neurological conditions

Question 1

What is the definition of a stroke?

What is the medical term for a stroke?

Answer 1

A serious life-threatening medical condition where blood flow to part of the brain is cut off. It causes a disturbance in cerebral function, with symptoms lasting 24 hours or more.
Cerebral Vascular accident.

Question 2

What are the risk factors for stroke?

Answer 2

Age- tissues get thinner with age, and the effects of lifestyle have time to accumulate.
Medical history- eg AF and hypertension
Lifestyle- smoking, drinking, lack of exercise
Family History
Ethnicity and associated lifestyle/diet

Question 3

What is the circle of Willis?

Answer 3

The circulatory system in the brain. The middle cerebral artery artery is the most common involved in strokes.

Question 4

What is a haemorrhagic stroke?

Answer 4

A spontaneous bleed following a ruptured blood vessel, resulting in a focal haematoma or an intraventricular haemorrhage.
This may lead to:
- oedema
- compression
- spasmodic blood vessels
- often fatal/devastating

Question 5

What is an ischemic stroke?

Answer 5

Occurs as a result of obstruction within a blood vessel supplying blood to the brain. The more common type of stroke.

Question 6

What is a transient ischemic attack?

Answer 6

Caused by a temporary disruption in blood supply to part of the brain. Produces the symptoms of a stroke but tend to only last between a few minutes and a few hours, before disappearing completely.

Question 7

What are the signs/symptoms of strokes/TIAs?

Answer 7

-sudden numbness or weakness, especially on one side
-confusion/dizziness, trouble speaking or understanding speech
- trouble seeing
- trouble walking/difficulty in balance
- sudden severe (thunderclap) headache
- loss of conciousness
- paralysis
- vertigo
-vomiting
- difficulty swallowing

Question 8

What is hemiparesis?

Answer 8

A mild or partial weakness or loss of strength on one side of the body

Question 9

What is hemiplegia?

Answer 9

A severe or complete loss of strength or paralysis on one side of the body

Question 10

What is ataxia?

Answer 10

Abnormal, uncoordinated movement

Question 11

What is dysphasia/aphasia?

Answer 11

language disorder affecting speech and understanding language

Question 12

What is dysphagia?

Answer 12

Difficulty in swallowing

Question 13

What is dysarthria?

Answer 13

When muscles used for speech are weak or struggle to control them. Causes slurred/slow speech that can be difficult to understand.

Question 14

What is the assessment/treatment for stroke?

Answer 14

ABC, GCS, BM - hypoglycaemia may mimic a stroke.
FAST test - Time is important as a window for thrombolytic therapy
Assess pupillary response
Administer oxygen if they are hypoxic
Calculate a NEWs score
Don’t delay transport but do a 12 lead

Question 15

What is the definition of epilepsy?

Answer 15

A condition of the brain that causes frequent seizures. Seizures are bursts of electricity that temporarily affect the function of the brain.

Question 16

What are the causes of epilepsy?

Answer 16

-unclear
-could have a genetic aspect
-can be caused by damage from strokes, brain tumour, head injury, drug or alcohol abuse, brain infection, lack of oxygen during birth

Question 17

What can trigger seizures?

Answer 17

-stress
-lack of sleep
-waking up
-drinking alcohol
-some medicines and illegal drugs
-periods
-flashing lights

Question 18

What happens in the brain to cause a seizure?

Answer 18

• neurones normally communicate by depolarisation
• they can send abnormal messages which cause larger-than-normal depolarisation. This can make other neurones send out abnormal messages.
• if many neurones do this, it could cause a seizure.

Question 19

What’s the difference between focal and generalised seizures?

Answer 19

focal are one part of the brain but generalised involve the whole brain

Question 20

What are the signs and symptoms of a simple partial seizure?

Answer 20

• consciousness not impaired
• a general strange feeling
• rising in the tummy
• unusual smells or tastes
• tingling in arms or legs
• intense fear or joy
• stiffness/twitching in part of the body
• lip smacking

Question 21

what are the signs/symptoms of a complete partial seizure?

Answer 21

• consciousness impaired
• lip smacking
• rubbing hands
• making random noises
• moving arms around
• picking at clothing or fiddling with objects
• chewing or swallowing
• wont be able to respond to people or remember the seizure

Question 22

What happens during a tonic-clonic seizure?

Answer 22

during the tonic stage, they loose consciousness, go stiff and fall to the floor.
During the clonic stage, limbs jerk about, loss of bladder/bowel control, bite tongue or cheeks, may have difficulty in breathing.

Question 23

What are the signs/symptoms of absence seizures?

Answer 23

-stare blankly into space
-flutter their eyes
-slight jerking movement of body or limbs
-usually only last 15 seconds
-no loss of clarity on resolve

Question 24

What is the treatment for seizures?

Answer 24

-Benzodiazepines (IV of rectally)
-Treat potentially sustained injuries
-follow patient treatment plan

Question 25

What is a psychogenic convulsion?

Answer 25

A non-epileptic convulsion. It is often as a result of mental illness/distress.

Question 26

what are the signs of PNES convulsions?

Answer 26

-fluctuating intensity/location
-brief pauses, tremor or slow flexion/extension movements
-arms and legs often not synchronised
-convulsion may move from one body area to another
-may respond in some way, eg blink reflex
-tongue biting rare
-eyes/mouth often shut
-pupils reacting
-may carry out purposeful movements
-pelvic thrusting common
-crying
-rapid end to convulsion and recovery