NLE Neurosensory Nursing — Seizure, Infectious, and Degenerative Neurologic DisordersCheat Sheet

Section Title

SEIZURES AND EPILEPSY

Important Facts

• DURING SEIZURE: Turn patient to **lateral (side) position** to prevent aspiration; **loosen tight clothing**; **protect the head**; **do NOT restrain** and **do NOT force anything in the mouth**.
• ASSESSMENT during seizure: **Time the seizure**, note characteristics (aura, eye movements, incontinence, progression).
• AFTER SEIZURE: Keep on side, reorient, check for injuries, allow rest; postictal period is normal (drowsiness, confusion).
• Seizure types in order of medical emergency: **Status epilepticus >> generalized tonic-clonic >> focal with LOC >> focal without LOC >> absence.**
• Status epilepticus = **MEDICAL EMERGENCY**: risk of hypoxia, hyperthermia, brain injury, death.
• FIRST-LINE treatment for acute seizure: **IV benzodiazepines** (lorazepam or diazepam) STAT.
• SECOND-LINE: Load with longer-acting antiseizure drug (phenytoin, fosphenytoin, or levetiracetam) AFTER benzodiazepine.
• **NEVER abruptly stop antiseizure medications**—can trigger status epilepticus.
• Patient teaching: Wear **medical identification**, follow **local driving restrictions**, **avoid alcohol**, maintain **steady drug levels**, report breakthrough seizures.

Key Definitions

Diagrams To Know

• Phases of generalized tonic-clonic seizure: aura → tonic (stiffening) → clonic (jerking) → postictal
• Seizure management algorithm: Safety → Airway → Time → Observation → Medication
• Status epilepticus hierarchy: Assess ABCs → Glucose check → IV benzodiazepine → Load antiseizure drug → Support

Common Values

Section Title

ANTISEIZURE MEDICATIONS

Important Facts

• **Phenytoin IV**: Give in **normal saline ONLY** (precipitates in dextrose); give **slowly ≤50 mg/min** to avoid hypotension and dysrhythmias.
• **Phenytoin therapeutic level**: 10–20 mcg/mL (some sources 8–12); above 20 = toxicity.
• **Phenytoin side effects**: **Gingival hyperplasia** (teach meticulous oral hygiene), nystagmus, ataxia, diplopia, hirsutism, rash.
• **Phenytoin drug interactions**: High protein binding; interacts with warfarin, oral contraceptives, many others.
• **Carbamazepine**: Induces own metabolism (autoinduction); monitor for hyponatremia, rash (SJS risk), CBC.
• **Lamotrigine**: Risk of **Stevens-Johnson syndrome (SJS)**—teach patient to report rash immediately.
• **Benzodiazepines (lorazepam, diazepam)**: Acute seizure termination; watch for **respiratory depression and sedation**.
• **Dosing consistency is CRITICAL**: Missed doses → low levels → breakthrough seizures → status epilepticus.
• **High-protein meals can interfere with phenytoin and levodopa absorption**—space from meals.

Key Definitions

Diagrams To Know

• Drug levels: subtherapeutic → therapeutic (10–20) → toxic (>20) and correlation with seizure control vs. side effects

