T3 - CNS - Brain - Headaches and Seizures Flashcards
Risk factors for migraine and cluster headaches
alcohol contraceptive - hormone stress tyramine foods milk products fatigue meds allergies depression strong odors bright lights
Which type of headache has a throbbing symptom
migraine
which type of headache has a boring symptom
cluster
Which type of headache worsens with movement, and has a symptom of phonophobia and photophobia
migraine
which type of headache can have an aura
migraine
Which type of headache lasts longer than 72 hours
Atypical migraine
How long does the common migraine (no aura) last
4-72 hours
What are the 3 R’s of a migraine
Recognize - symptoms
Respond - call Dr
Relieve - pain and Sx
What meds for abortive therapy of a mild migraine?
NSAIDS
Acetominophen
Antiemetics
What meds for abortive therapy of a severe migraine?
Triptans
Ergotamines
Isometheptine
What drugs to prevent a migraine?
NSAIDS
Beta Blockers
Calcium channel blockers
Antiepileptic
What alternative therapies can be done to prevent migraines?
yoga
meditation
massage
exercise
What is the duration of a cluster headache?
30 min - 2 hours
Cluster headaches occur daily for how long?
4-12 weeks
Do you have warning for a cluster headache
no
What additional facial symptoms can accompany a cluster?
facial sweating
facial drooping
miosis
facial pallor
Which type of headache is associated with pacing, rocking and walking?
cluster
Which type of headache can be treated with 100% O2
cluster
Bursts of anger and excessive physical activity are associated with which type of headache?
cluster headache
Which hemisphere of the brain does a generalized seizure involve?
both
How long does a tonic clonic seizure last?
2-5 minutes
Word that means abrupt increase in muscle tone: _________
Word that means muscle contraction and relaxation: __________
Tonic
Clonic
Part of the brain involved in seizures?
temporal lobe
Which type of partial seizure does the pt remain conscious, have one sided movement and an aura?
simple partial
Which type of partial seizure can involve automatisms, amnesia post seizure and is more common in older adults?
complex partial
What are some risk factors for seizures?
metabolic disorders acute alcohol withdrawal electrolyte disturbances heart disease high fever stroke substance abuse
KNOW Seizure precautions. What are they?
O2 in room Suction in room Get an airway Get IV access Siderails up No tongue blades
Seizure management:
Turn patient on ______ and keep _______ clear.
side
airway
Seizure management:
_______ restrictive clothes
Restrain movements?
What about the time?
- Loosen
- No
- Record the beginning and ending time of the seizure
At the end of a seizure what do you do in order: (5 things)
- take pt’s vitals
- perform neuro check
- keep pt on side
- allow pt to rest
- document seizure
Drugs for acute seizure management:
lorazepam (ativan)
Diazepam (valium)
Diastat
IV Pheny
Type of seizure that is a medical emergency:
status epilepticus
How long do status epilepticus seizures last?
5 minutes or longer or repeated ones over course of 30 min
What 2 do for status epilepticus: 4 steps
- Establish airway
- ABG’s
- IV push lorazepam or diazepam or rectal diazepam
- Loading dose of IV pheny
WARFARIN AND PHENY?
NOPE
Seizure type: sudden loss of muscle tone =
atonic
Seizure type: muscle contraction and relaxation:
clonic
Seizure type: person looks like they are spacing out
absence
Seizure type: brief jerking and stiffening
hypotonic
Seizure type: abrupt increase in muscle tone and loss of consciousness:
tonic
Main triptan for migraines
Sumatriptan
Sumatriptan weird side effect
Chest pain
