Term
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Definition
| A paroxysmal event characterized by abnormal excessive and synchronized discharge of CNS neurons *** |
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Term
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Definition
| A condition characterized by recurrent seizures caused by a chronic, underlying process.*** |
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Term
Drug withdrawal
High fever (esp. in infants, young children)
Infections (i.e. menningitis)
Vasovagal or orthostatic syncope |
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Definition
| Isolated (Non-recurring) Seizures can be associated with what? |
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Term
Primary is idiopathic or constitutional, with onset usually before age 20
Secondary is due to outside influence such as intracranial neoplasms, head trauma, meningitis, ect. |
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Definition
| What is the difference in primary and secondary epilepsy? |
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Term
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Definition
| Type of seizure with Loss of consciousness, rigidity, cessation of respiration |
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Term
1 Minute or less
2-3 Minutes |
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Definition
| How long does the tonic phase last in a tonic clonic seizure? What about the clonic phase? |
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Term
Tonic phase
Clonic phase
Flaccid coma
Post-ictal phase |
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Definition
| What are the four phases of a tonic clonic seizure? |
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Term
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Definition
Stage where there is
Headache and/or confusion
Fatigue, lethargy, malaise
Many will desire sleep
Muscle soreness
Duration of this phase: several to many hours |
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Term
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Definition
Repetitive seizures and…
Consciousness not regained between seizure or…
A seizure lasting > 5 minutes
Represents a Medical Emergency |
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Term
Try to help prevent injuries
During initial fall to the ground
During clonic phase by removing nearby objects
Do not try to restrain any movements
Do not insert anything into patient’s mouth
After seizure roll patient onto either side to facilitate oral cavity drainage
Call for medical help if status epilepticus occurs |
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Definition
| Grand-mal (tonic clonic seizure) First Aid |
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Term
Enhance inhibitory CNS influences
Increase GABA neurotransmitter activity
Reduce excitatory CNS influences
Decrease glutamate neurotransmitter activity
Modulate ionic conductance |
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Definition
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Term
| Abrupt withdrawal of treatment *** |
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Definition
| What may trigger frequent seizures and status epilepticus? |
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Term
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Definition
| How long should a patient be seizure free before considering gradual withdrawal of medications? |
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Term
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Definition
Characterized by areas of demyelination in the CNS ***
Inflammatory damage (probably autoimmune)
Followed by gliosis (scarring)
These lesion vary in time and location |
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Term
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Definition
Type of MS where Initial symptoms resolve or significantly improve over a span of weeks to months
Interval of months to years follows until new lesions develop which cause new symptoms
Eventually the remissions after each attack are less complete and the patient experiences increasing disability |
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Term
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Definition
Type of MS where there is Abrupt onset and steady progression
Remissions rare and incomplete |
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Term
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Definition
| Type of MS where After an initial relapsing-remitting phase, the disease progresses steadily |
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Term
Limb weakness, numbness or tingling
Spastic paraparesis of various muscle groups
Optic neuritis (vision loss)
Diplopia (double vision)
Loss of control of bladder or rectal sphincters
Vertigo |
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Definition
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Term
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Definition
| What is the gold standard of MS treatment? |
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Term
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Definition
| A progressive, irreversible decline in mental function |
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Term
Age
Female gender
Head injury
Chronic diseases: atherosclerosis, diabetes |
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Definition
| Risk enhancers for dementia |
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Term
Education & intellectual stimulation
Social interaction & physical exercise
Medications: statins & NSAIDs |
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Definition
| Risk reducers for dementia |
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Term
Alzheimer's Disease
Vascular dementia (multiple cerebral infarcts) |
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Definition
Most common cause of dementia
Second most common cause of dementia |
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Term
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Definition
Steady decline of intellectual and neurologic function
Memory
Speech
Motor functions |
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Term
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Definition
| Means to slow disease progression |
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Term
“Plaques & tangles”
Plaques of beta amyloid
AΒ42
Tangles of tau proteins |
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Definition
| Alzheimer’s Pathophysiology |
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Term
Secondary much more common
Primary tumors are usually single
Secondary tumors are usually multiple |
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Definition
| Primary vs. Secondary CNS tumor characteristics |
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Term
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Definition
| What is the most common glioma? |
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Term
Microadenomas: less than 10mm
Macrodenomas: 10 or more mm |
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Definition
| What are the two tumor size definitions of pituitary tumors? |
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Term
Hormone secretion symptoms
Visual field symptoms |
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Definition
| What are the two major pituitary tumor symptoms? |
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Term
| galactorrhea & hypogonadism |
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Definition
| When the pituitary tumor affects Prolactin what happens? |
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Term
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Definition
| When the pituitary tumor affects ACTH what happens? |
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Term
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Definition
| When the pituitary tumor affects Growth hormone what happens? |
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Term
| compression on the optic chiasm |
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Definition
| How do visual field deficits occur in pituitary tumors? |
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Term
Headache (chief complain in 30%)***
Seizures***
Nausea, vomiting |
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Definition
