The inflammation caused by this reaction can rapidly cause similar findings seen in aspiration pneumonia, such as an elevated WBC (white blood cell) count, radiologic findings, and fever. However, it is important to note that the findings of chemical pneumonitis are triggered by inflammation not caused by infection, as seen in aspiration pneumonia. Inflammation is the bodys immune response to any perceived threat to the body. Thus, treatment of chemical pneumonitis typically involves removal of the inflammatory fluid and supportive measures, notably excluding antibiotics. The use of antimicrobials is reserved for chemical pneumonitis complicated by secondary bacterial infection. Prevention
There have been several practices associated with decreased incidence and decreased severity of aspiration pneumonia as detailed below. Oral hygiene
Studies showed that the net reduction of oral bacteria was associated with a decrease in both incidence of aspiration pneumonia as well as mortality from aspiration pneumonia. One broad method of decreasing the number of bacteria in the mouth involves the use of antimicrobials, ranging from topical antibiotics to intravenous antibiotic use. Whereas the use of antibiotics focuses on destroying and hindering the growth of bacteria, mechanical removal of oral bacteria by a dental professional also plays a key role in reducing the bacterial burden. By reducing the amount of bacteria in the mouth, the likelihood of infection when aspiration occurs is reduced as well.
Initially, these contractions are of a high frequency and low amplitude, which will gradually progress to decreased frequency and high amplitude. An eventual decrease in contraction amplitude just before seizure cessation is also typical.Postictal phaseThe postictal phase causes are multifactorial to include alteration of cerebral blood flow and effects on multiple neurotransmitters. These changes after a generalized tonic–clonic seizure cause a period of postictal sleep with stertorous breathing. Confusion and total amnesia upon regaining consciousness are also usually experienced and slowly wear off as the patient becomes gradually aware that a seizure occurred and remembers their identity and location. Most often, patients regain consciousness within 30 minutes. Rarely, impaired consciousness duration can last several hours after a seizure, especially with a compounding central nervous system condition or a prolonged seizure. Occasionally the patient may vomit or burst into tears from the experienced mental trauma. An additional smaller seizure can also occur several minutes after the main seizure, particularly if the patients seizure threshold has been brought unusually low by known factors or combinations of such. Examples include: severe hangovers, sleep deprivation, elevated estrogen at ovulation, prolonged physical tiredness, and drug use or abuse (including, but not limited to, stimulants, alcohol and caffeine). Rarely, the respiration is inhibited during the postictal phase, leading to sudden unexpected death in epilepsy (SUDEP). Generalized tonic–clonic seizures represent the most important risk factor for SUDEP, especially in patients with nocturnal seizures, who are living alone or do not share a bedroom.