NUR631 Exam 1 Neuro| COMPREHENSIVE QUESTIONS WITH 100% RATED ANSWERS
Treatment of seizures - after a single isolated seizure a work up is done to identify the cause
of the seizure but anti-epileptic therapy is usually not required unless the pt experiences
recurrent seizure activity, or an underlying disorder with high pre-disposition for seizures is
revealed****
- refer to neurologist for initiation of therapy
First line treatment of absence and myoclonic seizures:
- Valproic acid (Depakene), SE is that drug values have to be checked periodically due to effects
on mood and can be toxic to liver and pancreas**
For focal (partial) seizures first line is usually Carbamazepine(Tegretol) or Lamotrigene
- second line would be Keppra (monitor for SE that include watching for alopecia, depression,
suicidal ideations, monitor CBC)
Abort seizure*:
- Benzodiazepines: Lorazepam (ativan) diazepam (valium)**
- Prevent reoccurrence:
-- Phenytoin (dilantin) monitor blood levels 10-20 mg/mL
SE: acne, hirsutism, gingival hyperplasia, steven johnson syndrome
Toxicity: ataxia, slurred speech, nystagmus
,Avoid alcohol!
-- Carbamazepine (Tegretol) SE include dizziness, sedation drowsiness, nausea and vomiting.
Check therapeutic levels, norm is 4-12 anything above 12 is toxic
ALS amyotrophic lateral sclerosis (Lou Gehrig's disease)
- progressive neurological disorder that involves destruction of the anterior horn motor cell in
the spinal cord or the brainstem
- both upper motor neurons ** located in the motor cortex and lower motor neurons** are
affected
- is a nervous system disease that weakens the muscles and impacts physical function, cause is
unknown
- it is universally fatal
Main symptom is muscle weakness! Hallmark is the combo of Upper and lower motor neuron
signs
CM:
- Upper motor neurons:
weakness with slowness, hyperreflexia**, spasticity, dysphagia
- Lower motor neurons:
--weakness, atrophy, hyporeflexia**, muscle twitching, foot drop
, - weakness of respiratory muscles as the disease progresses can lead to resp depression and
frequent aspirations
Diagnostic testing ALS - H and P
- EMG:
--** this is a diagnostic test to assess the health of the muscles and look at the nerve cells that
control the motor neurons, it can see if there is nerve dysfunction and see if the signals are
going through from nerve to muscle
Management for ALS No treatment
- supportive care
- psychological support for patient and family**
MS Multiple sclerosis
- chronic demyelinating disease of the CNS that begins most commonly in young adulthood**
- white matter becomes inflamed
Different forms of MS:
- Relapsing -remitting MS (RRMS)
- primary progressive MS (PPMS)
- Secondary progressive MS (SPMS)
- Progressive relapsing MS (PRMS)
Treatment of seizures - after a single isolated seizure a work up is done to identify the cause
of the seizure but anti-epileptic therapy is usually not required unless the pt experiences
recurrent seizure activity, or an underlying disorder with high pre-disposition for seizures is
revealed****
- refer to neurologist for initiation of therapy
First line treatment of absence and myoclonic seizures:
- Valproic acid (Depakene), SE is that drug values have to be checked periodically due to effects
on mood and can be toxic to liver and pancreas**
For focal (partial) seizures first line is usually Carbamazepine(Tegretol) or Lamotrigene
- second line would be Keppra (monitor for SE that include watching for alopecia, depression,
suicidal ideations, monitor CBC)
Abort seizure*:
- Benzodiazepines: Lorazepam (ativan) diazepam (valium)**
- Prevent reoccurrence:
-- Phenytoin (dilantin) monitor blood levels 10-20 mg/mL
SE: acne, hirsutism, gingival hyperplasia, steven johnson syndrome
Toxicity: ataxia, slurred speech, nystagmus
,Avoid alcohol!
-- Carbamazepine (Tegretol) SE include dizziness, sedation drowsiness, nausea and vomiting.
Check therapeutic levels, norm is 4-12 anything above 12 is toxic
ALS amyotrophic lateral sclerosis (Lou Gehrig's disease)
- progressive neurological disorder that involves destruction of the anterior horn motor cell in
the spinal cord or the brainstem
- both upper motor neurons ** located in the motor cortex and lower motor neurons** are
affected
- is a nervous system disease that weakens the muscles and impacts physical function, cause is
unknown
- it is universally fatal
Main symptom is muscle weakness! Hallmark is the combo of Upper and lower motor neuron
signs
CM:
- Upper motor neurons:
weakness with slowness, hyperreflexia**, spasticity, dysphagia
- Lower motor neurons:
--weakness, atrophy, hyporeflexia**, muscle twitching, foot drop
, - weakness of respiratory muscles as the disease progresses can lead to resp depression and
frequent aspirations
Diagnostic testing ALS - H and P
- EMG:
--** this is a diagnostic test to assess the health of the muscles and look at the nerve cells that
control the motor neurons, it can see if there is nerve dysfunction and see if the signals are
going through from nerve to muscle
Management for ALS No treatment
- supportive care
- psychological support for patient and family**
MS Multiple sclerosis
- chronic demyelinating disease of the CNS that begins most commonly in young adulthood**
- white matter becomes inflamed
Different forms of MS:
- Relapsing -remitting MS (RRMS)
- primary progressive MS (PPMS)
- Secondary progressive MS (SPMS)
- Progressive relapsing MS (PRMS)
