Neurology Flashcards
What is childhood epilepsy?
Epilepsy is a brain condition that causes a child to have seizures
What are the different types of focal seizures?
Simple focal seizure
Complex focal seizure
What are the symptoms of simple focal seizure?
- The symptoms depend on which area of the brain is affected.
- The seizure activity is limited to an isolated muscle group. For example, it may only include the fingers, or larger muscles in the arms and legs.
- Your child may also have sweating, nausea, or become pale.
- Your child won’t lose consciousness in this type of seizure.
What are the symptoms of complex focal seizures?
- This type of seizure often occurs in the area of the brain that controls emotion and memory function (temporal lobe).
- Your child will likely lose consciousness.
- These may range from gagging, lip smacking, running, screaming, crying, or laughing.
- Your child may be tired or sleepy after the seizure.
- This is called the postictal period.
What are the different types of generalised seizures?
- Absence seizures (petit mal)
- Atonic seizures
- Generalised tonic-clonic seizures (grand-mal)
- Myoclonic seizures
What are the symptoms of absence seizures?
How long do they last?
This is also called petit mal seizure
Changed state of consciousness and staring
Mouth or face may twitch or eyes may blink rapidly
Not recall what just occurred
These seizures may occur several times a day
The seizure usually lasts no longer than 30 seconds
At what age do absence seizures start?
Between the ages of 4 and 12
What are the symptoms of an atonic seizure?
This is also called a drop attack
With an atonic seizure, your child has a sudden loss of muscle tone and may fall from a standing position
What are the symptoms of a generalised tonic-clonic seizure?
This is also called grand mal seizure
The classic form of this kind of seizure has 5 distinct phases.
- Flex (contract)
- Extend (straighten out)
- Tremor (shake)
- Contraction and relaxation of the muscles (clonic period)
- Postictal period
What are the symptoms of myoclonic seizures?
Quick movements or sudden jerking of a group of muscles
These seizures tend to occur in clusters
this means that they may occur several times a day, or for several days in a row.
What are the causes of seizures in a child?
An imbalance of nerve-signaling brain chemicals (neurotransmitters)
Brain tumor
Stroke
Brain damage from illness or injury
How are seizures diagnosed in a child?
Asked for any of the following:
Recent fever or infection
Head injury
Congenital health conditions
Preterm birth
Recent medicines
EEG
Absence seizures - 3Hz
Lennox-Gastaut syndrome - 1.5 Hz - 2.5 HZ
Spinal tap
What are infantile spasms (West’s syndrome)?
Brief spasms beginning in first few (4-6) months of life; M>F
What are the symptoms of infantile spasms?
Flexion of head, trunk, limbs → extension of arms
(Salaam attack);
last 1-2 secs, repeat up to 50 times
How do you diagnose infantile spasms?
- Progressive mental handicap
- EEG: hypsarrhythmia
- Usually 2nd to serious neurological abnormality (e.g. TS, encephalitis, birth asphyxia) or may be cryptogenic
When do typical (petit mal) absence seizures affect children?
4-8 years
What are the symptoms of typical (petit mal) absence seizures?
Duration few-30 secs
No warning
Quick recovery
Often many per day
How do you diagnose absence seizures?
EEG: 3Hz generalized, symmetrical
What is the treatment for typical (petit mal) abence seizures?
Sodium valproate
Ethosuximide
What is the treatment for infantile spasms?
- Vigabatrin is now considered first-line therapy
- ACTH is also used
What is Lennox-Gastaut Syndrome?
Lennox-Gastaut syndrome (LGS) is a type of epilepsy.
Patients with LGS experience many different types of seizures
What are the symptoms of Lennox-Gastaut Syndrome?
Tonic
Stiffening of the body
Atonic
Temporary loss of muscle tone and consciousness, causing the patient to fall
Atypical absence
Staring episodes
Myoclonic
Sudden muscle jerks
What is the diagnosis for Lennox-Gastaut syndrome?
EEG: Slow spike
What is the treatment for all seizures?
Generalised tonic-clonic seizures
Sodium valproate
Second line: lamotrigine, carbamazepine
Absence seizures* (Petit mal)
Sodium valproate or ethosuximide
Myoclonic seizures**
Sodium valproate
Second line: clonazepam, lamotrigine
Focal seizures
Carbamazepine or lamotrigine
Second line: levetiracetam, oxcarbazepine or sodium valproate
What is a febrile convulsion?
A febrile seizure is a convulsion in a child caused by a spike in body temperature, often from an infection
What are the clinical features of a febrile convulsion?
Usually occur early in a viral infection as the temperature rises rapidly
Seizures are usually brief, lasting less than 5 minutes
Are most commonly tonic-clonic
What are the different types of febrile convulsions?
Simple
< 15 minutes
Generalised seizure
Typically no recurrence within 24 hours
Should be complete recovery within an hour
Complex
15 - 30 minutes
Focal seizure
May have repeat seizures within 24 hour
Febrile status epilepticus
> 30 minutes
How long should a parent wait before phoning an ambulence in febrile convulsions?
More than 5 minutes
Although febrile convulsions are caused by high temperatures, what has no effect on preventing them?
Antipyretics
