8d • Paramedic Talk
Neurologic Emergencies that may be on your test
Seizures = abnormal electrical activity in the brain
Tonic-Clonic (Grand Mal)
What it is:
Most recognizable seizure type
Phases (MEMORIZE)
- Tonic phase → stiffening
- Clonic phase → rhythmic jerking
- Postictal → confusion, fatigue
Presentation
- Loss of consciousness
- Full-body convulsions
- Possible incontinence
EMS Management
- Protect airway
- Oxygen
- Benzodiazepines (per protocol)
- Check glucose
NREMT Pearl: Actively seizing = treat immediately
Febrile Seizures
What it is:
Seizures in children caused by rapid rise in fever
Presentation
- Pediatric patient
- Fever present
- Generalized seizure
Key Point
- Usually self-limiting and benign
NREMT Pearl: Child + fever + seizure = febrile seizure
Absence Seizures (Petit Mal)
What it is:
Brief interruption in consciousness
Presentation
- “Staring spells”
- No postictal phase
- Patient resumes activity immediately
NREMT Pearl: Brief stare, no confusion = absence seizure
Meningitis
What it is:
Inflammation of the meninges (often infectious)
Transmission
- Spread via respiratory droplets
Classic Signs & Symptoms (MEMORIZE)
- Fever
- Headache
- Neck stiffness
- Altered mental status
- Irritability
- Possible rash
Special Signs
Brudzinski’s Sign
- Neck flexion → hips and knees flex
Kernig’s Sign
- Hip flexed → cannot fully extend leg
Life Threat:
- Can progress rapidly to sepsis and death
EMS Management
- PPE (droplet precautions)
- Oxygen
- Rapid transport
NREMT Pearl: Fever + stiff neck + altered = meningitis
Parkinson’s Disease
What it is:
Neurodegenerative disorder
Key Pathophysiology
Low dopamine in the brain
Presentation (MEMORIZE)
- Tremor (resting)
- Rigidity
- Bradykinesia (slow movement)
- Postural instability
NREMT Pearl: Parkinson’s = low dopamine → slow, rigid movement
Wernicke Encephalopathy
What it is:
Neurologic disorder from vitamin B1 (thiamine) deficiency
Common in:
- Chronic alcohol use
Classic Triad (HIGH-YIELD)
- Confusion
- Ataxia (unsteady gait)
- Ophthalmoplegia (eye movement abnormalities)
EMS Consideration
- Give thiamine before glucose (if available/protocol-driven)
NREMT Pearl: Alcoholic + confusion + ataxia = Wernicke
Hydrocephalus
What it is:
Accumulation of cerebrospinal fluid (CSF) in the brain
Effects:
- Increased intracranial pressure (ICP)
Presentation
Infants
- Bulging fontanelle
- Enlarged head
Adults
- Headache
- Vomiting
- Altered mental status
Complications
- Brain compression
- Herniation
- Death
EMS Management
- Airway support
- Monitor for ICP signs
- Rapid transport
NREMT Pearl: CSF buildup = increased ICP risk
Summary
- Tonic-clonic → full body seizure
- Febrile seizure → child + fever
- Absence seizure → brief staring, no postictal
- Meningitis → fever + stiff neck + Brudzinski/Kernig
- Parkinson’s → low dopamine
- Wernicke → B1 deficiency (alcoholics)
- Hydrocephalus → CSF buildup → ↑ ICP
NREMT Test Strategy
- Identify type of seizure
- Look for infection clues (fever, rash, stiff neck)
- Recognize metabolic deficiencies (B1, glucose)
- Prioritize: Airway Glucose check Benzodiazepines if seizing
7:09
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Neurologic Emergencies that may be on your test
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