ALOC

Question 1

ddx

Answer 1

trauma (head trauma, shaken baby, haemorrhagic shock)
metabolic (DKA, hypoglycaemia, electrolyte imbalance, renal failure, hepatic encephalopathy)
hypoxia (resp, cardiac arrest)
sepsis
OD/poisoning
infections
neurological (raised icp, brain tu, meningitits/encephalitits, seizure)

Question 2

causes of transient ALCO in infant/toddles

Answer 2

apnoea
febrile convulsion
breath holding spell
infantile spasm

Question 3

apnoea

Answer 3

occurs <1mo
limp twitching
no precipitating event

Question 4

breath holding spell

Answer 4

<18mo
precipitated by crying/pain
cyanotic
no post ictal phase

Question 5

reflex anoxic spell

Answer 5

precipitated by minor trauma
++ vagal response
rapid recovery
disappears by school age

Question 6

infantole spasm

Answer 6

jacknife spasm in clusters
usually associated with sleep
severe learning difficulty

Question 7

ALOC ddx school age

Answer 7

epilepsy
syncope
hyperventilation
cardiac arrhythmia