neurological emergencies for dentists Flashcards
blackouts what are they and main types
transient loss of consciousness
syncope
seizure
causes of blackouts
epilepsy
syncope (loss of blood supply to the brain)
subarachnoid haemorrhage, PE
adrenal insufficiency
what is seen with syncope
irregular movement
limbs one at a time
seizure
whole body stiff
posturing
jerking with rhythmic pattern
small fast movements
non epileptic fits/blackouts
hyperventilation
irregular movements
blackouts what to do
ABCDE + glucose
c - - BP (L+S),
- HR, tells you if arrhythmias are causing them
- ECG, first line of diagnosis/investigation
- epileptic seizures can cause syncope
disability
Plantars - primitive reflex
pupils - fixed dilated brainstem, small pupils likely to be something you’ve done eg injection)
status epileptics and tx
prolonged epileptic seizures longer than 5 mins
1) ABCDE
2) 99
3) benzodiazepines (lorazepam 2-4mg,repeat after 5mins; buccal/IM midazolam 10mg, rectal diazepam 10-20mg if no access)
4) AEDs (LEV,VPA, PHT)
5) general anaestethetic
focal weakness cause
stroke
either bleed or clot
999
drugs that can cause breathlessness
1) antibiotics
2) botox
3) corticosteroids
4) beta blockers
5) tricyclic antidepressants
neuroglocial breathlessness
respiratory muscle failure
- due to impaired innervation or weakness of muscles breathing
what is the neurological indication for breathlessness
average 31-49
below 20 may have weakness of the muscles
history for breathlessness
limb weakness diplopia sensory disturbance precipitants autonomic symptoms
