1: Peds Epilepsy Flashcards
Epilepsy syndrome found in neonates that has recurrent seizures and usually ends in 1 to 4 months.
Benign familial neonatal seizures
Treatment for juvenile myoclonic epilepsy.
Well controlled with broad-spectrum: Valproic acid Lamotrigine Levetiracetam Clonazepam Life-long disorder that must be treated indefinitely. Good prognosis of normal cognition.
Describe the spasms in West’s syndrome.
Sudden, rapid, tonic contraction of trunk and limbs. Intensity can vary from subtle head nodding to powerful body contraction. Can occur in clusters of several dozen separated by a few seconds. Often occurs during sleep/wake transition.
What are the general treatment options for pediatric epilepsy (3)?
Antiseizure meds
Surgery
Ketogenic diet
This infantile epilepsy is a severe myoclonic form with febrile seizures. It can have status epilepticus and lead to developmental delay.
Dravet syndrome
Family history of seizures (from any etiology) increases risk for febrile seizures following _____ vaccination.
Family history of seizures (from any etiology) increases risk for febrile seizures following MMRV vaccination.
What is the triad in Aicardi’s syndrome?
Infantile spasms
Agenesis of corpus callosum
Retinal malformation
What is the concern with repeated or prolonged febrile seizures?
Serious underlying cause like bacterial meningitis or encephalitis.
Criteria for febrile seizures (5).
Seizure + temperature greater than 38°C
Younger than 6
No central nervous system infection or inflammation
No acute systemic metabolic abnormality that may produce convulsions
No previous history of afebrile seizures
Ohtahara syndrome can develop into what?
West’s syndrome
Lennox-Gestaut syndrome
What is the difference between an anatomical and a functional hemispherectomy?
Anatomical: complete removal of one hemisphere.
Functional: disconnection of hemisphere. Some tissue left intact.
How long should the ketogenic diet be followed?
Not more than two years
Patient is typically a healthy young teenager with one or more of the following seizures:
Absence seizures
Myoclonic jerks
Generalized convulsions
Juvenile myoclonic epilepsy
Those with West’s syndrome have a poor prognosis. Idiopathic do better than symptomatic. What can develop in those with symptomatic disease (3)?
Severe mental retardation (70%)
Lennox-Gastaut syndrome (18-50%)
Autism spectrum disorders
What is the treatment for reflex epilepsy?
Avoidance of the trigger
T/F Viral/bacterial illness may precipitate fever and cause seizure.
True.
What two medications should be prescribed with a ketogenic diet?
Calcium
Vitamin D
Signs to look for: eye fluttering, eyes rolling upward, lip smacking, and autonomic symptoms (e.g., flushing or tachycardia).
Childhood absence epilepsy
This epilepsy syndrome occurs in juveniles and adults. It is triggered by a specific stimuli, such as emotions or sounds.
Reflex epilepsy
This epilepsy has acquired aphasia (word deafness).
Landau-Kleffner syndrome
What is the peak incidence of childhood absence epilepsy?
6 to 7 years old
Early myoclonic encephalopathy in neonates can become what after several months?
West’s syndrome
Treatment for Lennox-Gastaut syndrome (4).
- No drug has been very effective. Rufinamide (Banzel) and Clobazam (Onfi) used. Can use Valproic acid and Lamotrigine.
- Ketogenic diet
- Corpus callosotomy
- Vagal nerve stimulator
West’s syndrome is often symptomatic. Name examples.
The structural underlying cause can be a prenatal, perinatal, or postnatal disorder. Such as microcephaly, severe hydrocephalus, or encephalitis.
