Headache & seizures

Question 1

What is a headache?

Answer 1

• called cephalgia
  two types: primary and secondary
• causes significant discomfort and can interfere with activities and lifestyles

Question 2

What is a primary headache?

Answer 2

no known organic cause and includes migraine, tension headache, and cluster headache

Question 3

What is a secondary headache?

Answer 3

symptom with an organic cause such as a brain tumour or aneurysm

Question 4

What is some headache triggers?

Answer 4

stress, anxiety, time of day, routine, sleep, body tension, weather, exercise, activity level, mood, behaviour, diet, emotions, thoughts

Question 5

What are the four main classifications of headache?

Answer 5

1. tension-type
2. migraine
3. cluster
4. sinus

Question 6

What is a sinus headache?

Answer 6

pain is usually behind the forehead and/or cheekbones

Question 7

What is a cluster headache?

Answer 7

pain is in and around one eye
- rare, repeated headaches that occur for months or weeks with periods of remission
- most severe forms
- sharp, stabbing, intense pain around eyes radiating to temple, forehead, cheek, nose or gums

Question 8

What is a tension headache?

Answer 8

bilateral pain, band-like squeezing the head
- not brought on by physical activity
- most common, mild or moderate
- massage and heat packs can help

Question 9

What is a migraine?

Answer 9

pain, nausea, and visual changes are typical of classic form

Question 10

What is the etiology and pathophysiology of tension-type headaches?

Answer 10

Result of sustained and painful contraction of scalp and neck muscles

Question 11

What is the S&S of tension-type headache?

Answer 11

Pressure or tightness, mild to moderate, bilateral, worsens with physical activity, photophobia, phonophobia

Question 12

What is the diagnostic test used for a tension-type headache?

Answer 12

• hx
• electromyography
• resistance while moving head

Question 13

What is the etiology and pathophysiology of a migraine?

Answer 13

• family hx
• reoccurring, unilateral or bilateral throbbing pain
• triggering event or factor
• vascular, muscular, and biochemical factors are involved
• exact cause is unknown

Question 14

What is an aura in a migraine?

Answer 14

preceded factor before a migraine
-sensory dysfunction, motor dysfunction, dizziness, confusion, and even loss of consciousness

Question 15

What is the four phases in a migraine?

Answer 15

1. prodrome
2. aura
3. headache
4. recovery

Question 16

What are the S&S for a migraine?

Answer 16

Generalized edema, irritability, pallor, nausea, vomiting, sweating
- steady, throbbing pain that matches with the pulse
- people like to “hibernate”

Question 17

What is a diagnostic test for migraines?

Answer 17

• no specific test
• diagnosis is made from test
• neurological and diagnostic examinations are normal

Question 18

What kind of medications can be used for headaches?

Answer 18

prophylactic medications

Question 19

What is a seizure?

Answer 19

• neurological disorder that affects the brain
• Paroxysmal, uncontrolled electrical discharge of neurons in brain interrupting normal function

Question 20

What is the etiology and pathophysiology for a seizure by age?

Answer 20

6 mth or less: birth injury, birth defects, infections inborn errors of metabolism
2-20: birth injury, infection, trauma, genetic factors
20-30: structural lesions
50+: cerebrovascular lesions, metastatic brain tumours
- abnormal firing is unclear

Question 21

What is the two major classes of a seizure?

Answer 21

1. generalized
2. partial

Question 22

What is a partial seizure?

Answer 22

begin in one part of the brain

Question 23

What is a general seizure?

Answer 23

involve the whole brain

Question 24

What are the two types of partial seizures?

Answer 24

1. simple partial
2. complex partial

Question 25

What is a simple partial seizure?

Answer 25

consciousness remains intact

Question 26

What is a complex partial seizure?

Answer 26

impairment of consciousness - has an aura

Question 27

What are the four types of general seizures?

Answer 27

1. tonic-clonic(grand mal) 2. typical absence (petit mal) 3. myoclonic 4. atonic

Question 28

What is a tonic-clonic seizure?

Answer 28

**tonic phase**: Patient falls - muscles contract and consciousness is lost. horse cry at start, chest muscle contract than convulsions **clonic phase**: muscles relax and air rushes into the body causing vigorous jerky movements. frothing at mouth(could be red if they bite their tongue) - no memory of seizure, sore muscles, and feel abnormal for days

Question 29

What is a typical absence seizure?

Answer 29

- most common in children and adolescents - precipitated by hyperventilation and flashing lights - staring spell for couple seconds and usually goes unnoticed - eyes may blink rapidly or turn upwards for a moment - brief loss of conscience

Question 30

What is a myoclonic seizure?

Answer 30

- There is no loss of consciousness - Often associated with single or repetitive jerking motions of the muscles (myoclonus). - Myoclonic seizures are primarily observed in young children and infants. They are rarer in adults

Question 31

What is an atonic seizure?

Answer 31

- Often called drop attacks/seizures. - Characterized by sudden loss of muscle tone, resulting in an inability to sit or stand. - Usually rare in adults.

Question 32

What is status epilepticus?

Answer 32

generalized seizures that occur without full recovery of consciousness between attacks; continuous clinical or electrical seizures lasting at least 30 minutes, even without impairment of consciousness - CALL 911 if does not stop within 5-10 mina - can cause severe brain damage and even loss of life

Question 33

What is the diagnostic studies for a seizure?

Answer 33

- health hx - EEG -CBC, serum chemistries, liver and kidney function, UA to rule out metabolic disorders - CT or MRI in new onset seizure to rule out structural lesion - Cerebral angiography, SPECT, MRS, MRA, and PET in selected situations

Question 34

What is the collaborative care for a seizure?

Answer 34

- Drug therapy aimed at prevention - Primary drugs for treatment of generalized tonic-clonic and partial seizures - Status epilepticus treated with IV lorazepam (Ativan) and diazepam (Valium) - Antiseizure drugs should not be discontinued abruptly, as this can precipitate seizures - Side effects include diplopia, drowsiness, ataxia, and mental slowing

Question 35

What are some possible medications for a seizure?

Answer 35

antiseizure, Ativan, valium - carbamazepine (Tegretol) - clonazepam (Rivotril) - phenobarbital (Luminal) - phenytoin (Dilantin) - valproic acid (Depakene)

Question 36

What is the long term effect of dilantin?

Answer 36

gingival hyperplasia (swollen and tender gums)