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Neuro II Exam 2 > Seizures and Syncopes - Cohen > Flashcards

Seizures and Syncopes - Cohen Flashcards

1
Q

syncope

A

LOC from lack of blood flow

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2
Q

faint

A

syncope - bradycardia and hypotension

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3
Q

seizure

A

sudden electrical discharge of brain

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4
Q

most common cause of LOC

A

syncope

often lack of blood flow to brain cells

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5
Q

vasovagal syncope

A

faint
-sympathetic withdrawal - vasodilation

-increased PS activity - bradycardia

with crowding, ETOH, fatigue, severe pain, hunger, emotion or stress, needles, dental work

lasts less than 1 minute

often feel cold and sweaty

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6
Q

cardiovascular syncope

A

insufficient CO

with arrhythmia or structural abnormality of heart

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7
Q

cardiac causes of syncope

A

aortic stenosis - elderly

idiopathic subaortic hypertrophic cardiomyopathy - high school and college athletes

mitral valve prolapse - young women

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8
Q

cough syncope

A

repeated coughing - increased thoracic P - no blood to heart (decreased VR)

brief LOC

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9
Q

micturition syncope

A

men who stand to urinate at night - requires vagus nerve to pee
-patient passes out

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10
Q

epilepsy

A

2 or more spontaneous unprovoked seizures

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11
Q

bromide salts

A

prevent seizures

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12
Q

seizure disorder

A

aka epilepsy

preferred term is seizure disorder

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13
Q

provoked seizure

A

not epilepsy

2 MC causes

  • hypoglycemia
  • alcohol withdrawal - 2-3 days no drinks
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14
Q

check lytes

A

if have seizure

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15
Q

every patient with first seizure

A

full hx, PE, and neuro exam, MRI of brain, and full blood test

not every child needs MRI

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16
Q

diagnosis of seizure disorder

A

requires 2 or more unprovoked seizures

17
Q

partial seizure

A

one hemisphere

18
Q

generalized seizure

A

entire brain

19
Q

tonic clonic

A

grand mal

20
Q

clonic

A

muscle spasm

21
Q

tonic

A

stiff muscle

22
Q

convulsion

A

shaking

23
Q

status epilepticus

A

one seizure after another

or prolonged seizure

24
Q

grand mal seizure

A

generalized tonic-clonic

aura - brief warning

tonic phase first
-eyes open and roll up**

clonic phase - repetitive movements

end 2 minutes - remain unresponsive 5 minutes

  • no memory of seizure
  • confused for hours or days (post-ictal period)
25
Q

tonic clonic seizure changes

A 
HR increased
O2 sat drop
BP increase
pupils dilate
metabolic acidosis - low serum bicarb

remain weak onse side for another day - todds paralysis

26
Q

complex partial seizure

A

within one cerebral hemisphere

complex - LOC reduced

may gen an aura

deja vu and jamais vu

bad smell or taste, or dizziness

27
Q

jamais vu

A

familiar surrounding looks unfamiliar

28
Q

automatisms

A

repetitive blinking, chewing, simple motions, odd fumbling

with complex partial seizures

29
Q

absence seizures

A

in children

brief - 10 seconds or less

quickly recover and normal LOC - don’t know they had seizure

30
Q

absence epilepsy

A

100s of absence seizures/day

noticed by school teacher`

31
Q

EEG with 3/second spike waves

A

absence seizure

32
Q

tx of absence epilepsy

A

small dose of valproic acid

2/3 lose them at puberty

33
Q

treat seizure patient

A

when have second unprovoked seizure

34
Q

benzodiazepines

A

not give to seizure
-unless status epilepticus

chance of resp arrest

35
Q

pseudoseizure

A

asynchronous limb movement, closed eyes, pelvic thrusting, more than 2 minutes, don’t respond to epileptic drugs

closed eyes***
real seizure - open eyes

36
Q

weight gain, hair loss, platelet issues

A

depakote

37
Q

status epilepticus

A

multiple seizures without regaining normal fxn
or 30 minute seizure

medical emergency

tx - ABCs, glucose, O2 levels, urine toxicology

give small dose of lorazepam/diazepam - ONLY for status epilepticus

loading dose of phenytoin

IV glucose and O2 - if chance of hypoglycemia or hypoxia

38
Q

surgery for seizure

A

if know location

-can be very beneficial

Neuro II Exam 2 (20 decks)

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