Unstable

Nervous System & Special Senses


{"ops":[{"insert":"Initial Evaluation of a Patient presenting with a seizure"},{"insert":"\n","attributes":{"header":1}},{"insert":"The first step in the evaluation of a seizure is to ensure stable vitals, oxygenation, and the cessation of seizure activity.\r\n\r\nNext, the clinician should determine whether or not a seizure has actually occurred. Biting of the tongue, the presence of an aura, epigastric fullness, postictal confusion, and focal neurologic signs are all suggestive of a true seizure. \r\n\r\nThe presence of functional and structural lesions should be investigated for with electroencephalography, head MRI (or CT if intracranial bleeding is suspected), glucose levels, and serum electrolytes, especially in patients who present for the first time.\n"},{"insert":"Anticholinergic Syndrome"},{"insert":"\n","attributes":{"header":1}},{"insert":"Anticholinergic syndrome is a well-described toxidrome produced by the inhibition of cholinergic neurotransmission at the muscarinic receptors.\r\n\r\nAnticholinergic toxidromes are relatively common, and can be caused by an overdose of antihistamines, antipsychotics, and some herbal supplements. \r\n\r\nThis condition has overlapping features with serotonin syndrome, including hyperthermia and altered mental status. \r\n\r\nHowever, anticholinergic toxicity tends to cause warm, flushed dry skin, urinary retention, and decreased bowel sounds, with normal tone and reflexes, serotonin syndrome would present with diaphoresis, increased bowel sounds, muscle rigidity, and hyperreflexia.\n"}]}

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