Epilepsy, Headache & Vestibular Disorders

Epilepsy comes from the Greek word meaning what?
Click the card to flip 👆
1 / 198
Terms in this set (198)
How many people worldwide have epilepsy?45 millionIt is higher among what 2 age groups?1. Young children 2. ElderlyWhich gender is epilepsy more common in?More men than womenIt is the _______ most common serious Neurologic disease of old age.3rdWhat 2 neurologic diseases does epilepsy fall behind?1. Dementia 2. StrokeSeizure activity in children is less than ______.1%Although seizure activity in children is less than 1% seizures are the ______ common symptoms requiring medical attention in the __________.Most common, infantCauses of epilepsy are ______, symptoms may be _______.Multiple, transientWhat is the first symptom of an intracranial mass?SeizuresWhat is most common preventable cause of epilepsy?Head traumaWhat type of hematoma can cause seizure activity?Subdural hematomaWhat hormone change can be a trigger?Increases in estrogen levelTrue or False: Sudden, excessive electrical discharges of large aggregates of neurons results in seizureTrueWhat percent of complex partial seizures arise from the ________ lobe?70-80% TemporalWhat plays a role in both seizure activity and mood disordersHippocampusIn most individuals when do seizures occur?Unpredictably at any time and without any relationship to posture or ongoing activity.In some individuals what are seizures provoked by?Specific stimuli such as flashing lights or a flickering televisionWhat is the tonic phase?Body becoming rigidWhat is the clonic phase?Body becomes rhythmic and jerky with eventual relaxation of all body musclesWhat 4 things should you determine post seizure?1. Client state 2. Level of confusion 3. Sleepiness 4. HeadacheWhat 4 things should you know when learning about the history or observations of a clients seizures?1. Location of seizure activity 2. Level of consciousness 3. Level of generalized motor activity 4. Preceding level of seizure activityWhat will provide strong evidence that an even was a seizure when looking at an EEG?Interictal ActivityWhen should metabolic studied ideally be performed?At time of seizure occurrenceWhy should the metabolic studies be performed at the time of the event?When the test results are most likely to be abnormalWhat should you give patients support and education about?Behavioral, social, and economic consequences________ is effective for the severe, uncontrollable seizures found in ______.Hemispherectomies ChildrenWhat nerve when stimulated creates a reduction in seizure activity?Vagal Nerve StimulationWhat percent reports a reduction with vagal nerve stimulation50%_________ frequency of seizures with ________ doses of _________.Higher, large, caffeineWhat should be avoided?Amphetamines and other stimulantsWhat type of seizure has EEG evidence of local onset?Partial seizuresA complex partial seizure begins in one _________ but ________ moves to both.hemisphere, quicklyA simple partial seizure begins in one ________ and the patient does not lose _______.Hemisphere, consciousnessWhat are the 4 places seizures are usually identified?1. Temporal 2. Frontal 3. Parietal 4. OccipitalSimple partial seizures preserves _________ with __________ hemispheric involvement.Consciousness UnilateralWhat are simple partial seizures manifested by?Focal motor or somatosensory symptomsWhat are the 3 psychotic responses to seizure activity with simple partial seizures?1. Illusions 2. Hallucinations 3. Sudden sense of fearAre cognitive and affective changes seen with simple partial seizures?YesWhat are the 7 symptoms seen with simple partial seizures?1. Light flashes 2. Buzzing 3. Abnormal sensations of taste and smell 4. Nausea 5. Pallor 6. Flushing 7. Pupillary DilationHow does the person appear when they have a complex partial seizure?Dazed and confused with random walking, mumbling, head turning or pulling on clothingDescribe consciousness in regards to complex partial seizures?Patient has an alteration or loss of consciousness and bilateral hemispheric involvementWhat is a Partial Seizure Becoming Secondarily Generalized?Generalized tonic-clonic seizure that develops from either a simple or complex partial seizure and has convulsive manifestations.Is