Epilepsy: Continuum (Pediatrics) and Rowan's Ch 5-7 Flashcards

1
Q

3 Indications for Routine EEG

A

initial assessment
after AED introduction
After AED cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 indications for cEEG

A
Pre epilepsy surgery 
To detect subclinical seizure
Psychogenic non-epileptic attacks
Refractory epilepsy
Status
Comatose pt without clear cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 Elements of assessing the Background

A

Organization
Symmetry/frequency
Reactivity
Continuity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Systematic approach to EEG (ACNS guideline) “BDASIC”

A

Background, Discharges/patterns, activation procedures, events/seizure, Impression, clinical correlation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Normal Organization

A

PDR present with normal A-P gradient. Describe Sleep stages and transients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is normal symmetry

A

No focal slowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

West Syndrome:

Onset and semiology

A

<2 years old / clusters of neck/truncal flexion with arm abduction often seen in the AM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

West Syndrome:

Clinical triad

A

Psychomotor arrest, hypsarrhythmia and spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is hypsarrhythmia

A

Seen in West Syndrom. High amplitude slow waves on a background of irregular multifocal spikes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

West Syndrome:

Treatment

A

ACTH first line. Vigabatrin in tuberous sclerosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
Dravet Syndrome  (severe myoclonic epilepsy of infancy):
Onset and Semiology
A

< 2 years old. Hemiconvulsions with myoclonic and atypical absence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dravet Syndrome: EEG specific ?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dravet Syndrome: clinical symptoms and tx

A

regression with ataxia. NEVER sodium channel blockers (scn1a mut). VPA/BZD/LTC are common first line.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Benign epilepsy with centrotemporal spikes (BECTS or benign rolandic):
Onset and Semiology

A

age 7 with focal seizures that can be autnomic and focal involving mouth/throat. Tonic clonic as well.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Benign epilepsy with centrotemporal spikes (BECTS or benign rolandic):
EEG prognosis and tx

A

Centrotemporal BIPHASIC spikes/sharps that worsen in sleep. The are usually fine by age 16. Usually no tx but can use carbamazepine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
Lennox Gastaut (LGS: 
Triad
A

multiple seizure types, cognitive impairment, and slow spike and wave (1.5-2.5 Hz)

17
Q

Syndrome that can precede LGS

A

West syndrome

18
Q

LGS:

Tx and Prognosis

A

Can try ACTH, ketogenic diet but very pharmacoresistant with poor outcome.

19
Q

Childhood Absence epilepsy:

Onset and semiology

A

ages 4-8 (age >9 is juvenile absence)

Staring spells but 30% can have GTC

20
Q

Childhood Absence epilepsy:

EEG

A

3 Hz spike an wave with no post ictal slowing

21
Q

Bedside test for childhood absence epilepsy

A

Hyperventilation for 3 minutes

22
Q

Childhood Absence epilepsy:

Tx and Prognosis

A

Ethosuximide

70 % remit with 30% developing GTC which merits an added AED.

23
Q

JME:

Onset and semiology

A
teenage years
Mycolonic jerks (clumsy in AM) with potential for GTC
24
Q

JME:

EEG

A

4-6 Hz Generalized spike/polyspike and wave discharge that are photosensitive

25
Q

JME:

Tx and Prognosis

A

Lamotrigine or VPA indefinitely . Avoid photic stimuli/alcohol/stress and sleep deprivation

26
Q

What is epilepsia partialis continua and what is it associated with ?

A

continuous focal clonic seizures without impairment of consciousness. Associated with Rasmussen’s encephalitis.

27
Q

Tonic seizures, burst squppression, abnormal CT head

A

Ohtahara syndrome

28
Q

Besides 3hz spike-wive what other finding in absence ?

A

OIRDA - occipitaly perdominant generalized rhythmic delta activity

29
Q

Gene for Autosomal dominant partial epilepsy with auditory features

A

LGI1

30
Q

Syndrome with language regression and electrical status epileptics in sleep

A

Landau-Kleffner