Migraine Pathophysiology - CORRECT ANSWER -Pathophysiology - Not
entirely clear.; theories?
Prevalence: May be seen in children and adults; Among children more
common in boys; among adults more common in women.
History of patient with migraine: Otherwise healthy, usually female in 30's
Individualized triggers (stress, smells, foods, hormones, menses)
Tyramine rich foods- chocolate, cheeses, beer, wine, cigar, sweet and low.
Treatment for Migraine - CORRECT ANSWER -Vasoconstriction works the
best, irritation of the 5th cranial nerve, Estrogen hormone can causes
migraines.
Migraine Manifestations - CORRECT ANSWER -Manifestations
Pain: Usually unilateral, supra/retro-orbital, pulsating. Worse with
movement.
Accompanied by non-h/a symptoms: N/V, photophobia, phonophobia,
Aura: (20% of cases):
Migraine Interventions - CORRECT ANSWER -Pain management
Symptom management
Ex. Pitch black, turn off all the lights, N/V causes dehydration
Migraine Drug Therapy - CORRECT ANSWER -APAP/Caffeine/ Butabital
(Fioricet)
NSAIDS : Naprosyn
CCBs and Beta- Blockers (Preventative therapy) : Verapamil
Triptans and ergotamine's: Sumatriptan and Cafergot
,Anticonvulsants (Preventative therapy): Topiramate
Botox Injections (monthly)
Magnesium
Migraine Complementary and alternative therapies - CORRECT ANSWER
-Acupuncture, Yoga, Stress reduction activities, Supplemental mag,
Distraction sometimes works.
Pound acronym - CORRECT ANSWER -P:Pulsating
O:Duration
U: Unilateral location
N: N/V
D: Disabling
Epilepsy - CORRECT ANSWER -Chronic disorder with two or more seizures
experienced by the client.
Epilepsy Assessment - CORRECT ANSWER -Inquire about the seizure
activity, frequency, precipitating factors, aura (pre-ictal phase).
Family history
Collateral medical conditions (hx stroke, HTN, TBI, drug/alcohol abuse)
Seizure risk factors - CORRECT ANSWER -V: Vascular
I: Infection or Inherited conditions
T: Trauma
A: Alzheimers/Autoimmune
M: Metabolic derangements
,I: Idiopathic
N: Neoplasm
S: pSychiatric
Epilepsy Triggers - CORRECT ANSWER -Sleep deprivation
Stress
Alcohol/ Alcohol Withdrawl
MSG
pg 878 Chart 42-9
Aura - CORRECT ANSWER -Seizures often preceded by an aura; it is unique
to that patient, not every patient has them.
Somatic: rising epigastric sensation
Hallucinations: Visual, gustatory, olfactory
Halos, Zig-zags, h/a, paresthesias, psychiatric phenomenon, deja-vu
Epilepsy Partial: - CORRECT ANSWER -Partial (also called focal or local
seizures): Occurs in a specific part of the brain. May be characterized by
automatism or tic. Ex: Jerk, reflex, lip smacking (complex)
Epilepsy Simple: - CORRECT ANSWER -Client does not consciousness.
Localized jerking/movement. Strange sensations. Autonomic symptoms.
Focal awareness they do not lose consciousness.
Epilepsy Complex - CORRECT ANSWER -Involves altered LOC; may or may
not have total loss of consciousness. Automatisms. Patient may wander at
start or have amnesia after. Most common among older adults and difficult
, to diagnose bc symptoms appear similar to those of dementia, psychosis,
or neurobehavioral disorder, esp post-ictal.
Generalized epilepsy - CORRECT ANSWER -Affects brain as a whole,
bilateral seizure; we differentiate them based on how they appear while
observing them.
absence epilepsy - CORRECT ANSWER -(petit mal): Generalized seizure
involving sudden, brief loss of consciousness. Usually diagnosed in
children. Appears as if they are staring off into space. Lasts seconds.
tonic-clonic epilepsy - CORRECT ANSWER -"Grand mal." Stereotypical
body convulsions. Lasts minutes, involves muscle rigidity and convulsions.
Tonic=stiffening, Clonic=jerking
Myoclonic Epilepsy - CORRECT ANSWER -Brief muscle jerks, lasts
seconds
Atonic (akinetic) Seizure (drop seizure) - CORRECT ANSWER -Involves brief
loss of tone. May be confused with Fainting.
Acute Seizure Management (Observation) - CORRECT ANSWER -History
(if reported)
Look for underlying cause!
Record time sz began and ended.
