Week 10: Neurological Conditions Flashcards
Define fitting
A period of involuntary muscular convulsion, often followed by a period of profound lethargy, confusion and sleep
What are the two types of fitting?
- epileptiform
- non- epileptiform
Define epileptiform
Spike or sharp wave activity or other rhythmic waveforms, causing epilepsy
Define non-epileptiform
Similar symptoms of an epileptic seizure without any unusual electrical activity in the brain often caused by mental stress or physical condition
What are the different causes of a fit?
- generalised
- partial
Define generalised
both sides of the brain are used from outset
Define partial
Localised area of the brain
What are some risks of prolonged seizures
- permanent brain damage
- death
- apnea
- occluded airway
- heart rhythm (bradycardia, tachycardia, ictal asystole)
After how long is a seizure considered long?
5 minutes
What are the 4 stages of a seizure?
- aura stage
- tonic stage
- clonic stage
- postical stage
What are the different types of generalised seizure?
- tonic clonic
- tonic
- atonic
- abscences
Define tonic clonic
Rigid, falls, jerks
Define tonic
Rigid, falls, but no jerking
Define atonic
Sudden loss of muscle tone (drop attack)
Define abscences
Brief interruption, blank staring
What are the two partial/focal seizure types:
- simple
- complex
Define simple
Remain conscious, pins and needles, unusual taste/smell or some other sensory disturbance, localised jerking/sometimes a slight twitch
Define complex
Alteration of consciousness, pluck at clothing, fiddle with objects, act confused, lip smacking, chewing, undressing, appear intoxicated
What is secondary generalised?
Partial evolves into generalised
What symptoms/causes are there of non-epileptiform seizures?
- febrile convulsions
- cardiac arrêt in adults
- hypoglycaemia
- hypoxia
- stoke
- tumour
What is alcohol withdrawal seizures?
When someone consumes a lot of alcohol, or when someone whose body is used to having alcohol regularly and suddenly stop or changes their drinking, the brain may react and trigger a seizure
What are some treatments for alcohol withdrawal seizures?
Benzodiazepines such as diazepam
What is the assessment for a seizure?
- ABCD
- history- head injury/infection
- assess mouth/tongue, any incontinence
- raised temp or rash
- any arrhythmia
What is the management for seizures?
- CABCDE
- high flow O2 15L/100%
- lie patient down
- loosen tight clothing
- remove harmful objects
- do not restrain movements
- do not put anything in mouth
- IV access
- use own patient buccal midazolam
- rectal diazepam
- allow the to recover
- take medication to hospital
- Obs
- ATMIST
Define a stroke
A stroke is classically characterised as neurological defecit attributed to an acute focal injury of the CNS
What are the two different types of stroke?
Transient ischemic attack (TIA) and Cerebrovascular accident (CVA)
What is a TIA?
An acute loss of cerebral or ocular function with symptoms lasting less than 24 hours
What is a TIA caused by?
An inadequate cerebral or ocular blood supply as a result of low blood flow, ischaemia, or embolism with the disease of the blood vessels, heart or blood
Does a TIA cause permanent damage?
A TIA is a temporary interruption in blood flow to an area of the brain that does not last long enough to cause permanent damage to the brain
What is a CVA?
Loss of blood flow to the brain, which damages the brain tissue
What is a CVA caused by?
Caused by blood clots and broken blood vessels in the brain
What can a CVA lead to?
Life changing disabilities or death
How are strokes classified?
By their main causes as either ischaemic (most common) or haemorrhagic
What is a ischemic stroke?
Obstruction blocks blood flow to part of the brain causing an area to be deprived of blood
What causes a hemorrhagic stroke?
Weakened vessel wall ruptures causing bleeding in the brain
What are the risk factors of a stroke?
- age
- being male
- heredity
- heart disease
- diabetes
- smoking
etc
What are some conditions that can also look like a stroke?
- seizures
- migraines
- hypo/hyperglycemia
- ms/bells palsy/parkinsons
- brain tumours
- sepsis
- trauma
What test is used to detect a stroke?
FAST test
What does the FAST test look for?
- facial weakness
- arm weakness
- speech problems
- time
How long max should you stay on scene if a stroke is suspected?
Less than 25 minutes
What should you do if suspected stroke?
- monitor with a 3 lead cardiac monitor to see for arrhythmia
- pre alert for patient who were last seen well within 10 hours/ woke up with a stroke
What is meningitis?
The meninges covering the brain and spinal cord are infected by bacteria causing inflammation
What is septicaemia?
Bacteria in the bloodstream, produces a clinical indication of shock. Deterioration can be rapid, early recognition and prompt treatment improves clinical outcomes
What are symtpoms of meningitis?
- irritability
- flu like symptoms
- neck stiffness
- photophobia
- haemorrhagic rash
- cold mottled skin
- reduced O2 saturation
- tachycardia
- painful joints, muscles and limbs
- headaches
- seizures
- D&V
- drowsiness and confusion
What is Parkinsons ?
Parkinsons is a disease caused by a loss of nerve cells in the brain, a reduction of dopamine is responsible for the many symptoms of parkinsons
What must you make sure if taking a patient with parkinsons into hospital?
That they take their medication as it is imperative that it is taken at the same time of day.
