Podcast
Questions and Answers
A patient with a neurological disorder exhibits rhythmic jerkiness of extremities and loss of consciousness. Which of the following clinical manifestations is also likely to be observed?
A patient with a neurological disorder exhibits rhythmic jerkiness of extremities and loss of consciousness. Which of the following clinical manifestations is also likely to be observed?
- Heightened sensitivity to pain
- Complete paralysis of all limbs
- Increased alertness and orientation to surroundings
- Automatisms such as lip smacking or chewing (correct)
A patient is admitted with a suspected primary brain tumor. Which diagnostic procedure would be most definitive in determining the tumor type and guiding treatment decisions?
A patient is admitted with a suspected primary brain tumor. Which diagnostic procedure would be most definitive in determining the tumor type and guiding treatment decisions?
- Lumbar puncture
- Electroencephalogram (EEG)
- Cerebral angiogram
- Brain biopsy (correct)
A nurse is assessing a child with a neurological disorder. Which finding requires immediate intervention?
A nurse is assessing a child with a neurological disorder. Which finding requires immediate intervention?
- Positive Babinski reflex
- Bulging fontanelles (correct)
- Occasional spasticity in lower extremities
- Moro reflex
A patient with a history of epilepsy is prescribed an antiepileptic drug (AED). What is the most critical instruction the nurse should emphasize regarding the medication regimen?
A patient with a history of epilepsy is prescribed an antiepileptic drug (AED). What is the most critical instruction the nurse should emphasize regarding the medication regimen?
What is the priority nursing assessment when the patient arrives in the ED?
What is the priority nursing assessment when the patient arrives in the ED?
Which of the following assessment findings would be most concerning in a child who has experienced a head injury and has altered mental status (AMS)?
Which of the following assessment findings would be most concerning in a child who has experienced a head injury and has altered mental status (AMS)?
A 60-year-old patient is scheduled for an EEG. Which pre-procedure instruction should the nurse emphasize to ensure accurate test results?
A 60-year-old patient is scheduled for an EEG. Which pre-procedure instruction should the nurse emphasize to ensure accurate test results?
Which of the following factors is most likely to increase a child's oxygen demand?
Which of the following factors is most likely to increase a child's oxygen demand?
A patient presenting with a headache reports severe, unrelenting pain in and around one eye, accompanied by tearing and nasal congestion. Which type of headache is most consistent with these symptoms?
A patient presenting with a headache reports severe, unrelenting pain in and around one eye, accompanied by tearing and nasal congestion. Which type of headache is most consistent with these symptoms?
A patient is being evaluated for possible seizures. Which question is most important for the healthcare provider to ask when gathering the patient's history?
A patient is being evaluated for possible seizures. Which question is most important for the healthcare provider to ask when gathering the patient's history?
During a neurological assessment, which of the following findings would be most indicative of increased intracranial pressure (ICP) in an infant?
During a neurological assessment, which of the following findings would be most indicative of increased intracranial pressure (ICP) in an infant?
A patient experiencing a seizure is noted to have repetitive, unconscious movements such as lip smacking and chewing. Which term accurately describes these movements?
A patient experiencing a seizure is noted to have repetitive, unconscious movements such as lip smacking and chewing. Which term accurately describes these movements?
Which of the following is the most common form of primary brain tumor?
Which of the following is the most common form of primary brain tumor?
What is the therapeutic goal of antiepileptic drug (AED) therapy in managing seizures?
What is the therapeutic goal of antiepileptic drug (AED) therapy in managing seizures?
What is the rationale for asking about LMP during priority assessments?
What is the rationale for asking about LMP during priority assessments?
A patient with a known seizure disorder is prescribed phenytoin (Dilantin). Which of the following instructions should the nurse emphasize regarding medication management?
A patient with a known seizure disorder is prescribed phenytoin (Dilantin). Which of the following instructions should the nurse emphasize regarding medication management?
Which of the following findings in a patient with a primary brain tumor would be most indicative of vasogenic edema?
Which of the following findings in a patient with a primary brain tumor would be most indicative of vasogenic edema?
