Diseases Of The Nervous System Short Essays
Question 1. Status epilepticus
Answer:
Status Epilepticus
- Status Epilepticus 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
Read And Learn More: General Medicine Question and Answers
Question 2. Anti-epileptic drugs
Answer:
Anti-Epileptic Drugs Classification:
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:
- Pathological
- Dental pathosis
- Traction on divisions of trigeminal nerve
- Ischaemia
- Aneurysm of internal carotid artery
- 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
- 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
Etiology Clinical Manifestations:
- Emotional symptoms
- Sadness
- Misery
- Hopelessness
- Low self esteem
- Loss of interest
- Suicidal thoughts
- Biological symptoms
- Fatigue
- Apathy
- Loss of libido
- Loss of appetite
- Lack of concentration
- Sleep disturbances
- 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
Question 7. Causes of epilepsy
Answer:
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
- Migraine headache
- Tension type of headache
- Cluster headache
- Miscellaneous headache
- Traumatic headache
- Headache due to vascular causes- hematoma
- Headache due to non vascular causes- due to increased pressure
- Headache due to substance abuse- alcohol
- Headache due to systemic infection
- Headache due to metabolic disorders
- Headache due to referred pain- from ear, etc
- Cranial neuralgia- trigeminal neuralgia
- Unclassified headache