Seizures Flashcards Preview

Paediatric Neurology > Seizures > Flashcards

Flashcards in Seizures Deck (22)
Loading flashcards...
1
Q

Epilepsy, DDx in neonates/infants (2)

A

benign neonatal myoclonus

shuddering attacks

2
Q

Epilepsy, DDx in toddlers (5)

A

breath holding

febrile convulsions

masturbation and gratification

night terrors

BPPV of childhood

3
Q

Epilepsy, DDx in older children (5)

A

daydreaming (not present during fun activities)

reflex anoxic seizures

pseudoseizures

vasovagal syncope

cardiac dysryhtmias

(stay off Rx if in doubt, consider hypoglycaemia in all ages)

4
Q

Features of reflex anoxia seizures (4)

A

triggered by pain, mild head trauma, fear

child goes deathly pale>hypotonic/rigid w. upward eye deviation

urinary incontinence

> vasovagal syncope and LOC

5
Q

Features of breath holding (4)

A

in toddlers

triggered by anger/frustration

child holds breath>blue>LOC>spontanenous recovery

brief jerks may occur

6
Q

Ix for seizure of unknown cause (3)

A

MRI not indicated after 1st seizure

EEG normal in 50%

ECG is 1st line: cheapest and most effective

7
Q

Specific epileptic syndromes (11)

A

Neonatal:

  • epileptic encephalopathy
  • West syndrome
  • Lennox-Gestaut syndrome
  • benign myoclonic epilepsy of infancy
  • severe myoclonic epilepsy of infancy

Idiopathic generalised epilepsies:

  • myoclonic absence epilepsy: cornflake epilepsy
  • childhood absence epilepsy
  • juvenile absence epilepsy
  • juvenile myoclonic epilepsy: after waking

Idiopathic partial epilepsies:

  • rolandic epilepsy
  • panayiotopoulos syndrome
  • NB in focal seizures, MRI always indicated
8
Q

Features of epileptic encephalopathy (2)

A

tonic spasms+/- clustering

transforms into west syndrome

9
Q

Presentation and features of West syndrome (5)

A

triad of:

  • infantile spasms
  • characteristic hypsarrythmia on EEG
  • LD and developmental regression

most have underlying co-morbidity e.g. Down’s, hydrocephalus,microcephaly, trauma, encephalitis. therefore poor prognosis

often progresses to Lennox-Gestaut syndrome

10
Q

Rx of West syndrome (2)

A

1st: vigabatrin-SEs: visual impairment

ACTH

11
Q

Features, associations and Rx of Lennox-Gestaut syndrome (4)

A

tonic seizures w. truncal flexion

developmental delay

assoc. w. tuberous sclerosis

Rx w. lamotrigine

12
Q

Features of benign myoclonic epilepsy of infancy

A

requires no Rx

13
Q

Rx of severe myoclonic epilepsy of infancy

A

sodium valproate

14
Q

Features of Rolandic epilepsy (5)

A

benign childhood epilepsy w. controtemporal spikes

15% of childhood epilepsies-v. common

symptoms typically occur at night

partial seizures w. unilateral facial/oropharyngeal motor-sensory Sx which spread from one arm to one leg.

hypersalivation and speech arrest

15
Q

Features of Panayiotopoulos syndrome (4)

A

Benign focal syndrome in early/mid childhood

Sx mainly at night

get vomitting and eye deviation (occipital predominance)

Seizures can last for >30mins

16
Q

Conservative measures for epilepsy and Mx of general, partial and absence seizures (4)

A

keto-diet, educate teachers and parents

generalised: valproate 1st, lamotrigine 2nd
partial: carbemazepine
absence: ethosuxemide

17
Q

Sturge-Weber syndrome

A

do MRI at birth for any child w. port wine stain in trigeminal distribution to look for seizure activity.

18
Q

Features of febrile convulsions (5)

A

single tonic clonic seizure lasting <20mins as temperature rises in absence of intracranial infection/neurological disorder

most common cause of seizure in childhood

peak incidence: 6mo-6yrs

1/3 will have recurrence in future fevers: higher if <18mo or FHx

often occur on 1st day of fever

19
Q

Red flag features of febrile convulsions (5)

A

lasting >15mins

febrile status epilepticus

focal features at onset or during seizure

incomplete recovery after 1hr

recurs w/i 24hrs or w/i same febrile illness

20
Q

DDx if red flag features present in febrile convulsion (6)

A

meningo-encephalitis

trauma

hypoglycaemia

hypomagnesaemia/hypocalcaemia

CNS lesion

epilepsy

21
Q

Ix for febrile convulsions (3)

A

Bloods:
-FBC, ESR, U+Es, coagulation

Urine MC&S

Consider LP if <12mo/suspicious features:
-CI in decreased consciousness, raised ICP, meningitis, shock, focal neurology, bleeding disorder.

22
Q

Mx of febrile convulsions (4)

A

Find cause:

  • exclude meningitis, septicaemia, UTI, LRTI, cerebral malaria
  • most common causes: viral illness, otitis media, tonsilitis
  • can be caused by gastroenteritis

place in recovery position, paracetemol if extremely hot

if lasting >5mins, standard status protocol: IV Lorazepam, buccal midazolam, rectal diazepam.

Admit and Rx as meningitis if: drowsy before fit/1hr after, neck stiffness, rash, bulging fontanelle