What is the primary reason for completing CSF testing for a patient with a severe headache?
What is the primary reason for completing CSF testing for a patient with a severe headache?
A patient with a history of migraine headaches is prescribed sumatriptan. What is the primary mechanism of action of this medication?
A patient with a history of migraine headaches is prescribed sumatriptan. What is the primary mechanism of action of this medication?
What is the priority education for a patient when being discharged?
What is the priority education for a patient when being discharged?
A patient is being assessed using the Glasgow Coma Scale (GCS) after a traumatic brain injury. The patient opens their eyes to pain, makes incomprehensible sounds, and withdraws from pain. What is the patient's GCS score?
A patient is being assessed using the Glasgow Coma Scale (GCS) after a traumatic brain injury. The patient opens their eyes to pain, makes incomprehensible sounds, and withdraws from pain. What is the patient's GCS score?
What is the priority for treating a patient with Seizures?
What is the priority for treating a patient with Seizures?
A patient is diagnosed with epilepsy characterized by frequent partial seizures. What clinical manifestation is most likely to be observed in this patient?
A patient is diagnosed with epilepsy characterized by frequent partial seizures. What clinical manifestation is most likely to be observed in this patient?
A patient is experiencing increased intracranial pressure (ICP). Which intervention is most important for positioning the patient to promote venous drainage from the brain?
A patient is experiencing increased intracranial pressure (ICP). Which intervention is most important for positioning the patient to promote venous drainage from the brain?
A nurse is caring for a child who has just experienced a tonic-clonic seizure. What is the priority nursing intervention during the postictal phase?
A nurse is caring for a child who has just experienced a tonic-clonic seizure. What is the priority nursing intervention during the postictal phase?
A patient is being evaluated for possible meningitis. Which diagnostic finding is most indicative of bacterial meningitis?
A patient is being evaluated for possible meningitis. Which diagnostic finding is most indicative of bacterial meningitis?
A patient reports experiencing an aura before the onset of a seizure. What is the most accurate description of an aura?
A patient reports experiencing an aura before the onset of a seizure. What is the most accurate description of an aura?
A patient with a brain tumor develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which electrolyte imbalance is most likely to occur as a result of this condition?
A patient with a brain tumor develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which electrolyte imbalance is most likely to occur as a result of this condition?
According to the Pediatric Nursing Tip, which of the following is least likely to cause Altered Mental Status (AMS)?
According to the Pediatric Nursing Tip, which of the following is least likely to cause Altered Mental Status (AMS)?
A nurse is educating a patient with epilepsy about common seizure triggers. Which factor should the nurse include as a potential trigger for seizures?
A nurse is educating a patient with epilepsy about common seizure triggers. Which factor should the nurse include as a potential trigger for seizures?
A patient in the emergency department complains of a sudden, severe headache unlike any they have experienced before. Which type of headache should the nurse suspect?
A patient in the emergency department complains of a sudden, severe headache unlike any they have experienced before. Which type of headache should the nurse suspect?
A patient has a history of chronic daily headaches and has been keeping a headache diary. Which aspect of their headaches should the patient meticulously document?
A patient has a history of chronic daily headaches and has been keeping a headache diary. Which aspect of their headaches should the patient meticulously document?
A patient is under observation for a possible neurological disorder. Which change in thermoregulation is likely with age?
A patient is under observation for a possible neurological disorder. Which change in thermoregulation is likely with age?
Which extracranial cause is the least likely to cause a pediatric seizure?
Which extracranial cause is the least likely to cause a pediatric seizure?
Which assessment is not included during Neuro Assessment?
Which assessment is not included during Neuro Assessment?
What is the purpose of Diagnostic Testing when caring for HA?
What is the purpose of Diagnostic Testing when caring for HA?
A patient is admitted to the hospital with a suspected neurological disorder. What neurological assessment is most likely to be impacted by restraints?
A patient is admitted to the hospital with a suspected neurological disorder. What neurological assessment is most likely to be impacted by restraints?
