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Emergencies in Neurology

Emergencies in Neurology. Neurovascular emergencies Seizure and status epilepticus Headache and its emergencies Guillain Barre syndrome. Neurovascular Emergencies. Ischemic CVA or TIA Intracerebral hemorrhage Subarachnoid hemorrage. Ischemic CVA & TIA. Ischemic CVA.

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Emergencies in Neurology

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  1. Emergencies in Neurology

  2. Neurovascular emergencies • Seizure and status epilepticus • Headache and its emergencies • GuillainBarre syndrome

  3. Neurovascular Emergencies • Ischemic CVA or TIA • Intracerebral hemorrhage • Subarachnoid hemorrage

  4. Ischemic CVA & TIA

  5. Ischemic CVA • Sudden onset focal neurologic deficit due to a vascular deficit occurs in CNS • Can be thrombotic or embolic • Can be TIA or CVA

  6. Etiology • Atherosclerosis • Cardioembolic • Non-atherosclerotic vasculopathies • Vasculitis • Drugs

  7. Diagnosis • CBC • FBS • Lipid profile • BUN,Cr,Electrolyte • PT,PTT,INR • ECG • CXR

  8. Diagnosis • Brain CT Scan • Brain MRI • Echocardiography • Carotid dopplersonography • Angiography

  9. Management • Antiplatelettherapy+statins • Anticoagulant therapy • Thrombolytic therapy • Neuroprotective agents • Supportive care • Control of blood pressure • physiotherapy

  10. Intracerebral hemorrhage

  11. Intracerebral Hemorrhage • Hypertensive • Non-hypertensive • AVM • Aneurysm • Cavernous angioma • Tumor

  12. Diagnosis • CBC • BUN,Cr,Electrolyte • PT,PTT,INR • FBS • Lipid profile • ECG • Brain CT Scan • Angiography

  13. Management • Supportive Care • Control of BP • Surgery

  14. Seizure Disorders

  15. Definitions • Seizure • Convulsion • Epilepsy

  16. Classification • Generalized epilepsy • Generalized Tonic-clonic seizure • Absence seizure • Tonic seizure • Atonic seizure • Myoclonic seizure • Focal(partial) epilepsy • Simple partial seizure • Complex partial seizure

  17. Diagnosis • History • Imaging • EEG • BUN,Cr,Electrolyte • LFT • Ca

  18. Treatment • Old Generation Drugs • Phenobarbital • Phenytoin(Dilantin) • Sodium valproate • Carbamazepine

  19. Treatment • New generation drugs • Lamotrigine • Topiramate • Levetiracetam • Gabapentine • Pregabaline • Zonisamide • Oxcarbazepine

  20. Status Epilepticus

  21. Management • Benzodiazepine • Phenytoin or phosphenytoin • Phenobarbital • IV Depakine • Midazolam • General anesthesia

  22. Headache

  23. Red Flags • age>50 • Sudden onset headache • Progressive headache • Changing pattern • Trauma • Immunocompromised • Malignancy

  24. Red Flags • Fever • Seizure • Focal neurologic deficit • Impaired consciousness • Papilledema • OCP consumption

  25. GuillainBarre Syndrome

  26. Definition • Polyneuropathy • Acute • Inflammatory • Demyelinating

  27. manifestations • Symmetrical weakness • Areflexia • Cranial neuropathy • Bulbar dysfunction • Autonomic dysfunction

  28. Diagnosis • Clinical • LP • EMG-NCV

  29. Management • IVIG • Plasmaphresis • Supportive care • physiotherapy

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