17 Neurologic Emergencies

Question 1

Key Signs and Symptoms of Stroke

Answer 1

facial drooping
sudden weakness or numbness to one side
decreased sensation to one side 
blurred or double vision 
ALOC
speech disorders
aphasia 
dysarthria

Question 2

Conditions that mimic a Stroke

Answer 2

hypoglycemia
postictal state post seizure
subdural or epidural bleeding

Question 3

Cause for Epileptic Seizure

Answer 3

congenital

Question 4

Cause for Structural Seizure

Answer 4

tumor, infection, scar tissue, trauma, stroke

Question 5

Cause for Metabolic Seizure

Answer 5

hypoxia, hypoglycemia, poisoning, drug overdose, sudden withdrawal from alcohol or medications

Question 6

Cause for Febrile Seizure

Answer 6

sudden high fever

Question 7

AEIOU TIPS

Answer 7

assess ALOC:
Alcohol, Epilepsy, Insulin, Opiates, Uremia
Trauma, Infection, Poisoning, S’s (shock, stroke, seizure, syncope, subarachnoid hemorrhage)

Question 8

Cincinnati Prehospital Stroke Scale

Answer 8

Facial droop: smile
Arm drift: close eyes and hold both arms out and up
Speech: ask to repeat complete sentence

Question 9

FAST

Answer 9

facial droop
arm drift
speech
time

Question 10

Glasgow Coma Scale (GCS): Motor

Answer 10

6 obeys commands 
5 localizes pain
4 withdraws to pain
3 abnormal flexion 
2 abnormal extension 
1 none

Question 11

Glasgow Coma Scale (GCS): Verbal

Answer 11

5 oriented x4
4 confused 
3 inappropriate words 
2 incomprehensible sounds 
1 none

Question 12

Glasgow Coma Scale (GCS): Eyes

Answer 12

4 spontaneous
3 responds to speech
2 responds to pain
1 unresponsive

Question 13

aphasia

Answer 13

inability to understand and/or produce speech

Question 14

aura

Answer 14

sensation experienced before a seizure, which can serve as a warning sign

Question 15

CVA

Answer 15

cerebrovascular accident s/p interruption of blood flow to the brain resulting in loss of function aka stroke

Question 16

coma

Answer 16

state of profound unconsciousness from which a patient cannot be aroused

Question 17

delirium

Answer 17

temporary change in mental status e.g. disorganized thoughts, inattention, memory loss, hallucinations, and disorientation

Question 18

dysarthria

Answer 18

slurred speech

Question 19

embolus

Answer 19

blood clot or other substance in circulatory system traveling to a blood vessel causing blockage

Question 20

epilepsy

Answer 20

abnormal electrical discharges occurring in the brain causing seizures and syncope

Question 21

hemiparesis

Answer 21

weakness on one side of the body

Question 22

hemorrhagic stroke

Answer 22

stroke s/p bleeding inside the brain

Question 23

status epilepticus

Answer 23

seizures recur every few minutes or last longer than 30 minutes

Question 24

thrombosis

Answer 24

blood clot in the arterial or venous system

Question 25

TIA

Answer 25

transient ischemia attack i.e. brain cells temporarily stop functioning s/p insufficient oxygen causing stroke like symptoms that completely resolve after 24 hours from onset