Common paeds histories - fits/faints/seizures/funny tunrs Flashcards
What woud you ask about a child who has had a fit/faint/collapse?
- Before - warning, circumstance
- During - tongue biting, LOC, incontinence, complexion
- After - Amnesia, muscle pain, confusion/sleepiness, injuries from fall
- Background - previous attacks, frequency, impact
What general symptoms would you want to ask about in a child who has had a fit/faint/collapse?
- Fever
- Behaviour
- Actvitiy/apathy/alertness
What neurological symptoms would you want to ask about in a child with a fit/faint/collapse?
- General - LOC/fit/faint, headache, dizziness, vision/hearing, memory loss, neck stiffness, photophobia
- Motor - weakness/wasting, incontinence
- Sensory - pain, numbness, tingling
What cardiorespiratory symptoms would you want to ask about in a child with fit/faint/collapse?
- Dyspnoea
- Cyanosis
- Chest pain/palpitations
What would you want to ask about in your systemic enquiry for a child with fit/faint/collapse?
- General symptoms
- Neurological symptoms
- Cardioresp symptoms
What features associated with fits/faint/collapse in a child would suggest febrile convulsion as a cause?
- Short, self-limiting generalised seizure
- Early in infection when fever is rising
What types of seizures can occur in children?
- Abscence seizure
- Focal seizures
- Generalised tonic-clonic seizure
What features of a seizure would suggest a tonic-clonic seizure?
- Suggested by loss of bladder/bowel control
- Tongue biting
What features of fit/faint/seizures would suggest paediatric epileptic syndromes?
Characteristic features of syndromes:
- Trunk spasms
- Trunk flexion
- Myoclonus
- Eye deviation
- Language impairment
What features associated with fits/faint/collapse in children would suggest reflex anoxic seizure?
- Often precipitated by bump on head, emotion, crying or fever
- Stops breathing, loses consciousness and falls to floor
- Very pale
What features associated with fits/faints/seizure would suggest a vasovagal as a cause?
Faint after prolonged standing/emotion/pain
What features associated with fits/faint/collapse in a child would suggest pseudoseizures?
Atypical seizures
What featurs associated with fits/faint/collapse suggest breath holding spell as a cause?
- Child holds breath and goes blue
- Usually when upset
What are neurological causes of fits/faints/collapse in a child?
- Febrile convulsion
- Seizures
- PAediatric epileptic syndrome
- Reflex anoxic seizure
- Nacrolepsy
What are non-neurological causes of fits/faints/funny turns in a child?
- Vasovagal
- Pseudoseizure
- Breath holding spell
- Arrythmia
- Simple faint
- HOCM
- Hypoglycaemia