When discussing the treatment of primary brain tumors, the nurse recognizes that which of the following is often used?
When discussing the treatment of primary brain tumors, the nurse recognizes that which of the following is often used?
A patient reports experiencing brief episodes of altered sensation and awareness but remains fully conscious. Which type of seizure is this patient likely experiencing?
A patient reports experiencing brief episodes of altered sensation and awareness but remains fully conscious. Which type of seizure is this patient likely experiencing?
A patient with a neurological disorder exhibits motor and sensory changes. Which element of the neurological assessment is most crucial to evaluate?
A patient with a neurological disorder exhibits motor and sensory changes. Which element of the neurological assessment is most crucial to evaluate?
When obtaining a history from a patient presenting with a persistent headache, what aspect of the patient's history is most important to ascertain?
When obtaining a history from a patient presenting with a persistent headache, what aspect of the patient's history is most important to ascertain?
A patient is admitted with a suspected secondary headache. Why is diagnostic testing crucial in this situation?
A patient is admitted with a suspected secondary headache. Why is diagnostic testing crucial in this situation?
A patient is undergoing an EEG for seizure evaluation. What pre-procedure instruction is essential to ensure accurate results?
A patient is undergoing an EEG for seizure evaluation. What pre-procedure instruction is essential to ensure accurate results?
A nurse is assessing a child with potential neurological dysfunction and observes asymmetrical pupils in the presence of altered mental status (AMS). What action should the nurse take?
A nurse is assessing a child with potential neurological dysfunction and observes asymmetrical pupils in the presence of altered mental status (AMS). What action should the nurse take?
During the neurological assessment of an infant, which finding is most indicative of neurological distress?
During the neurological assessment of an infant, which finding is most indicative of neurological distress?
A patient with a primary brain tumor is at risk for seizures. What is the underlying mechanism that connects the tumor to the increased seizure risk?
A patient with a primary brain tumor is at risk for seizures. What is the underlying mechanism that connects the tumor to the increased seizure risk?
Which of the following is the priority intervention for a college student presenting to the health center with a persistent headache?
Which of the following is the priority intervention for a college student presenting to the health center with a persistent headache?
A patient is being evaluated for possible seizures. Which laboratory finding would least likely be related to the seizures?
A patient is being evaluated for possible seizures. Which laboratory finding would least likely be related to the seizures?
A patient with epilepsy is prescribed an antiepileptic drug (AED). What is the most critical instruction to provide?
A patient with epilepsy is prescribed an antiepileptic drug (AED). What is the most critical instruction to provide?
A patient reports experiencing an aura before the onset of a seizure. What is the nurse's best response?
A patient reports experiencing an aura before the onset of a seizure. What is the nurse's best response?
What activity is least likely to trigger a seizure?
What activity is least likely to trigger a seizure?
When counseling a patient on avoiding triggers for headaches, what recommendation is most appropriate?
When counseling a patient on avoiding triggers for headaches, what recommendation is most appropriate?
A patient is being assessed to determine the appropriate interventions. The following is completed to determine plan of care:
A patient is being assessed to determine the appropriate interventions. The following is completed to determine plan of care:
A patient is admitted to the hospital with seizures. The patient has two or more unprovoked seizures; how far apart are they?
A patient is admitted to the hospital with seizures. The patient has two or more unprovoked seizures; how far apart are they?
A 5-year-old patient is having a seizure. Which of the following would least likely be the cause?
A 5-year-old patient is having a seizure. Which of the following would least likely be the cause?
What tool is used to assess level of consciousness in a patient?
What tool is used to assess level of consciousness in a patient?
A patient has a low PaO2, a high PaCO2, and low blood pressure. These are all signs and symptoms of:
A patient has a low PaO2, a high PaCO2, and low blood pressure. These are all signs and symptoms of:
What would the Glasgow Coma Scale be graded if the patient did none of the following: opened eyes, verbal response or motor response?
What would the Glasgow Coma Scale be graded if the patient did none of the following: opened eyes, verbal response or motor response?
If a patient’s temperature rises 1 degree in fever, what does this do to their oxygen level?
