Migraines Seizures Patho/Risk Factors/Causes Hyperexcitability of the neurons leads to dilation of the cerebral blood vessels and inflammation. Cause: "not clear" Triggers: Each patient is different. Some examples: Alcohol MSG Caffeine Stress Excessive, uncontrolled firing of brain neurons. Causes: *Some are idiopathic. *Some are caused by injury to the brain such as: Trauma, stroke, or tumor. Assessment Aura: A sensation that signals the onset of a migraine. Pain is typically throbbing and unilateral. Associated symptoms: photophobia: sensitivity to light. phonophobia: sensitivity to sound. Typically lasts 4-72 hours hours. *Ditans - block serotonin without vasoconstriction so are considered safer than triptans. Types of seizure: Generalized: Tonic-clonic - stiffening of the muscles followed by jerking. May experience incontinence or become cyanosis. For up to 1 hour after, patient Treatment Priority intervention: Pain management. Abortive therapy (patient should take the medication at the start of migraine): *NSAIDS - decrease inflammation. *Triptans & ergotamines- Cause vasoconstriction. Contraindicated in patients with a cardiovascular history. Preventative therapy (patient should take the medication daily): These meds work by decreasing neuron excitability. Any beta or calcium-channel Examples: blocker meds - patient must Propranolol Verapamil Topiramate Nortriptyline Seizure prevention: AED Considerations: Antiepileptic drugs (AED's): Phenytoin Carbamazepine Valproic Acid Seizure Management: Stop acute seizure with Nursing Considerations/ Patient Teaching Be sure patients know the difference between abortive and preventative meds. Triptans: Report any chest pain. May cause flushing or tingling sensations. Don't mix with SSRI's. Ergotamines: Do not give within 24 hours of a triptan. Teach patient avoidance of triggers. monitor heart rate and report any bradycardia. *Check drug levels as ordered because AED's must be within a therapeutic range to be effective. *Educate about taking AED's as prescribed. *Monitor liver enzymes and
*Electrolyte imbalances: Low Na+, low Mg * Alcohol withdrawal. Epilepsy: Repeated, unprovoked seizure activity. may be confused, lethargic (postictal). Duration of 2-5 min. Myoclonic - Jerking of one or more extremity. Duration of a few seconds. Atonic - Sudden loss of muscle tone. High risk of injury. May experience confusion after. Duration of few seconds. Partial: Complex-partial - Causes meaningless, repetitive motor activities called automatisms. Examples: wandering, lip smacking. Patient's LOC: "blackout" - appears awake. Duration of 1-3 minutes. Often mistaken for dementia in older adults. Simple-partial - Unpleasant sensations, feeling of déjà vu, unilateral jerking movement, or change in HR. Remains conscious throughout seizure. Often has aura prior. Diagnosed with EEG. EMERGENCY: Status epilepticus: Seizure lasting Lorazepam or diazepam. "benzos break seizures." Status epilepticus: PRIORITY is airway/breathing. Start normal saline IV. IV lorazepam/diazepam. After seizure, a loading dose of phenytoin to prevent additional seizures. white blood cell counts. *Educate about need for frequent oral care due to the risk of gingival hyperplasia. Seizure Precautions: Suction & O2 at bedside. Insert a saline lock (IV site). Other Teaching: *Wear a medical alert bracelet. *Be sure a family member knows how to help during a seizure. *Avoid alcohol.
Parkinson's Multiple Sclerosis Neurodegenerative disease that results from a lack of dopamine in the brain. Dopamine is responsible for controlling