Seizure Disorder and Thyroiditis
Case Studies 2
The skull X-ray study ruled out the possibility of a skull fracture as the cause of the boy’s
problem. Lumbar puncture excluded the possibility of meningitis or subarachnoid
hemorrhage; however, the high protein count and questionable positive cytology indicated a
possible neoplasm. An EEG located an area of nonspecific abnormality in the posterior
aspect of the brain. Brain scanning, cerebral angiography, and CT scanning indicated a
posterior fossa tumor. These tests are mentioned in this case study mostly for historical
interest. Under most circumstances, this young boy would have a MRI of the brain early in
the diagnostic period.
Because of these findings, the patient underwent a craniotomy. In many centers, this young
boy would have a nonoperative stereotactic brain biopsy instead of a craniotomy. An
invasive medulloblastoma was found to be arising from the patient’s cerebellum and
involving the occipital lobe of the cerebrum. The tumor was unresectable. Postoperatively,
the patient was given phenytoin (Dilantin) and radiation therapy to the involved area. A
chemotherapy regimen was administered. The patient’s tumor did not respond to the therapy,
and he died 4 months after the onset of disease.
Critical Thinking Questions
- What are the major assessments that the nurse should make during seizure activity?
- Why is the EEG a priority study for patients with seizure disorders?
The pathophysiological definition of seizure disorder is that it is a paroxysmal manifestations of the electrical properties of the cerebral cortex that result in uncontrolled electrical disturbance between excitatory and inhibitory forces (Engel, 2013). After first aid activities that include clearing airway, major assessments that the nurse should make during seizure activity include X-ray to check possibilities of skull fracture, lumbar puncture, or neoplasm as the cause of the symptoms. Also, a nurse’s assessments should include brain scanning, cerebral angiography, and CT scanning. Further, among advanced clinical assessments is to be an electroencephalogram (EEG) scan more specifies the diagnosis as it tracks and records brain wave patterns. Based on the diagnostic results, craniotomy or nonoperative stereotactic brain biopsy could be the operative measures taken.
EEG is a priority test since it is used to detect brain electrical activities that could be associated with brain disorders as seizure disorder. By definition, seizure disorder is caused by disruption of communication of the brain nerve cells which can be best detected by thee EEG scan is the prime test for the disorder.
Thyroiditis is an inflammation of the thyroid gland, yet not an infection. Thyroid antibodies develop when a person’s immune system targets components of the thyroid glands (thyroid proteins) by mistake. Since the body system actively maintains a relatively stable level of thyroid hormones, an interference of thyroid antibodies can lead to autoimmune disorders that associate with hypothyroidism or hyperthyroidism (Caturegli, De Remigis, & Rose, 2014). Since the thyroid antibodies are integral causative agents of this disorder, test of its amount in the blood is central to diagnosis of Hashimoto thyroiditis.
Among the unpleasant symptoms of overmedication of thyroid replacement include elevated blood pressure, insomnia, anxiety, nervous energy, tremors, Irritability/Overemotional, Difficulty concentrating, fatigue, the feeling of overheating, and weight loss.
Caturegli, P., De Remigis, A., & Rose, N. R. (2014). Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmunity reviews, 13(4-5), 391-397.
Engel, J. (2013). Seizures and epilepsy (Vol. 83). Oxford University Press.