Pediculosis Corporis This condition is an infestation of the skin by body  lice.  The  louse  inhabits  the  seams  of  clothing and  feeds  on  the  skin,  which  results  in  severe itching and produces small red lesions occurring from the bites. The most common sites of lesions are  the  buttocks,  shoulders,  and  abdomen.  The body louse is an important vector in transmitting typhus,  trench  fever,  and  relapsing  fever. Pediculosis  Pubis This condition is characterized by infestation of  the  anogenital  regions  with  crab  lice.  This infestation is the result of direct contact with the lice through sexual activity, toilet seats, clothing, or bedding. The louse is comparatively large but not   eaily   seen,   and   itching   is   almost   always present.  The  patient  may  note  the  presence  of small  specks  on  the  sheets  upon  arising. TREATMENT—The  treatment  for  all  pedi- culosis  infestations  consists  of  applying  ointments containing  benzoate  and  benzocaine  and  main- taining proper hygiene habits. Use caution when treating  around  the  eyes.  Two  applications  of medication are usually sufficient. Check contacts. Use   calamine   lotion   to   control   itching,   and launder  all  bedding  and  clothing. DISORDERS OF THE NERVOUS  SYSTEM Levels of Consciousness Abnormal  levels  of  consciousness  may  be associated   with   decreased   or   increased neurological   activity,   such   as   stupor,   coma, delirium,  or  violent  behavior.  There  may  be partial  to  complete  mental  clouding  or  loss  of consciousness. Frequent  causes  are  cerebro- vascular   accident   (CVA),   drugs,   poisons,   and fever. The two major categories of loss of conscious- ness  are  stupor  and  coma.  Stupor  ranges  from partial to almost complete loss of consciousness. Coma  is  complete  unconsciousness  from  which the  patient  cannot  be  roused. In  any  case  of  consciousness  disorder,  it  is important  to  obtain  a  complete  history  from  those who  know  the  patient  or  who  may  have  witnessed the  incident  causing  it.  Perform  a  thorough physical   examination,   including   checking   the pupils for size and reaction to light. The key points to  look  for  when  a  neurological  disorder  is suspected  are  abnormal  vital  signs,  signs  of injury, or alcohol or drug intoxication. Also look for discolorations of the skin in the area behind the ears that may indicate a skull fracture. TREATMENT—The   immediate   objective   of treatment   is   to   maintain   life   until   a   specific diagnosis is made. Avoid sedatives and stimulants, and keep semiconscious patients NPO. Catheter- ize  unconscious  patients  and  test  the  urine  for sugar, acetone, and albumin. Treat symptomati- cally. Syncope and Vertigo Syncope is a temporary loss of consciousness as in fainting. Vertigo is an illusionary sensation of  motion. SYMPTOMS—The  patient  is  usually  in  an upright position when an attack occurs. He or she may  experience  mot  or  weakness,  epigastric distress, perspiration, restlessness, yawning and sighing,  bradycardia,  and  a  fall  in  blood  pressure. TREATMENT—Place  the  patient  in  the shock   position, and   administer   spirits   of ammonia. Headache Headaches  are  so  common  that  most  everyone has  some  experience  with  them  at  one  time  or another. They may be caused by tension, tumors, trauma,  or  any  number  of  other  causes.  The following  are  the  more  common  types  of headaches. l  Tension—These  headaches  are  caused  by spasm   or   contraction   of   diseased   muscles   or adjacent  structures,  or  they  may  be  associated wit  h  fatigue  or  emotional  stress.  The  muscles attached  to  the  occiput  are  the  most  frequently involved.   This   is   the   most   common   type   of headache. SYMPTOMS—The   common   complaints   are a  feeling  of  pressure  or  tightness  or  a  bandlike constriction  and  pain. TREATMENT—General  measures  consist  of analgesics,  rest,  relaxation,  massage,  and  heat applied  to  the  involved  musculature. 2-28