19- seizure

Question 1

most common type of seizure in kids

Answer 1

tonic clonic

Question 2

when do absence seizures begin, what age

Answer 2

3 years

Question 3

supportive evidence of a true seizure

Answer 3

A history of alteration of consciousness or loss of consciousness
Incontinence
Deviation of the eyes
Often rhythmic motor movements that cannot be stopped by touching or holding the child
A postictal state.

Question 4

other causes of seizures

Answer 4

motor tics,
myoclonus,
gastroesophageal reflux (Sandifer’s syndrome), and
pseudo seizures (psych)

Question 5

questions to ask parents about seizure of child

Answer 5

• description of event
• timeline
• precipitating factors (fever)
• ingestion of toxins?
• history of injury (head)
• PMH/Fam hx- premature? delay?

Question 6

febrile seizure

Answer 6

Febrile seizures occur in children ages 6-60 months at a frequency of 2-5% in this age group.
Seizures usually occur on the first day of the febrile illness, often as the first sign to the parents that the child is ill.
Fever > 38 degrees is typically present.
Children with febrile seizures tend to be developmentally normal and often have a positive family history for other first-degree relatives with febrile seizures as children.
Most febrile seizures are generalized.

Question 7

how long after head injury would you get a seizure

Answer 7

1-2 hours after the incident.

Question 8

“toxic child”

Answer 8

Has poor or absent eye contact.
Fails to recognize caregivers.
Is very irritable and cannot be consoled or distracted.
Has a minimal response to painful procedures, such as an IV placement or blood draw.
Has signs of poor perfusion or respiratory distress.

Question 9

fever without a source

Answer 9

when a child with acute fever has no localizing symptoms or signs on physical exam

usually 24-72 hours after the onset of fever)

Question 10

common causes of serious bacterial infection

Answer 10

**UTI
bacteremia
meningitis

Question 11

fever of unknown origin (FUO)”

Answer 11

beyond a 7- to 10-day period.

unusual infections, malignancies, or collagen vascular disorders.

Question 12

is EEG needed for a kid with one febrile seizure

Answer 12

no

Question 13

which tests for afebrile seizure?

Answer 13

EEG

MRI

Question 14

complex (vs simple) seizures

Answer 14

over 15 min
more than once in 24 hrs
focal

Question 15

risk of recurrence after febrile seizure

Answer 15

If a child has his first febrile seizure before age 12 months, the recurrence risk for a second febrile seizure is about 50%.

If a child has his first febrile seizure after age 12 months, the recurrence risk is about 30%.

Question 16

risk of epilepsy after febrile seizure

Answer 16

slightly increased above the 0.5-1% baseline population risk.

more common among those children with early, recurrent febrile seizures, especially if there is a family history of epilepsy.

Question 17

do febrile seizures affect future intelligence

Answer 17

no

Question 18

in case of a seizure

Answer 18

Place the child on his side so that he won’t choke on stomach contents or saliva.

Be sure the child is in a safe

nothing should be placed in mouth

Do not restrain the child’s movements

remain calm

Call 911 if the seizure lasts more than five minutes.

Question 19

what do you think of when fever for 4 days and then stops, then maculopapular rash

Answer 19

roseola (HHV-6)

Question 20

presentation of meningitis

Answer 20

fever,
altered mental status,
decreased PO intake, and
decreased urine output.

Question 21

febrile seizure common age

Answer 21

6 mo- 5 years

Question 22

differential for unresponsive child

Answer 22

toxic ingestion
seizures
syncope (breath holding spells)
closed head injury
Infection (encephalitis)
Intracranial tumor
Intussusception