashcards
Sodium
sodium abnormalities
can lead to AMS and Seizures
Hyponatremia effects on brain
intravascular compartment is hypotonic
fluid will flow out into the neurons of the brain
neuron brain swelling
Nausea and vomiting.
Headache.
Confusion.
Loss of energy, drowsiness and fatigue.
Restlessness and irritability.
Muscle weakness, spasms or cramps.
Seizures.
Coma.
Hypernatremia effects on brain
hypertonic intravascular space
fluid to flow into the vessels shrinking/dehydrating neurons
Muscle weakness.
Restlessness.
Extreme thirst.
Confusion.
Lethargy.
Irritability.
Seizures.
Unconsciousness.
Seizures
inappropriate discharge of impulses by the cerebral neurons, sudden onset, transient loss of brain function
epilepsy –> seizure disorder with no underlying cause
what can cause seizures
cerebral lesions, cerebral trauma, idiopathic, genetic predisposition, perinatal injury, post-natal trauma, infection, brain tumor, vascular disease, congenital malformations, hypoglycemia, fatigue, lack of sleep, stress, fever, hyponatremia, constipation, use of stimulate drugs, ETOH withdrawal, withdrawal from depressant medications, hyperventilation and environmental stimuli (blinking lights, odors and loud noise)
focal/partial seizure
involves one cerebral hemisphere
often originate from the medial temporal lobe
and are often preceded by an Aura
simple partial seizure
-no LOC
complex partial seizure
-LOC (forgetful)
Jacksonian march –> seizure begins at one part and spread throughout whole limb
Automatism
actions without conscious thought
person may appear wide-eyed
lip smacking, chewing, facial grimacing, swallowing movements, patting, picking, rubbing oneself or clothes.
Generalized Seizure
both cerebral hemispheres
whole body manifestation of the seizure
LOC
Absence
-blank stare
Tonic
-muscle contraction and increase muscle tone
Clonic
-quick repetitive movement
Tonic Clonic/Grand Mal
-both alternating stiffening and jerking movements
Status Epilepticus
state of continuous seizures which last more than 5 minutes or seizures which occur rapidly before patient reaches a baseline.
one seizure that last greater than 30 minutes
medical emergency
can lead to permanent neurology injury
Postictal state
follows a seizure characterized by drowsiness, headache, confusion, aphasia, memory loss and paralysis which can last for hours or days
Non-convulsive Status Epileptic
presents without any signs of seizure activity
patient will have AMS that is not explained by any other cause
only way to Dx EEG
Acute confusion state
marked by sudden cerebral dysfunction which causes confusion, agitation, memory impairments, distractibility, compulsive disorders and obsession.
Delirium
Hyperactive Delirium
overstimulation of the ANS
decreased Acetylcholine and melatonin
increased dopamine, norepinephrine and glutamate
S/S: combative, aggressive, able to tolerate pain, breath rapidly, sweat, fever, are agitated, superhuman strength.
Hypoactive Delirium
seen in people with fevers, metabolic disorders (renal or liver disease) CNS depressants, recovering from Sx
S/S: decreased LOC, decreased LOC and attention span, inaccurate perception and interpretation of the environment, forgetful, confused and apathetic
Delirium Causes
ETOH withdrawal, drug intoxication, electrolyte abnormalities (sodium and calcium)
hypoglycemia, seizure activity, hypoxia, hypercapnia, infection, head injury or cerebral lesion.
reversible by treating underlying cause
Dementia
loss of cognitive function
(memory, orientation, and language)
occurs over time and not reversible
chronic