HLTH 2501: congenital neurological disorders and seizures

Question 1

hydrocephalus

Answer 1

is a condition mostly in infants is which excess CSF accumulates within the skull, compressing the brain tissues and blood vessels; this can occur because the sutures of the skull have no yet closed

Question 2

why does excess CSF form in hydrocephalus?

Answer 2

because there is usually an obstruction in some area, causing more to be produced than is absorbed

Question 3

two types of hydrocephalus

Answer 3

noncommunicating (obstructive) or communicating

Question 4

noncommunicating hydrocephalus

Answer 4

occurs in babies when the flow of CSF through the ventricular system is blocked, usually at the aqueduct of Sylvius or the foramen magnu,

Question 5

what does noncommunicating hydrocephalus result from?

Answer 5

a fetal developmental abnormality like stenosis, a neural tube defect or Arnold-Chiari malformation; the obstruction will lead to increased back pressure of fluid in the ventricles, which gradually enlarge

Question 6

communicating hydrocephalus

Answer 6

occurs when the absorption of CSF through the subarachnoid villi is impaired, resulting in increased pressure of CSF in the system

Question 7

atresia

Answer 7

is the absence of a canal or opening at the connecting channels between the ventricles

Question 8

most common causes of hydrocephalus

Answer 8

stenosis, an atreisa, or a thickened arachnoid membrane

Question 9

signs of hydrocephalus

Answer 9

enlarges head, scalp veins appear dilated, enlarged eyes (sunset sign), pupil response is slow, lethargy, and high-pitched dry

Question 10

sunset sign

Answer 10

is when the white sclera of the eyes is visible above the coloured pupil; is a sign of hydrocephalus in infants

Question 11

hydrocephalus signs in adults

Answer 11

decreased memory, difficulty in coordination, impaired balance, and urinary incontinence

Question 12

when may hydrocephalus develop in adults?

Answer 12

from obstruction due to tumors, infection, or scar tissue, as well as meningitis

Question 13

diagnosis for hydrocephalus

Answer 13

a CT or MRI

Question 14

treatment for hydrocephalus

Answer 14

surgery to remove an obstruction or provide a shunt for CSF from the ventricle

Question 15

spina bifida

Answer 15

refers to a group of neural tube defects that are congenital anomalies of varying severity

Question 16

how do spina bifida disorders develop?

Answer 16

is failure of the posterior spinous processes on the vertebrae to fuse, which may permit the meninges and spinal cord to herniate, resulting in neurologic impairment

Question 17

where does spina bifida most commonly develop?

Answer 17

the lumbar region

Question 18

three types of spina bifida

Answer 18

spina bifida occulta, meningocele, and myelomeningocele

Question 19

spina bifida occulta

Answer 19

develops when the spinous processes do not fuse, but when herniation of the spinal cord and meninges does not occur, leaving a small gap in the bones of the spine

Question 20

how is spina bifida occulta diagnosed?

Answer 20

by a dimple or a tuft on hair present on the skin over the site

Question 21

meningocele

Answer 21

spinous processes do not fuse but herniation of the meninges occurs through the defect and the meninges and CSF form a sac on the surface; neurological impairment is usually not present

Question 22

myelomeningocele

Answer 22

the most serious form of spina bifida and occurs when there is herniation of the spinal cord and nerves along with the meninges and CSF, resulting in considerable neurological damage

Question 23

what spina bifida is often seen in conjunction with hydrocephalus?

Answer 23

myelomeningocele

Question 24

how is spina bifida generally diagnosed?

Answer 24

by alpha-fetoprotein that has leaked from the defect into the amniotic fluid surrounding the fetus and ultrasounds

Question 25

spina bifida causes

Answer 25

is multifactorial; genetic conditions like anencephaly or environmental conditions like exposure to radiation, gestational diabetes, and deficits of vitamin A or folic acid

Question 26

anencephaly

Answer 26

is the absence of cerebral hemispheres and superior cranial vault

Question 27

what spina bifida disorders appear as a protruding sac over the spine?

