Neurology Review: Delirium, Lewy Bodies and Status Epilepticus | Part 2 | 意識認知 | OET Music

Dr Allison Lu · Pip & Barnaby · Medical English

本頁提供本曲完整英文歌詞與影片搭配的繁中醫學提示。歌詞保留原演唱文字；遇到過度簡化或舊門檻，請搭配下方提示與原始資料閱讀。這是概念學習材料，不替代個別醫療評估。

Lyrics · 完整歌詞

The central distinctions can be recalled as follows.

All sudden confusion in an older person is delirium until proven otherwise;
find the infection, the drug or the electrolyte before naming dementia.
Is the dementia fluctuating, with visual hallucinations and parkinsonism?
It is Lewy body disease, and haloperidol is contraindicated.
On the fifth minute a convulsive seizure becomes status epilepticus;
give a benzodiazepine first, then levetiracetam, valproate or fosphenytoin.
Lumbar drainage of thirty to fifty millilitres is the tap test that
predicts shunt response in normal pressure hydrocephalus.


All sudden confusion in an older person is delirium until proven otherwise;
find the infection, the drug or the electrolyte before naming dementia.
Is the dementia fluctuating, with visual hallucinations and parkinsonism?
It is Lewy body disease, and haloperidol is contraindicated.
On the fifth minute a convulsive seizure becomes status epilepticus;
give a benzodiazepine first, then levetiracetam, valproate or fosphenytoin.
Lumbar drainage of thirty to fifty millilitres is the tap test that
predicts shunt response in normal pressure hydrocephalus.

Medical Notes · 醫學學習提示

  1. 急性認知改變需迅速評估；歌詞口訣不能取代診斷
  2. 突然混亂應優先評估譫妄，同時排除中風、低血糖等急症
  3. 檢查感染、藥物、代謝與缺氧等誘因；失智可同時存在
  4. 認知波動、視幻覺與巴金森症提示路易氏體病，仍需鑑別
  5. 路易氏體失智應避免 haloperidol，可能引發嚴重反應
  6. 持續抽搐達 5 分鐘，或反覆且未恢復意識，須啟動急救
  7. 先 benzodiazepine；依反應加第二線藥，同步監測呼吸循環
  8. 放液試驗常取 CSF 30–50 mL；圖為神經概念，非穿刺位置
  9. 放液後客觀評估步態等改善；陰性不能排除分流受益

References