Module 10 Part 2
* Brief disruption in the brain's electrical functions*
Tonic-Clonic Seizure: Petit mal or Grand mal
- both brain hemispheres
Tonic-Clonic Seizure: S/s
-LOC, depressed respiration, tongue biting, Loss of bodily function
-Several seconds to minutes
-Post-ictal Period: ALOC min-hrs
Absence Seizures: Describe
Whats the hint?
- "day dreaming" **hint**
- No LOC or post-ictal period
- usually 10-20 sec
-"person has full awareness after seizure but not during"
Absence Seizures: MC in what pt?
MC in children
Simple Partial Seizure: Describe
-usually due to isolated impulse in brain
- start suddenly & brief 60-120sec
- "still aware of whats going on. Smells bagels but no bagels around?
Simple Partial Seizure: Affects
-motor, sensory, autonomic, psychological
- consciousness is maintained& usually event is remembered in detail
Complex Partial Seizure: Often preceded by what?
Often preceded by a seizure aura (light headed, dizzy, halucination, confused)
Complex Partial Seizure: Is the person aware of whats happening?
-Not aware of whats happening and wakes up confused
Complex Partial Seizure: If you address the patient will you get a response?
Complex Partial Seizure: Impaired awareness
pt normally walks, but action was not planned
Complex Partial Seizure: Often seen after what event? and what can it progress to?
Brain injury, trauma or infection
Can progress to tonic-clonic seizure
5 days or more for 2 wk period everyday
Appetite high or low
Psychomotor function low
Meds: valuate every 6 months if on anti-depressants
Genetic + Environment
-MC onset age
-Hallucinations: auditory, visual, tactile
- Onset rarely in children & after 45 yrs
-R/O other "physical" causes- drug abuse
Schizophrenia: Over production or underproduction of what NT?
Overproduction of dopamine
B1 Thiamine Function
Production of ATP
If low death and damage of neurons
What Syndrome is associated with low B1 Thiamine?
Wernicke-Korsakoff Syndrome: What?
Loss of brain function due to B1 thiamine deficiency
Wernicke-Korsakoff Syndrome: AKA what and why?
Aka " Wet Brain" - Alcoholism inhibits B1 absorption
Wernicke: What is affected?
Movement - irreversible
Korsakoff: What is affected?
Memory formation and bizarre behavior
- acute onset of memory impairment -amnesia
Wernicke-Korsakoff Syndrome: Causes
- Aids, Wt loss procedures
- Hyperemesis gravidarum (extreme N/V)
Wernicke-Korsakoff Syndrome: S/s
**know on exam**
**confabulations: make up info they cant remember; pt believes what they are saying - not lying
**Eye twitch: Visual (Nystagmus)
-Coordinatio & memory changes
-Anterograde amnesia: Trouble forming new memories(long term black out)
Wernicke-Korsakoff Syndrome: Testing
- Low Thiamine (B1)
- Liver function test (confirm alcoholism)
- Pregnancy test
- TSH, T3, T4
- MRI may show tissue changes; not needed usually
Wernicke-Korsakoff Syndrome: Tx
-High dose of B1; stops destruction but does not repair damage
Stroke: What is it?
*decrease O2 to brain*
- Hemorrhagic: Dissected Aneurysm, subarachnoid hemorrhage
- TIA: "mini stroke" Due or a full on stroke soon
Stroke: Risk Factors
-increase cholseterol(or decrease HDL-high density lipoprotein)
-Congestive heart disease, A-Fib, Pneumonia
-Difficulty: walking, talking, vision, memory
- HA, Paresthias, Paralysis
-CT/MRI, Carotid US
What disease is associated with too little of what NT?
Parkinsons: low dopamine
Parkinson's Disease: Physiology
*depletion of dopamine resulting in hypertonia(tremor & rigidity) & Akinesia*
-Loss of substantia nigradopamine - producing neurons
- Too much cholinergic activity in basal ganglia
Parkinson's Disease: S/s
-Always bilateral, but may involve only one sided early on
- Pill rolling: resting tremor
- Rigidity: cogwheel
-Shuffling Gait: festinating gait
Parkinson's Disease: What happens in the basal ganglia
Not enough dopamine is being released
Parkinson's Disease: Tx
Levadopa: *Activation of cental dopamine receptors*
- Peripheral(outside dopamine receptor: N/V
- Dopa Decarboxylase Inhibitor(DDCI): Carbidopa cannot cross blood brain barrier
prevents peripheral conversion of levadopa to dopamine
Parkinson's Disease: Dopamine boosting drugs
increase dopamine, balance acetylecholine