Convulsion Disorder Flashcards by Zahra Kalifa

What is the most comon cause of seizures in 6m to 6y

Febrile seizures

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What is febrile seizures

Fever + seizures

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What is the rate of recurrence of febrile sieuzres

30-50%

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What are the types of febrile seizures

Simple - complex

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What are the characterstics of simple febrile seizures

generalized
<15
once in 24h
temp >38.5

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What to do if diagnosed with simple febrile seizures

Just reassurance

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What are the characterstics of complex febrile seizures

focal
> 15min
> 1 in 24
temp <38.5

“One is enought”

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Why is complex febrile seizures worrisome?

Simple is two hemispheres. So no worry

infection & tumor is more associated with 1 hemisphere.

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Childhood epilipsy syndromes

Benign (Self-limited) childhood epilipisy with centrotemporal spikes - juvenile - abscence

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What is the onest of benign centrotemporal?

4-10

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When does benign centrotemporal occur usually

At night

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benign centrotemporal is focal vs generalized?

Focal

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What are the clinical symptoms of benign centrotemporal

Sweating, speach impairment, motor and sensory of face and arm.

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What are EEG findings in benign centrotemporal?

bilateral centerotemporal sharps

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How to treat benign centrotemporal?

Tegretol - valpoarate

“Good response”

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Do we always treat benign centrotemporal?

No if the seizures subside and little

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What are the comobridiries associated with benign centrotemporal?

ADHD - learning difficulties

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What is the age for abscence and benign centrotemporal

4-10 years

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What is the clinical presentation of abscence seizures?

Sudden onset\offset of stairing more than 100 times per day

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How long is abscence seizure last

<15 sec.

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Can absence seizzure have motor symptoms

yes

Eye fluttering and automatism

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What provokes abscence seizures usually?

Hyperventilation

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What is the EEG finding of CAE?

3 hz generalized spike and wave.

What is the prognosis of CAE?

Good and resolve. But > some might go to juvenile myoclonic epilipsy

Why is absence seizure require treatment even though it’s benign?

To avoid learning disabilities

How to treat abscence epilipsy?

- present with GIS: valporic acid | - first line: ethusuxamide

Differentiate between aura and absecne seizures

- abscence: less than 15 sec, specific EEG, neurological examination and neuroimaging is normal, treated by ethusuxamide - aura: there’s pre and post ictal, less frequent, lasting more than 15 sec, treated by carbamezapine

What is the onset age for juvenile abscence?

9-12 years

What are the EEG findings of juvenile abscence

3.5-4hz spike or polyspike

Atypical abscence seizure is different from typical in that

- Slow Onset - Slow Offset - it has more motor symptoms - EEG: 2 spike

Juvenile myoclonic epilispy characterstic presentation

Drop items in the morning

What other type of seizure is myoclonic juvenile jerks associated with

GTC

What is the EEG finding of juvenile myoclonic epilipsy?

4-6 Hz spike and polyspike and wave

What is the trigger for juvenile myoclonic sieuzre

Photosenstivie

How to treat juvenile myoclonic?

Valporic

What is infantile spasm?

Flexsion or extension spasms but is more frequent and happens in cluster

When does infantile spasm usually occur?

Before sleep or after wake

What parts of the body affected by infantile spasms?

Neck, trunk and arm

Name a common etiology of infantile spasms?

Tuberus sclerosis

How to treat infantile spasms

Steroids - vigabatrin (symptomatic type & tubereus sclerosis)

What is west syndrome

- development regression - infantile spasm - EEG hypsarythmia “EEG ملخبط"

What is the Dravet syndrome?

Severe infantile epilipsy with myoclonic types

What trigger dravet syndrome

Fever, infection, vaccine, warm bath

When do dravet syndrome usually occur?

In the first year of life

How to treat dravet syndrome

Valporic and clopazam refractabotry to medications

What is the EEG finding of lennox gastaut syndrome

1.5-2.5 spike

When does breat holding spells ceases

4 yeaes

How to treat breath-holding spells

Reassurance and parenting

How is the pattern holding spells

Crying > stop breathing > apnea and become cyanosed > fall (limb) for few seconds > wake up and cry again

How to recognize breath holding spells

- It never occurs spontanously - always provoked by taking his stuff - injury, can never occur from sleep - only for few seconds

If the patient with breath holding spells has some myoclonus what does this indicate?

It’s accepted due to the hypoxia

What are the causes of psychogenic seizures

- patient with already seizures | - or someone in the family has seizures

Clues to the psychogenic

- close eyes - fast - preserved sphincter - don’t bite their tongue - could be initiated and terminated - normal eeg

How to treat status epilipticus?

1- benzodiapine After 2 doses with 5 minutes apart 2- phenytoin, valporic, continues infusion, and then anasthesia

What is the basic workup for all seizure

- CBC - electrolye - RFT and LFT - bone panel - LP for CNS infection - metabolic panel for neonates