Common Values

Section Title

CENTRAL NERVOUS SYSTEM INFECTIONS

Important Facts

• **CLASSIC TRIAD of bacterial meningitis**: Fever + Severe Headache + Nuchal Rigidity (stiff neck).
• Associated symptoms: **Photophobia, altered LOC, seizures, nausea, vomiting, confusion**.
• **Lumbar puncture (LP) findings—BACTERIAL vs. VIRAL**:
• • **BACTERIAL**: Cloudy CSF; **HIGH protein (>100 mg/dL)**; **LOW glucose (<40 mg/dL or CSF:blood ratio <0.4)**; **HIGH neutrophils (>80%)**; **HIGH pressure**.
• • **VIRAL**: Clear CSF; Normal/mildly elevated protein; **Normal glucose (>40 mg/dL)**; **Lymphocytes (not neutrophils)**; Normal or slightly elevated pressure.
• **MENINGOCOCCAL MENINGITIS** → petechial/purpuric rash + can progress to **Waterhouse-Friderichsen syndrome** (septic shock, adrenal failure, DIC).
• **DO NOT DELAY ANTIBIOTICS** in suspected bacterial meningitis—start **empiric IV antibiotics BEFORE culture results**.
• Common empiric regimens: **Ceftriaxone ± vancomycin ± ampicillin** (depends on age, local resistance patterns).
• **Dexamethasone (corticosteroid)** given with or before antibiotics to reduce ICP and complications.
• **DROPLET PRECAUTIONS** for meningococcal and H. influenzae meningitis until **24 hours of effective antibiotics**.
• **Prophylaxis for close contacts** (meningococcal, H. influenzae): Rifampin, ciprofloxacin, or ceftriaxone.
• Nursing environment: **Quiet, dimly lit room** (photophobia); monitor ICP; manage headache; monitor vitals and neuro status closely.
• **Herpes encephalitis**: Treat immediately with **IV acyclovir** (don't wait for confirmation); mortality high without treatment.
• **Japanese encephalitis** (arbovirus endemic in Philippines): **Vector control and vaccination** are key prevention; supportive care for cases.

Key Definitions

Diagrams To Know

• CSF findings: Bacterial (cloudy, high protein, low glucose, neutrophils) vs. Viral (clear, normal glucose, lymphocytes)
• Meningitis pathway: Infection → Meningeal inflammation → Classic triad → Complications (sepsis, DIC, seizures)
• Kernig's and Brudzinski's signs: How to elicit and what positive result looks like

Section Title

PARKINSON'S DISEASE

Important Facts

• **CLASSIC TRIAD**: **Tremor (resting, pill-rolling) + Rigidity (cogwheel) + Bradykinesia (slow movement)**.
• Additional features: **Postural instability, shuffling festinating gait, mask-like face, micrographia, stooped posture**.
• **Levodopa-carbidopa** is the cornerstone: Levodopa → dopamine in brain; carbidopa blocks peripheral conversion.
• **Dosing strategy**: Give **on a consistent schedule**; HIGH-PROTEIN MEALS INTERFERE with absorption.
• **Side effects of levodopa**: **Dyskinesias, orthostatic hypotension, on-off phenomenon (sudden loss of effect), wearing-off (shorter duration)**.
• **Dopamine agonists** (pramipexole, ropinirole): Used alone early or with levodopa to reduce dyskinesias.
• **MAO-B inhibitors** (selegiline, rasagiline): Slow dopamine breakdown; used early monotherapy or adjunct.
• **COMT inhibitors** (entacapone): Inhibit catecholamine metabolism; extend levodopa duration.
• **Anticholinergics** (benztropine, trihexyphenidyl): Useful for **tremor early**; avoided in elderly due to cognitive side effects.
• **Nursing care priorities**: Fall prevention (supervised ambulation, environmental safety), exercise/PT (slow progression), small frequent nutrient-dense meals, swallowing precautions, allow extra time for activities.
• **Deep brain stimulation (DBS)** is surgical option for advanced disease with motor complications.
• TEACHING: **Do NOT skip doses**; take meals 1–2 hours before/after levodopa; expect gradual decline over years; safety measures for falls and orthostasis.