localized onset evident on an EEG with generalized seizures?NoWhat are generalized absence seizures also called?Petit malWhat is a generalized absence seizure?Sudden cessation of ongoing conscious activity with minor convulsive muscular activity or loss of postural controlWhat is often a symptom of generalized absence seizure?Person often stares into spaceDescribe the onset and termination of a generalized absence seizure?Attacks are abruptDo generalized absence seizures have an aura?NoIs the patient aware of the loss of conscious control when they have a petit mal seizure?NoWhat are atypical absence seizure similar too?Absence seizuresWhat are myoclonic seizures?Sudden, brief, single or repetitive muscle contractionsWhat are a tonic seizures?Brief loss of consciousness and postural tone not associated with tonic muscular contractionsWhat are tonic-clonic seizures also called?Grand malA tonic-clonic seizure is considered to be an archetypal seizure, what does this mean?Total loss of controlWhat do tonic-clonic seizures begin with?Sudden loss of consciousness and often a fallWhat order are the phases?Rigidity phase followed by very rapid generalized jerking movements_______ of bowel and bladder occur and _______ can briefly cease.Incontinence, respirationRecovery after a short seizure is ______. Recovery after a prolonged seizure may induce a __________.Swift, deep sleepWhat 5 things may follow a tonic-clonic seizure?1. Altered Speech 2. Transient Paralysis / Ataxia 3. HA 4. Disorientation 5. Muscle SorenessGrand mal seizures are ________ common than partial seizuresLessWhat is status epilepticusCondition in which seizures are so prolonged / repeated that recovery does not occur between attacksWhat type of seizure requires medical attention and is a medical emergency?Status epilepticus (convulsive)When does severe myoclonic epilepsy of infancy begin?5-6 months of ageWhat are severe myoclonic epilepsy of infancy?Treatment-resistant seizures of various types characterized by psychomotor retardationWhat is benign myoclonic epilepsy in infancy?Clusters of myoclonic movementsWhere are benign myoclonic epilepsy in infancy confined to?Neck, trunk and extremitiesWhat is the prognosis and normal development of benign myoclonic epilepsy in infancy?Good prognosis Normal development by 2 years of ageWhat is the most common seizure disorder that occurs during childhood?Febrile ConvulsionsWhat are febrile convulsions a result of?FeverWhen are febrile convulsions rare?Rare before 6 months and after age 5What are febrile convulsions?Brief, generalized and tonic-clonic in sequence and the body temperature is highWhat percent of all seizures occur within the first 24 hours of fever?90%What possibility exists with febrile convulsions?Permanent brain damageWhat are atonic seizures are also called?Drop attacksWhat do people who have seizures normally only need protection from?Injury in the environment and fall preventionWhat helps keep the airway clear during a seizure?Rolling the person onto their sideIf status epilepticus occurs what measures must be taken?Emergency measuresHeadaches are a common complain that can result in what?Decreased function at work, home and schoolWhat percent of the total population has never had a headache?4%How many days of work / year are reported as lost due to HA / migraine?6 daysWhat are the 3 types of primary headaches?1. Migraines 2. Tension-HA 3. Cluster HAWhat are most headaches caused by?Muscle contraction or blood flow problemsTension HA are often felt where? (Figure 37.1)Top of the head, pressure downMigraine HA are often felt where? (Figure 37.1)One side of the headCluster HA are often felt where? (Figure 37.1)Behind one eyeWhat is the most common type of headache?Tension headacheWhat do tension headaches primarily occur as a response to?StressWhat are the 3 subcategories of tension-type headaches?1. Infrequent episodic 2. Frequent 3. ChronicWhat are the definitions of those subcategories?1. Infrequent = less than 12 days / year 2. Frequent = 12-180 days / year 3. Chronic = 180+ days / yearWhen is prevalence highest for tension type headaches30 - 40 year olds Increasing with level of educationWith tension headaches pain input to the brain may be increased due to what?Activation