Epilepsy II (Peds)

Question 1

How is status epilepticus treated?

Answer 1

1. benzos (lorazepam or diazepam), then
2. phenytoin, then
3. phenobarbital

Question 2

seizures which do not respond to a trial of at least 3 anticonvulsants

Answer 2

intractable epilepsies

Question 3

What are the 5 types of generalized sz’s?

Answer 3

1. absence (3 Hz, no postictal confusion, blank stare)
2. myoclonic (quick, repetitive jerks)
3. tonic-clonic (alternating stiffening and mvmt- grand mal)
4. tonic (stiffening)
5. atonic (drop sz’s- falls to floor- looks like fainting)

Question 4

What is the risk for recurrence for febrile seizures?

Answer 4

• 25-40% will have a recurrent febrile seizures
• increased risk if family hx, less than 1 yo, low grade/brief fever

Question 5

What is a generalized sz?

Answer 5

• sz activity involving the entire brain (diffuse)
• can be absence, myoclonic, tonic-clonic, tonic, or atonic

Question 6

What is epilepsy?

Answer 6

• 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

Question 7

What is benign epilepsy?

Answer 7

• 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)

Question 8

Dx?

• sz activity involving the entire brain (diffuse)
• can be absence, myoclonic, tonic-clonic, tonic, or atonic

Answer 8

generalized sz

Question 9

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)

Answer 9

benign epilepsy

Question 10

What is catastrophic epilepsy?

Answer 10

• 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

Question 11

____% of new onset seizure patients may develop intractable epilepsy.

Answer 11

30

Question 12

What is status epilepticus?

Answer 12

• 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

Question 13

• most common childhood sz
• 3mo-5yo
• associated with fever but without evidence of intracranial infection or defined cause
• 30% of are complex sz’s

Answer 13

febrile seizure

Question 14

What are the 2 types of partial sz’s?

Answer 14

1. simple
2. complex

Question 15

Most broadly, seizures can be defined as either ____ or _____.

Answer 15

partial or generalized

Question 16

• 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

Answer 16

status epilepticus

Question 17

What is a febrile seizure?

Answer 17

• most common childhood sz
• 3mo-5yo
• associated with fever but without evidence of intracranial infection or defined cause
• 30% of are complex sz’s

Question 18

Dx?

• generalized sz’s
• cognitive dysfunction
• onset usually btw 1-7yo (avg 3-5yo)
• caused by malformations, Hypoxic-ischemic injury, Encephalitis, Meningitis, Tuberous sclerosis***

Answer 18

Lennox Gastaut Syndrome

Question 19

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

Answer 19

catastrophic epilepsy

Question 20

What are intractable epilepsies?

Answer 20

seizures which do not respond to a trial of at least 3 anticonvulsants

Question 21

Dx?

• a sz that originates in 1 part of the brain
• can be simple partial (no LOC) or complex partial (impaired or LOC)

Answer 21

a partial sz

Question 22

What is Lennox Gastaut Syndrome?

Answer 22

• generalized sz’s
• cognitive dysfunction
• onset usually btw 1-7yo (avg 3-5yo)
• caused by malformations, hypoxic-ischemic injury, encephalitis, meningitis, or tuberous sclerosis***

Question 23

What is a partial sz?

Answer 23

• a sz that originates in 1 part of the brain
• can be simple partial (no LOC) or complex partial (impaired or LOC)

Question 24

What can cause status epilepticus?

Answer 24

• Stroke
• Hemorrhage
• Intoxicants or adverse reactions to drugs
• sudden withdrawal of a medication (especially anticonvulsants)
• alcohol withdrawal
• genetics/congenital
• infections
• trauma
• metabolic
• tumors

Question 25

What is the difference btw a simple partial and a complex partial sz?

Answer 25

• simple partial = no LOC
• complex partial = AMS or LOC