MedSurg 120 Neuro Lecture notes

Topics: Epilepsy, Migraine, Neurology Pages: 2 (462 words) Published: April 17, 2014
Neuro MS120 LecNotes
• Headaches
• Cluster Headaches: unilateral, around or behind the eyes, not familial • Patho: Vasospasm r/t histamine release (allergies)
• Manifestations: tearing, running nose, photophobia, bradycardia, B/P changes • Treatment: Similar to migraine headaches
• Tension Headaches: Muscle tension around forehead, neck and shoulders • Patho: Tension at neck and shoulders
• Treatment: muscle relaxors
• Migraines are episodic, familial, experienced the same way every time • “I’m having a migraine”: Proceed with a neuro assessment, pain scale, ask them what the typical course of the migraine is.

• blurred vision, photophobia, ptosis
• Etiology: Vasospasm in the brain leading to intermittent hypoxia of the brain • Manifestations: How does the patient experience their typical migraines? • Prodrome phase: Mood change, food craving, sensation. Anything that indicates that a migraine is coming • Aura phase: Visual changes

• Headache phase: When the patient is experiencing the headache • Termination phase: Headache is improving, but pain is still present • Postprodrome phase: Headache pain gone, but neck may begin to fill stiff and achy, feelings of fatigue • Treatment: Pain meds, antiemetics (for nausea), quiet/dark room, caffeine, ice packs • Teach to avoid migraine triggers, encourage preventative therapy (yoga, meditation, acupuncture) • Seizures:

• Primary: etiology unidentifiable
• Treatment: antiepileptics drugs, many interactions. Recent dx of seizures usually will require more than one drug for treatment. Watch labs for therapeutic ranges of AEDs • Warn newly diagnosed patients to never stop taking meds. • Secondary: Caused by something (tumor, trauma, f/e imbalance) • Generalized seizures affect both hemispheres vs local/focal seizures in a specific area that can progress to a generalized seizure

• Post-ictal phase: period after the seizure (lethargy, confused) • Complex parital seizures: characterized by automatism
• Status...
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