or sensitization of peripheral sensory afferent neuronsWhat neurotransmitters are involved with tension type headachesSerotonin and bradykininWhat is one of the main symptoms of a tension headacheTenderness to palpating of the tissues around the head (especially muscles)What does the level of tenderness correlate with?Intensity of the headacheWhat is pain in the whole head or neck described as?Dull and non-throbbing, tightness or pressureIs nausea reported with tension headachesNoWhat 3 things are reported with tension headaches?1. Anorexia 2. Mild photophobia 3. PhonophobiaWhat type of disorders are common with tension headaches?Sleep disordersWhere do you identify trigger points?Pericranial musclesWhat drugs are used to help tension headaches?1. Analgesics 2. NSAIDs 3. Tricyclic antidepressantWhat is the prognosis of tension headaches?Okay but they may develop into chronic tension-type HAMigraines are usually confined to __________ of the head.One sideWith migraines is the side of the head the same each time?NoThere is a strong ______ component with migraines.GeneticWhat are the 5 steps of a migraine?1. Starts deep in brain 2. Electrical impulse spreads 3. Symptoms such as vision disturbances, numbness, tingling & dizzy 4. BV Dilation and inflammation 5. Inflammation irritates trigeminal nerve = severe and throbbing painWhat percent of the female and male populations have migraines?Female = 18% Male = 6%What percent of migraine cases emerge during childhood?45%What percent of migraine cases have a positive family history?60%What 2 things are migraines believed to be a result of?1. Dilation of BVs in the brain 2. Low availability of serotoninWhat nerve is mainly affected with migraines?Trigeminal nerveWhat is the most common complaint of migraines?PainWhat signals platelets to aggregate?ProstaglandinWhat contains all of the serotonin present in the blood that releases all the serotonin?PlateletsWhat does increased serotonin cause?VasoconstrictionWhat does vasoconstriction cause?Decreased blood flow which causes ischemia result in in increased acidWhat causes the BVs to dilate?Localized acidosis and ischemiaWhat does vasodilation result in?HeadachesPlatelet aggregation then decreases, what does this do to serotonin?Decreases serotonin which leads to more vasodilation and painful inflammationWhen you have a headache with aura, cerebral blood flow is decreased by what percent?20% before the HAWhat happens to blood flow during a headache?It increasesHow do migraines without aura build up and how long do they last?Build up gradually 4-72 hoursWhat is common with migraines without aura?PhotophobiaWhen migraines without aura resolve how do you feel after?Feeling of heaviness and aching in the head, scalp tenderness and considerable fatigueWhat 3 things do migraines with aura frequently start with?1. Depression 2. Irritability 3. Loss of appetiteWhat do the autonomic changes result in with migraine with aura?Paresthesia of the face or extremitiesDefine visual auraMigraine preceded by visual symptomsWhat is aura usually described asChanges in the visual field that often begins with a hazy spotWhere is the hazy spot often seenClose to the center of visionDescribe the HA with migraine with auraIntense, throbbing and usually contralateral to the visual field changesWhat is a hemiplegic migraineMigraine with aura including motor weaknessWhat are the symptoms with hemiplegic migraineNumbness and weakness preceding the onset of the HAWhat are symptoms of hemiplegic migraine accompanied by?Dysphasia or aphasiaWhat artery causes basilar migraines?Basilar arteryWhat complaint is often seen with basilar migraines?Complaints of altered level of consciousness followed by occipital HAWhat is the primary complaint of vestibular migraineDizzinessWhat do chronic migraine start as?Migraine without auraWhat is the most common cause of chronic migraines?Medication overuseWhat classifies chronic migraines?15 + days a month for more than 3 monthsWhat type of drugs are often helpful with migraines?Vasoconstriction drugs TriptansWhat common substance causes cerebral vasoconstriction and could be helpful?CaffeineWhat is the persistence rate of men and women with migraines?Female = 79% Male = 48%What can help relieve some