15960351
Description
Flashcards by Amelia Tuffley, updated more than 1 year ago
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Created by Amelia Tuffley
over 5 years ago
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| Question | Answer |
| Causes of unconsciousness | A - alcohol, arrhythmia E - epilepsy, electrolytes I - insulin O - oxygen, overdose U - uremia T - trauma, tumour, thermal I - infection P - psychiatric, perfusion S - stroke, seizure, chock |
| Epilepsy definition | The tendency to have seizures A lowered seizure threshold |
| Causes of epilepsy | Metabolic disorders Genetics Cerebral tumours Birth trauma Stroke Head injuries Intracranial haemorrhage Intracranial infection Hypoxia Low glucose Drugs and alcohol |
| Seizure definition | A sudden, uncontrolled electrical discharge in group of neurons causing: Strange sensations Strong emotions Convulsions and spasms Uncharacteristic behaviour Impact on thought processes Loss of consciousness |
| Types of focal seizures (3) | - Motor, negative, atonic, weakness - Motor, positive, jerks, twitching - Non-motor -- somatosensory, visual, olfactory, gustatory, auditory, autonomic, psychic, automatisms |
| List the kinds of automatisms (7) | Oro-alimentary - chewing, lip smacking, drooling Mimicry - laughter, fear, anger Gestural - fiddling with hands, tapping, patting, rubbing, undressing Ambulatory - walking, circling, running Verbal - meaningless sounds, humming, grunting, whistling Responsive - quasi-purposeful behaviour, seemingly responsive to stimuli Violent behaviour - likely if restrained |
| List the types of generalised seizures (8) | Tonic clonic Absence - typical Absence - atypical Absence - special features Clonic Tonic Atonic Myoclonic |
| Describe tonic clonic sezires | ♣ 1-3 mins ♣ Loss of consciousness ♣ Body becomes stiff – tonic ♣ Jerking occurs – clonic ♣ May bite tongue, produce excess saliva, lose control of bladder ♣ Headache, deep sleep and confusion |
| Describe absence - typical seizures | • Pause in activity with blank stare • Occur frequently • 5-10 secs • Rapid eye blinking/eye deviation • Triggered by hyperventilation |
| Describe absence - atypical seizures | • Begin and end gradually • >10 secs • Not triggered by hyperventilation • Eye blinking/movements of lips • Refractory epilepsy |
| Describe absence - special features seizures | • Myoclonic absence • Eyelid myoclonic |
| Describe clonic seizures | Bilateral rhythmic jerking of arms and legs Rare |
| Describe tonic seizures | Drop attack Stiffening of body without jerking |
| Describe atonic seizures | Drop attack Sudden loss of muscle strength and pt falls forward recovers quickly with risk of injury to face and head May need to wear helmet |
| Describe myoclonic seizures | ♣ Jerking movements of body, mostly head and upper limbs ♣ Linked to sleep patterns |
| Levels of consciousness in seizures | • Full awareness – auras • Dialeptic – loss of awareness • Dyscognitive – confused behaviour • Unconscious |
| Stages of seizures | 1. Pre-ictal behaviour 2. Ictal behaviour 3. Post-ictal behaviour a. Pt is susceptible to recurring seizures b. Need to relax, with oxygen c. Walking, movement, rubbing or stimulation may make them seize again |
| Anticonvulsant medication aims | Achieve seizure control without major side effects May take time Often patients will stop taking it after long periods without seizures so need to consider compliance |
| Most common side effects of anti seizure meds | o Sedation, lethargy o Cognitive slowing, depression o Memory disturbance o Aggression, irritability |
| Factors affecting seizure threshold | Sleep deprivation Trauma Hyperventilation Emotion Hydrations Fever Alcohol/drugs Hormones Illness Photosensitivity |
| When to call an ambulance for a seizure | • They have any doubts or it is part of a management plan • A seizure lasts more than 5 minutes or a second one comes quickly • The seizure occurs in water • The person is pregnant, has diabetes or is injured • It is the person’s first seizure |
| Status epilepticus definition | • Prolonged, continuous or repeated seizures with or without complete recovery of consciousness • A seizure lasting > 5 minutes (impending status) • Seizures that are more frequent than every 20 minutes apart with or without recovery (clustering) |
| Sudden unexpected death in epilepsy (SUDEP) | • No obvious cause in post mortem other than the seizure • Those at risk may include: • Uncontrolled seizures • Generalised seizures during sleep • Non-compliant • Frequent or sudden medication changes |
| Differential diagnosis of seizures | Anoxic/ischaemic events - breath holding, vasovagal syncope, reflex anoxic seizures, cardiac Sleep related phenomena Drugs/alcohol Behavioural events Psychiatric events Hyperekplexia Metabolic - kalaemia, calcaemia |
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