Epilepsy: Continuum (Pediatrics) Flashcards
West Syndrome:
Onset and semiology
<2 years old / clusters of neck/truncal flexion with arm abduction often seen in the AM
West Syndrome:
Clinical triad
Psychomotor arrest, hypsarrhythmia and spasms
What is hypsarrhythmia
Seen in West Syndrom. High amplitude slow waves on a background of irregular multifocal spikes.
West Syndrome:
Treatment
ACTH first line. Vigabatrin in tuberous sclerosis.
Dravet Syndrome (severe myoclonic epilepsy of infancy): Onset and Semiology
< 2 years old. Hemiconvulsions with myoclonic and atypical absence
Dravet Syndrome: EEG specific ?
No
Dravet Syndrome: clinical symptoms and tx
regression with ataxia. NEVER sodium channel blockers (scn1a mut). VPA/BZD/LTC are common first line.
Benign epilepsy with centrotemporal spikes (BECTS or benign rolandic):
Onset and Semiology
age 7 with focal seizures that can be autnomic and focal involving mouth/throat. Tonic clonic as well.
Benign epilepsy with centrotemporal spikes (BECTS or benign rolandic):
EEG prognosis and tx
Centrotemporal BIPHASIC spikes/sharps that worsen in sleep. The are usually fine by age 16. Usually no tx but can use carbamazepine.
Lennox Gastaut (LGS: Triad
multiple seizure types, cognitive impairment, and slow spike and wave (1.5-2.5 Hz)
Syndrome that can precede LGS
West syndrome
LGS:
Tx and Prognosis
Can try ACTH, ketogenic diet but very pharmacoresistant with poor outcome.
Childhood Absence epilepsy:
Onset and semiology
ages 4-8 (age >9 is juvenile absence)
Staring spells but 30% can have GTC
Childhood Absence epilepsy:
EEG
3 Hz spike an wave with no post ictal slowing
Bedside test for childhood absence epilepsy
Hyperventilation for 3 minutes