Key Definitions

Diagrams To Know

• Dopamine-acetylcholine balance in Parkinson's: Loss of dopamine → relative excess acetylcholine → symptoms
• Levodopa mechanism: Levodopa (crosses BBB) → Dopamine + Carbidopa (blocks peripheral conversion)

Section Title

MULTIPLE SCLEROSIS (MS)

Important Facts

• **Typical presentation**: Young to middle-aged adults, more often **women**.
• **MOST COMMON and DISABLING symptom**: **FATIGUE** (not weakness).
• **Other manifestations**: Optic neuritis (blurred vision, color blindness), diplopia, weakness, spasticity, numbness/tingling, ataxia, bladder/bowel dysfunction, cognitive changes.
• **Diagnosis**: **MRI** (demyelinating plaques in brain/spinal cord) + **CSF analysis** (elevated IgG, oligoclonal bands).
• **Triggers to avoid**: **Heat, stress, infection**—all can worsen symptoms or trigger relapses.
• **Acute relapse treatment**: **IV corticosteroids (methylprednisolone)** to speed recovery.
• **Disease-modifying therapies (DMTs)**: **Interferon beta (Betaseron, Avonex), glatiramer acetate (Copaxone), newer agents (natalizumab, fingolimod)**—reduce relapse frequency and slow progression.
• **Nursing care**: Energy conservation techniques, fall prevention, fatigue management, heat avoidance, PT/OT, psychosocial support, education on DMT adherence.
• **Teach**: Monitor for relapse signs (new neurologic symptoms); avoid heat exposure; maintain exercise; report medication side effects; connection with MS support groups.

Key Definitions

Diagrams To Know

• MS relapse-remission cycle: Normal → Relapse (exacerbation) → Remission → Stable → Next relapse
• Demyelination process: Normal axon → Myelin damage → Conduction slowing/blocks

Section Title

AMYOTROPHIC LATERAL SCLEROSIS (ALS)

Important Facts

• **Key feature**: **Motor neurons die**, causing **progressive weakness, atrophy, fasciculations, spasticity, dysarthria, dysphagia**.
• **Sensation, cognition, eye movements are PRESERVED**—patient retains awareness.
• **No cure**; **riluzole** modestly slows progression (~2–3 months longer survival).
• **Death usually from RESPIRATORY FAILURE** as diaphragm and intercostal muscles weaken.
• **Nursing care**: Respiratory support planning (BiPAP, mechanical ventilation decision-making), **aspiration precautions**, nutrition (swallowing assessment, G-tube if needed), communication aids, advance care planning, psychosocial support.
• **Teach**: Realistic prognosis, advance directives, palliative care options, genetic counseling if familial ALS, support resources (ALS Association).
• Progression is relentless; average survival 2–5 years from symptom onset; patient awareness throughout is both a burden and an opportunity for dignity-preserving care.

Key Definitions

Diagrams To Know

• Motor neuron vs. preserved function: Motor (weak, atrophic) vs. Sensory (normal) vs. Cognition (normal) vs. Eye movement (normal)