Duration
Types of movements
Ongoing seizure observations
entirely clear.; theories?
Prevalence: May be seen in children and adults; Among children more
common in boys; among adults more common in women.
History of patient with migraine: Otherwise healthy, usually female in 30's
Individualized triggers (stress, smells, foods, hormones, menses)
Tyramine rich foods- chocolate, cheeses, beer, wine, cigar, sweet and low.
Treatment for Migraine - CORRECT ANSWER -Vasoconstriction works the
best, irritation of the 5th cranial nerve, Estrogen hormone can causes
migraines.
Migraine Manifestations - CORRECT ANSWER -Manifestations
Pain: Usually unilateral, supra/retro-orbital, pulsating. Worse with
movement.
Accompanied by non-h/a symptoms: N/V, photophobia, phonophobia,
Aura: (20% of cases):
Migraine Interventions - CORRECT ANSWER -Pain management
Symptom management
Ex. Pitch black, turn off all the lights, N/V causes dehydration
Migraine Drug Therapy - CORRECT ANSWER -APAP/Caffeine/ Butabital
(Fioricet)
NSAIDS : Naprosyn
CCBs and Beta- Blockers (Preventative therapy) : Verapamil
Triptans and ergotamine's: Sumatriptan and Cafergot
,Anticonvulsants (Preventative therapy): Topiramate
Botox Injections (monthly)
Magnesium
Migraine Complementary and alternative therapies - CORRECT ANSWER
-Acupuncture, Yoga, Stress reduction activities, Supplemental mag,
Distraction sometimes works.
Pound acronym - CORRECT ANSWER -P:Pulsating
O:Duration
U: Unilateral location
N: N/V
D: Disabling
Epilepsy - CORRECT ANSWER -Chronic disorder with two or more seizures
experienced by the client.
Epilepsy Assessment - CORRECT ANSWER -Inquire about the seizure
activity, frequency, precipitating factors, aura (pre-ictal phase).
Family history
Collateral medical conditions (hx stroke, HTN, TBI, drug/alcohol abuse)
Seizure risk factors - CORRECT ANSWER -V: Vascular
I: Infection or Inherited conditions
T: Trauma
A: Alzheimers/Autoimmune
M: Metabolic derangements
,I: Idiopathic
N: Neoplasm
S: pSychiatric
Epilepsy Triggers - CORRECT ANSWER -Sleep deprivation
Stress
Alcohol/ Alcohol Withdrawl
MSG
pg 878 Chart 42-9
Aura - CORRECT ANSWER -Seizures often preceded by an aura; it is unique
to that patient, not every patient has them.
Somatic: rising epigastric sensation
Hallucinations: Visual, gustatory, olfactory
Halos, Zig-zags, h/a, paresthesias, psychiatric phenomenon, deja-vu
Epilepsy Partial: - CORRECT ANSWER -Partial (also called focal or local
seizures): Occurs in a specific part of the brain. May be characterized by
automatism or tic. Ex: Jerk, reflex, lip smacking (complex)
Epilepsy Simple: - CORRECT ANSWER -Client does not consciousness.
Localized jerking/movement. Strange sensations. Autonomic symptoms.
Focal awareness they do not lose consciousness.
Epilepsy Complex - CORRECT ANSWER -Involves altered LOC; may or may
not have total loss of consciousness. Automatisms. Patient may wander at
start or have amnesia after. Most common among older adults and difficult
, to diagnose bc symptoms appear similar to those of dementia, psychosis,
or neurobehavioral disorder, esp post-ictal.
Generalized epilepsy - CORRECT ANSWER -Affects brain as a whole,
bilateral seizure; we differentiate them based on how they appear while
observing them.
absence epilepsy - CORRECT ANSWER -(petit mal): Generalized seizure
involving sudden, brief loss of consciousness. Usually diagnosed in
children. Appears as if they are staring off into space. Lasts seconds.
tonic-clonic epilepsy - CORRECT ANSWER -"Grand mal." Stereotypical
body convulsions. Lasts minutes, involves muscle rigidity and convulsions.
Tonic=stiffening, Clonic=jerking
Myoclonic Epilepsy - CORRECT ANSWER -Brief muscle jerks, lasts
seconds
Atonic (akinetic) Seizure (drop seizure) - CORRECT ANSWER -Involves brief
loss of tone. May be confused with Fainting.
Acute Seizure Management (Observation) - CORRECT ANSWER -History
(if reported)
Look for underlying cause!
Record time sz began and ended.
Duration
Types of movements
Ongoing seizure observations
