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Seizures and Meningitis Flashcards

1
Q

What is a neuron

A

Brain cells

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2
Q

What is an electrical signal?

A

Ions flowing in and out of protein channels of neurons

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3
Q

What is the normal neuron function?

A
  • Ions flow in and out of neuron through protein channels
  • Neuro transmitters carry the impulsive and neuron receptors receive it
  • Neuro transmitters bind to the receptors and tell the cell to open or close the protein channel
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4
Q

What is it called when neurotransmitters that cause the cell to open ion channels?

A

Excitatory

This allows the electrical message to pass into the cell

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5
Q

What is the main neurotransmitter in excitable?

A

Glutamate

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6
Q

What is the main receptor in excitable?

A

NMDA

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7
Q

What is the main ion exitable?

A

Calcium (CA2+)

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8
Q

What is it called when neurotransmitters that cause the cell to close ion channels?

A

Inhibitory neuro transmitters

This prohibits the electrical message from passing into the cell

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9
Q

What is the main neurotransmitter of inhibitory?

A

GABA

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10
Q

What is the main receptor of inhibitory?

A

GABA receptors

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11
Q

What is the main ion in inhibitory?

A

Chlorine (CL-)

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12
Q

What does calcium do when it enters the cell?

A

Calcium is positively charges and so when it enters the cell it tells the cell to keep sending signals

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13
Q

What does chlorine do when it enters the cell?

A

Chlorine is negatively charged and so when it enters the cell it tells the cell to stop sending signals

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14
Q

What is the pathophysiology of a seizure?

A

Involved abnormal, excessive and synchronous (existing or occurring at the same time) electrical activity in the brain neurons.

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15
Q

How are seizures caused?

A

Caused by an abundance of excitation and a limited amount of inhabitation

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16
Q

How does the abundance of excitation happen?

A
  • Fast or long-lasting activation of NMDA receptors
  • This causes the protein channel to remain open causing continuous influx of calcium ions
  • This causes the cell to continually send and receive signals leading to the excitation
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17
Q

What causes limited inhibitation?

A
  • Dysfunctional GABA receptors meaning the cells cannot inhibit signals
  • Chlorine is not let into the cell and the cell continues to send signals
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18
Q

What is epilepsy?

A

The transient occurrence of signs or symptoms due to abnormal electrical activity in the brain leading to disturbance of consciousness, behaviour, emotion, motor function or sensation

19
Q

What are some causes of epilepsy?

A
  • Most are idiopathic (relating to or denoting any disease or condition which arises spontaneously or for which the cause is unknown)
  • Head injury
  • CNS infections
  • Drugs
  • Neurodegenerative disease (Alzheimer’s disease)
  • Brain neoplasms (abnormal collection of tissues- can be benign or cancerous)
  • Metabolic medical disorders (hypo glycemia/traemia)
20
Q

What are the types of seizure?

A
  • Focal (partial)
  • Generalised (absence, tonic-clonic, tonic, atonic, myoclonic)
21
Q

What is a focal seizure?

A
  • Localised to one hemisphere
  • Can be simple focal seizures - motor or sensory
  • Can be focal dyscognitive seizure - impaired awareness
  • Focal seizures can progress to generalised seizures
22
Q

What is a generalised seizure?

A

Disorganised electrical activity occurring in both sides of the brain with impairment of consciousness

23
Q

What happens during an absence seizure?

A
  • Interruption of mental activity for less than 20 seconds
  • Often so brief they are barely noticed
24
Q

What is Aura?

A

A subjective sensation prior to a seizure
May occur seconds to hours before the seizure

Include:
- Psychic
- Visual
- Olfactory
- Auditory
- Taste

25
What happens during a tonic-clonic seizure?
- Previously called a grand mal seizure - Often preceded by an aura - Has a tonic (increased tone) phase and a clonic (rhythmic jerking) phase - Respiratory muscles are affected causing cyanosis - Oral secretions result in frothing at the mouth - Incontinence is common - Followed by a postictal period
26
What are some possible seizure symptoms?
- Sudden falls - Involuntary limb movements - Episodes of confusion - Loss of memory - Disorientation - Hallucinations - Automatisms (lip smacking, rubbing hands, chewing)
27
What is the diagnosis for seizures/epilspsy?
Test includes: - EEG - Neuroimaging - ECH - Neuropsychological testing - Genetic testing It can be quite difficult to diagnose and witness accounts help
28
What is status epilepticus and what are some causes?
A seizure that continuous longer than 5 minutes or repeated seizures without recovery Causes include: - Hypoxia - Stroke - Metabolic disturbance - Alcohol intoxication/withdrawal - Poor anticonvulsant therapy adherence
29
What are some facts for sudden unexplained death in epilepsy?
- Unexplained, unwitnessed, sudden, non-traumatic, non-drowning death of a person who has epilepsy - This can occur with or without a seizure (excluding status epilepticus) when a post mortem reveals no toxicological or structural cause
30
What is the highest risk in people who have sudden unexplained death in epilepsy?
Those who have uncontrolled generalised tonic-clonic seizures
31
When does sudden unexplained death in epilepsy commonly occur?
- During sleep - Young adults - Neurological comorbidities - AED polytherapy (overtreatment of epilepsy)
32
What is a non-epileptic seizure?
The descriptive term for paroxysmal (intermittent) events which could be mistaken for epilepsy but are not due to epileptic order
33
What are some non-epileptic causes?
Organic: - Syncope - Non epileptic myoclonus - TIA - Sleep disorders - Paroxysmal movement disorders Psychogenic: - Dissociative seizures - involuntary and subconscious - Factitious seizure - fabricated or induced illness - Psychiatric disorders A patient can suffer from both an epileptic and non-epileptic seizure
34
How does non-epileptic seizure present?
- Difficult to differentiate from epilepsy Epileptic seizures and non-epileptic seizures both: - Happen suddenly without warning - Include loss of awareness, repeated movements or convulsions - Both can cause injury and incontinence - Both can happen when awake or sleep - Essential to assess and treat appropriately to ensure no harm
35
What are some seizure managements?
- lateral - move any hazards away - O2 - protect head - pharmacology if possible - new patient once seizure ends (FUL A -E)
36
What do benzodiazepines do?
- Influence binding to GABA and increased action of GABA - Open ion - chloride enters - Hyperpolarisation and less likely to fire an actional potential - Sedation and anxiolytic effect seen
37
What are some facts about meningitis?
- 1-2 per 100,000 - Around 750 cases per year in the UK - Can occur at all ages - Bacterial meningitis most serious - Viral the most common - Treat all cases as bacterial, until proven otherwise
38
What are the main causes for meninigits?
Infection: bacteria, virus, fungi HIV Mumps Herpes simplex Cryptococcus
39
What are some presentations of meningitis?
- Headache - Nausea/vomiting - Lethargy - Joint/Muscle pain - Neck stiffness - Seizures - Signs of shock
40
What would we do to see if a patient had meningitis?
Kernig's Sign: Flexing the patient's hip 90 degrees then extending the patient's knee causes pain Brudzinki's Sign: Flexing the patients neck causing flexion of the patient's hips and knees Tumbler test: Get a glass on the rash and sign non-blanching
41
What are some symptoms of meningitis?
Central - headache, altered mental state Ears - Photophobia Eyes - Photophobia Neck - Stiffness Systemic - high ever Trunk, mucus membranes, extremities - petechiae
42
What is a drug given for meningitis?
Benzylpenicillin - antibiotic
43
What is a drug given for seizures?
- Midazolam - Diazepam

Neuro (4 decks)

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