Category: Fundamentals
Dementia follows a gradual course, with evolution occurring over months to years. Although patients with dementia exhibit confusion, unlike delirium, manifestations of autonomic nervous system abnormalities are minimal or absent.
Category: Fundamentals
Delirium is characterized by a fluctuating neurobehavioral disturbance typically progressing over a short period. It is a direct consequence of an acute systemic or central nervous system (CNS) stressor.
Category: Fundamentals
Cognition is a composite of attention, orientation, memory, language, visual-spacial ability and executive function. Both delirium and dementia affect cognition but in very different ways and over very different time courses.
Category: Fundamentals
Eclampsia is the major consideration in pregnant patients of at least 20 weeks’ gestation, who present with new-onset seizures. Postpartum eclampsia represents 25% of eclamptic seizures and can occur up to 8 weeks after delivery.
Category: Fundamentals
Seizures occurring after abuse of N-methyl-3,4-methylenedioxyamphetamine (MDMA) compounds (“ecstasy” and “Molly”) may be due to associated hyponatremia and hyperthermia.
Category: Fundamentals
Tonic-clonic seizures have been reported with use of synthetic cannabinoids (“spice” and “K2”). Marijuana, however, is not commonly associated with seizures and some forms of severe epilepsy have been treated with medical marijuana.
Category: Fundamentals
Toxins can alter the brain equilibrium of excitatory and inhibitory neurotransmitters to cause seizures. Many illicit drugs disrupt the equilibrium, including cocaine and other stimulants and narcotics.
Category: Fundamentals
Benzodiazepines are the treatment of choice in an alcohol-withdrawal seizure. They offer cross-tolerance with alcohol by acting at the GABA receptor site and reduce the signs and symptoms of alcohol withdrawal.
Category: Fundamentals
Alcohol-withdrawal seizures account for a large portion of seizures, but alcohol abuse/dependence puts patients at risk of seizure in other ways, such as increased incidence of traumatic brain injury and hypomagnesemia due to malnutrition.
Category: Fundamentals
The management of a patient experiencing a seizure begins with active, anticipatory airway management. A jaw thrust, use of a nasopharyngeal airway and supplemental oxygen may be required.
Category: Fundamentals
The electroencephalogram (EEG) is the definitive test for diagnosing a seizure disorder, although its sensitivity varies depending on timing and location of the seizure focus. It is particularly helpful when the diagnosis is in doubt.
Category: Fundamentals
Seizures start when the equilibrium across the cell membrane is disturbed. Infection, toxins, electrolyte imbalances, and other pathologic processes can disrupt the neuronal equilibrium locally and trigger electrical activity, resulting in a seizure.
Category: Fundamentals
When normal neurophysiology exists, neuronal cell membranes are stabilized by electrochemical gradients and by equilibrium among inhibitory neurotransmitters, such as gamma-aminobutyric acid and excitatory neurotransmitters.
Category: Fundamentals
A simple focal seizure traditionally refers to focal seizure with preserved mental status. A generalized seizure denotes abnormal neuronal firing throughout both brain hemispheres and always involves alterations of consciousness.
Category: Fundamentals
Partial seizures involve abnormal neuronal firing within a confined population of neurons in one brain hemisphere, and the clinical manifestations tend to reflect the area of electrical activity.
Categoey: Fundamentals
Epilepsy is a condition of recurrent unprovoked seizures. For example, a patient who suffers head trauma might have a seizure but would not be considered to have epilepsy unless there are recurrent unprovoked events as a result of the brain injury.
