NR 507NP Week 8 CNS; Brain Disorders

g. Toxin/Heavy Metal exposure h. Drug/Alcohol i. Fevers 5. Seizure Phases a. Prodroma: (hours or days before with fatigue, malaise, HA b. Aura: Olfactory, visual, and emotional changes. c. Ictal: Symptoms d. Postictal: Disoriented/confused 6. Epilepsy Diagnosis i. Check CBC and CMP ii. Check for heavy metals iii. Check drug/alcohol iv. EEGs v. MRI and CT 7. Epilepsy Tx a. Benzos (usually IM or IV when in active seizure) b. Maintain safety (padding) c. Airway patency (side-lying) d. Meds e. Ketogenic diet (high fat, low carb) f. Vagus nerve stimulation (VNS) and responsive nerve stimulation (RNS) g. Surgery 8. Pathophys of NONepileptic Seizure: Sign of mental distress. a. Risk Factors i. Psychological/emotional trauma ii. Physical/sexual abuse iii. Depression/anxiety iv. PTSD b. CMs i. Unequal/fluctuating movements b/w right and left side ii. Signs of consciousness during episode iii. Side-to-side neck movement iv. Breaking fall v. Easing to ground vi. Eyes closed vii. Yelling viii. No post-ictal phase HEADACHE SYNDROMES b. Neurological and Brain changes: central nervous system is crucial in initiating and propagating migraine attacks c. Neurotransmitter Dysregulation d. Inflammatory and Vascular: Interactions between the trigeminovascular and vascular systems are suspected migraine pain mechanisms e. Environmental: Stress, sleep, food 2. Risk Factors a. Family Hx b. Women (hormones) c. Adolescence and adulthood d. Hormones d/t estrogen e. Other medical conditions (mental health and epilepsy) f. Mood/stress g. Sleep (too much and too little) h. Diet (alcohol, caffeine, chocolate, aged cheese, and MSG) i. Environmental (odors, lights) j. Rebound migraines from overuse of meds 3. CMs a. Prodromal/Premonition: Subtle warning signs b. Aural c. Headache: Throbbing, pulsating pain (usually to one side) i. Sometimes photophobia, phonophobia, and nausea ii. Lasts 4-72 hours d. Postictal i. Residual pain ii. Fatigue iii. Lack of concentration iv. Irritable v. Weakness/lethargy 4. Diagnosis a. Response to triptans = support of diagnosis b. Rule out other possible causes 4. Trochlear: One eye muscle that helps move eyes down and in 5. Trigeminal: sensory from face and motor control of chewing. 6. Abducens: Outward movement of eye 7. Facial: Motor control of facial muscles, sense of taste, and sensory info from ear 8. Vestibulocochlear: Hearing and balance 9. Glossopharyngeal: Sensory info from throat and taste from back of tongue, motor control of throat muscles. 10.Vagus: Controls muscles of throat and voice box and regulates HR and BP and digestion. 11.Accessory: Muscles responsible for moving head, neck, and shoulders. 12.Hypoglossal: Controls muscles of tongue, speech, swallowing, and other tongue movements. 13.Oh, Oh, Oh, To Touch And Feel Very Good Velvet AH 14.Some Say Marry Money Buy My Brother Says Big Brains Matter Most 2. Pathophys of Trigeminal Neuralgia (Nerve V) = 3 branches a. Ophthalmic  meninges and cornea b. Maxillary  Upper lip, teeth, and mucosa c. Mandibular  Lower lip, teeth, and jaw. d. Types of TN i. Idiopathic: ~10% ii. Classic: Neurovascular compression causing atrophy and nerve root displacement. 1. Leads to demyelination and damage to axons  hyperactive firing. iii. Secondary: From tumor or abnormal