migraines?Manipulation of the c/spineTreatment of soft tissues of what 2 places will help bring relief?1. Neck 2. Occipital structuresWhat type of cluster headaches is most common?Episodic cluster HAWhat are episodic cluster headaches?Periods of susceptibility, alternating with periods of remissionWhat classifies chronic cluster headaches?HAs for at least 12 months and remissions for less than 14 daysWhat do chronic cluster headaches evolve from?Episodic cluster headachesCluster headaches are most common in ______ between the ages of _________.Men Ages 20-50Vasodilation of what arteries are ipsilateral to pain1. Ophthalmic 2. Internal CarotidWhat neurotransmitters are high during cluster headaches and low in the absence of headaches?Histamine SerotoninWhat happens to the BP and HR during cluster headachesBP increases HR decreasesWhat is the onset like with cluster headachesSudden with excruciating painA majority of cluster headaches remain on ________ of head throughout life.One sideWhat is the pain like with cluster headaches?Boring and no throbbingWhat induces cluster attacks?Vasodilator________ often induces an acute cluster attack.AlcoholWhat 2 types are cluster headaches commonly induced?Awakening from an afternoon nap or from sleep during the nightA typical client with CH __________ and _________.Smokes cigarettes, drinks alcoholWhat type of exercise appears to improve symptoms in CH as it does in migraines?AggressiveWhere is pain localized with cervicogenic headaches?Neck and occipital regions that projects to the forehead, orbital region, temples, vertex or earsWhat 6 things do x-rays show With cervicogenic headaches?1. Movement abnormalities in flexion / extension 2. Abnormal posture 3. Fractures 4. Congenital abnormalities 5. Bone tumors 6. Rheumatoid arthritisIs spondylitis or osteochondrosis seen with cervicogenic heaachesNoWhat is usually present during cervicogenic headachesParesthesisa and numbnessWhat does occipital nerualgia arise from?Entrapment of occipital nerveWhat should be ruled out as a cause of cervicogenic headaches?TMJ DysfunctionWhich apophyseal joint produces cervicogenic headaches?C2-C3What is passive motion is reported as painful with cervicogenic headaches?Extension, rotation to side of pain / digital pressure on involved facetWhere are the 3 points of muscle trigger points with cervicogenic headaches?1. Suboccipital 2. Cervical 3. Shoulder musculatureIs aging the primary cause of imbalance?NoHow does the vestibular system create motor output?Through vestibulospinal reflexes (VSRs)What is posturographyVSRs evaluate somatosensory and visual influence on posture and equilibriumWhat is BPPV?Episodic, intense vertigo related to head positionWhat is the main mechanical disorder of the labyrinthsBPPV_____ remissions are common, but the disorder can _____ and the condition can trouble the person for _______.Spontaneous, recur, years______ in the ______ can become loose, clump and form densities that are known as what?Otoconia Otolith CanalithsViral infections commonly affect what nerve unilaterallyVestibular nerveWhat is infection of the vestibular nerve called?Vestibular neuritisWhat does viral infection cause a sudden onset of?Rotary vertigo, nystagmus, nausea and vomitingWhat is endolymphatic hydropsDisorder of membranous inner ear as a consequence of overaccumulation of endolymphWhat is Meineres SyndromeEpisodic vertigo, fluctuating loss of hearing, fullness in ear, tinnitusWhat is a common cause of vertigo in people over 50 yearsVertebrobasilar insufficiencyWhat is electronystagmographyMethod of measuring eye movement by surrounding the orbit with electrodesWhat is bithermal caloric testManipulation of endolymphatic flow in semicircular canals by creating a temperature gradientWhat test is used in a dark room using a light bar that is controlled by a clients relation to vertical or horizontalSubjective Visual Vertical or HorizontalWhat is the Dix-Hallpike Maneuver used to diagnosis?BPPVWhat is the dix-hallpike maneuverPassive movement of the head from the upright position to one with head hanging extended and rotated 45 degreesWhat do you observe the eyes for?Nystagmus (should subside in 60 seconds)When does nystagmus occur?When the affected ear is placed down