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Neurology RIA > Loss of consciousness > Flashcards

Loss of consciousness Flashcards

(50 cards)

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1
Q

3 factors that can lower seizure threshold in those susceptible to them

A
  • severe disease
  • dehydration
  • infection
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2
Q

Transient loss of consciousness due to a postural change is likely to be due to

A

vasovagal syncope

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3
Q

4 features of syncope

A
  • light headedness
  • nausea
  • vomiting
  • greying out of vision
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4
Q

clues to focal onset seizures (3)

A
  • unexplained smell
  • deja vu
  • focal muscle jerking/twitching
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5
Q

first memory upon arrival for:

a) syncopal blackout
b) epileptic seizures

A

a) regain awareness and memory for events quickly

b) may remember nothing

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6
Q

4 features favouring epileptic seizures

A
  • tongue biting
  • urinary + faecal incontinece
  • pain
  • injuries
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7
Q

physical signs of syncope

A
  • pale
  • sweaty
  • light headedness
  • nausea
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8
Q

physical signs of focal onset seizure

A
  • focal twitching
  • forced head turning
  • eye deviation
  • blank staring
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9
Q

rhythmic clonic jerks following rigid tonic phase: jerking movements reduces in amplitude and frequency

A

generalised tonic clonic seizures

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10
Q

brief myoclonic jerks of low amplitude and less rhythmic

A

syncope

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11
Q

condition of recovery following

a) syncope
b) seizure
c) NEAD

A

a) rapid recovery
b) 15 min drowsy
c) pseudosleep = prolonged unresponsiveness

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12
Q

6 investigations in a seizure/LoC

A
  • vital signs
  • oxygenation
  • ECG
  • blood tests
  • BM reading
  • CT scan
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13
Q

Electrolyte abnormalities that can cause seizures (2)

A
  • hyponatraemia

- hypocalcaemia

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14
Q

complex and simple describe what?

A

consciousness in a seizure

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15
Q

temporal lobe seizures can involve:

A
  • memory disturbances: e.g. deja vu
  • hallucinations
  • automatism
  • psychic phenomena
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16
Q

types of hallucinations in temporal lobe seizures

A
  • olfactory

- auditory

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17
Q

examples of automatism

A
  • lip smacking
  • absent mindedly plucking at clothes
  • repetitive mumbling
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18
Q

e.g. of more complex automatism

A

getting undressed with no or only partial awareness/recollection

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19
Q

causes of epilepsy

A
  • birth history

- febrile convulsions

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20
Q

what is atrophy and scarring of the temporal lobe called

A

Mesial temporal sclerosis

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21
Q

what are the risk factors for children with febrile convulsions going on to develop MTS or epilepsy?

Study These Flashcards
A
  • prolonged + severe febrile convulsions
  • multiple attacks
  • transient hemiparesis
  • atypical age for febrile convulsion
  • minor pyrexia at the time of febrile convulsion
  • fhx epilepsy
22
Q

typical age of febrile convuslsions

23
Q

syncope is …

Study These Flashcards
A

loss of consciousness caused by a lack of cerebral blood flow

24
Q

3 P’s of pre-syncopal features:

Study These Flashcards
A

P - Positional: upright position

P - Provoking factors: pain, emotional shock, dehydration

P - Prodromal feeling: light headedness, dizzy, visual blurring, ringing in ears

25
physical features of NEAD? (6)
- violent shaking of arms + legs - head shakes from side to side - upset + cries on coming round - pelvic thrusting - back arching - preserved consciousness
26
Epilepsy is ...
a recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain
27
examples of aura
- strange feeling in gut - deja vu - strange smells - flashing lights
28
post ictal features of seizures
- headache - confusion - myalgia - dysphasia
29
structural causes of epilepsy (4)
- cortical scarring - poor cerebral developmemt - SOL - stroke
30
non epileptic causes of seizures
- trauma - stoke - haemorrhage - raised ICP - alcohol/benzo withdrawal
31
What is a generalized seizure and what are the types (5)
Electrical discharge throughout both sides, LoC immediately - Absence - Tonic-Clonic - Myoclonic - Atonic - Infantile spasms
32
3 types of Partial seziures
- Simple - Complex - Partial seizure with secondary generalisation
33
1st and 2nd line treatment for Partial seizures
1) Lamotrigine | 2) Na valporate
34
1st line treatment for generalised seziures
Na valporate
35
localising features for frontal lobe partial seizure
- head/leg movements - posturing - post ictal weakness
36
localising feature for parietal lobe partial seizure
paraesthesia
37
localising feature for occipital lobe partial seizure
flashers + floaters
38
3 features of simple partial seizures
- awareness is unimpaired - focal symptoms - no post ictal symptoms
39
what age group are absence seizures mostly seen in features?
3-10 year olds suddenly stops speaking mid sentence and then carried on where left off
40
Investigations following a generalised seizure:
- EEG - Blood glucose - FBC - Electrolytes - Toxicology screen - CT head (if presence of neurological deficits) - Serum prolactin - LP (if concerns of primary CNS infection)
41
when should anti-epileptic medication be commenced?
Following 1 seizure if any of the following are present: - patient has a neurological deficit - Brain imaging: structural abnormality - EEG findings - Patient or family members consider the risk of having another epileptic seizure to be unacceptable
42
how does Na Valporate work to reduce seizure activity
increases GABA activity
43
Side effects of Na Valporate, as per the penumonic
``` V - Valporate A - apetite increase L - Lfts watch over first 6m P - Pancreatitis O - Oedema R - reversible alopecia A - Ataxia T - Teratogenecity, tremor, thrombocytopaenia E - Encephalopathy due to high ammonia ```
44
common side effects of Lamotrigine (3)
- blurred vision - aggression - dry mouth
45
severe complication of Lamotrigine
Skin rash: stevens johnson syndrome
46
4 side effects of carbamazepine
- drowsiness - dizziness - headache - double vision
47
DVLA guidance regarding switching anti-epileptic medications
stop driving for 6 months due to recognised risk of breakthrough seizures
48
2 medications that lower seizure thresholds
- amitryptyline | - tramadol
49
metabolic disturbances that can lower seizure thresold
- hypoglycaemia | - hyponatraemia
50
medically refractory epilepsy is
seizures that have failed to come under control with at least 2 different anticonvulsant drugs

Neurology RIA (11 decks)

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