Chronic Neurologic Problems Vocabulary

Vocabulary flashcards generated from lecture notes on Chapter 63 Chronic Neurologic Problems.

Tension-Type Headache

The most common primary headache, characterized by bilateral pressing or tightening pain that feels like a band squeezing the head.

Sinus Headache

A headache characterized by pain located behind the browbone and/or cheekbones.

Migraine Headache

A recurring headache characterized by unilateral throbbing pain, which can occur with or without aura and last up to $72\,\text{hours}$.

Cluster Headache

The most severe primary headache, involving the Trigeminal Nerve (CN V) and presenting as sharp, stabbing, one-sided pain in and around one eye.

Migraine Aura

Neurological warning symptoms preceding or accompanying a migraine, including visual, sensory, and aphasic disturbances.

Cluster Headache Duration

Severe one-sided headache attacks that usually occur at the same time of day and last between $15\,\text{min}$ and $3\,\text{hours}$.

Diagnostic Studies for Headaches

Diagnostic tools including a thorough history and physical examination, CT scan, MRI, and EMG.

Headache Diary

A thorough assessment tool kept by the patient to record headache frequency, timing, severity, and potential triggers.

Tension Headache Pharmacotherapy

Treatment using ASA, Tylenol, or NSAIDs (sometimes combined with caffeine), as well as sedatives or muscle relaxers.

Migraine Pharmacotherapy

Acute therapy using NSAID/ASA/caffeine combos or Triptans, and preventive therapy using topiramate, beta-blockers, botox, or CGRP inhibitors.

Cluster Headache Abortive Therapy

Acute medical management utilizing Triptans and high-flow oxygen.

Verapamil

A medication specified as a preventive treatment for cluster headaches.

Seizure

A sudden, abnormal, excessive electrical discharge of neurons in the brain.

Epilepsy (Seizure Disorder)

A group of neurologic diseases marked by recurring seizures, defined as $2$ or more seizures occurring more than $24\,\text{hours}$ apart without an underlying cause.

Status Epilepticus

A medical emergency characterized by continuous or consecutive seizure activity without recovery of consciousness lasting $> 5\,\text{minutes}$.

Prodromal Phase

The initial seizure phase where symptoms such as confusion, anxiety, tremors, and mood disturbances start before the actual seizure.

Aural Phase

The warning sign right before a seizure, characterized by sensory phenomena like odd smells, strange tastes, altered vision, or dizziness.

Ictal Phase

The active phase during which seizure activity occurs.

Postictal Phase

The recovery period after a seizure, commonly marked by headache, pain, confusion, lethargy, muscle soreness, and fatigue.

Tonic Phase

The initial phase of a tonic-clonic seizure involving loss of consciousness and stiffening of the body.

Clonic Phase

The secondary phase of a tonic-clonic seizure characterized by rhythmic jerking of the extremities.

Tonic-Clonic Seizure Symptoms

Generalized motor symptoms including body stiffening followed by extremity jerking, cyanosis, excessive salivation, tongue/cheek biting, and incontinence.

Typical Absence Seizure

A generalized nonmotor seizure occurring mostly in children, marked by a sudden brief staring spell lasting less than $10-20\,\text{sec}$.

Atypical Absence Seizure

An absence seizure characterized by a staring spell accompanied by motor symptoms like blinking or lip jerking, lasting up to $30\,\text{sec}$.

Automatisms

Involuntary, repetitive motor behaviors seen during atypical absence seizures, such as rapid blinking or finger tapping.

Focal-Onset Seizure

A seizure originating in one localized region of the brain, causing symptoms specific to the affected area.

Focal Aware Seizure

A focal seizure where the patient remains conscious, alert, and aware while experiencing unusual feelings, emotions, or sensations.

Focal Impaired Awareness Seizure

A focal seizure involving loss of consciousness or altered awareness with eyes open and no memory of events.

Psychogenic Nonepileptic Seizures (PNES)

Pseudoseizures triggered by emotional events rather than neuronal activity, requiring an EEG to differentiate from epileptic seizures.

Status Epilepticus Complications

Severe physiological complications including respiratory insufficiency, hypoxemia, cardiac dysrhythmia, and systemic acidosis.

Status Epilepticus First-Line Medication

Emergency administration of a rapid-acting antiseizure drug, specifically an IV benzodiazepine.

Seizure Precautions

Nursing safety interventions including padded side rails up, bed in lowest position, pillow under head, loosened clothing, and side-lying postseizure position.

