clinical cal
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| Attends to environment, responds appropriately to commands & questions with minimal stimulation | Alert
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| Disoriented to surroundings, impaired judgement, need cues to respond to commands | Confused
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| Drowsy, needs gentle verbal or touch stimulation to intimate response | Lethargic
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| Responds slowly to external stimulation, needs repeated stimulation to maintain attn & response to environment | Obtunded
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| Responds only minimally with vigorous stimulation, may only mutter or moan as a verbal response - typically don't make sense | Stuporous
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| 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
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| 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
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| 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
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| No voluntary movement & are unresponsive to environment, EEG still looks normal but can't move - not even their eyes | Akinetic mutism
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| Responds sometimes but very unpredictable responses - do show signs of awareness but inconsistent | Minimally conscious state
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| No reversible causes known, unresponsive to stimuli, no brain stem reflexes | Brain dead
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| Irreversible cessation of brain function | Legal definition of death
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| 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
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| 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
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| Occur with young females before periods, prodromal - vision loss (partial), vertigo, ataxia, dysarthria, tinnitus, tingling fingers/toes, severe occipital throbbing, vomiting | Basilar artery migraine
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| Full persistent ache, tender spots on head/neck, easier to fx than migraines | Muscle contraction headache
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| Neuro deficits, hard to differentiate, narcotics fail to relieve pain, can be subdural or subarachnoid | Intracranial bleed headache
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| 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
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| Often adolescents, episodic, dull, bilateral, neck/shoulder, poorly defined, no prodromal, neck tension | Tension headache
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