Diseases Of The Nervous System Short Essays

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Diseases Of The Nervous System Short Essays

Question 1. Status epilepticus

Answer:

Status epilepticus

  • It is a condition in which a series of seizures occur in the patient without regaining consciousness in between successive attacks

Status Epilepticus Precipitating Factors:

  • Sudden withdrawal of drugs
  • Irregular use of anti-convulsants
  • following intracranial pathology

Status Epilepticus Management:

  • Loosen clothes around neck
  • Maintain airway
  • Administration of high concentration of oxygen
  • Diazepam 10-20 mg IV over 1-5 minutes
  • Monitor BP, ECG, and blood gases
  • Diazepam 10 mg IV repeat once after 15 minutes
  • Start infusion drip of phenytoin, 18 mg/ kg at the rate of 50 mg/min
  • If seizure are not controlled, start infusion drip of chloromethiazol 4 0.5-1.2 g/hour
  • If seizures are not still controlled start 4 drip of thiopentone sodium 20 mg/kg 4 at 50-100 mg/min

Question 2. Anti-epileptic drugs

Answer:

Anti-Epileptic Drugs Classification:

Diseases Of The Nervous System Anti Epileptic Drugs

Anti-Epileptic Drugs – Mechanism of Action:

  • Blockade of sodium channels
  • Prolongation of their inactive state
  • Blockade of low threshold calcium current in the thalamic neurons
  • Enhancing GABA-mediated inhibition

Question 3. Trigeminal neuralgia

Answer:

Etiology:

  1. Pathological
    • Dental pathosis
    • Traction on divisions of trigeminal nerve
    • Ischaemia
    • Aneurysm of internal carotid artery
  2. Environmental
    • Allergic
    • Irritation to the ganglion
    • Secondary lesions

Trigeminal Neuralgia Clinical Features:

  • Age: Around 35 years
  • Sex: Common in female
  • Site: Right lower portion of the face, usually unilateral
  • Duration: Few seconds to few minutes

Read And Learn More: General Medicine Question and Answers

  • As time passes duration between the cycles decreases
  • Nature: stabbing or lancinating
  • Aggravating factors: Activation of TRIGGER ZONES
  • These are Vermillion border of lip, around the eyes, ala of nose

Interference with other activities:

  • Patient avoids shaving, washing face, chewing, brushing, as these may aggrevate pain
  • These lead to poor lifestyle
  • Extreme cases: leads to FROZEN OR MASK-LIKE FACE

Trigeminal Neuralgia Management:

1. Medical

  • Carbamazepine: initial dose: 100mg twice daily until relief is achieved
  • Dilantin: 300-400mg in single or divided doses
  • Combination therapy: Dilantin + carbamazepine

2. Surgical

  • Injection of alcohol in gasserian ganglion
  • Nerve avulsion: Performed on lingual, buccal or mental nerve
  • Part of nerve is sectioned
  • Electrocoagulation of gasserian ganglion: diathermy is done
    • Rhizotomy: Trigeminal sensory root is sectioned
    • Newer technique: TENS
  • Low-intensity current is used at high frequency is applied to the skin through electrodes attached by a conduction paste

Question 4. Etiology and clinical manifestations of depression

Answer:

Etiology

  • Depression is a common psychiatric disorder

Diseases Of The Nervous System Etiology And Clinical Manifestations Of Depression

Clinical manifestations:

  1. Emotional symptoms
    • Sadness
    • Misery
    • Hopelessness
    • Low self esteem
    • Loss of interest
    • Suicidal thoughts
  2. Biological symptoms
    • Fatigue
    • Apathy
    • Loss of libido
    • Loss of appetite
    • Lack of concentration
    • Sleep disturbances
  3. Symptoms of bipolar depression
    • Over enthusiasm
    • Overconfidence
    • Irritation
    • Aggression

Question 5. Petit mal epilepsy

Answer:

Petit mal epilepsy

  • This form of epilepsy is seen in children

Petit mal epilepsy Features:

  • Child stops working
  • Looks confused
  • Stares in space
  • May blink or roll up eyeballs
  • Fails to respond to verbal commands
  • Attack is brief

Petit mal epilepsy Diagnosis:

  • EEG changes shows spike and wave complexes at a frequency of 3 Hz per second

Question 6. Peripheral neuropathy

Answer:

Peripheral neuropathy

  • Peripheral neuropathy is the disorder of peripheral nerves either sensory, motor, or mixed, symmetrical, and affecting distal parts of limbs

Diseases Of The Nervous System Peripheral Neuropathy

Question 7. Causes of epilepsy

Answer:

Causes of epilepsy

Diseases Of The Nervous System Causes Of Epilepsy

Question 8. Hypertensive encephalopathy

Answer:

Hypertensive encephalopathy

  • Hypertensive encephalopathy is characterized by a very high blood pressure and neurological disturbances including transient abnormalities in speech, vision, paresthesia, disorientation, fits, loss of consciousness, and papilloedema

Hypertensive Encephalopathy Treatment:

  • Intravenous sodium nitroprusside-0.3-1 micro- gratn/kg/ min
  • Parenteral labetelol- 2 mg/min
  • Hydralazine-5-10 mg every 30 min
  • Bed rest
  • Sedation
  • Diuretics

Question 9. Discuss the differential diagnosis of headache

Answer:

The differential diagnosis of headache

  1. Migraine headache
  2. Tension type of headache
  3. Cluster headache
  4. Miscellaneous headache
  5. Traumatic headache
  6. Headache due to vascular causes- hematoma
  7. Headache due to non vascular causes- due to increased pressure
  8. Headache due to substance abuse- alcohol
  9. Headache due to systemic infection
  10. Headache due to metabolic disorders
  11. Headache due to referred pain- from ear, etc
  12. Cranial neuralgia- trigeminal neuralgia
  13. Unclassified headache

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