42b - Pediatric Seizures Flashcards
What is PNES?
psychogenic nonepileptic seizures. Pychological in orign.
No epileptiform actiivty on EEG
Should you put something in the child’s mouth to prevent them from swallowing the tongue?
NO. it is impossible to swallow the tongue.
What should you do to a patient having a seizure in the hospital?
ABCs. Place pateint on side. administer oxygen.
give benzodiazepine and possilby antiepileptic.
What type of seizure is a patient whose EEG shows 3Hz spikes having?
absence seizure
What is most common type of childhood seizure?
febrile seizure.
What is a febrile seizure?
occurs in febrile children between 6 and 60 months of age who have had no history of afebrile seizures or other known cause.
What is a simple febrile seizure?
an isolated, generalized seizure. (most common)
What is a complex febrile seizure?
multiple occuring in a 24-hour period for more than 15 min.
How often will a child who has had a febrile seizure have a recurrance?
90% of the time within 1 year.
Should EEG be performed on a child who was just brought in with a febrile seizure?
no. should NOT be performed on healthy child with first simple febrile seizure
Should blood studies be done on a child who has had a first simple febrile seizure?
no. instead try to find source of seizure. Do not do neuroimaging either.
Will antipyretics prevent febrile seizures?
no.
What will help prevent recurrence of febrile seizures?
intermittent oral diazepam.
Should anticonvulsants be given to children with 1 or more simple febrile seizures?
no. risk benefit is not good enough.
What did FEBSTAT study find?
children with FSE are at risk for acute hippocampal injury and abnormal hippocampal development.
HHV-6B infection common in FSE.
HHV-7 less so.
Both together account for 1/3 of FSE.
Is cerebrospinal fluid pleocytosis a contributing factor of FSE?
no. not usually.
When should AEDs be given to a child?
when they have status epilepticus (SE).
What are stomach crunching infants doing?
having infantile spasms.
What is west syndrome?
triad of infantile spasms, hypsarrhythmia and develpmental arrest/regression
What are treatments for infantile spasms?
correct the cause. Ex: B6 or diet for PKU.
Treat with ACTH, vigabatrin, topiramate, zonisamide, valproic acid, BNZs, ketogenic diet.
What is Lennox-Gastuaut?
traid of specific seizure types, specific EEG and mental deficiencies.
- tonic, atypical absence, atonic seizures
- slowed mental develop
- slow spike and wave EEG (1.25-2.5 Hz)
What is childhood absence epilepsy (CAE)?
normal neurologic status but have absence seizures multiple times/day.
3Hz spike-and-wave dishcarges
Can be triggered by hyperventilation
Normal EEG background.
What is preffered treatment for CAE?
ethosuximide, but also valproic acid or lamotrigine if they have more than just absence seizures.
What is JME?
onset in adolescence, may b tonic-clonic, or myoclonic or absence.
precipitated by sleep deprivation, alcohol, sterss, menstraution.
Normal neuro exam and neuroimaging.
Requires life-long treatment.
Thought to be linked to chromosome 6 autosomal dominant.
What is benign rolandic epilepsy (BRE)?
most common form of benign partial epilepsy in childhood. discharges arise from lower Rolandic area of brain. AKA BECT or BFEC.
Facial motor seizure!!. with nocturnal generalized tonic-clonic seizures.
EEG = central-temporal spikes.
Do studies support use of a 3rd AED for peds epilepsy?
no. only 4% show better results.
