Neurology Flashcards
State some differentials for seizures in children
Syncope Breath holding spells Reflex anoxic seizures Daydreaming Tics Self-gratification Psychologically induced events
Compare breath holding spells and reflex anoxic seizures
Breath holding: emotional event leads to crying then holding breath on exhalation. They go limp, collapse and may have brief clonic jerks
Reflex anoxic seizures: fear or pain leads the child to stop breathing. They go pale and limp and can seize
A child presents to A&E seizing, what needs to be ruled out?
Hypoglycaemia Hypoxia Fever Meningitis Intracranial bleed Hypercalcaemia Toxins
Compare simple and complex febrile seizures
Simple:
- <15 minutes
- only one event per fever
- complete recovery within an hour
Complex:
- > 15 minutes
- may have focal features
- can reoccur within same fever
How should parents manage febrile seizures?
- cool blankets and fluids during a febrile illness
- if seizing then clear the area
- can give rectal diazepam
- call 999
- check for non-blanching rash
Describe myoclonic, tonic and clonic
Myoclonic: electric like shock movements
Tonic: sustained contraction
Clonic: rhythmic jerking
What does an EEG of absence seizures show?
3 - 4 Hz spike and wave
How would an occipital focal seizure present?
bright coloured flashing lights
How would a centroparietal focal seizure present?
- spreading sensorimotor phenomenon
- paraesthesia
How would a temporal focal seizure present?
- lip smacking
- plucking at clothes
- de ja vu
- post ictal dysphasia
How would a frontal focal seizure present?
- dystonic posture
- guttural noises
- Jacksonian march
- post ictal weakness
Wests syndrome/ infantile spaspsm:
a) age of onset
b) description of child
c) EEG
d) management
a) <1 year
b) flexion of limbs and trunk followed by arching of back and extended arms - lasts seconds but can get 50+ in a row. Developmental delay
c) hypsarrhythmia
d) Vigabatrin
Dravet syndrome/ severe myoclonic:
a) age of onset
b) description of child
a) <1 year
b) focal or general, affecting one side of body. Development delay after a couple of years
Lennox-Gastoux:
a) age of onset
b) description of child
c) EEG
d) management
a) < 4 years
b) complete variety of seizure types
c) slow spikes
d) ketogenic diet
Janz syndrome/ juvenile myoclonic:
a) age of onset
b) description of child
c) EEG
d) management
a) teenagers
b) myoclonic seizure on waking up +/- GTC and absence.
c) generalised spike and wave
d) valproate
