Pathophysiology DQR W 9

Description Each Discussion post response 150 words or more with 2 references peer review journal less than 5 years POST 1 A 40-year old, male comes to see you for follow up. He states that he had a seizure at home yesterday and was taken to the emergency room. He is accompanied by his wife who witnessed the seizure. He states he has never had a seizure in the past. Discussion Questions: 1) What would you ask him and his wife regarding the seizures, and why? A seizure is a sudden uncontrolled release of electrical activity in the brain. A patient experiencing a seizure without any past-history of one is cause for concern. It is vital to gather any subjective data to determine the underlying cause of the patient’s seizure. It is important to ask specific details about the seizure from the patient and his wife to determine if it was a generalized or focal seizure. Seizures are categorized based upon presentation and etiology for example, a generalized seizure is one that compromises both hemispheres. A focalized seizure involves only one area of the brain (Adams & Knowles, 2007). In this case identification of the type of seizure the patient has experienced will help rule out epilepsy, or any type of neurological defect that may affect treatment. Seizures are a major indicator of pre or perinatal brain injury (Adams & Knowles, 2007). It must be determined that a true seizure has occurred, and not syncope, pseudoseizure, or a traumatic brain injury. 2) What would be the most important parts of a physical exam in this patient and why? The physical examination should include normal vital findings, and an adequate oxygen supply. It is important to make sure the patient is alert and oriented with no sign or symptoms of seizure. The patients level of consciousness should be evaluated, as well as a thorough neurologic and mental status (Adams & Knowles, 2007). The patients speech should be evaluated, as well as sensitivity or response to painful stimuli. A bilateral upper extremity test/ pronator drift can be done to examine motor and sensation skills should also be assessed. Patients reflexes should be tested, as well as vison loss or impairments. 3) What lab or radiology tests would you want to do and why? He tells you he has no insurance so be sure to defend the importance of a particular test. The most important exam to test for presence of a true seizure is a neuroimaging exam. Most importantly an MRI, in patients 40 and older because it can more accurately detect abnormalities. A serum glucose and sodium test can be done to monitor levels and indicate signs of seizure. Based on the patients subjective/objective findings it is possible to determine if a seizure occurred by examining his glucose levels. An electroencephalogram can also be used to evaluate the electrical activity of the brain. The patient is an ideal candidate for EEG testing because it’s been 24 hours since his last seizure the presence of an abnormality will be present.