Section Title

MYASTHENIA GRAVIS (MG) AND MYASTHENIC VS. CHOLINERGIC CRISIS

Important Facts

• **Hallmark**: **Weakness that WORSENS with activity and IMPROVES with rest** (opposite of most diseases).
• **Classic symptoms**: **Ptosis (drooping eyelids), diplopia (double vision), weak voice, difficulty chewing/swallowing, generalized weakness**.
• **Respiratory muscles can be affected** → respiratory failure → danger.
• **Diagnosis**: Serology (ACh receptor antibodies), **edrophonium (Tensilon) test**, electromyography (EMG).
• **First-line drug**: **Pyridostigmine (Mestinon)** (anticholinesterase); improves strength by increasing available ACh.
• **Dosing critically important**: Give **BEFORE MEALS** (to maximize chewing/swallowing); consistent timing required.
• **Side effects of anticholinesterases**: Muscarinic (salivation, diarrhea, cramps, miosis) and nicotinic (fasciculations, weakness).
• **Immunosuppressants**: Corticosteroids, azathioprine, mycophenolate for long-term control.
• **Acute exacerbation treatment**: Plasmapheresis or IV immunoglobulin (IVIG); remove or neutralize antibodies.
• **Thymectomy**: Often beneficial if positive chest imaging (thymoma) or even without (remission possible).
• ---
• **MYASTHENIC CRISIS vs. CHOLINERGIC CRISIS (CRITICAL DIFFERENTIAL)**:
• | Feature | Myasthenic Crisis | Cholinergic Crisis |
• | --- | --- | --- |
• | **Cause** | TOO LITTLE medication (missed doses, infection, stress, surgery) | TOO MUCH medication (overdose, toxicity) |
• | **Weakness** | Worsens (under-treated) | Worsens (over-treated) |
• | **SLUDGE** | Absent | Present (salivation, lacrimation, urination, defecation, GI, emesis) |
• | **Fasciculations** | Absent | Present (visible muscle twitches) |
• | **Pupils** | Normal | Pinpoint (miosis) |
• | **Tensilon test** | **IMPROVES strength** → needs more drug | **WORSENS strength** → already has too much |
• | **Management** | Increase anticholinesterase; support airway | STOP anticholinesterase; give **ATROPINE** (antidote); support airway |
• **TENSILON TEST MECHANISM**: Edrophonium is a short-acting anticholinesterase. **Improvement = myasthenic** (needs more ACh). **Worsening = cholinergic** (already has excess).
• **ATROPINE**: Anticholinergic antidote for cholinergic crisis; blocks excess muscarinic effects.
• **PRIORITY IN EITHER CRISIS**: **AIRWAY and VENTILATORY SUPPORT**; both cause respiratory failure.
• **Keep atropine and edrophonium at bedside** for crisis patients with MG.

Key Definitions

Diagrams To Know

• Myasthenic vs. Cholinergic Crisis: Cause (too little vs. too much) → Presentation (weak without SLUDGE vs. weak with SLUDGE) → Tensilon test (improve vs. worsen) → Treatment (increase drug vs. STOP + atropine)
• Acetylcholine physiology: Normal → Reduced receptors (MG) → Weakness; Treated with anticholinesterase → More ACh available → Better strength (until too much = cholinergic crisis)

Section Title

GUILLAIN-BARRÉ SYNDROME (GBS)

Important Facts

• **Trigger**: Often follows viral or bacterial infection (URI, GI illness, Zika virus, Campylobacter jejuni).
• **Onset**: Usually begins 1–3 weeks after infection; rapid progression (hours to days).
• **Classic progression**: **Ascending symmetric weakness** starting in legs, moving to arms, trunk, face; **diminished/absent reflexes**.
• **CHIEF DANGER**: **Ascending paralysis reaching respiratory muscles** → respiratory failure → ICU/mechanical ventilation.
• **PRIORITY MONITORING**: **Serial vital capacity (VC) measurements** and respiratory assessment; **never relax vigilance**.
• **Autonomic instability**: Tachycardia, hypertension/hypotension, arrhythmias, urinary retention.
• **Diagnosis**: Clinical presentation + elevated CSF protein (without pleocytosis—"albuminocytologic dissociation") + NCS/EMG showing demyelination.
• **Treatment**: **Plasmapheresis** or **IV immunoglobulin (IVIG)**; both remove/neutralize antibodies; usually given early.
• **Prognosis**: Most patients plateau within 2–4 weeks; then gradual recovery over weeks to months; 80% make good recovery; 20% have residual weakness.
• **Nursing care PRIORITY**: **Respiratory support** (mechanical ventilation ready), **immobility prevention** (DVT prophylaxis, skin care, PT), **pain management**, **nutrition/swallowing**, **psychosocial support**, monitor for autonomic changes.
• **Teach**: Realistic recovery timeline; reassure that sensation is intact (patient feels everything but cannot move); need for family involvement; support during recovery.

