Postictal S&S - edema. Postictal paralysis or Todds...

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Learning Issue: Neuro after localizing Seizure-MH I was not exactly sure what we wanted, other than what we may find and/or if anything on a neuro exam post seizure. If we needed something else please shoot m an email and I will add to the LI. Postictal state: o Definition: Is the sate that follows most generalized seizures, which typically is characterized by a decreased level of arousal and responsiveness, disorientation, amnesia and headache. o Time: Minutes to hours and may not be consistent from seizure to seizure. o Clinical Evaluation: It is important to monitor and investigate the altered mental status after seizure; otherwise, dangerous underlining metabolic or toxic abnormalities may be overlooked. At minimum, airway positioning maneuvers, pulse oximetry, rapid glucose determination, and cardiac rhythm monitoring are necessary. Two unusual postictal manifestations may provoke particular consternation in an ED: postictal paralysis and neurogenic pulmonary
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Unformatted text preview: edema. Postictal paralysis or Todds paralysis may follow generalized or complex partial seizures and is a focal motor deficit that may persist up to 24 hours. Weakness of one extremity or a complete hemiparesis may occur; the patient must be safely restrained to avoid falls caused by a combination of weakness and diminished responsiveness. Neurogenic pulmonary edema is a relatively common, although often subclinical, complication to any structure CNS insults, including seizure, trauma, and hemorrhage. It may be caused by centrally mediated sympathetic discharge and generalized vasoconstriction, coupled with increased pulmonary capillary membrane permeability. Resource: http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05472-0..00100-6--s0020&isbn=978-0-323-05472-0&type=bookPage&sectionEid=4-u1.0-B978-0-323-05472-0. .00100-6--s0020&uniqId=237027579-8#4-u1.0-B978-0-323-05472-0. .00100-6--s0020...
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This note was uploaded on 02/18/2012 for the course PAS 600 - 601 taught by Professor Garrubba during the Fall '10 term at Chatham University.

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