Neurological
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2 groups of seizures
Focal- affect one area of the brain Generalised- affect multiple areas of the brain/ spread to all areas
Types of seizures
Focal (one area of the brain) Generalised: -absence -tonic -atonic -clonic -myoclonic -tonic clonic
Absence seizures
Stare into space/ repetitive movements Last 5-10s, can occur in clusters Often occur in children
Tonic seizure
Stiff muscles (back,legs, arms) May have LOC
Tonic seizure
Stiff muscles (back,legs, arms) May have LOC
Atonic seizure
Loss of muscle control Falls
Clonic seizure
Repeated Jerking movements
Myoclonic seizures
Sudden brief jerks Often no LOC
Tonic clonic seizures
Most dramatic seizure Stiffness of limbs followed by jerking Sudden LOC Bite tongue Lose bladder control Can start as focal and spread Last for several minutes
When seizures require hospital conveyance?
Last longer than 5 mins First seizure 3 or more seizures in an hour Unresponsive to treatment (benzodiazepines- midazolam- diezapam) Head injury/ injury from seizures that requires hospital Stroke/ illness/ infection cause of seizure
Seizure definition
Sudden and uncontrolled burst of electrical activity in the brain (Excessive neuronal activity)
Symptoms of seizures
Confusion Loss of consciousness Jerking/ stiff movements Staring spells Cognitive/ emotional changes
Symptoms of seizures
Confusion Loss of consciousness Jerking/ stiff movements Staring spells Cognitive/ emotional changes
Causes of seizures
Stroke/ head injury Infection of the brain eg meningitis/ encephalitis Epilepsy Pyrexia Hypoxia Severe illness Lack of sleep Legal/ illegal drugs Alcohol misuse (eg withdrawal/ extreme intoxication) Low blood sodium Hypoglycaemia
Questions to ask for seizures
First seizure? How many seizures have you had? How long have they lasted for? (>5 mins= medical emergency) Any signs/symptoms that forewarn a seizure? Epilepsy? History? Medication taken? Taken alcohol? Characteristics of seizure? Care plan/ treatment plan for seizures?
Treatment for seizures?
If seizing- place in comfortable/safe position, maintain ABC Hypoxic- 15lpm o2, OPA/NPA Benzodiazepines- midazolam, diazepam (if multiple seizures, seizures lasting longer than 5 mins)
Stages of seizures
Prodome- early warning of seizure, changes in behaviour/ aura/ feeling off Ictal- middle part of seizure, spans from first symptom- end of seizure Post ictal- recovery period, can last minutes/hours, length dependent on the area of the brain that was affected/type of seizure, feel sleepy/ trouble talking/ weakness
Branches of the nervous system
CNS (brain and spinal cord) Peripheral NS (neurons in body)- Somatic NS (voluntary) + autonomic NS (involuntary)- parasympathetic NS (relax) + sympathetic NS (fight or flight)
How many cranial nerves/ spinal nerves
12 cranial 31 pairs spinal (C-8, T-12, L-5, S-5, C-4)
Neuron structure
Myelin sheath- conductor, insulator Axon Nodes of ranvier (impulses jump across) Dendrites (connect to other neurons/cells) Cell body Nucleus
Cell bodies clustered in CNS?
Nuclei
Cell bodies clustered in peripheral CNS?
Ganglia
Sensory/ afferent neuron?
Receive impulses from receptors on sensory organs, transmit impulses to CNS
Motor/ efferent neuron
Receives impulse from sensory neuron, sends impulse to an effector (gland/muscle) that generates a response Can be somatic/voluntary or autonomic/involuntary