NR 507
WEEK 8 EDAPT
CNS NOTES
UNDERSTANDING SEIZURES
HEADACHES TREATMENT
, SZ
● Generalized tonic-clonic seizures: there is wide-spread and uncontrolled
neuron activity in the entire cerebral cortex. These occur in 10% of
patients who have epilepsy. There is excessive neuronal discharge in
the motor nerves through the brain.
○ Tonic-clonic phase (lasts 10-20 seconds): Due to the excessive
discharge of neurons in the motor nerves that results in:
■ the muscles of the body become contracted. without any
relaxation.
■ loss of consciousness.
■ ictal cry. This is a typical sound produced by the tonic
contractions of the laryngeal muscles and muscles of
expiration.
■ respiratory impairment that results in cyanosis.
■ tonic contraction of the jaw muscles that can cause tongue
biting.
■ Increased sympathetic activity. This will cause increased
heart rate and blood pressure
○ Clonic phase (lasts one minute): continuous discharge of neurons
gets interrupted. It is characterized by small durations of
relaxation. This occur because of inhibitory mechanisms of the
brain to try to control the wide-spread neuronal activity. The
patient will exhibit spasms and jerking. This is perceived as violent
shaking of muscles.
○ Post-ictal phase (lasts one to two hours): this stage is
characterized by confusion, unresponsiveness and muscle
flaccidity. Following the post-ictal state, there will be a return to
normal state of consciousness.
● Generalized tonic seizures: this seizure is characterized by
unconsciousness and muscle rigidity.
● Generalized clonic seizures: this seizure is characterized by muscle
spasms.
● Generalized absence seizure: this seizure is most common in children.
It is caused by a genetic abnormality. They are characterized by sudden
, and brief loss of consciousness without muscle tone and last for only a
few seconds. There is no associated post-ictal confusion.
Treatment
Anticonvulsants – Wide variety of options available ad is based on needs of the patient
Surgery – Removes the cause of the seizure
Nerve stimulation — Controls the seizure by influencing neurotransmitter release
Ketogenic diet — Produces energy other than glucose to be used by the brain
Tonic-clonic phase (lasts 10-20 seconds): Due to the excessive discharge of
neurons in the motor nerves that results in:
1. The muscles of the body become contracted. without any relaxation.
2. Loss of consciousness.
3. Ictal cry. This is a typical sound produced by the tonic contractions of
the laryngeal muscles and muscles of expiration.
4. Respiratory impairment that results in cyanosis.
5. Tonic contraction of the jaw muscles that can cause tongue biting.
6. Increased sympathetic activity. This will cause increased heart rate and
blood pressure
HEADACHE SYNDROME
● Unilateral: this involves one side of the face. This is known as the
migraine headache.
● Tension headache: this feels like a tightness around the forehead.
● Cluster headache: this is located around the orbital eye area
● Sinus headache: related to sinusitis
Simple analgesics and Non-steroidal anti-inflammatory drugs (NSAIDS) are
commonly used for a tension headache.
The symptoms of the aural phase of a migraine headache correspond directly
to the movement of the cortico-spreading depression across the cerebral
cortex. Tension headache is the most common type of headache.
WEEK 8 EDAPT
CNS NOTES
UNDERSTANDING SEIZURES
HEADACHES TREATMENT
, SZ
● Generalized tonic-clonic seizures: there is wide-spread and uncontrolled
neuron activity in the entire cerebral cortex. These occur in 10% of
patients who have epilepsy. There is excessive neuronal discharge in
the motor nerves through the brain.
○ Tonic-clonic phase (lasts 10-20 seconds): Due to the excessive
discharge of neurons in the motor nerves that results in:
■ the muscles of the body become contracted. without any
relaxation.
■ loss of consciousness.
■ ictal cry. This is a typical sound produced by the tonic
contractions of the laryngeal muscles and muscles of
expiration.
■ respiratory impairment that results in cyanosis.
■ tonic contraction of the jaw muscles that can cause tongue
biting.
■ Increased sympathetic activity. This will cause increased
heart rate and blood pressure
○ Clonic phase (lasts one minute): continuous discharge of neurons
gets interrupted. It is characterized by small durations of
relaxation. This occur because of inhibitory mechanisms of the
brain to try to control the wide-spread neuronal activity. The
patient will exhibit spasms and jerking. This is perceived as violent
shaking of muscles.
○ Post-ictal phase (lasts one to two hours): this stage is
characterized by confusion, unresponsiveness and muscle
flaccidity. Following the post-ictal state, there will be a return to
normal state of consciousness.
● Generalized tonic seizures: this seizure is characterized by
unconsciousness and muscle rigidity.
● Generalized clonic seizures: this seizure is characterized by muscle
spasms.
● Generalized absence seizure: this seizure is most common in children.
It is caused by a genetic abnormality. They are characterized by sudden
, and brief loss of consciousness without muscle tone and last for only a
few seconds. There is no associated post-ictal confusion.
Treatment
Anticonvulsants – Wide variety of options available ad is based on needs of the patient
Surgery – Removes the cause of the seizure
Nerve stimulation — Controls the seizure by influencing neurotransmitter release
Ketogenic diet — Produces energy other than glucose to be used by the brain
Tonic-clonic phase (lasts 10-20 seconds): Due to the excessive discharge of
neurons in the motor nerves that results in:
1. The muscles of the body become contracted. without any relaxation.
2. Loss of consciousness.
3. Ictal cry. This is a typical sound produced by the tonic contractions of
the laryngeal muscles and muscles of expiration.
4. Respiratory impairment that results in cyanosis.
5. Tonic contraction of the jaw muscles that can cause tongue biting.
6. Increased sympathetic activity. This will cause increased heart rate and
blood pressure
HEADACHE SYNDROME
● Unilateral: this involves one side of the face. This is known as the
migraine headache.
● Tension headache: this feels like a tightness around the forehead.
● Cluster headache: this is located around the orbital eye area
● Sinus headache: related to sinusitis
Simple analgesics and Non-steroidal anti-inflammatory drugs (NSAIDS) are
commonly used for a tension headache.
The symptoms of the aural phase of a migraine headache correspond directly
to the movement of the cortico-spreading depression across the cerebral
cortex. Tension headache is the most common type of headache.
