CNS Anatomy & Seizure Assessment Review

Study Notes

Neurologic assessment covers mental status, general appearance, cognition, affect, strength, coordination, muscle ability, range of motion (ROM), sensation, and cranial nerves.
Sensory system assessment involves touch, pain, temperature and vibration/position sense.
Pupil assessment and documentation should be reviewed.
Stroke review and seizure review are important topics.

Seizure causes include systemic and metabolic factors (acidosis, electrolyte imbalance, hypoglycemia, hypoxia), drug and alcohol withdrawal, and dehydration.
Epilepsy includes identifying the cause and treatment, spontaneous recurrences and underlying issues, and understanding triggers.

Generalized seizures involve both sides of the brain, may occur without warning.
Tonic-clonic seizures (grand mal) involve stiffening and jerking movements.
Absence seizures (petit mal) are characterized by smaller motions or zoning out.
Partial seizures involve a focal point and are described as focal irritant seizures.

ICP is the hydrostatic pressure exerted by brain tissue, blood, and cerebrospinal fluid (CSF) within the skull.
Increased ICP (IICP) is an acute condition, typically characterized by a change in mental status or loss of consciousness.
Important signs/symptoms may include headache, vomiting, and neurologic dysfunction, (e.g., altered levels of consciousness).
Factors affecting ICP include arterial and venous pressure, intra-abdominal and intrathoracic pressure, posture, and temperature.

Head trauma includes scalp lacerations, resulting in profuse bleeding due to poor vasoconstriction of blood vessels in scalp.
Skull fractures include basilar skull fractures (associated with tearing of dura, CSF leakage from nose or ears, and possible periorbital ecchymosis (i.e., battle sign)) and linear/depressed/simple/comminuted fractures.
It is important to monitor for cranial infections (if exposed/hematomas), as brain damage can be localized and swelling might occur.
Concussions present as cognitive and physical symptoms for an unknown period following trauma. Major head trauma may include contusions.

Expected findings after head trauma include amnesia (loss of memory) before or after the injury, loss of consciousness, CSF leakage, and neurologic/cranial nerve changes.
Interventions focus on airway and oxygen management and addressing potential complications such as increased ICP.

Gliomas, Astrocytomas, and Glioblastoma multiforme are among the most common types of brain tumors.
Symptoms include headaches, seizures, neurologic changes, and/or changes in memory/mood.

MS is an autoimmune disease affecting the CNS, causing demyelination and nerve impulse impairment and resulting in neurological symptoms.

ALS is a progressive neurologic disorder characterized by the gradual degeneration of motor neurons in the brain and spinal cord.
It leads to significant muscle weakness, difficulty with movement, speech, swallowing, and breathing.
Risks include aspiration, falls, respiratory insufficiency, and pain due to muscle weakness.

Bacterial Meningitis is a serious infection of the lining of the brain and spinal cord.
Signs and symptoms include headache, fever, stiff neck, and altered mental status.
Diagnosis is typically made through a lumbar puncture (spinal tap) where cerebrospinal fluid (CSF) is collected for laboratory analysis to identify the causative bacteria.
Treatment is critical, and typically will involve intravenous antibiotics to address the causative bacteria as well as supportive care, such as fever reduction, and fluid balance.