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What is most important for seizers?
Always time them
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What is ictus seizure?
seizure that lasts about 1-3 mins
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What is status epilepticus?
Greater than 5 mins of back-to-back seizers. This is a medical emergency.
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(3) Major predisposing factors for ischemic stroke?
- Atrial fibrillation
- Carotid stenosis
- Cerebral arteriosclerosis
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(3) Major predisposing factor for hemorrhagic stroke?
- Hypertension
- Oral anticoagulation
- Cerebral aneurysm
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What is the first stage of a seizer?
Prodromal.
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What is the seconds stage of a seizer? What's special about this stage.
Aura. Does NOT happen with all types
Only with Focal seizure or tonic-clonic types
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What is the third stage of a seizer?
The ICTUS, which is the actual seizer
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What is the forth stage of a seizer?
Post Ictus
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What is the prodromal stage?
First stage of a seizer. Will have depression, anger, issues sleeping, anxiety, GI and urinary issues. Can start days before a seizer occurs.
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What is the Aura?
Second stage of a FOCAL seizer. Altered vision or hearing, anxiety, sudden weird taste or smell, dizzy, inability to speak.
Happens within seconds or mins that a seizer happens. Warning sign that a bigger seizer is expected.
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What is the ICTUS
This is the actual seizer.
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What is post ictus?
After the seizure. Recovery. May takee hours or days to recover.
Very tired, confused, headache, injury
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What is a focal seizer?
Affects a portion of the brain
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What is a generalized seizer? *
- Whole brain. Tonic clonic (Grand-Mal) Will have aura phase.
- Most common*
- Loss of consciousness.
- Tonic: body stiffening
- Clonic: recurrent jerking, extremities
- IF excess 5 mins: status epilepticus, which is medical emergency.
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What is the 2nd generalized whole brain seizer?
- Absence (petit-mal)
- Most common in reds.
- Staring (appears to be daydreaming) goes unnoticed.
- Very short.
- For the post ictus: won't remember event
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Atonic seizer
- without muscle tone, goes limp, falls(when standing) slump (when sitting)
- Not aware during event. Post ictus: recover is immediate once they regain consciousness.
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Focal onset aware seizer?
Simple partial: Patient aware. Aura. <2mins
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Focal Impaired awareness
Complex partial. Unaware of motor symptoms.
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Uhthoff's sign?
Neurological test that is positive when patient cannot tolerate heat. + in Multiple sclerosis
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What is normal ICP (intracranial pressure)
5-15 mmHg
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How much ICP is a means patient needs treatment?
>20 mmHg
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What is the Normal CPP (Cerebral Perfusion Pressure) ?
60-100 mmHg
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How to calculate CPP? Whats the formula? What do you need?
- Need the BP and ICP.
- Take the diastolic BP and multiple by 2. Then divide by 3. Then subtract the ICP.
- = CPP
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Formula to determine MAP (Mean Arterial Pressure)
(systolic * .333333) + (diastolic * .666666)
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