Contraindicated Action During a Seizure

Restraining the client's limbs during active seizure activity.

Vagal Nerve Stimulation

A surgical medical management option for refractory seizure disorders.

Ketogenic Diet

A high-fat, low-carbohydrate dietary therapy used to manage recurring seizures.

Parkinson's Disease

A chronic, progressive neurodegenerative disorder caused by the degeneration of dopamine-producing neurons.

Substantia Nigra Neuron Degeneration

The pathological loss of dopamine-producing neurons leading to movement disorders in Parkinson's disease.

Four Main Manifestations of Parkinson's

The cardinal motor signs of Parkinson's disease: tremor, rigidity, bradykinesia, and postural instability.

Pill-Rolling Tremor

An involuntary resting tremor of the hand that progresses as Parkinson's disease advances.

Bradykinesia

Slowness of movement, a hallmark feature of Parkinson's disease.

Masked Face

A fixed, expressionless facial appearance resulting from facial muscle rigidity and bradykinesia.

Shuffling Gait

A gait disturbance in Parkinson's disease marked by short, shuffling steps, stooped posture, and reduced arm swing.

Parkinson's Diagnostic Criteria

Diagnosis based on clinical history, presence of $2$ out of $4$ main manifestations, and a positive response to Parkinson drugs.

Levodopa/Carbidopa (Sinemet)

The primary drug therapy for Parkinson's disease aimed at restoring dopamine levels in the brain.

Cogentin

An anticholinergic drug used in the medical management of Parkinson's disease.

Deep Brain Stimulation (DBS)

A surgical therapy for Parkinson's disease involving implanted electrodes to stimulate specific brain areas.

Ablation Therapy in Parkinson's

A surgical procedure used to destroy specific hyperactive brain tissues causing motor symptoms.

Rocking Technique for Bradykinesia

A patient instruction technique where the client rocks back and forth to help initiate movement during freezing or bradykinesia.

Fall Prevention Strategies

Safety measures including reviewing medications, exercising daily for $30\,\text{minutes}$, wearing fitting footwear, removing clutter, checking vision, and using walking aids.

Aspiration Precautions in Parkinson's

Nursing measures implemented to prevent choking and aspiration due to dysphagia caused by rigidity and bradykinesia.

Cognitive Impairment

Any deficit in intellectual functioning involving memory, orientation, attention, or concentration.

Dementia

A decline from a previous level of function in one or more cognitive domains, such as memory, language, or executive function.

Alzheimer's Disease

A chronic, progressive, irreversible neurodegenerative disease accounting for $60\%-80\%$ of dementia cases.

Vascular Dementia

A form of dementia caused by cerebrovascular disease, representing approximately $20\%$ of dementia cases.

Dementia with Lewy Bodies

A progressive dementia type characterized pathologically by Lewy body inclusions, making up approximately $10\%$ of cases.

Beta-Amyloid Plaques

Toxic protein clumps formed from amyloid accumulation in the extracellular space between neurons in Alzheimer's disease.

Neurofibrillary Tangles

Abnormal intracellular tangles of tau protein found inside neurons in Alzheimer's disease.

Neuronal Loss and Atrophy

Progressive loss of synaptic connections and neuron death resulting in overall brain atrophy in Alzheimer's disease.

Alzheimer's Disease Risk Factors

Predisposition factors including advanced aging, family history, cardiovascular risk factors, and head trauma.

Early-Stage Alzheimer's Symptoms

Initial manifestations including short-term memory loss, mild disorientation, and difficulty with words or numbers.

Aphasia

Loss of the ability to speak or understand spoken/written language as Alzheimer's disease progresses.

Apraxia

Inability to perform purposeful motor tasks despite intact motor strength and sensory function.

Visual Agnosia

Inability to recognize or identify objects or faces visually despite intact optic pathways.

Dysgraphia

Impairment in the ability to write, commonly seen in progressive Alzheimer's disease.

Preclinical Stage of AD

The stage of Alzheimer's disease where brain pathologic changes occur prior to the onset of clinical symptoms.

Mild Cognitive Impairment (MCI)

Cognitive decline involving memory and language problems that do not interfere with daily functional activities.

Dementia due to AD Stage

The advanced stage of Alzheimer's disease where cognitive and behavioral deficits impair daily functioning.

Diagnosis of Exclusion

The diagnostic process for Alzheimer's disease where all other potential causes of cognitive decline are ruled out.

Donepezil (Aricept)

A cholinesterase inhibitor prescribed to manage symptoms of Alzheimer's disease.