| What are the general CNS tumor symptoms? |
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Term
Personality changes
Intellectual decline |
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Definition
| In specific CNS symptoms, what happens when the tumor is in the frontal lobe? |
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Term
Seizures with olfactory or gustatory hallucinations
Déjà vu or jamais vu |
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Definition
| In specific CNS symptoms, what happens when the tumor is in the temporal lobe? |
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Term
Sensory and motor deficits
Spontaneous pain syndromes |
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Definition
| In specific CNS symptoms, what happens when the tumor is in the parietal lobe? |
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Term
Visual field defects
Visual agnosia |
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Definition
| In specific CNS symptoms, what happens when the tumor is in the occipital lobe? |
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Term
Ataxia
Nystagmus
Cranial nerve palsies |
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Definition
| In specific CNS symptoms, what happens when the tumor is in the brainstem/cerebellum? |
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Term
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Definition
| Prognosis for pituitary tumors? |
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Term
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Definition
| Prognosis for meningiomas? |
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Term
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Definition
| Prognosis for astrocytomas? |
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Term
bioengineered polio virus***
Virus altered so it can only reproduce in cancer cells
Releases toxins into the cancer cells
Also stimulates immune system reaction |
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Definition
| What is the new treatment approach for glioblastomas? |
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Term
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Definition
| A benign (not associated with increased mortality) and recurring syndrome of headache associated with other symptoms of neurologic dysfunction |
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Term
Moderate to severe headache
Often unilateral
“Throbbing”, “pulsating”
With associated symptoms:
Nausea (87%)
Photophobia (82%)
Lightheadedness (72%)
Visual disturbances (36%) |
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Definition
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Term
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Definition
symptoms hours or days before headache
Mood changes, food cravings, stiff neck muscles |
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Term
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Definition
symptoms minutes before the headache
Visual: scintillations
Sensory: “pins & needles”, numbness
Motor: hemiplegic weakness |
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Term
Cluster headaches
(clustered in time 4-8 weeks) |
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Definition
Episodes of severe headaches
Usually occur at night
Usually unilateral periorbital headache for up to 3 hours
Often with unilateral nasal & eye symptoms |
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Term
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Definition
| What is the typical patient for a cluster headache? |
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Term
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Definition
| What is often useful in treatment for a cluster type headache? |
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Term
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Definition
| Dopamine excess in this location is associated with psychotic behavior |
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Term
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Definition
Neurotransmitter Prominent in midbrain and brainstem
Especially Pons
Involved with visceral control
Sleep
Temperature
Appetite
Neuroendocrine |
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Term
| Gamma-AminoButyric Acid (GABA) |
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Definition
Neurotransmitter that Usually inhibits neuronal depolarization
Makes neuronal discharge less likely
Present in many CNS areas |
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Term
| Reactive (secondary, exogenous) |
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Definition
| What depression type is Adjustment disorder with depressed mood |
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Term
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Definition
| What depression type is Major depressive disorder |
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Term
| Bipolar affective disorder |
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Definition
| What depression type is Manic-depressive illness |
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Term
Lowered mood, sadness, difficulty in thinking & concentrating
Loss of interest, diminished involvement in work and recreation |
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Definition
| What are the symptoms of most types of depression? |
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Term
Suicidal ideation
Psychomotor retardation or agitation
Physical symptoms: anorexia, weight loss, insomnia, somatic complaints |
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Definition
| What are the symptoms of severe depression? |
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Term
| Selective Serotonin Reuptake Inhibitors (SSRI) |
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Definition
Commonly used to treat chronic depression
Also Used for:
Eating Disorders (Bulimia/anorexia)
Obsessive-Compulsive Disorder
Panic Attacks
Premenstrual Syndrome (PMS) |
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Term
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Definition
| What is the length of time from lag time to full effect of SSRI's? |
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Term
Essentially no risk from intentional overdose
Better side-effect profile |
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Definition
| What are the benefits of SSRI's to other anti-depressents? |
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Term
Sleep disturbances
Appetite changes (usually increased)
Sexual dysfunction
Diminished drive
Orgasmic dysfunction |
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Definition
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Term
| First few months (patient may gain sufficient energy to attempt suicide) |
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Definition
| When is the risk of suicide highest in depression treatment? |
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Term
| Teens and young adults <25 (may be due to increase in impulsive behavior) |
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Definition
| In what age group does suicide risk go way up with antidepressants? |
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Term
| Bipolar Affective Disorder |
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Definition
| Disorder characterized by episodes of depression (often severe) alternating with periods of manic behavior |
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Term
Usual treatment choices for the depression phase
Lithium carbonate to stop and then prevent manic phase |
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Definition
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Term
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Definition
Diminished capacity to recognize reality
Characterized by:
Delusions
Hallucinations
Abnormal Cognition
Genius not excluded |
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Term
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Definition
Peak age of onset is teen years & early 20’s
Chronic and often progressive mental illness
Characterized by…
Social withdrawal, decline in personal hygiene
Flight of ideas
Autistic absorption in inner thoughts
Concrete thinking and difficulty with abstract thought
Delusions, hallucinations |
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