Epilepsy in children Flashcards
What are infantile spasms also known as
west syndrome
define infantile spasms and when they occur
breif spasms beginning in the first few months of life
key features of infantile spasms
flexion of head trunk and limbs-> extension of arms (Salaam attack)
-lasts 1-2 secs
-repeat up to 50 times
-progressive mental handicap
-EEG: hypsarrhythmia
what are infantile spasms usally secondary to
serious neurological abnormality
-eg tuberous sclerosis
-encephalitis
-birth asphyxia
CAN BE IDIOPATHIC
possible treatment / prognois for infnantile spams
vigabatrin and sterorids
poor prognosis
onset of typical (petit mal) absence seizures
4-8yrs
duration of typical (petit mal) absence seizures
duration 3-30 seconds
presentation of typical (petit mal) absence seizures 3
no warning -blank out or stare into space for a few seconds/ lip smacking/ fluttering eyelids
symettircal
quick recovery
pften multiople per day
EEG in typical (petit mal) absence seizures
3Hz generalized
symmetrical
treatment for typical (petit mal) absence seizures 2
sodium valoprate
ethosuximide
prognosis for typical (petit mal) absence seizures
good prognosi - 90-95% seizure free in adolescence
what type of seziures can be an extension of infantile spasms
lennox-gastaut syndrome
onset of lennox-gastaut syndrome
1-5 yrs
features of lennox-gastaut syndrome 3
atypical absences , falls,jerks
90% moderate-sever mental handicap
EEG on lennox-gastaut syndrome
slow spike
treatment for lennox-gastaut syndrome 1
ketogenic diet may help
who gets benign rolandic epilepsy (age, gender)
most common inchildhood and amongst males
features of benign rolandic epilepsy 1
-treatment
paraestheia (unilateral face)
-usually on waking up]
-levetriceratam
who gets juvenile myoclonic epilepsy (Janz syndrome)
teenage years , more common in girls
features of juvenile myoclonic epilepsy (Janz syndrome) 4
infrequent generalised seizures
- often in morning/ following sleep deprivation
-daytime absences
-sudden, shock like myoclonic seziures (these may develop before seizures)
treatment for juvenile myoclonic epilepsy (Janz syndrome) 1
good response to sodium valporate
features of an epilepsy history 8
WITNESS CRUCIAL
where
when
what was person doing before
first signs
detailed descriptiong of event
aftermath
timing
video/ mimicry
define febrile convulsions
seizures provoked by fever in otherwise normal children
who gets febrile convulsions
-typically occur between ages of 6 months and 5 years
-seen in 3% of children
clinical features of febrile convulsions 3
early viral infection as temperature rises rapidly
usually brief last less than 5 mins
most commonly tonic-clonic
types of febrile convulsions 3
simple
complex
status epilepticus
length of time in simple febrile convulsions
<15 mins
length of time in complex febrile convulsions
15-30mins
length of time in febrile status epilepticus
> 30mins
type of seizure in simple febrile sezirues
would it recur within 24 hours
generalised seziures
typically would not recur within 24hrs
*-should have complete recovery within an hour
type of seziure in complex febrile seizures
would it recur within 24 hours
focal seizure
may repated within 24 hours
when should children with febrile seizures be admitted to paediatrics 2
first seizure
or
complex
managemtn of febrile seizures
advise paretns to call abulance if >5 minutes seizure
antipyretics do not reduced chance pf febrile zeizure occuring
if recurrnet febrile convulsions occur -> benzo as resuce mdication may be considered
-only started on adivce of specialist
-rectal diazepam or buccal midazolma
recurrence rate of febirle convulsison
1 in 3