If a patient’s temperature rises 1 degree in fever, what does this do to their oxygen level?
What is most likely to cause changes in the body and/or body image?
What is most likely to cause changes in the body and/or body image?
Which clinical manifestation of seizure would be considered neurovascular?
Which clinical manifestation of seizure would be considered neurovascular?
Within the Pathophysiology of Headaches, what nerve triggers messages to the thalamus?
Within the Pathophysiology of Headaches, what nerve triggers messages to the thalamus?
A chronic disorder characterized by two seizures unprovoked by any immediately identifiable cause is called:
A chronic disorder characterized by two seizures unprovoked by any immediately identifiable cause is called:
Multiple diagnostic techniques can be used to determine the Plan of Care to treat seizures; what could these include?
Multiple diagnostic techniques can be used to determine the Plan of Care to treat seizures; what could these include?
What are the clinical manifestations that determine primary brain tumor diagnosis?
What are the clinical manifestations that determine primary brain tumor diagnosis?
A patient with seizures is prescribed medication therapy; how long does this treatment typically last?
A patient with seizures is prescribed medication therapy; how long does this treatment typically last?
What is the best way for someone to provide their medical history to a healthcare provider?
What is the best way for someone to provide their medical history to a healthcare provider?
A person experiencing chronic daily headaches has been keeping a headache diary, which of the following should be documented?
A person experiencing chronic daily headaches has been keeping a headache diary, which of the following should be documented?
How can seizures be difficult to diagnose in older adults?
How can seizures be difficult to diagnose in older adults?
A patient asks what a headache is commonly referred to as, how should the provider reply?
A patient asks what a headache is commonly referred to as, how should the provider reply?
Which is not a clinical manifestation of seizures?
Which is not a clinical manifestation of seizures?
What is the most common type of primary brain tumor?
What is the most common type of primary brain tumor?
A patient is concerned about developing meningitis because of her headaches. What assessment would help rule out meningitis?
A patient is concerned about developing meningitis because of her headaches. What assessment would help rule out meningitis?
A male college student reports to the campus clinic with headache pain around his eye accompanied by nasal congestion. What type of headache is he likely experiencing?
A male college student reports to the campus clinic with headache pain around his eye accompanied by nasal congestion. What type of headache is he likely experiencing?
You are providing education at a local community center about neurological changes with aging. Which is an important point you would include?
You are providing education at a local community center about neurological changes with aging. Which is an important point you would include?
Following a craniotomy for a primary brain tumor, a patient develops vasogenic edema. The nurse would monitor for:
Following a craniotomy for a primary brain tumor, a patient develops vasogenic edema. The nurse would monitor for:
A patient who underwent Biopsy for a primary brain tumor must be evaluated for the following complications
A patient who underwent Biopsy for a primary brain tumor must be evaluated for the following complications
A nurse is caring for a patient with limited mobility due to a neurological disorder. What is the rationale for promoting Activities of Daily Living(ADL)?
A nurse is caring for a patient with limited mobility due to a neurological disorder. What is the rationale for promoting Activities of Daily Living(ADL)?
When assessing a patient with a neurological disorder, which factor can significantly affect the accuracy of the Glasgow Coma Scale (GCS) if not properly accounted for?
When assessing a patient with a neurological disorder, which factor can significantly affect the accuracy of the Glasgow Coma Scale (GCS) if not properly accounted for?
A child presents to the emergency room with a high fever and altered mental status (AMS). Besides fever, which additional finding would be most concerning, requiring immediate intervention?
A child presents to the emergency room with a high fever and altered mental status (AMS). Besides fever, which additional finding would be most concerning, requiring immediate intervention?
An elderly patient is being evaluated for possible seizures. Why might the diagnosis of seizures be challenging in this population?
An elderly patient is being evaluated for possible seizures. Why might the diagnosis of seizures be challenging in this population?
A patient presenting with a headache is suspected of having a secondary headache. What is the primary reason for performing diagnostic testing in this situation?
A patient presenting with a headache is suspected of having a secondary headache. What is the primary reason for performing diagnostic testing in this situation?
