Neurological Disorders - Medical Flashcards
What type of stroke are seizures associated with?
Hemorrhagic
What is a Coma?
A deep state of unconsciousness. Patient cannot be aroused by external stimuli
What are the six general causes of a coma?
Structural, metabolic, drugs, cardiovascular, respiratory, infection
What causes a structural coma
Tumours, abscesses, and pressure from bleeding encroach on the RAS in brain
What causes a toxic coma?
Presence of circulating toxins, metabolites or lack of oxygen and glucose. Progressive deterioration. Hypoglycaemia, sepsis, drugs
What are some examples of structural causes of a coma?
Inter cranial bleeding, head trauma, brain tumours
What are some examples of metabolic causes for coma?
Anoxia, hypoglycaemia, diabetic keto acidosis, thiamine deficiency, kidney and liver failure.
What are some drugs that may induce coma?
Barbiturates, narcotics, Hallucinogens (interfere with neurotransmitter), depressants, alcohol.
What is a Barbiturate?
Sedative or anesthetic drug
What are some examples of narcotics that can induce coma
Morphine, fentanyl
How might the cardiovascular system induce a coma
Dysthymia, shock, stroke, hypertensive encephalopathy (sudden raise in BP with headache nausea, seizures )
How might the respiratory system induce a coma
COPD (irregular levels of co2/o2), toxic inhalation
How might infection induce a coma?
Meningitis (bacterial-fatal, or viral- slow and recoverable), sepsis
What does the pneumonic AEIOU TIPS stand for?
The causes for coma;
ACIDOSIS, ALCOHOL
EPILEPSY
INFECTION
OVERDOSE
UREMIA
TRAUMA
INSULIN
PSYCHOSIS
STROKE
What does CVA stand for?
Cerebral vascular accident
What is a CVA
Sudden alteration in level of consciousness, sensation, and/ or voluntary movement due to obstruction or rupture of an artery in the brain.
What are the modifiable risk factors for a stroke?
Hypertension, cigarette smoking, TIA, heart disease, diabetes, high cholesterol
What are some non-modifiable risk factors for a stroke?
Age, gender, race, prior strokes, genetics, hypercoagulopathy, high RBC
What are the complications of a hemorrhagic stroke?
Rapidly fatal, can’t stop the bleed - often associated with a seizure
What are the characteristics of an ischemic stroke?
Blood clot/blockage, rarely lethal in first hour, 80-85% of strokes, clot buster meds (6 hour!)
Signs and Symptoms of an ischemic stroke?
hemiplegia, aphasia, numbness, confusion, convulsions, incontinence, double vision, slurred speech, headache, dizziness
What is the difference between a throbus and an embolus
thrombus is a blood clot, embolus is an obstruction due to a mass of undissolved matter lodging in a vessel
What are some causes of cerebral embolus?
air embolism after thoracic surgery, fat embolism after long bone injuries, gas embolus (diving)
What is a TIA
Transient ischemic attack, temporary reduction in blood flow. Lasts minutes to 2 hours, recovery in 24 hours
S/S of TIA
related to location of ischemia, weakness, paralysis, numbness in face, speech disturbances,
What are some assessments for stroke?
arm/leg drift, smile test, slurred speech, pupils
How does a paramedic manage a stroke pt
stroke protocol, ABC, position supine with head elevated, assessment, history collection
What 3 things does the LAMS scorecard evaluate?
facial droop, arm drift, grip strength
In simplest terms, what is a Seizure?
brain hyperactivity. A temporary alteration in behavior of consciousness caused by the abnormal electrical activity at one or more groups of neurons in the brain
What are the 2 types of seizures
Generalized; entire brain, Partial: known focus
What is a petit Mal seizure
lapse of consciousness in(often) 4-12 y/o, short lived, no loss of motor activity/posture
What is a Tonic Clonic Seizure
Grand Mal, two phases, sudden onset with loss of organized muscle tone
What are the characteristics of the tonic phase?
ext. muscle tone activity, flexion, apnea, tongue biting, incontinence (short duration)
What are the characteristics of the clonic phase in grand mal?
rigidity then relaxation, convulsions, 1-3 minute, massive ANS discharge- hyperventilation salivation, tachycardia
What are the characteristics of postictal phase of Grand Mal
Drowsiness or unconsciousness, Lasts minutes to hours, Followed by confusion and fatigue, Transient neurological deficits
What is status Epilepticus
prolonged seizure activity, re occurring before recovery.
What is a Simple Partial seizure
Motor (one part of body) or sensory(tingling, numbness, visual, auditory taste, no LOC, may lead to generalized
What is a Jacksonian seizure
seizure with brief alteration in movement, sensation or nerve function. head twitches, word repeating, lip smacking
What is a complex partial seizure?
arise from focal seizure in temporal lobe. Changes in behavior. preceded by an aura, abnormal repetitive motor behavior, period of amnesia, brief
What is the assessment for seizures?
Status on arrival, history of seizures and other significant factors, description of seizure (Onset duration, pattern events prior), head trauma, fever, headache
What are the drugs used for Seizures
Dilantin, Valium, Ativan, Versed
