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08 Neuro > Epilepsy in Children > Flashcards

Epilepsy in Children Flashcards

1
Q

most common reasons for pediatric er visits

A

febrile seizures

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2
Q

motor symptoms of a seizure

A

convulsions

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3
Q

sudden, involuntary, time-limited alteration in behavior including a change in motor activity, autonomic function, consciousness or sensation + abnormal electrical discharge in the brain

A

seizures

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4
Q

enduring predispositiong to generate seizures

A

epilepsy

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5
Q

definition of epilepsy

A
  • at lest 2 provokes seizures ocurring >24 h
  • one unprovoked seizure and a probability of further seizures similar to the general recurrence risk
  • after two unprovoked seizures ocurring over the next 10 years
  • diagnosis of an epilepsy syndrome
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6
Q

decreased inhibition of the brain

A

defective gaba-a inhibition
defective gaba-b inhibition
defective activation of gaba neurons
defective intracellular buffering of calcium

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7
Q

increased activation of the excitable channels and receptors

A

increased activation of nmda receptors
increased synchrony between neurons
increased synchrony and/or activation due to recurrent excitatory collaterals

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8
Q

etiology of seizures in neonates

A 
acute metabolic
cerebrovascular
cns infection
developmental conditions
others
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9
Q

etiology of seizures in infants and children

A 
genetic
metabolic
neurodev problems
cns infections
head trauma
vascular
neurocutaneous syndromes
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10
Q

what is a focal seizure

A

arising from a specific location in one cerebral hemisphere

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11
Q

what is generalized seizure

A

first clinical and eeg changes indicate synchronous involvement on all or both hemispheres

originating at one point and engages both hemispheres
involves corticothalamic and subcortical structures

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12
Q

presentationi of childhood absence epilepsy

A

brief and frequent absence seizures with abrupt and severe impairment of consciousness
normal neuro exam and development

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13
Q

clinical features of benign focal epilepsy with centrotemporal spikes (bects)

A 
unilateral sensorimotor symptoms
oropharyngeal menifestations
speech arrest
hypersalivation
eeg: centrotemporal spikes
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14
Q

benign occipital epilepsy: panayiotopoulos type

A 
benign susceptibility to autonomic seizures and autonomic status epilepticus
autonomic: pallor, flushing, cyanosis
vomiting
behavioral changes
deviation of the eyes
usual convuslions are not seen
eeg: focal spikes
good prognosis
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15
Q

benign occipital epilepsy: gastaut type

A

purely occipital

visual: elementary visual hallucinations, blindness, deviation of the eyes, post-ictal headache
?? prognosis

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16
Q

juvenile myoclonic epilepsy

A 
generalized tonic clonic seizure later
myoclonic jerks
typical absences
perioral reflex myoclonias
eeg: polyspike and wave discharges
17
Q

epileptic encephalopathy

A

cognitive and behavioral impairments

part of a group of syndromes

18
Q

early infantile epileptic encephalopathy

A

onset: 10d-3 mos
tonic spasms, results in developmental delay
eeg: burst suppression pattern
can evolve to west syndrome

19
Q

severe myoclonic epilepsy of early infancy: dravent syndrome

A

onset: first year

clinical features**

20
Q

infantile spasms: west syndrome

A

onset: 3-10 mos
spasms of head neck trunk extremities
developmental regression
hypsarrhythmia

21
Q

lennox gestaut syndrome

A

triad: multiple seizure types, cognitive impairment, eeg 1-2 hz diffuse slow spike and wave discharge (awake)

22
Q

definition of status epilepticus

A 
>/= 5 mins continuous seizure
>/= 2 discrete seizures between which there is incomplete recovery of consciousness
23
Q

etiology of status epilepticus

A

the failure of mechanisms responsible for seizure termination OR initiation of mechanisms which lead to abnormally prolonged seizures

long term consequences after t2

24
Q

why aggressively treat se

A

mortality rate 10%
overall mortality rate in children 6%
developmental deterioration

25
Q

t/f the occurence of a single seizure or febrile seizure implies the diagnosis of epilepsy

A

false

26
Q

t/f there are no long term adverse effects of having >/= 1 simple febrile seizures

A

true

27
Q

t/f simple febrile seizures increase the risk of mortality

A

false but complex febrile seizure can

28
Q

simple febrile seizures

A

primarly generalizing, usually tonic-clonic
max 15 min
not recurrent within a 24 hr period

29
Q

complex febrile seizure

A

focal
>15 mins
recurs more than once in a 24 h period

30
Q

febrile status epilepticus

A

febrile seizures >30 mins

31
Q

major risk factors for recurrence of febrile seizures

A

<1 yr
fever <24 hr
fever 38-39

32
Q

risk factors for subsequent epilepsy

A

neurodevelopmental abnorlaities
focal complex febrile seizure
family history

08 Neuro (24 decks)

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