Rivastigmine (Exelon)

A cholinesterase inhibitor used in the pharmacological management of Alzheimer's dementia.

Memantine (Namenda)

An NMDA receptor antagonist used for moderate to severe Alzheimer's disease.

Selective Serotonin Reuptake Inhibitors (SSRIs) in AD

Antidepressant drugs prescribed to help manage depressive symptoms in Alzheimer's patients.

Delirium

An acute state of confusion developing over hours to days, characterized by fluctuating attention and altered awareness.

Delirium Pathophysiology

Neurochemical dysfunction involving decreased brain oxygenation, cholinergic deficiency, excess dopamine, and serotonin dysregulation.

DELIRIUM Mnemonic: D

In the causes mnemonic DELIRIUM, 'D' represents Dementia and Dehydration.

DELIRIUM Mnemonic: E

In the causes mnemonic DELIRIUM, 'E' represents Electrolyte imbalances and Emotional stress.

DELIRIUM Mnemonic: L

In the causes mnemonic DELIRIUM, 'L' represents organ diseases of the Lung, liver, heart, kidney, or brain.

DELIRIUM Mnemonic: I (Infection/ICU)

In the causes mnemonic DELIRIUM, the first 'I' represents Infection and Intensive care unit stay.

DELIRIUM Mnemonic: R

In the causes mnemonic DELIRIUM, 'R' represents Rx drugs.

DELIRIUM Mnemonic: I (Injury/Immobility)

In the causes mnemonic DELIRIUM, the second 'I' represents Injury and Immobility.

DELIRIUM Mnemonic: U

In the causes mnemonic DELIRIUM, 'U' represents Untreated pain and Unfamiliar environment.

DELIRIUM Mnemonic: M

In the causes mnemonic DELIRIUM, 'M' represents Metabolic disorders.

Major Risk Factors for Delirium

Predisposing factors including advanced age, pre-existing dementia, hypertension, alcohol use, and severe illness on admission.

Hyperactive Delirium

A subtype of delirium presenting with restlessness, agitation, rapid incoherent speech, and hallucinations.

Hypoactive Delirium

A subtype of delirium presenting with lethargy, drowsiness, reduced motor activity, and sluggishness.

Confusion Assessment Method (CAM)

A standardized diagnostic algorithm used to evaluate the presence of delirium based on four specific features.

CAM Feature 1

Acute Onset and Fluctuating Course of mental status changes.

CAM Feature 2

Inattention, marked by difficulty focusing, sustaining, or shifting attention.

CAM Feature 3

Disorganized thinking, demonstrated by rambling, irrelevant, or illogical thought processes.

CAM Feature 4

Altered Level of Consciousness, ranging from hyperalert to sluggish or lethargic.

Reversibility of Delirium

The characteristic of delirium where acute confusion often resolves completely once the underlying cause is identified and treated.

Delirium Nursing Management

Interventions aimed at eliminating precipitating factors, reorienting the patient, ensuring safety, and avoiding overstimulating environments.

Low Lighting Intervention

A nursing management strategy aimed at reducing photophobia and pain during acute migraine and cluster headaches.

Triptans

First-line abortive medications used for acute treatment of migraine and cluster headaches.

Headaches Visual Comparison Diagram

An anatomical chart comparing pain locations for Sinus (browbone/cheekbones), Cluster (one eye), Tension (band squeezing head), and Migraine (unilateral pain with nausea and visual changes).

Etiology of Epilepsy Diagram

An infographic mapping causes of epilepsy including stroke, head injuries, genetic basis, brain tumors, neurodevelopmental defects, infections, prenatal damage, and unknown causes.

Phases of Seizures Diagram

A nursing infographic detailing the four seizure phases: Prodromal Phase (before), Aural Phase (right before warning sign), Ictal Phase (seizure activity), and Postictal Phase (recovery after).

Postseizure Positioning Diagram

A clinical diagram illustrating correct postseizure precautions: bed in lowest position, side rails up and padded, pillow under head, loosened clothing, and side-lying position.

Parkinson's Symptoms Diagram

An anatomical illustration showing Parkinson's features: stooped posture, masked face, back rigidity, forward trunk tilt, flexed elbows/wrists, reduced arm swing, hand tremor, leg tremors, flexed hips/knees, and shuffling gait.

Alzheimer's Pathology Diagram

A brain pathology diagram depicting Beta-Amyloid Plaques, Neurofibrillary Tangles, Neuroinflammation, and Synaptic Dysfunction leading to neuronal loss, atrophy, and memory loss.