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Alterations of Consciousness

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					Clinical Neuropsychology
   Alterations in Consciousness
            Chapter 16
                 Consciousness
   Level of mental alertness and attention
   Are we always aware of alterations in our
    level of consciousness?
   http://www3.interscience.wiley.com/journ
    al/104520276/abstract?CRETRY=1&SRETR
    Y=0
   Rhythms of Consciousness
       Circadian Rhythms- 24 Hour Cycles
       Ultradian Rthythms- 90 Minute Cycles
Sleep Architecture
Sleep Architecture
       Sleep Architecture




http://www.nature.com/nri/journal/v4/n6/execsumm/nri1369.ht
ml
Sleep Architecture
    Memory Consolidation REM Sleep
   Long Term Potentiation
       Long lasting enhancement in signal transmission between two
        neurons
   Glutamate receptors in the Hippocampus
       GABA blocks receptors and inhibits LTP
   Hippocampal Theta Waves during REM
   Rats learning spatial tasks showed same neural activation
    (intensified) when sleep induced and REM sleep began
   Learning tasks in both REM Normal and REM Deprived
   Interference
       Alcohol, Drugs, Medications, Phone Radiation
       http://electromagnetichealth.org/electromagnetic-health-
        blog/mice-exposed-to-cell-phone-radiation-exhibit-memory-
        deficits/
                          Sleep Disorders
   Narcolepsy
   http://www.ninds.nih.gov/disorders/narcolepsy/narcolepsy.htm
        Inability to regulate sleep-wake cycles normally
             EDS –Excessive Daytime Sleepiness
             Involuntary Sleep Episodes
             Often combined with Cataplexy (motor paralysis)
             Vivid hallucinations (hypnogogic)
        Episodes can be brought on by environmental stressors
        Prevalance is about 1 per 2,000
        High genetic propensity
        Any age of onset
        http://www.youtube.com/watch?v=-zVCYdrw-1o&feature=related
        http://www.youtube.com/watch?v=70jFzlxCnZA&feature=related
                             Narcolepsy
   Medical Treatments
       Stimulant Medications
            Modafinil (non amphetamine tx for EDS)
            Tricyclics, and SSRI’s
            Xyrem (Gamma Hydroxybutyrate) for Cataplexy
   Behavioral Treatments
       Frequent Naps
       Sleep Schedule
       Avoid Caffeine and Alcohol
       Reduce/Eliminate Smoking
       Exercise
       Safety Mechanisms (Driving, Machinery, etc.)
              Sleep Apnea Syndrome
   Disruptions in airway during sleep (5-15%)
             Central-Inadequate CNS Signals to Breathe
                   Chronic CO2 in blood dysregulates the CNS Sensors
                   Cardiac or Pulmonary Disease
             Obstructive- Genioglossus muscle atonia
             Mixed
             5-15% of people have Sleep Apnea
                   70% Obese People
                   African Americans 2.5 Times greater risk
   Symptoms
        Heavy Snoring
        Night Time Choking or Gasping
        Morning Headaches
        Inability to Focus or Concentrate
        Memory Problems
        Mood Irritability
        Daytime Sleepiness
        Sleep Apnea Syndrome
   Treatment
       Medications Largely Ineffective
       Dental Appliances (75% effective)
       CPAP
       BiPAP
       Smart CPAP (Auto-Titrating)
       Surgery
       Weight Control
       Exercise and Dietary Adjustments
                          Seizure Disorders
   Neurons fire excessively in rapid synchronous oscillation (6 times faster than
    normal)
   Generalized Seizure
        Affects both hemispheres of the Brain
              Absence
              Myoclonic
              Tonic Clonic
              Atonic
   Partial
        Affects specific areas of the brain
              Simple Partial – consciousness is preserved
                     Focal Motor
                     Somatosensory
                     Psychic
                     Autonomic
              Complex Partial – consciousness is impaired
                     Psychomotor
                     Temporal Lobe
   http://www.epilepsyontario.org/client/EO/EOWeb.nsf/web/All+About+Epile
    psy+-+Video+Clips

				
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posted:12/17/2012
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