Conditions of the Nervous System

Question 1

typically temporal or frontal.

Answer 1

Simple partial – remain conscious, brief episode of hallucinations or ‘butterflies’ in stomach, fear, illusions.
Complex partial – altered level of consciousness, may smack lips or chew, plucking or fiddling.

Question 2

Febrile convulsion

Answer 2

Provoked by sudden increase in temperature
Commonly affect children between 6months and 6 years
NOT linked to epilepsy

Question 3

Status EpilepticusEpileptics

Answer 3

A generalised convulsion lasting > 30 minutes
OR
A series of convulsions lasting 30 minutes with no periods of recovery (fully conscious) in between.

Question 4

management

Answer 4

Ensure patient safety, remove dangers
Do not put anything in the patients mouth
Oxygen if able
When seizure stops assess ABC
BM, Temp, BP, Spo2, ECG
Note duration of seizure
Reassure patient 
Reassess Observations

Question 5

Assessment

befast

Answer 5

Balance
Eyes
Face
Arms
Speech
Time

Question 6

Management

Answer 6

Time of onset (time patient was last symptom-free)
Blood Glucose
Oxygen only if SpO2 < 94%
FAST
IF FAST +ve, nearest hyperacute stroke unit
Pre-alert

Question 7

Management

stroke

Answer 7

Time of onset (time patient was last symptom-free)
Blood Glucose
Oxygen only if SpO2 < 94%
FAST
IF FAST +ve, nearest hyperacute stroke unit
Pre-alert

Question 8

Meningitis

Signs and Symptoms

Answer 8

Pyrexia
Nausea & vomiting
Lethargy & changes in level of consciousness
Aching joints
Stiff neck
Photosensitivity
Cold peripheries
Non-blanching rash is a LATE sign !!

Question 9

Meningitis
Signs and Symptoms
Other infantile signs

Answer 9

Refusal of feeds
Agitated
May not want to be picked up
Bulging fontanelle
Floppy or unresponsive
Stiff body
Unusually high-pitched cry

Question 10

Treatment

Answer 10

Assess DRcABCDE
Oxygen if necessary (SpO2 94-98%)
Measure & record BM and treat if necessary
A&E with pre-alert

Question 11

Cauda Equina

What is it ?

Answer 11

Rare condition
Severe compression of all the nerves in the lower back
Symptoms
‘Saddle Parasthesia’ & leg weakness
Numbness of skin around anus
Loss of bladder or bowel control causing incontinence
OR loss of bladder control causing urine retention
Can lead to permanent damage if left untreated

Question 12

Cauda Equina

Treatment

Answer 12

Pain relief if necessary
Careful handling
Transportation to A&E