Neurology Flashcards
Define impaired consciousness.
the loss of normal level of awareness
what is the spectrum of impaired consciousness? from ? to ?
mild confusion to unrousable coma
what does GCS stand for?
glasgow coma scale
what is the minimum and maximum scores on the GCS?
3 - 15
what are the 3 subsections in the GCS?
- movement
- speech
- eye opening
how many points can you get in movement in GCS?
6
how many points can you get in speech in GCS?
5
how many points can you get in eye opening in GCS?
4
The lower the GCS score, the…
less conscious (the greater the impaired consciousness)
what does AVPU stand for?
Alert
Verbal
Pain
Unresponsive
give the 2 broad causes of impaired consciousness.
- structural damage
- global failure
what are the 2 types of structural damage? causing impaired c
- external (head injury)
2. internal (stroke, tumour, abscess etc)
what are the 4 types of global damage? causing impaired c
- metabolism
- infection
- seizure
- drugs & toxins
name 3 types of infections affecting the brain.
- meningitis
- malaria
- encephalitis
name 3 other severe infections that could affect the brain.
- urine
- GI
- pneumonia
Examples of drugs that can cause impaired conscious are..
- alcohol
- opiates
- ‘recreational drugs’
- anti-depressants
- anti-epileptics
- tranquilliser
- benzodiazepines
the 3 stages of treatment for impaired consciousness are..
1 - ABCDE
2 - Identify causes
3 - treat cause
define epilepsy
excessive electrical discharge in the brain
what are the 2 clinical features of epilepsy?
- focal (partial) seizures
- generalised seizures
what are the 2 types of focal seizure?
- simple and complex
indications of a simple focal seizure?
shaking down one side
indications of a complex focal seizure?
1st an aura
2nd odd behaviour (lip smacking, staring, odd posture, “out of it”)
name 4 generalised seizures?
- tonic/clonic
- petit mal
- myoclonic
- atonic
what is a petit mal seizure and who do they effect?
absence seizure in children (staring into space for 10 sec)
what happens during a myoclonic seizure?
limbs jerking and collapse
what happens in a atonic seizure?
limbs collapse
what are some causes of epilepsy?
primary - hereditary
secondary
- structural damage
- metabolic damage
3 ways to investigate epilepsy?
- blood tests
- brain imaging
- EEG
2 ways to treat epilepsy
- drugs
2. surgery
name 4 drugs that can be given to treat epilepsy?
- phenytoin
- carbamazepine
- sodium valproate
- lamatorigine
what are 2 surgery options that can help some kinds of epilepsy?
- tumour removal
- arteriovenous malformation
when to avoid dental treatment with an epileptic patient?
if not well controlled
what are the red flags that indicate secondary headache disorders? (8)
- sudden onset
- severe pain
- features of raised intracranial pressure signs are
- worse on change in position
- present on walking
- nausea and vomiting - focal neurology (CNS deficit = weakness in limbs)
- impaired consciousness/confusion
- fever - meningitis?
- associated history ie cancer/HIV
- visual changes
name 5 types of primary headache disorders.
- tension headache
- migraine
- cluster headache
- medication overuse headache
- trigeminal neuralgia
symptoms of a tension headache are…
- gradual onset (chronic)
- symetrical
- ‘tight band’ feeling
- worse towards end of the day
what is the cause of tension headache?
stress related
what are the 2 treatment options for tension headache?
- conventional analgesic
- tricyclic anti depressants for prophylaxis
define a migraine.
the temporary reduction in blood flow, followed by compensatory increase in blood flow
what is the incidence of migraines?
common
8% more in females