A patient with epilepsy is prescribed an antiepileptic drug (AED) and is instructed to maintain lifelong therapy. What is the primary reason for this long-term commitment?
A patient with epilepsy is prescribed an antiepileptic drug (AED) and is instructed to maintain lifelong therapy. What is the primary reason for this long-term commitment?
You are caring for a patient who reports experiencing an aura before a seizure. What is the significance of the aura in the context of seizure management?
You are caring for a patient who reports experiencing an aura before a seizure. What is the significance of the aura in the context of seizure management?
A patient with a primary brain tumor is at risk for developing seizures. What underlying mechanism best explains the connection between the tumor and the increased risk of seizures?
A patient with a primary brain tumor is at risk for developing seizures. What underlying mechanism best explains the connection between the tumor and the increased risk of seizures?
A patient is undergoing an EEG to evaluate seizure activity. Which pre-procedure instruction is most important to ensure accurate test results?
A patient is undergoing an EEG to evaluate seizure activity. Which pre-procedure instruction is most important to ensure accurate test results?
A 22-year-old female presents to the college student health center with a persistent headache for 2 days. What is the priority intervention?
A 22-year-old female presents to the college student health center with a persistent headache for 2 days. What is the priority intervention?
A patient is being assessed to determine the appropriate plan of care. What initial assessment is MOST important?
A patient is being assessed to determine the appropriate plan of care. What initial assessment is MOST important?
A patient with a known seizure disorder has been prescribed phenytoin (Dilantin). Besides routine blood tests, what additional advice should the nurse emphasize?
A patient with a known seizure disorder has been prescribed phenytoin (Dilantin). Besides routine blood tests, what additional advice should the nurse emphasize?
Within the Pathophysiology of Headaches, what area in the brain can be triggered by the trigeminal nerve?
Within the Pathophysiology of Headaches, what area in the brain can be triggered by the trigeminal nerve?
Following a craniotomy for a primary brain tumor, a patient develops vasogenic edema. Which finding is most significant?
Following a craniotomy for a primary brain tumor, a patient develops vasogenic edema. Which finding is most significant?
A patient who underwent Biopsy for a primary brain tumor must be evaluated for which immediate post-operative complication?
A patient who underwent Biopsy for a primary brain tumor must be evaluated for which immediate post-operative complication?
What interventions can assist if a patient has altered social roles or body image issues?
What interventions can assist if a patient has altered social roles or body image issues?
Flashcards
Neurological Assessment Components
Neurological Assessment Components
A neurological assessment includes history, level of consciousness, cranial nerves, motor and sensory systems, cerebellar assessment, and reflexes.
Glasgow Coma Scale (GCS)
Glasgow Coma Scale (GCS)
Eye opening (1-4), Verbal response (1-5), Motor response (1-6). Scores range from 3 (coma) to 15 (fully alert).
Causes of Altered Mental Status (AMS)
Causes of Altered Mental Status (AMS)
Altered mental status can be caused by hypoxia, hypercapnia, hypotension, fever, drugs, seizures, or increased ICP.
Neurological Monitoring (Infants/Children)
Neurological Monitoring (Infants/Children)
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Pupil Assessment After Head Injury
Pupil Assessment After Head Injury
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Primary vs. Secondary Headaches
Primary vs. Secondary Headaches
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Types of Primary Headaches
Types of Primary Headaches
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Headache Pathophysiology
Headache Pathophysiology
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Management of Headaches
Management of Headaches
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Types of Primary Brain Tumors
Types of Primary Brain Tumors
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Treatment for Brain Tumors
Treatment for Brain Tumors
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Complications of Brain Tumors
Complications of Brain Tumors
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Epilepsy Definition
Epilepsy Definition
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Pathophysiology of Seizures
Pathophysiology of Seizures
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Clinical Manifestations of Seizures
Clinical Manifestations of Seizures
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Diagnosis of Seizures
Diagnosis of Seizures
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Pre-EEG Testing Instructions
Pre-EEG Testing Instructions
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Seizures in the Elderly
Seizures in the Elderly
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Extracranial Causes of Pediatric Seizures
Extracranial Causes of Pediatric Seizures
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Three Phases of a Seizure
Three Phases of a Seizure
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Partial Seizures
Partial Seizures
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Study Notes
- Neurological disorders affect cognition, personality, mobility, and activities of daily living.
