Collapse and seizures

Question 1

What % of the worlds population will have a seizure in their lives?

Answer 1

5% - does not mean they have epilepsy

Question 2

Most important and sometimes only investigation done for child following 1st seizure?

Answer 2

ECG to rule out cardiac causes e.g. long QT

Question 3

Investigation for a child <2yrs following a focal seizure

Answer 3

MRI

Question 4

A seizure-free period of how long warrants withdrawal from AED?

Answer 4

2 years

Question 5

What is a febrile seizure?

Answer 5

Seizure caused by infection outside the CNS in a 6 month- 7 year old who is otherwise neurologivally normal

Question 6

Epidemiology and aetiolgy of febrile seizures

Answer 6

Genetic omponenet: simbling 25% more likely if sibling has had one

Affect 4% children by age of 5 (Western Europe)

One febrile seizure = more likely to have another

Children usually have a mild fever around the time of seizure

Question 7

Features of febrile seizures

Answer 7

Tonic clonic

Loss of consciousness

Important to ascertain whether it was a complex or simple seizure

Complex: >15mins, focal features, incoplete recovery within 1hr or recurrence within 24hrs

Simple: isolated, generalised, tonic clonic, <15mins, do not recur within same illness period

Question 8

Diagnosis of febrile seizures

Answer 8

Seek source of fever: often URTI/ otitis media

If seizure was complex: be sure to rule out CNS infection, hypoglycaemia, brain injury

Focal signs: investigate with CT/ MRI

Question 9

Management of febrile seizures

Answer 9

Treat underlying cause

Most children are admitted to reassure parents

AEDs not routinely given

Question 10

Risk of epilepsy in children who have had a febrile seizure?

Answer 10

6x general population

Generally prognosis is good

Question 11

Most common cause of headache in children

Answer 11

Migraine