Epilepsy II (Peds) Flashcards
How is status epilepticus treated?
- benzos (lorazepam or diazepam), then
- phenytoin, then
- phenobarbital
seizures which do not respond to a trial of at least 3 anticonvulsants
intractable epilepsies
What are the 5 types of generalized sz’s?
- absence (3 Hz, no postictal confusion, blank stare)
- myoclonic (quick, repetitive jerks)
- tonic-clonic (alternating stiffening and mvmt- grand mal)
- tonic (stiffening)
- atonic (drop sz’s- falls to floor- looks like fainting)
What is the risk for recurrence for febrile seizures?
- 25-40% will have a recurrent febrile seizures
- increased risk if family hx, less than 1 yo, low grade/brief fever
What is a generalized sz?
- sz activity involving the entire brain (diffuse)
- can be absence, myoclonic, tonic-clonic, tonic, or atonic
What is epilepsy?
- a chronic disease of recurrent, unprovoked seizures
- 2 or more unprovoked seizures separated by greater than 24 hours OR
- 1 seizure with studies suggesting further risk for seizures
What is benign epilepsy?
- Easily treated with medications
- Normal intelligence
- Most often tests are normal and we don’t know why someone has seizures
- Genetic predisposition?
- Remission after a certain age (usually teens)
Dx?
- sz activity involving the entire brain (diffuse)
- can be absence, myoclonic, tonic-clonic, tonic, or atonic
generalized sz
Dx?
- Easily treated with medications
- Normal intelligence
- Most often tests are normal and we don’t know why someone has seizures
- Genetic predisposition?
- Remission after a certain age (usually teens)
benign epilepsy
What is catastrophic epilepsy?
- Intractable to medications
- effect development with mental retardation and shortens lifespan
- EEG, MRI and other tests are abnormal
- often will have symptomatic reason for seizure
____% of new onset seizure patients may develop intractable epilepsy.
30
What is status epilepticus?
- an epileptic seizure of greater than five minutes OR
- more than one seizure within a 5 min period without the person returning to normal between them
- a medical emergency
- 10-30% of pts die w/I 30 days
- most common childhood sz
- 3mo-5yo
- associated with fever but without evidence of intracranial infection or defined cause
- 30% of are complex sz’s
febrile seizure
What are the 2 types of partial sz’s?
- simple
- complex
Most broadly, seizures can be defined as either ____ or _____.
partial or generalized
- an epileptic seizure of greater than five minutes OR
- more than one seizure within a five-minute period without the person returning to normal between them
- a medical emergency
- 10-30% of pts die w/i 30 days
status epilepticus
What is a febrile seizure?
- most common childhood sz
- 3mo-5yo
- associated with fever but without evidence of intracranial infection or defined cause
- 30% of are complex sz’s
Dx?
- generalized sz’s
- cognitive dysfunction
- onset usually btw 1-7yo (avg 3-5yo)
- caused by malformations, Hypoxic-ischemic injury, Encephalitis, Meningitis, Tuberous sclerosis***
Lennox Gastaut Syndrome
Dx?
- Intractable to medications
- Effect development with mental retardation and shortens lifespan
- EEG, MRI and other tests are abnormal
- Often will have symptomatic reason for seizure
catastrophic epilepsy
What are intractable epilepsies?
seizures which do not respond to a trial of at least 3 anticonvulsants
Dx?
- a sz that originates in 1 part of the brain
- can be simple partial (no LOC) or complex partial (impaired or LOC)
a partial sz
What is Lennox Gastaut Syndrome?
- generalized sz’s
- cognitive dysfunction
- onset usually btw 1-7yo (avg 3-5yo)
- caused by malformations, hypoxic-ischemic injury, encephalitis, meningitis, or tuberous sclerosis***
What is a partial sz?
- a sz that originates in 1 part of the brain
- can be simple partial (no LOC) or complex partial (impaired or LOC)
What can cause status epilepticus?
- Stroke
- Hemorrhage
- Intoxicants or adverse reactions to drugs
- sudden withdrawal of a medication (especially anticonvulsants)
- alcohol withdrawal
- genetics/congenital
- infections
- trauma
- metabolic
- tumors
What is the difference btw a simple partial and a complex partial sz?
- simple partial = no LOC
- complex partial = AMS or LOC