Neuro Assessment
- History is best provided by the patient.
- Physical assessment includes level of consciousness, cranial nerves, motor and sensory systems, cerebellar assessment, and reflexes.
Glasgow Coma Scale (GCS)
- Eye Opening (E): Ranges from 1 (none) to 4 (spontaneous).
- Verbal Response (V): Ranges from 1 (none) to 5 (oriented).
- Motor Response (M): Ranges from 1 (none) to 6 (obeys commands).
- Total scores range from 3 (coma) to 15 (fully alert).
- Know the patient's baseline GCS score.
- Consider any impacting factors, such as sedation, paralytics, intubation, or restraints, that could affect assessment.
Pediatric Considerations for Altered Mental Status (AMS)
- A fall to 60 mm Hg, or below, of PaO2, indicates AMS
- A rise above 45 mm Hg of PaCO2, indicates AMS
- Low blood pressure causing cerebral hypoxia, indicates AMS
- Fever (a 1° rise in fever increases oxygen need by 10%), indicates AMS
- Drugs (sedatives, antiepileptics), indicates AMS
- Seizures (postictal state), indicates AMS
- Increased ICP, indicates AMS
Neurological Monitoring of Infants and Children
- Assess pain stimuli response and arousal awareness.
- Evaluate cranial nerve and motor responses.
- Observe for posturing.
- Assess pupil response of the eyes.
- Asymmetrical pupils after a head injury with AMS is a MEDICAL EMERGENCY.
- Check for bulging fontanelles and scalp vein distention.
- Monitor for ataxia and spasticity of lower extremities.
- Assess Moro/tonic neck with withdrawal reflexes.
Psychosocial Considerations and Age-Related Changes
- Factors influencing patient and family response to an event include age, general health, social status, chronic illness history, life experience, job, and home responsibilities.
- Consider altered social roles and body image issues.
- Age-related changes in the nervous system include motor and sensory changes, and alteration of thermoregulation.
Headache - Differential Diagnosis
- Potential diagnosis for headache includes meningitis, hemorrhage, migraines, stroke, stress, head injury, headaches, infection, dehydration, hyper and hypo tension, medication side effects, substance use or abuse.
Headache: Priority Assessments: OPQRST
- Onset
- Provocation
- Quality
- Region/Radiation
- Severity
- Timing
- History taking needs to include LMP, PMH, heal, urine, stool, sleep, eye exams, and positioning.
- Priority interventions: hydration (2 liters), cool compress, avoid triggers, and consistent caffeine intake.
Headache Education
- Avoid triggers and keep a headache diary.
Headache
- Also referred to as cephalalgia.
- Primary headaches are not associated with other underlying causes, and include tension-type, migraine, and cluster headaches.
- Secondary headaches are caused by an underlying pathology like infection, neoplasms, vascular abnormalities, or medication-induced disorders.
- Secondary headaches typically present with a sudden onset of severe pain.
- In the United States, 20% to 40% of the population, 5% to 9% of males, and 12% to 25% of females experience migraine headaches.
Headache Pathophysiology
- Headaches are the result of the reaction of nociceptors (pain-sensitive nerve endings) to triggers, sending messages to the thalamus via the trigeminal nerve (cranial nerve V).
- 4% of the population experiences chronic daily headaches.
Headache: Clinical Manifestations
- Tension headaches: episodic (10-15 days per month lasting 30 minutes to several days) or chronic (>15 days per month over 3-month period).
- Cluster headaches: severe, unrelenting pain in and around the eye.
- Migraines: isolates into phases, which include premonitory, headache, and postdromal phases.
Headache: Management
- Maintain a headache diary and undergo a complete neurological assessment.
