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Neuro LOC

clinical cal

QuestionAnswer
Attends to environment, responds appropriately to commands & questions with minimal stimulation Alert
Disoriented to surroundings, impaired judgement, need cues to respond to commands Confused
Drowsy, needs gentle verbal or touch stimulation to intimate response Lethargic
Responds slowly to external stimulation, needs repeated stimulation to maintain attn & response to environment Obtunded
Responds only minimally with vigorous stimulation, may only mutter or moan as a verbal response - typically don't make sense Stuporous
No observable response to any external stimulation - unarousable, unresponsive even to painful stimuli, no purposeful responses, may have reflexes present but no brain activity you can see Comatose
No cognitive function, no voluntary movement, may be posturing, PT cannot really think or perform voluntary movements, EEG will show sleep wake cycles Persistent vegetative state
Motor pathway destroyed - cognitive function but no motor function, communicates by eye movements only, damage to pons - usually permanent - naturally happens when sleeping very soundly & get woken unexpectedly, mind becomes aware before body can move Locked in syndrome
No voluntary movement & are unresponsive to environment, EEG still looks normal but can't move - not even their eyes Akinetic mutism
Responds sometimes but very unpredictable responses - do show signs of awareness but inconsistent Minimally conscious state
No reversible causes known, unresponsive to stimuli, no brain stem reflexes Brain dead
Irreversible cessation of brain function Legal definition of death
Usually happens on weekend or holidays, prodromal fatigue, aurora, flashing lights, n/v, fluid imbalance, sensitive to light & noise, uni or bilateral, throbbing Common migraine
Compulsive personalities, prodromal - zigzag lines & bright lights, tingling face, lips & hands, weakness, recurrent or periodic, hemiplegia or ophthalmoplegic (one eye goes blind), can last for days, severe unilateral pain, extraocular muscle palsy Classic migraine
Occur with young females before periods, prodromal - vision loss (partial), vertigo, ataxia, dysarthria, tinnitus, tingling fingers/toes, severe occipital throbbing, vomiting Basilar artery migraine
Full persistent ache, tender spots on head/neck, easier to fx than migraines Muscle contraction headache
Neuro deficits, hard to differentiate, narcotics fail to relieve pain, can be subdural or subarachnoid Intracranial bleed headache
Early adult, male>female, episodes cluster together for days to wks, throbbing, unilateral, infraorbital head to neck, hard to differentiate from sinus headaches, flushing, tearing, stuffy nose, narcotic to to, extremely painful, lasting 15min to 2 hrs Cluster headaches
Often adolescents, episodic, dull, bilateral, neck/shoulder, poorly defined, no prodromal, neck tension Tension headache
Created by: stephanie.gage