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Flashcards in Neurology Deck (204)
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1

pupil size in coma:

- one dilated, nonreactive or sluggish pupil
- cause
- examples

- cause: parasympathetic nerve problem
- oculomotor nerve compression from uncal herniation
- aneurysm of posterior
-communicating artery

2

pupil size in coma:

- one pinpoint pupil (miosis)
- cause
- examples

- cause: sympathetic nerve problem (Horner)
- lateral medullary syndrome- hypothalamus injury- Pancoast tumor- carotid dissection

3

pupil size in coma:- two midpoint, nonreactive pupils- cause- examples

- cause: parasympathetic and sympathetic nerve destruction- midbrain disruption (can affect one or both pupils)- anoxia- hypothermia- anticholinergics- severe barbituate overdose

4

pupil size in coma:- two dilated, nonreactive pupils- examples

- anoxia- hypothermia- anticholinergics- severe barbituate overdose

5

pupil size in coma:- two dilated, nonreactive pupils- examples

- opiates- pontine destruction

6

what is a seizure?

- paroxysmal electrical discharges of brain that cause LOC- alteration of perception or impairment of psychic function- convulsive movements- disturbance of sensation- or some combination thereof

7

what is epilepsy?

recurrent, unprovoked seizures

8

what is status epilepticus?

- prolonged or repetitive seizures- life-threatening

9

what are triggers for seizures in susceptible individuals?

- alcohol- cocaine- intense emotions- strobe lighting- loud music- stress- menstruation- lack of sleep

10

seizures are categorized into what 2 categories?

- GENERALIZED- FOCAL

11

focal seizures involve how many sides of the brain, and motor activity is noted on how many sides?

- 1 hemisphere- usually 1

12

generalized seizures involve how many sides of the brain, and motor activity is noted on how many sides?

- both hemispheres- usually both, but not necessarily

13

focal (partial) seizures are further classified into what categories?

1. simple partial: no LOC2. complex partial: LOC3. partial w/ secondary generalization

14

generalized seizures are further classified into what categories?

1. nonconvulsive: absence seizure2. convulsive:2a. myoclonic2b. clonic2c. tonic-clonic2d. atonic

15

focal seizures are commonly d/t what?

focal brain lesions

16

primary generalized seizures are more typically d/t what?

genetics

17

if PNES (psychogenic nonepileptic seizures) are suspected or when the events do not respond to tx and the dx is not clear, what should be ordered?

video EEG monitoring

18

what percentage of pts w/ PNES (psychogenic nonepileptic seizures) also have epilepsy?

20%

19

what is an aura?

perceptual disturbance that may precede a FOCAL seizure

20

auras may precede what type of seizure?

FOCAL seizures

21

auras do NOT occur w/?

PRIMARY generalized seizures

22

how can auras manifest?

- SENSES- MOTOR

23

auras are thought to be produced by?

EARLY seizure activity

24

describe generalized tonic-clonic seizures

- involve both hemispheres- BILATERAL motor involvement- LOC- pronounced postictal period

25

describe absence seizures

- nonconvulsive- no aura- no postictal symptoms- sudden interruption of consciousness- can be induced by HYPERVENTILATING- 3-per-second spike and wave pattern on EEG

26

what number of children outgrow absence seizures?

2/3

27

describe focal (aka simple partial) seizures

- no LOC- symptoms depend on affected region of cortex

28

describe focal seizures w/ diminished consciousness (aka complex partial): temporal lobe type

- aura may hallucination- altered behavior/consciousness- amnesic- automatisms: lip-smacking, chewing or swallowing movements, salivation, fumbling of hands, shuffling of feet

29

definition of status epilepticus

- seizure lasting > 30 minutes- 2 or more seizures WITHOUT regaining consciousness in between

30

when should you be aggressive when treating seizures and use abortive therapy?

when seizure lasts 5 minutes or more