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PAEDIATRICS > CNS > Flashcards

CNS Flashcards

1
Q

What is a Seizure ?

A

Seizures are abnormal paroxysmal electrical activity in the brain that result in motor,sensory behavioural and autonomic manifestations.

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2
Q

True or false. Upto 5% of children will experience a seizure in the 1st 5 years of life ?

A

True.

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3
Q

Classify the causes of Seisures in the Neonatal period. Give examples at each classification.

A

The causes of Seizures in Neonates are classified as : Infections, Metabolic, Events at birth,Others [ OMIE]

  1. INFECTIONS : Meningitis, Sepsis, TORCH, Tetanus neonatorum
  2. METABOLIC : hypoglycaemia,hypocalcemia, hypomagnesemia, Inborn errors of metabolism
  3. Events at birth: Asphyxia, Trauma (H.I.E)
  4. OTHERS : Intracranial Haemorrhage, Pyridoxine dependent seizures, Iatrogenic
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4
Q

Lead (Pb) poisonings can cause seizures ?

A

Yes

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5
Q

What systemic conditions can cause Seizures?

A
  1. Vasculitis
  2. SLE
  3. Hypertensive encephalopathy
  4. Hepatic encephalopathy
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6
Q

Classify the causes of seizures in the post-neonate period .

A
  1. INFECTIONS (meningitis,febrile seizures,Encephalitis,TORCH,brain abcess)
  2. METABOLIC : Hypoglycaemia,hypocalcemia,hypernatremia,hyponatremia,hypomagnesemia, Storage diseases, Reye syndrome, porphyria
  3. Poisoning:

Lead (Pb), Drug toxicity and withdrawal

  1. Neurocutaneous syndromes :

Tuberous sclerosis
NFM
Sturge-Weber syndrome
Incontinetia pigmenti

  1. Systemic:

Vasculitis, SLE, HTN encephalopathy, Hepatic Encephalopathy

  1. Others :

Trauma, Child abuse, Raised ICP, space occupying lesions, Cryptogenic

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7
Q

What is epilepsy?

A

The occurrence of two or more unprovoked seizures over a day apart, beyond the neonatal period.

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8
Q

What is a febrile seizure ?

A

A seizure associated with fever ( >38 degrees) in a neurologically normal child (between 6 months and 6 years of age) without any intercurrent intracranial infection or history of an unprovoked seizure.

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9
Q

In what age group is a febrile seizure most common ?

A
  1. Between 6 months and 6 years of age.
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10
Q

The two types of febrile seizures are :

A
  1. Simple febrile seizures

2. Complex febrile seizure

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11
Q

Characteristics of a simple febrile seizure are the following except ?

  1. Generalised seizure
  2. Lasts more than 15 minutes
  3. Occurs once in a space of 24 hours
  4. Child is neurologically normal
A
  1. Simple febrile seizures last less than 15 minutes
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12
Q

What are the symptoms/sign of a complex febrile seizure that distinguish it from a simple febrile seizure ?

A
  1. Last more than 15 minutes
  2. Are Focal (signs/symptoms)
  3. Recurrent seizures within one febrile illness
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13
Q

An Upper respiratory tract infection can cause a seizure in an infant? True/False

A

True

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14
Q

What are some risk factors for recurrent febrile seizures?

A
  1. Age < 18 months
  2. Family Hx
  3. 1st seizure at low temp (<40]
  4. Multiple seizures
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15
Q

What questions can you ask an informant about the Preictal phase of seizures during history taking ?

A
  1. What was child doing before seizure ?
  2. Where there any warning signs ? (Crying, abdominal pain ,fear, unpleasant sensation ?)
  3. Was the child asleep/ awake
  4. What could have triggered this ?
  5. Was the child well ? Any fever ?
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16
Q

What vital sign is important in the physical examination of seizures ?

A
  1. Temperature
17
Q

What can a paediatrician do for prophylaxis of febrile seizure in children with a history of more than 3 episodes in 6 months or 4 in a calendar year ?

A
  1. Begin Oral benzodiazepine (0.6-0.8mg/kg/day in 3 divided doses)
    Or
  2. Clobazam (0.8mg -1mg/kg/day in 2 divided doses)

This medication is started at the first sign of a febrile Illness for the 1st 3 days.

18
Q

Questions to ask about the Ictal phase ?

A
  1. Responding ?
  2. Body movements, eyes, lips, head,limbs ? General ?
  3. Cyanosis ?
  4. Incontinence
  5. How long did it last
  6. How many times did it happen ?
19
Q

Termination of a febrile seizure involves use of :

A
  1. Rectal diazepam or
  2. IV Lorazepam
  3. IV midazolam
20
Q

The primary symptom in an absence seizures is ?

A
  1. Loss of awareness (brief < 15 s)
21
Q

Absence seizures usually begin between 4-6 years of age ?

A

True

22
Q

EEG of Absence seizures shows ?

A

3 Hz spike waves

23
Q

What is status epilepticus?

A

A seizure lasting more than 30 minutes. Or concurrent seizures occurring without gain of Consciousness in between.

PAEDIATRICS (20 decks)

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