Epilepsy Flashcards
What is epilepsy?
Chronic neurological disorder characterised by recurrent unprovoked seizures
Seizure = clinical event where there is a sudden disturbance of neurological function caused by
abnormal or excessive neuronal discharge
Epilepsy = underlying tendency to have seizures
What is the most common cause of childhood epilepsy?
Idiopathic
Brain abnormality is the most common cause of seizures in children
What is the seizure pattern in West’s Syndrome?
Violent flexor spasms of the head, trunk and limbs followed by extension of the arms (so-called 'salaam spasms') • Flexor spasms last 1-2 s • Often multiple bursts of 20-30 spasms • Often on waking (may occur many times a day) • May be misinterpreted as colic • Social interaction can deteriorate (useful marker in the Hx)
What are the features of Wests syndrome?
4-6MO
Many causes, but 2/3 have underlying neurological cause • EEG – shows characteristic hypsarrhythmia (chaotic pattern of high-voltage slow waves, and multi-focal sharp wave discharges) • Rx – vigabatrin or corticosteroids (unwanted effects are common) • Prognosis – most will subsequently lose skills and develop learning disability and/or epilepsy
What is the seizure pattern in Benign Rolandic epilepsy? (4-10y)
Tonic-clonic seizures in sleep (characterised by facial twitching and aphasia) OR • Simple focal seizures with awareness of abnormal feelings in the tongue and distortion of the face (supplied by the Rolandic area of the brain)
What are the features of BRE?
15% of all childhood epilepsies • More common in boys • EEG – shows focal sharp waves from the Rolandic or centrotemporal area • Important to recognise as it is benign and does not always require Rx • Almost all remit in adolescence
What is the seizure pattern in JME?
Myoclonic seizures (generalised tonic-clonic seizures and absences may also occur) • Mostly just after waking • Typical Hx is throwing drinks or cereal about in the morning • Learning is unimpaired
What are the features of JME?
Response to Rx is usually good but lifelong • Genetic linkage identified (autosomal dominant) • Remission unlikely (develop generalised tonic-clonic seizures later)
What is the seizure pattern in lennox gastaut syndrome?
Multiple seizure types, but mostly
drop attacks (astatic seizures),
tonic seizures and atypical
absences.
What are the fetures of lennox-G? (1-3yr)
Neurodevelopmental arrest or regression and behaviour disorder • Often other complex neurological problems or Hx infantile spasms. • Prognosis is poor
What is the seizure pattern in Childhood absence?
Stare momentarily and stop moving, may twitch their eyelids or a hand minimally. • Lasts only a few seconds and certainly not longer than 30 s. • Child has no recall except realises they have missed something and may look puzzled or say 'pardon'
on regaining consciousness.
• Developmentally normal but can
interfere with schooling
What are the features of childhood absence epilepsy?
• Only 2% of childhood epilepsy • 2/3 female. • Episodes can be induced by hyperventilation (ask child to blow on a piece of paper or windmill for 2-3 min = useful test in the clinic) • EEG shows generalised 3/second spike and wave discharge, which 92
What are the seizure like in benign childhood occipital epilepsy?
Younger children - periods of unresponsiveness, eye deviation, vomiting and autonomic features. • Older children - headache and visual disturbance including distorted images, hallucinations
(is uncommon and remit in childhood)
