5- Paediatric Epilepsy Flashcards
How is epilepsy classified
Based on seizure type (focal/generalized), Motor involvement
Consciousness
EEG
Age of onset
Associated features (ILAE 2017 classification).
How is a diagnosis of epilepsy made?
Primarily clinical history and observation. Videos of events help, and EEG is used in unclear cases.
What does it need to be differentially diagnosed from?
Syncope, tics, sleep disorders, emotional/functional events, daydreaming, sensory overload, pseudoseizures.
What is a common aetiology of epilepsy?
Brain developmental issues, trauma, infection, metabolic or genetic disorders, stroke, or post-surgical injury.
What are possible triggers?
Fever, stress, lack of sleep, flashing lights (photosensitivity), hyperventilation (esp. for absences).
Where in the brain would the focal seizure be if the child is having visual phenomena?
Occipital lobe.
What are 4 main the treatment options?
Medications
Ketogenic diet
Surgery
Vagus nerve stimulation.
What is the aim of using medications for epilepsy?
To prevent seizure recurrence and improve quality of life.
What is the difference between epilepsy and non-epilepsy?
Epilepsy = recurrent unprovoked seizures
Non-epileptic = provoked or mimicking events without abnormal brain electrical activity
What other events or things may look like epilepsy?
Syncope, sleep movements, tics, functional seizures, daydreaming, inattention, migraines.
What is an epileptic seizure
A transient event caused by excessive, synchronous electrical discharges in the brain
What part of the brain causes seizures
the cortex
What are 3 non epiletic evens mistaken for seizures
Syncope, tics, sleep phenomena.
What is myclonus
Rapid, non-rhythmical jerks lasting less than 100 microseconds.
What are epileptic spasms
Brief stiffening (1–2 seconds), often seen in 6–9-month-olds, resembling sit-ups or arm flinging.
What is a clonic seizure
Rhythmical jerking that starts slow, builds, then fades.
What is a tonic seizure
Muscle stiffening lasting more than 3 seconds, possibly with eye deviation.
What is an atonic seizure
sudden loss of muscle tone which causes head injury or body drops
What is a gelastic serizure
a seizure characterised by an odd mirthless laighter
What is an absent seizure
Sudden blank spell, unresponsive to touch, with automatisms like blinking or lip-smacking.
How are generalised seisures defined
Seizures involving both sides of the brain at onset.
How are focal seizures defines
Seizures that start on one side of the brain.
What is a focal to generalised seizure
A focal seizure that spreads to involve both brain hemispheres.
What are the steps to describe a seizure
Describe, identify as epileptic, determine focus/generalization, motor/non-motor, consciousness status.
What classification system is used for seizures
ILAE 2017 classification.
What is the first step in diagnosing epilepsy
Clinical history and seizure description.
When is EEG useful
For difficult diagnoses when events can be captured.
What is benign neonatal sleep myoclonus
Jerking only during sleep; not a seizure.
What are infantile spasms associated with
Serious genetic, metabolic, or structural brain issues.
What is a reflex anoxic serizure
A syncope-like event in toddlers triggered by upset or trauma.
What is the old term for a focal seizure with impaired awareness
Complex partial seizure.
What condition are gelastic seizues often associated with
Hypothalamic hamartomas.
What is epilepsy
Recurrent unprovoked seizures or one seizure with >50% risk of another.
Name three events that are not considered epilepsy.
Febrile seizures, trauma-induced seizures, electrolyte imbalance.
What factors help diagnose epilepsy syndromes?
Seizure type, age of onset, EEG, development, and family history.
Name two epilepsy syndromes.
West Syndrome and Lennox-Gastaut Syndrome.
What is a cause of epilepsy involving development?
Developmental abnormalities in the brain.
What metabolic sign in the eye might suggest a lysosomal disorder?
Cherry red macula
What syndrome involves roving eyes and chorioretinal lacunae?
Aicardi Syndrome.
What is vigabatrin used for?
Treating West Syndrome.
What is a side effect of vigabatrin?
Visual field loss after 6 months.
How can orthoptists assist with occipital lobe epilepsy?
Ask children to draw visual hallucinations like colored blobs.
What are treatment options for epilepsy?
Medication, ketogenic diet, surgery, vagus nerve stimulation.
What should you do during a convulsive seizure?
Ensure safety, recovery position, open airway, follow rescue plan.
What differentiates epilepsy from non-epileptic events?
Epilepsy = unprovoked seizures with abnormal brain activity; non-epileptic = external cause or mimicry.
