NEUROLOGY(D)

 

A1.

Occurrence of seizure due to brain stroke:

·         Cells in the brain send electrical signals to one another

·         The electrical signals pass along your nerves to all parts of the body

·         A sudden abnormal burst of electrical activity in the brain can lead to the signals to the nerves being disrupted, causing a seizure

·         This electrical disturbance can happen because of stroke damage in the brain.

·         A seizure can affect vision, smell and taste, loss of consciousness and jerking movements.






Mechanism of seizure activity:

·         You’re more likely to have a seizure if you had a haemorrhagic stroke (bleed on the brain).

·         Seizures can also be more likely if you had a severe stroke, or a stroke in the cerebral cortex, the large outer layer of the brain where vital functions like movement, thinking, vision and emotion take place.

·         Some people will have repeated seizures, and be diagnosed with epilepsy.

·         The chances of this happening may depend on where the stroke happens in the brain and the size of the stroke.

·         There are several causes for early onset seizures after ischaemic strokes.

·         An increase in intracellular Ca2+ and Na+ with a resultant lower threshold for depolarisation, glutamate excitotoxicity, hypoxia, metabolic dysfunction, global  hypo perfusion and hyper perfusion injury ,(particularly after carotid end arterectomy) have all been postulated as putative neurofunctional aetiologies.

·         Seizures after haemorrhagic strokes are thought to be attributable to irritation caused by products of blood metabolism.

·         The exact pathophysiology is unclear, but an associated ischaemic area secondary to haemorrhage is thought to play a part.

·         Late onset seizures are associated with the persistent changes in neuronal excitability and gliotic scarring is most probably the underlying cause.

·         Haemosiderin deposits are thought to cause irritability after a haemorrhagic stroke.

·         In childhood, post‐stroke seizures can occur as part of perinatal birth trauma.

 

 

A2.

Normally the “consciousness system”—a specialized set of cortical-subcortical structures—maintains alertness, attention and awareness. Diverse seizure types including absence, generalized tonic-clonic and complex partial seizures converge on the same set of anatomical structures through different mechanisms to disrupt consciousness.

 

 

 





Comments

Post a Comment

Popular posts from this blog

INFECTIOUS DISEASE HEPATOLOGY(B)

 A1. Most likely cause is Amoebic liver abscess because of the following findings:             - Age of the patient             - Single abscess             - Right lobe involvement A2.  - right hypochondriac and epigastric pain , fever ➡ can be liver, biliary or right lower lobe pneumonia -Invesigations:          -CBP : Leucocytosis          -LFT : Elevated Alkaline phosphatase          -RFT           -Urine analysis           -USG : Single hyperechoic   oval shaped mass in right lobe                               ...
Read more

A 18yr old male Fever with thrombocytopenia

Image
  This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment"   A 18yr old male Fever with thrombocytopenia I've been given this case to solve in an attempt to understand the topic of "Patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan.        A 18 yr old male came to the OPD with chief complaints of   -fever since 2 days - vomiting’s since 2 days -diarrhea ...
Read more

55yr old female with fever and headache

Image
Final exam Short case Name: M.Tejaswini Halltkt:1701006107 A 55yr old female came with chief complaints of: -fever since 4 days -headache since 4 days History of present illness Patient was apparently asymptomatic 4 days back then she developed fever which was insidious in onset, continous type relieved with medication and not associated with chills and rigors. Fever was associated with diffuse headache which was throbbing type present throughout the day and relieved with medication. There was 1 episode of vomiting which non projectile, non bilious, content was food. She also had neck stiffness. There's no history of photophobia, giddiness,seizures. Past history No similar complaints in past Not a known case of DM, HTN, TB, asthma, epilepsy Personal history Diet:mixed Appetite:normal Sleep:adequate Bowel and bladder: regular No addictions No known drug and food allergies Family history Not significant General examination Patient is conscious, coherent, coperative. Moderately built ...
Read more