Key Definitions

Diagrams To Know

• GBS progression: Lower limbs → Upper limbs → Trunk → Respiratory muscles (ascending order)
• GBS timeline: Infection → 1–3 weeks → Ascending weakness (rapid) → Plateau (2–4 weeks) → Gradual recovery (weeks to months)

Section Title

ALZHEIMER'S DISEASE AND DEMENTIA

Important Facts

• **DEMENTIA vs. DELIRIUM** (critical distinction for exams):
• • **Dementia**: Slow onset (months/years), progressive, **irreversible**, stable/consistent, alert, sleep-wake intact, caused by neurodegeneration.
• • **Delirium**: Acute onset (hours/days), **fluctuating** (worsens and improves), **REVERSIBLE** if cause treated, disoriented, sleep-wake disrupted, caused by infection/drugs/hypoxia/etc.
• **Alzheimer's pathology**: Beta-amyloid plaques + neurofibrillary tangles → neuronal death → progressive cognitive decline.
• **Stages**: Early (forgetfulness, mild confusion) → Middle (confusion worsens, wandering, behavior change) → Late (total dependence, minimal communication).
• **Cholinesterase inhibitors** (donepezil, rivastigmine, galantamine): Modest benefit (~6–12 months); **reduce acetylcholinesterase breakdown** to improve available ACh.
• **Memantine** (NMDA receptor antagonist): Moderate-to-severe disease; modestly improves cognition/function.
• **Non-pharmacologic care** is CORNERSTONE:
• • **Safety**: Wandering precautions (locks, alarms, ID bracelets), fall prevention.
• • **Structure**: Consistent routine, familiar faces, simple environment.
• • **Communication**: Short, simple sentences; face-to-face; **validation** (acknowledge feelings without correcting facts).
• • **Orientation**: Calendars, clocks, photos; repeated orientation; memory aids.
• • **Activity**: Purposeful activity, music, reminiscence therapy.
• **Caregiver support**: Critical for family burnout; respite care, support groups, education on progression.
• **Behavioral symptoms**: Agitation, aggression, sundowning (increased confusion at dusk) — manage with non-pharmacologic means first; medications as last resort.
• **End-of-life planning**: Advance directives, code status, palliative care discussion while patient can participate.

Key Definitions

Diagrams To Know

• Dementia vs. Delirium: Onset (slow vs. acute), Progression (progressive vs. fluctuating), Reversibility (irreversible vs. reversible), Cause (neurodegeneration vs. medical/toxic)
• Alzheimer's stages: Early (forgetfulness) → Middle (confusion, wandering, behavior change) → Late (total dependence, minimal communication)
• Nursing interventions by stage: Early (psychoeducation, memory aids) → Middle (safety, routine, validation) → Late (comfort, hygiene, dignity)

Section Title

COMPLICATIONS COMMON TO ALL NEUROLOGIC DISORDERS

Important Facts

• **ASPIRATION RISK**: ALS, MG, Parkinson's, stroke, myositis → **Assess swallowing; NPO if unsafe; consider G-tube**.
• **RESPIRATORY FAILURE**: ALS (diaphragm), GBS (ascending), severe Parkinson's, MG crisis → **Monitor vital capacity, have intubation plan**.
• **IMMOBILITY COMPLICATIONS**: DVT/PE, pressure ulcers, contractures, muscle atrophy → **Prophylaxis (SCD, anticoagulation), frequent turning, ROM, mobilization**.
• **INFECTION RISK**: Indwelling catheters, aspiration, immobility → **Sterile technique, infection precautions, early ambulation**.
• **SEIZURES in degenerative disorders**: Alzheimer's, Parkinson's, ALS can have seizures → **Fall precautions, medication adherence**.
• **MEDICATION TOXICITY**: Phenytoin gingival hyperplasia, anticholinergic effects, cholinergic toxicity → **Monitoring, teaching on toxicity signs, dose timing**.
• **MEDICATION WITHDRAWAL**: Sudden stop of seizure meds, Parkinson's meds → **Status epilepticus, worsening of symptoms → NEVER stop abruptly**.
• **PAIN MANAGEMENT**: Chronic pain in neuropathies, MS, ALS → **Multimodal approach; never undertreat**.
• **BOWEL/BLADDER DYSFUNCTION**: Many neurologic disorders → **Bowel regimen, catheter care, UTI prevention**.
• **COGNITIVE/BEHAVIORAL ISSUES**: Dementia, Parkinson's, MS → **Safety, structure, behavioral strategies, medication if necessary**.

