Neurological Disorders

Central and Peripheral Nervous Systems

• Central Nervous System: Brain and spinal cord.
• Peripheral Nervous System: Spinal nerves, cranial nerves, autonomic nervous system.

Headaches

• Origins of Headaches:
  • Muscle fibers (tension headaches).
  • Meninges (meningeal irritation).
  • Facial structure.
  • Blood vessels.
  • Cranial or spinal nerves.
• Characteristics:
  • Vary in intensity, duration, frequency, and location.
• Classification:
  • Primary:
    • Migraines.
    • Cluster headaches.
    • Tension-type headaches.
  • Secondary:
    • Trauma.
    • Infection.
    • Intracranial disorders.
    • Psychiatric reasons.
• Etiology and Risk Factors:
  • Tension-Type Headaches:
    • Stress.
    • Posture.
    • Depression and anxiety.
  • Cluster Headaches:
    • Stress.
    • Allergens.
    • Environmental factors.
    • Medications.
    • Smoking.
  • Migraines:
    • Genetic predisposition.
  • Secondary Headaches:
    • Underlying causes (e.g., premenstrual headaches).
• Impact on Overall Health:
  • Physiological: Pain.
  • Psychosocial: Psychological distress.
  • Social: Limitations in activities (e.g., avoiding triggers).
  • Considerations for aging adults.
• Clinical Presentation:
  • Tension-Type, Cluster, and Migraine Headaches:
    • Phases: Prodromal, headache, post-stroke (postdrome) period.
    • Aura (particularly in migraines): Visual disturbances (e.g., flashing lights).
  • Secondary Headaches:
    • Presentation depends on the underlying problem.
• Lab Testing and Diagnostic Studies: Associated with headaches.
• Role of the Nurse:
  • Consider environment and individual factors.
  • Address safety concerns, especially in elderly patients.
  • Educate patients on symptom recognition and management.
• Clinical Judgment:
  • Glasgow Coma Scale: Used in assessments for headaches.
• Differentiation of Headache Types:
  • Stress/Tension Headaches, Migraines, Cluster Headaches: Recognize different presentations.
  • Cluster Headaches: Severe, with high suicide rates due to intensity of pain.

Seizure Disorders

• Definition:
  • Abnormal and unregulated brain impulses causing seizures.
  • Acute or chronic condition (epilepsy).
• Categories:
  • Generalized, focal, unknown, motor, and non-motor seizures.
• Etiology:
  • Structural, genetic, infectious, metabolic, immune, unknown causes.
• Impact on Overall Health:
  • Psychosocial: Restrictions on driving, career choices, and potential need for disability.
  • Physiological: Safety concerns (e.g., cooking).
  • Considerations for aging adults.
• Clinical Presentation (Stages):
  • Prodromal: Early signs or aura.
  • Ictal: Active seizure period.
    • Generalized movement (tonic-clonic movements).
    • Atonic, myoclonic, absence, focal seizures.
  • Postictal: Recovery period with fatigue.
• Types of Seizures:
  • Tonic-Clonic: Generalized movement with convulsions.
  • Absence: Blank staring.
  • Focal Onset: Aware or impaired awareness.
    • Motor: Atonic, clonic spasms.
    • Non-Motor: Behavior arrest, cognitive or emotional changes.
  • Generalized Onset: Motor tonic-clonic or clonic-tonic.
• Role of the Nurse:
  • Environment and safety considerations.
  • Priorities during a seizure: Ensure safety, maintain airway, and prevent injury.
  • Privacy: Dignity, cover patient in case of loss of bladder control.

Head Injuries

• Types:
  • Traumatic Brain Injury (TBI), Concussions, Subdural Hematoma.
• Pathophysiology:
  • Increased intracranial pressure (ICP) due to blood and cerebral spinal fluid.
  • Ischemia to brain tissue.
  • Diffuse axonal injury.
• Classification:
  • Mild, moderate, severe, primary, secondary.
• Etiology and Risk Factors:
  • Abuse cases, motor vehicle accidents, falls, assaults.
  • Blunt, penetration, and blast traumas.
• Clinical Presentation:
  • Concussions: Cognitive changes, somatic symptoms (sleepiness).
• Diagnostic Studies: Clotting times, CAT scans.
• Nursing Role: Environment assessment and safety measures.

Aneurysms

• Definition:
  • Bulging of blood vessels.
• Affected Arteries:
  • Gensumiga, intima, media, and adventitia.
  • Carotid and vertebral arteries and circle of Willis.
• Etiology:
  • Defects in the artery, degenerative problems, hemodynamic stress, inflammatory responses, structural issues.
• Risk Factors:
  • Modifiable: Hypertension.
  • Non-Modifiable: Genetics.
• Clinical Presentation:
  • Unruptured Aneurysm: Bulging of the vessel.
  • Ruptured Aneurysm: Leakage of blood, similar to a stroke.
  • Thunderclap headache: Sudden, severe headache at the time of rupture.
• Diagnostic Measures: Lab tests and imaging.

Parkinson's Disease

• Definition:
  • Loss of substantia nigra in the brain.
  • Loss of dopamine and norepinephrine.
• Etiology:
  • Often genetic; may involve exposure to unknown factors or occupational factors.
• Impact on Overall Health:
  • Physiological: Loss of function, mobility, tissue, and tech function.
  • Psychosocial: Need for supportive and psychological attention.
  • Common among aging adults.
• Diagnosis:
  • Clinical presentation, lab testing, and diagnostic evaluations by a neurologist.
• Staging: Stages one through five.

Peripheral Neuropathy

• Definition:
  • Damage to the peripheral nervous system.
• Etiology:
  • Diabetes, genetic diseases, segmental demyelination.
• Comorbidities: Consider associated health conditions.
• Clinical Considerations:
  • Risk of wounds and injuries, especially in diabetics.
  • Potential for pain.
• Treatment: Common medications include gabapentin and Lyrica.