Childhood Convulsions

Question 1

types of seizure can be

Answer 1

1. Convulsive seizure or motor seizure
2. Non convulsive seizure
3. Sensory seizure
4. Psychic seizure
5. Autonomic seizure

Question 2

not all seizures are convulsive

Answer 2

true

Question 3

unprovoked seizures are called

Answer 3

epilepsy

Question 4

causes of provoked seizures

Answer 4

wide range 
1.febrile seizures
2.metabolic events (hypoglycaemia ,hyponatremia hypernatremia, acidosis &hypocalcaemia)
3.acute cnsinfections : (meningitis, encephalitis, cerebral malaria)
4.drug intoxication
5.intracranial haemorrhage or thrombosis
6.head trauma
7- inborn errors of metabolism
8.space occupying lesions in the brain
9.vascular malformation
10.hypoxic ischemic encephalopathy

Question 5

involve the excessive and or hyper synchronous discharge of neurones in the brain

Answer 5

epileptic activity of the brain

Question 6

repeated seizures with an identified provocation are not epileptic

Answer 6

true

Question 7

consistent with initial activation of only part of one cerebral hemisphere

Answer 7

focal epileptic seizures

Question 8

the child will go stiff may let out a cry and lose consciousness falling to the ground

Answer 8

tonic phase of generalised clonic seizures

Question 9

rhythmic jerking of the limbs colour change urinary & faecal incontinence, automatic features such as breathing irregularities

Answer 9

clonic phase of generalised clonic seizures

Question 10

• no diagnosis or suspected underlying brain disorder

- presumed to be genetic in origin and often age-related

Answer 10

idiopathic epilepsy

Question 11

involve an increase in tone which may be generalised and obvious or localised and subtle (e.g. retropulsion of head)

Answer 11

tonic seizures

Question 12

involve loss of postural tone again can be obvious or subtle like a head nod

Answer 12

atonic seizures

Question 13

sudden shock like contractions of muscles, and may be single, repetitive or rhythmic or a rhythmic

Answer 13

myoclonic seizures (jerks)

Question 14

main manifestation is impairment of consciousness

Answer 14

absence seizure

Question 15

reflex anoxic seizures breath holding attacks.

simple faints cardiac syncope e.g. Long QT disorders, aortic stenosis suffocation

Answer 15

syncope and anoxic seizures

Question 16

non epileptic myoclonus including benign neonatal sleep myoclonus dyskinesia paroxysmal ataxias

Answer 16

paroxysmal movement disorders

Question 17

investigation go brain mri

Answer 17

focal epilepsy develop epilepsy < 2 years.

-In whom seizure continue despite first line medication

Question 18

anticonvulsant medication for generalised seizure are

Answer 18

Sodium Valproate Lamatrogine or Topiramate

Question 19

drug of choice for absence seizure is

Answer 19

Ethosuxamide

Question 20

focal seizures can be treated with

Answer 20

Carbamazapine

Question 21

extra treatment for seizures

Answer 21

ketogenic diet vagal nerve stimulation surgery

counselling pts regarding safety and activities

Question 22

seizure that lasts more than 30 minutes or recurrent seizures without recovery

Answer 22

Status epilepticus (SE)

Question 23

treatment for Status epilepticus (SE)

Answer 23

patient given Diazepam 0.3 mg/kg IV or Lorazepam 0.1 mg/kg iv

Question 24

if theres non vascular accessor status epilepticus patient is given

Answer 24

rectal Diazepam 0.5 mg/kg or Buccal Midazolam

Question 25

the two status epileptics no response drugs

Answer 25

phenytoin and then phenobarbitone last resort anathema