Key Definitions

Diagrams To Know

• Immobility cascade: Paralysis → Immobility → DVT/PE risk, pressure ulcers, contractures, atrophy
• Aspiration pathway: Dysphagia → Food enters airway → Aspiration pneumonia → Respiratory compromise

Item

**SEIZURE DURING EXAM**: Turn patient **LATERAL (side)** to prevent aspiration. **DO NOT restrain**, **DO NOT force anything in mouth**. **Time the seizure**. Protect from injury.

Priority

CRITICAL — Life-saving intervention

Item

**STATUS EPILEPTICUS = Seizure ≥5 minutes or repeated seizures without recovery between them = MEDICAL EMERGENCY**. Immediate **IV benzodiazepines (lorazepam or diazepam)**, then load with longer-acting drug (phenytoin, fosphenytoin, or levetiracetam).

Priority

CRITICAL — Know first-line meds

Item

**NEVER ABRUPTLY STOP** antiseizure medications (can trigger status epilepticus). Teach **consistent dosing**, **steady blood levels**, **medical identification**, **no alcohol**.

Priority

HIGH — Common teaching point

Item

**BACTERIAL MENINGITIS = Fever + Severe Headache + Nuchal Rigidity (stiff neck)** + possibly Kernig's and Brudzinski's signs + petechial/purpuric rash (meningococcal). **START ANTIBIOTICS IMMEDIATELY** (don't wait for culture). **Droplet precautions** ×24 hours of effective antibiotics.

Priority

CRITICAL — Classic triad

Item

**MYASTHENIC CRISIS vs. CHOLINERGIC CRISIS**: Both cause respiratory failure. **Myasthenic = TOO LITTLE drug** (weakness worsens); **Cholinergic = TOO MUCH drug** (SLUDGE, fasciculations, miosis present). **Tensilon test**: Improves = myasthenic; Worsens = cholinergic. **Antidote for cholinergic**: **ATROPINE**. **PRIORITY IN EITHER: Airway/ventilation**.

Priority

CRITICAL — High-yield differential

Item

**PARKINSON'S = Tremor (resting, pill-rolling) + Rigidity (cogwheel) + Bradykinesia (slow movement)**. **Levodopa-carbidopa** cornerstone; **take on consistent schedule**; **high-protein meals interfere with absorption**. **Gingival hyperplasia** is side effect (oral hygiene). Watch for dyskinesias, orthostatic hypotension, on-off phenomenon.

Priority

HIGH — Classic triad

Item

**GUILLAIN-BARRÉ = Acute ascending symmetric paralysis from legs upward**, diminished reflexes, often follows infection. **PRIORITY = Respiratory monitoring (vital capacity)** — ascending can reach respiratory muscles. Treat with plasmapheresis or IVIG. Usually self-limiting; gradual recovery over weeks to months.

Priority

CRITICAL — Ascending pattern + respiratory priority

Item

**ALS = Motor neuron death** with worsening weakness, atrophy, fasciculations, dysphagia, dysarthria, BUT **sensation and cognition PRESERVED**. **Death from respiratory failure**. **Riluzole** modestly slows it. Focus on swallowing precautions, respiratory support, nutrition, advance planning.

Priority

HIGH — Preserved sensation/cognition distinguishes it

Item

**ALZHEIMER'S = Irreversible dementia** (most common cause). Distinguish from **delirium** (acute, fluctuating, REVERSIBLE, identifiable cause). Alzheimer care: **Safety (wandering, falls), routine, simple communication, validation, caregiver support**. **Cholinesterase inhibitors** (donepezil, rivastigmine, galantamine) and **memantine** modestly slow decline.

