Common Paediatric Epilepsy Syndromes Flashcards
Paediatric epilepsy syndromes
-why is the approach different
Brain is rapidly changing during infanthood and early life
Approach to classifying epilepsy
Is it a seizure?
Is it focal, generalised or unknown seizure
-unknown is very common in children due to variable presentation
Is it an epilepsy?
-recurrent seizures but again can be unknown
Possible underlying cause
- structural
- genetic
- infectious - meningitis
- metabolic
- immune
- unknown
Consider the additional support needed to support their everyday life
Assessing for seizures
Before, during, after
Birth history
Developmental history
Family history
Classification of seizures
Focal - epileptic activity in 1 region of EEG
- aware/impaired?
- motor onset/non motor
Generalised - epileptic activity in all regions on the EEG
- aware/impaired?
- motor onset/non motor
- bilateral involvement
Difference between
myoclonus
-tonic
-clonic
Myoclonus - brief contraction, jerks
Tonic - sustained contraction
Clonus - sustained shaking
-usually structural cause
Non motor onset syndromes
Autonomic aura - feeling sick, epigastric rising
Behaviour arrest
Cognitive
Infantile spasms
- triad of West Syndrome
- possible differential
Clustering around sleep
Head nods, flexion of limbs
Hypsarrythmia on EEG
Psychomotor deterioration - not meeting developmental milestones
Childhood gratification
-excitement over highchairs, simillar physical presentation
Benign Rolandic epilepsy
Seizures that start in sleep
Focal seizure in mouth and face (mouth deviation, speech arrest, drooling) => spreads to other limbs
Affects Rolandic area of the brain - motor region for mouth
Generally self limiting but may need treatment if frequency or severity increases
Childhood absence epilepsy
Hyperventilation can trigger attack
- staring, vacant, unresponsive
- mouth smacking
- amnesia
- can have motor elements
Frequent daily absence seizures in school age, peak at 7-9
