Mr Bolin, I am Mr Bolin as well. I didn't see my issue of concern and wondered if you are there to take a question pertaining to Shingles Neuropathy/Neuralgia. Alzheimers definitely is of concern to me for sure as well but step 1 is healing the Nerves in my temple and surrounding areas
Lorazepam is effective to abort an ongoing seizure, but in this case the convulsions have stopped so preventing another bout of seizure should be the aim for which fosphenytoin is the best as the initial choice. 10 to 15 mg per kg.
Question 4, are we going to just let the patient go without doing a 24-hour EEG? I'm preparing for British boards but I find USMLE materials to be very useful. I understand treatment wouldn't be necessary for this patient but wouldn't we do 24-hr EEG?
Vladislav Zaichenko i thought about adjusment disorder also but he didnt specify the how long after his death .. But the main issue is whenever you have a clear 5 or more in SIGECAPS then the diagnosis is major depression
Isn't a seizure lasting 5+ minutes considered status epileptics? Video mentions 15 minutes as the cutoff, maybe this is a new standard? Otherwise great video.
Yeah, so there’s actually a variety of definitions, and it really depends on who you ask. The Epilepsy Foundation defines it as > 5 minutes, while the International League Against Epilepsy (ILAE) defines it as > 30 minutes. Obviously there’s a big difference here and clinically we would regard the severity of a 5 minute episode quite differently from that of a 35 minute episode in terms of potential morbidity. I took the liberty of settling on something in between. Ultimately, however you define status epilepticus, it doesn’t change your management. You will want to initiate benzodiazepines at 5 minutes, according to most sources, and then administer a second dosage or an alternative agent after 5-15 minutes or so. I used an algorithm that I received when I was in medical school from one of the neurologists that taught us, and it closely resembles what I found in the Kaplan Test Prep material. But there are different approaches in the literature.
There is disagreement about this. I've heard 30, and 15, and 10. I've also heard 5. But the reasoning for "5" was that if the seizure hadn't stopped after 5 minutes, you needed to behave like it was going to continue longer. Get your IV (if you don't have one) and order your meds, because it's going to take a few minutes to get them. If you wait until minute 10, it'll be several minutes beyond that before you're delivering the meds. So the argument for 5 minutes wasn't that it *is* status, but that it's heading that way. You see? But like so much advice, we begin to lose sight of why a recommendation was given and soon the definition will be 5 minutes. Then someone will say, "But you really need to recognize it a little earlier than 5 minutes so you can be ready to give meds"... and then... ;)
Status epilepticus is seizure lasting more than 30 mins, more than 5 mins means impending status epilepticus, so we start treatment if seizure lasts for more than 5 mins
Cluster headache will have rhinorrhea, conjunctivitis, watery discharge from eyes ie epiphora. And they occur in clusters.
I have an exam in a few days I was nervous before but thanks to your lectures Doc am much confident now...
How was it?
xDomglmao I got my highest score that semester 😍🙏🏼 so grateful
@@queen90 Awww, glad to hear that!
xDomglmao thanks 🙏🏼 can we be UA-cam friends?
@@queen90 haha, go ahead, add me
Mr Bolin, I am Mr Bolin as well. I didn't see my issue of concern and wondered if you are there to take a question pertaining to Shingles Neuropathy/Neuralgia. Alzheimers definitely is of concern to me for sure as well but step 1 is healing the Nerves in my temple and surrounding areas
Symptoms have lasted for a few months so no need for repeat MMSE.
Very informative thankyou. Your videos are interesting and easier to learn from.
Why not MRI for Qn 6? After 20 mins, Ischemic changes will likely be missed on the CT and an MRI will be needed, isnt it?
This is cortical stroke so why crossed paralysis? Left facial and right UL palsy.
Right sided facial droop implies angle of mouth has deviated to the normal right side. It's left facial palsy.
Lorazepam is effective to abort an ongoing seizure, but in this case the convulsions have stopped so preventing another bout of seizure should be the aim for which fosphenytoin is the best as the initial choice. 10 to 15 mg per kg.
Ictal phase so do EEG. Watchful waiting is usually 5 minutes and that has transpired. EKG is ECG? That also necessary.
Head CT. Left facial palsy, right UL paresis.? Faciobrachial monoplegia.
Tension headache pain is like a band sensation all around the head.
Question 4, are we going to just let the patient go without doing a 24-hour EEG? I'm preparing for British boards but I find USMLE materials to be very useful. I understand treatment wouldn't be necessary for this patient but wouldn't we do 24-hr EEG?
Q1. The time brackets after a death of the spouse is less than 6 month. How can we exclude normal grief as a cause of the depression-like state?
Vladislav Zaichenko i thought about adjusment disorder also but he didnt specify the how long after his death .. But the main issue is whenever you have a clear 5 or more in SIGECAPS then the diagnosis is major depression
Awesome job. LEMS/MG question and SCCA of lung association was good info. TY!
This was very helpful! Thank you
Isn't a seizure lasting 5+ minutes considered status epileptics? Video mentions 15 minutes as the cutoff, maybe this is a new standard? Otherwise great video.
Yeah, so there’s actually a variety of definitions, and it really depends on who you ask. The Epilepsy Foundation defines it as > 5 minutes, while the International League Against Epilepsy (ILAE) defines it as > 30 minutes. Obviously there’s a big difference here and clinically we would regard the severity of a 5 minute episode quite differently from that of a 35 minute episode in terms of potential morbidity. I took the liberty of settling on something in between. Ultimately, however you define status epilepticus, it doesn’t change your management. You will want to initiate benzodiazepines at 5 minutes, according to most sources, and then administer a second dosage or an alternative agent after 5-15 minutes or so. I used an algorithm that I received when I was in medical school from one of the neurologists that taught us, and it closely resembles what I found in the Kaplan Test Prep material. But there are different approaches in the literature.
There is disagreement about this. I've heard 30, and 15, and 10. I've also heard 5. But the reasoning for "5" was that if the seizure hadn't stopped after 5 minutes, you needed to behave like it was going to continue longer. Get your IV (if you don't have one) and order your meds, because it's going to take a few minutes to get them. If you wait until minute 10, it'll be several minutes beyond that before you're delivering the meds. So the argument for 5 minutes wasn't that it *is* status, but that it's heading that way. You see? But like so much advice, we begin to lose sight of why a recommendation was given and soon the definition will be 5 minutes. Then someone will say, "But you really need to recognize it a little earlier than 5 minutes so you can be ready to give meds"... and then... ;)
Status epilepticus is seizure lasting more than 30 mins, more than 5 mins means impending status epilepticus, so we start treatment if seizure lasts for more than 5 mins
Love your videos keep going
Thank you.
Methosuximide also.
Great man u looks great
thank you sir.
Naproxen or Rizatriptan
Thank you :)
Librium is chlordiazepoxide. Added in Toddy, arrack and fed to elephants. 😝. Mahouts drink with jumbos.
CT chest.
chlordiazepoxide Librium
AV malformation rupture.
FAST = FACE ARMS SPEECH TIME
24 hour EEG
Venkafaxine.
EKG