- Diagnostic testing may include CBC and blood cultures to check for infection, CRP and ESR to check for inflammation, and CSF testing and imaging to rule out potential causes.
Primary Brain Tumors
- Primary brain tumors originate in the brain.
- Can be slow-growing, benign tumors or highly malignant, aggressive tumors.
- Gliomas tend to develop along curved areas.
- Meningiomas are the most common form.
- Oligodendrogliomas are slow-growing and may not spread.
- Acoustic neuromas, also known as schwannomas, can occur.
- Clinical manifestations depend on their location in the brain.
Primary Brain Tumors: Management
- Chemotherapy, radiation, and craniotomy may be used.
- Biopsies of brain masses are performed to examine cells and provide a specific diagnosis.
Primary Brain Tumors: Complications
- Complications can include intracranial bleeding, cerebral edema, vasogenic edema, seizures (due to Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) causing dilutional hyponatremia), venous thromboembolism, and increased intracranial pressure.
Seizures
- Epilepsy is a chronic disorder characterized by two unprovoked seizures, occurring more than 24 hours apart.
- Seizures result in a range of manifestations from behavior changes to loss of consciousness.
Seizures: Pathophysiology
- The cause of unprovoked seizures may involve genetic or developmental mutation of synapses and of genes coding for sodium channel proteins, causing sodium channels in the brain to remain partly ajar or improperly closed, increasing neuronal hyperexcitability of glutamate.
- Another possibility involves mutations causing ineffective activity of gamma-aminobutyric acid (GABA), the most common neurotransmitter.
Seizures: Clinical Manifestations
- Rhythmic jerkiness of all extremities and loss of consciousness.
- Automatisms (repetitive unconscious movements such as lip smacking, chewing, or swallowing), sudden loss of motor tone, and incontinence can occur.
- May include episodes of daydreaming without loss of consciousness.
Seizures: Diagnosis
- Labs, CT, or MRI of the head may be conducted.
- An EEG can detect seizures.
- Pre-EEG testing includes: avoid fasting (hypoglycemia can alter results), hair and scalp need to be clean and free of any products, no sedatives 12-24 hours prior to test (consult with provider about stopping antiepileptic medications prior to EEG), and no stimulants for 12-24 hours prior to test.
Seizures Management
- Seizures can be difficult to diagnose in the elderly because of their resemblance to other conditions of old age such as dementia and Alzheimer’s disease.
- Antiepileptic drugs (AEDs) or anticonvulsants almost always provide complete control of the seizures.
- This is LIFE-LONG THERAPY.
- SUDDEN CESSATION OF AEDs CAN CAUSE STATUS EPILEPTICUS!
Pediatric Seizures
- Can be febrile or related to epilepsy.
- Are sudden, intermittent episodes of ALOC that last seconds to minutes and may include involuntary tonic and clonic movements.
Pediatric Seizures: Intracranial Causes
- Epilepsy
- Congenital anomaly
- Birth injury’s
- Infection
- Trauma
- Degenerative disease
- Vascular disorder
Pediatric Seizures: Extracranial Causes
- Fever
- Heart disease
- Metabolic disorders
- Hypocalcemia
- Hypoglycemia
- Dehydration and malnutrition
- These do not become epilepsy or increase risk of epilepsy.
Pediatric Seizures: Toxic Causes
- Anesthetics
- Drugs
- Poisons
Pediatric Seizures: Triggering Factors
- Flashing of dark/light patterns
- Startling movements
- Overhydration
- Photosensitivity
Pediatric Seizures: Phases
- Aura
- Tonic/clonic seizure
- Postictal
Pediatric Seizures: Partial
- Account for 40%
- Consciousness may be intact or slightly impaired
- Can have simple or complex seizures
Pediatric Seizures: Treatment
- Initially aimed at trying to determine type, site, or cause
- Multiple diagnostic techniques can be used
- CT/MRI, EEG
- Laboratory tests to rule out poisonings or electrolyte abnormalities
- Lumbar puncture: looking for changes in color, increase in opening pressure, increases in WBCs, low glucose
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