Week 9 Menigitis and seizures Flashcards
What parts of the brain does bacterial meningitis affect
pia mater
arachnoidmater
subarachnoid space
ventricles
CSF
How does bacteria get into the brain?
upper res. tract
blood stream
skull fractures
penetrating wounds
What are the meningitis specific clinical manifestations
- Throbbing headache
- Photophobia
- Nuchal rigidity
- Kernig sign- hamstring = can’t bend leg when hip is 90 degrees
- Brudzinski sign - neck flex= knees flex because of nuchal rigidity
what are the neurospecific clinical manifestations of meningitis
- LOC drop
- Nausea & vomitting
- Seizure
- Cranial nerve dysfunctions (3, 6, 7, 9)
- Motor dysfunction
What is Epilepsy
minimum 2 seizures over 24 hours apart
it’s a disorder
50-60% we don’t know why they occur
What are the metabolic changes that can lead to seizure
- Hypoglycaemia
- Hypoxia
- Alcohol
- Electrolyte imbalance
- Barbs withdrawl
- Acidosis
- Dehydration
- Water intoxication
What is a generalized seizure?
- Seconds to minutes long
- no warning usually
- *Both sides of brain
- Tonic-clonic is most common
- Absence seizure
- Atonic
- Myoclonic
- Tonic
- Clonic
What is a tonic- clonic seizure
- most common
- 2-5 min
- Tonic - stiff
- Clonic- jerking
What is an Absence (childhood) seizure
- 5-10 seconds
- person is unaware
- affects learning
- eyelid flutter
- walk around aimlessly
what is a myoclonic seizure
- Waking up
- Bed time
- brief jerking/stiffening of extremities
- drop things
What is atonic seizure
- Drop attack - sudden
- Lose muscle tone
- wear helmet always
what is a focal aware seizure
- one side of the brain
- no loss of consciousness
- Occipital lobe - flashing light/visual issues
- Motor cortex - Jerky on opposite side
- Parietal - Spacial awareness change
- frontal lobe - speech issues
Stages of seizure
- Prodome
- hours to days
- mood/anxiety
- hard to sleep
- light headed/dizzy - Aura
- early seizure
- nausea
- headache
- smell/sounds odd
-dizzy/panic - Ictal phase
- 1st symptom - end of seizure - Postictal phase
- sore, confused, exhausted, shame, injury, headache, fear/anxiety, weakness
What are the consequences of seizures (must know as a nurse)
- aspiration
- Impaired gas exchange
- Injury - protect the patient
- Quality of life - mental health
What is status epilepticus
** A medical emergency**
-Longer than 5 min seizure or
many seizures in 30 min
- brain is hypermetabolic requiring lots of O2 - think of all the things that go wrong when the brain is deprived of oxygen
- Longer than 10 min can equal death
- muscle breakdown - rabdo & renal failure