Answer 27

meningocele and myelomeningocele

Question 28

myelomeningocele neurological impairments

Answer 28

may be lost sensory and motor function at and below the level of the herniation, muscle weakness or paralysis, and bladder and bowel control may be lost

Question 29

spina bifida treatment

Answer 29

surgical repair may be done in utero before birth and PT and OT after birth to manage neurological deficits

Question 30

potential complications of surgery with spina bifida

Answer 30

rupture and infection

Question 31

cerebral palsy

Answer 31

is a group of disorders marked by some degree of motor impairment, caused by genetic mutations, abnormal fetal formation, infection, or brain damage in the perinatal period

Question 32

what may impact the brain in a child with cerebral palsy?

Answer 32

mechanical trauma, hypoxia, hemorrhage, hypoglycemia, hyperbilirubinemia, or infection

Question 33

major causes of cerebral palsy

Answer 33

hypoxia or ischemia which can occur prenatally, perinatally, or postnatally

Question 34

what can hypoxia be caused by?

Answer 34

placental complications, a difficult delivery, hemorrhage, aspiration, or respiratory impairment

Question 35

kernicterus

Answer 35

occurs when bilirubin crosses the blood-brain barrier and damaged the neurons

Question 36

what is cerebral palsy classified on?

Answer 36

the area affected (ex. quadriplegia or diplegia) or on the basis of the motor disability

Question 37

4 types of cerebral palsy

Answer 37

spastic, dyskinetic, ataxic, and mixed

Question 38

largest group of cerebral palsy

Answer 38

spastic paralysis

Question 39

spastic paralysis

Answer 39

results from damage to the pyramidal tracts, the motor cortex, or from general cortical damage; is characterized by hyperreflexia, increased muscle tone, and the scissors gait

Question 40

scissors gait

Answer 40

on the toes and with crossed legs

Question 41

dyskinetic cerebral palsy

Answer 41

results from damage to the extrapyramidal tract, basal nuclei, and cranial nerves; characterized by athetoid, choreiform involuntary movements, and loss of coordination with fine movements

Question 42

athetoid

Answer 42

slow, involuntary writhing

Question 43

choreiform

Answer 43

rapid and jerky movements

Question 44

ataxic cerebral palsy

Answer 44

commonly develops from damage to the cerebellum and manifests as loss of balance and coordination

Question 45

why do spasms occur in cerebral palsy?

Answer 45

increased muscle tone

Question 46

general signs of cerebral palsy

Answer 46

spasticity, unilateral use of hands and feet, writhing movements, unusual positions, impaired intellectual function, impaired communication and speech, seizures, and visual problems

Question 47

why is communication hard for cerebral palsy individuals?

Answer 47

because of motor disability, possible impaired mentation, and visual or hearing defects

Question 48

learning disabilities in those with cerebral palsy

Answer 48

ADD, spatial disorientation, and hyperactivity

Question 49

what type of seizure is common for cerebral palsy individuals?

Answer 49

tonic-clonic

Question 50

visual problems in those with cerebral palsy

Answer 50

astigmatism and strabismus

Question 51

treatment for those with cerebral palsy

Answer 51

speech therapy, PT (Medak program), regular exercise, OT, seizure medication, and hearing devices

Question 52

what do seizures result from?

Answer 52

uncontrolled, excessive discharge of neurons in the brain, which cause abnormal motor or sensory activity, and possibly loss of consciousness

Question 53

what are recurrent seizures called?

Answer 53

convulsions or epilepsy

Question 54

what are seizure disorders classified on?

