Fits and Faints Flashcards
How does a cyanotic breath holding attack present?
Stops breathing, goes blue, extends limbs, loses consciousness. Becomes limp and breathes normally. No postictal state.
How does a pallid breath holding attack present?
Traumatic trigger, maybe absent cry, pallor and collapse. Rapid recovery, no postical phase.
How does a syncopal attack present?
Blurred vision, light headedness, sweating, nausea. Resolves on lying down.
What age do febrile convulsions occur in? How common are they?
6m to 5y. 10% children.
How does a febrile convulsion present?
Generalised convulsion for a few minutes.
O/E: High fever, normal neuro exam, signs of infection.
How would you investigate a febrile convulsion?
LP to rule out meningitis if <18m or signs.
Investigation for cause.
How do you manage a febrile convulsion?
If >5/10mins - rectal diazepam. Otherwise fairly self limiting.
Educate parents: no long term risks. Manage yourself: undress child, sponge with tepid water, give paracetamol, rectal diazepam if >10mins, seek advice if no fever / worrying.
How common is epilepsy?
8:1000.
How would you investigate a ?epileptic?
EEG for confirmation of diagnosis.
CT if focal neurology / focal EEG, raised ICP etc.
How would you manage an epileptic?
Patient education.
Referral to epilepsy specialist nurse.
First line = sodium valproate.
What are the side effects of valproate?
Vomiting, anorexia, lethargy, hair loss, hepatomegaly.
