Final ReviewFinal Review

END 104

Review• Idiopathic

• Symptomatic

Review• SSPE

– Dormant measles virus, slow virus

• Reye’s Syndrome– Encephalitis, URI or chicken pox

• Pick’s Disease– Progressive dementia and aphasia– Atrophy to frontal and temporal poles

• Huntington's Chorea– Inherited, chorea, intellectual decline, loss of self

care

Review• Herpes Simplex Encephalitis

– Early stages: • disorganized, polymorphic delta• Focal or lateralized• Predominance over infected temporal

region

Review• Cerebral abscess

– EEG:• Usually shows, localized or lateralized

high voltage, irregular delta activity• Degree of abnormality reflects the

severity of inflammation

Review• Vital signs of meningitis

– Neck stiffness (rigidity)– Kernig’s sign

Review• TIA

– Transient ischemic attack• Focal neurological deficit, secondary to

inadequate blood supply• Sudden in onset• Resolve completely in 24 hours, no

deficits

Review• Middle cerebral artery CVA

– Most common– Motor and sensory, opposite face and

arm– Aphasia if dominant hemisphere – Visual field losses

Review• Anterior cerebral artery CVA

– Confusion and behavior disorders– Both motor and sensory impairment

in the opposite leg

Review• Ischemic CVA

– The blood supply to part of the brain suddenly becomes inadequate for the brain to function

• Hemorrhagic CVA– A blood vessel ruptures and blood rushes

into either the brain and destroys it or the subarachnoid space causing increased ICP

Review• PLEDS

– Associated with acute ischemic CVA

Review• Partial seizures

– Simple (elementary)– Complex– Secondarily generalized

• Generalized Seizures• Unclassified

Review• Tonic clonic seizure

– EEG:• High voltage fast beta• Polyspikes and muscle during tonic phase• Polyspike complexes with each clonic

movement• Generalized suppression with gradual

build-up of activity

Review• Alzheimer’s disease

– Atrophy of the cerebral cortex

– EEG:• May be normal early• Diffuse slow, with a slow, poorly

organized or absent background.

Review• Neuroleptic medications

– anti-psychotic medication– Adverse reactions

• Pseudoparkinsonism• Tardive dyskinesia

Review• Metabolic disorders

– The EEG, in general, shows non-specific changes

– Usually, diffuse slowing in varying degrees. Slow alpha to generalized delta

• Anoxia• Hypoglycemia / hyperglycemia• Hypocapnia• Hypocalcemia• Etc….

Review• Alpha coma

– Brainstem infarcts

Review• Triphasic waves

– EEG is diffusely slow– No alpha– Frontally dominant– Generalized with time lag– Three phases

Review• Hyperthyroidism

– Grave’s Disease– Excessive secretion of the thyroid

gland

Review• Mysoline primidone• Depakote valproic acid• Valium diazepam• Luminal phenobarbital• Dilantin phenytoin• ACTH

adrenocorticotropic hormone

Review• Psychotherapeutics

– Induce decreased emotionality and indifference to external stimuli

– Thorazine, Mellaril, Haldol, Compazine, Stelazine, etc..

– Decrease of background frequency, increase in amplitude

– Thorazine, lowers threshold to PS and can cause status epilepticus in those with epilepsy

Review• Common migraine – no aura• Classical migraine – aura• Hemiplegic migraine – with neuroilogical

deficits• Cluster headache – vascular headache,

unilateral, usually in or around one eye• Tension headache – muscle contraction, tight,

band like pressure

Review• Epidural hematoma – bleeding

above dura• Subdural hemoatoma – bleeding

between the dura and arachnoid• Subarachnoid hemorrhage –

between the arachnoid and pia