Answer 54

their location in the brain and their clinical features (including EEG patterns during and between)

Question 55

generalized seizures

Answer 55

have multiple foci or origins in the deep structures of both cerebral hemispheres and the brain them, and cause loss of consciousness

Question 56

partial seizures

Answer 56

have a single or focal origin, often in the cerebral cortex, and may or may no involve altered consciousness; may progress to generalized seizures

Question 57

primary seizures

Answer 57

are idiopathic

Question 58

secondary seizures

Answer 58

are acquired with an identified cause such as PTSD

Question 59

what systemic causes may cause seizures?

Answer 59

hypoglycemia or withdrawl from drugs

Question 60

neurons causing seizures

Answer 60

are hyperexcitable and have a lowered threshold for stimulation; they can be stimulated by physiologic changes like alkalosis or flashing lights

Question 61

how are seizures analyzed?

Answer 61

EEG's and MRI's

Question 62

status epilepticus

Answer 62

is recurrent or continuous seizures without recovery of consciousness; can lead to hypoxia, hypoglycemia, acidosis, and decreased BP

Question 63

causes of seizures

Answer 63

varies and is idiopathic but are associated with 4 genes, CP, head injuries, tumor, infections, hemorrhage in the brain, renal failure, and substance withdrawal

Question 64

precipitating factors

Answer 64

are seizure triggers like physical stimuli, loud noises, bright lights, or biochemical stimuli like stress, excessive premenstrual retention, hypoglycemia, change in medication or hyperventilation (alkalosis)

Question 65

another name for absence seizures

Answer 65

petit mal

Question 66

absence seizures

Answer 66

common in children, last about 5-10 seconds, and may occur many times in a day; there is a brief loss of awareness, sometimes facial movements, and no memory of the episode

Question 67

another name for tonic-clonic seizures

Answer 67

grand mal

Question 68

tonic-clonic seizures

Answer 68

may occur spontaneously or after simple seizures; includes prodromal signs, an aura, loss of consciousness, strong muscle contraction, followed by a clonic stage and consciousness returning; the person is fatigued, with aching muscles after

Question 69

prodromal signs of a tonic-clonic seizure

Answer 69

nausea, irritability, depression, or muscle twitching

Question 70

aura

Answer 70

is a peculiar visual or auditory sensation, immediately preceding the loss of consciousness

Question 71

tonic muscle contraction

Answer 71

is flexion, followed by extension of the limbs and rigidity in the trunk

Question 72

clonic stage

Answer 72

is when the muscles alternately contract and relax, resulting in a series of forceful jerky movement; may involve foaming at the mouth and bowel and bladder incontinence

Question 73

why may hypoxia occur with a seizure?

Answer 73

the individual may have airway obstruction due to excess saliva and tongue position, while contracting muscles have a higher need for O2

Question 74

types of general seizures

Answer 74

tonic-clonic and absence

Question 75

another name for partial seizures

Answer 75

focal seizures

Question 76

partial seizures

Answer 76

arise from an epileptogenic focus, often related to a single area of damage in the cortex

Question 77

signs of a partial seizure

Answer 77

repeated motor activity causing jerking or turning the head or eye aside, sensation such as tingling that beings in the one area and spreads, auditory or visual experiences, and memory and consciousness remain, although awareness is reduced

Question 78

jacksonian seizure

Answer 78

is a focal motor seizure in which the clonic contraction begins in a simple area and spreads progressively

Question 79

temporal lobe seizures

Answer 79

aka psychomotor seizures; these are complex, partial seizures that originate in the temporal lobes, but may also involve the frontal lobe and limbic system

Question 80

signs of a temporal lobe seizure

Answer 80

an aura like the perception of a odd odor, bizarre behaviour like waving and clapping the hands, visual or auditory hallucinations or feeling of deja vu, and the person is unresponsiveness during the episode

Question 81

treatment for seizures

Answer 81

anticonvulsant drugs like phenytoin raise the threshold for neuronal stimulation which are often combined with sedatives like phenobarbital

Question 82

adverse effects for seizure medication

Answer 82

they may affect dosage of other medications, cause gingival hyperplasia, reduce WBC count, and reduce blood-clotting capability