Priority

HIGH — Dementia vs. delirium critical distinction

Item

**MULTIPLE SCLEROSIS = CNS demyelination**, usually relapsing-remitting. **MOST COMMON/DISABLING symptom = FATIGUE** (not weakness). Avoid **heat, stress, infection triggers**. **Acute relapses**: IV corticosteroids. **Disease-modifying therapies** (interferon, glatiramer, newer agents) reduce relapse frequency and slow progression.

Priority

HIGH — Fatigue is key; triggers to avoid

Tip

**SEIZURE MANAGEMENT**: "Side-protect-time" = Turn LATERAL, Protect from injury, TIME the seizure. This mantra covers the three critical actions. Never restrain or mouth-guard (old teaching is WRONG).

Context

Exam scenario: Patient seizing in hospital. What do you do first? Answer: Position lateral.

Tip

**MENINGITIS = ANTIBIOTICS FIRST**: If you see fever + stiff neck on exam, your first action is antibiotics STAT, not LP, not cultures, not waiting. **LP can be done after antibiotics started**. This is a common exam trap.

Context

Exam scenario: Patient admitted with fever, headache, stiff neck. What is the immediate intervention? Answer: Start empiric IV antibiotics (ceftriaxone, vancomycin ± ampicillin).

Tip

**MYASTHENIC vs. CHOLINERGIC**: If exam asks about **SLUDGE, fasciculations, or miosis**, it's **cholinergic crisis** (TOO MUCH drug). If weakness with **NO SLUDGE/fasciculations**, it's **myasthenic** (TOO LITTLE). The Tensilon test is confirmatory but clinical signs often tell you first.

Context

Exam scenario: MG patient presents with respiratory failure, drooling, diarrhea, pinpoint pupils. Is this myasthenic or cholinergic? Answer: Cholinergic (SLUDGE present = too much drug = stop it and give atropine).

Tip

**PHENYTOIN IV**: Remember **NS ONLY** (not dextrose) and **≤50 mg/min slow**. One of the most commonly tested antiseizure drug details. Forgetting this = wrong answer on IV push rate or precipitate forming.

Context

Exam scenario: You're loading phenytoin IV in a seizing patient. What do you use as diluent? Answer: Normal saline only.

Tip

**GBS RESPIRATORY PRIORITY**: On exam, if you see ascending weakness, the question is almost always testing whether you know to **monitor vital capacity and have mechanical ventilation ready**. Don't focus only on plasmapheresis/IVIG; respiratory support is the priority intervention.

Context

Exam scenario: GBS patient with leg weakness. What is your immediate nursing priority? Answer: Monitor respiratory function (vital capacity); prepare for possible intubation.

Rows

Columns

• Seizure Type
• Consciousness
• Duration
• Phases
• Postictal State
• Most Common Age

Table Title

Seizure Types: Classification and Clinical Features

Rows

Columns

• Feature
• Bacterial Meningitis
• Viral Meningitis

Table Title

CNS Infections: Bacterial vs. Viral Meningitis

Rows

Columns

• Feature
• Myasthenic Crisis
• Cholinergic Crisis

Table Title

Myasthenic Crisis vs. Cholinergic Crisis (CRITICAL DIFFERENTIAL)

Rows

Columns

• Disorder
• Typical Age
• Onset
• Progression
• Key Feature
• Prognosis

Table Title

Degenerative & Neuro Disorders: Onset, Progression, Prognosis

Rows

Columns

• Feature
• Dementia
• Delirium

Table Title

Dementia vs. Delirium (MUST-KNOW FOR NLE)

Rows

Columns

• Drug
• Mechanism
• Key Monitoring
• Side Effects
• Notes

Table Title

Antiseizure Drugs: At-a-Glance