Neurology - Types Of Childhood Epilepsy

Question 1

Infantile spasm (West’s syndrome)

Answer 1

Brief spasms beginning in the first few months of life
Key features:
- Flexion of head, trunk, limbs -> extension of arms (Salaam attack)
- Last 1-2 seconds, repeat up to 50 times
- Progressive mental handicap
- EEG: hypsarrhythmia
- Usually secondary to serious neurological abnormalities (e.g. tuberous sclerosis, encephalitis, birth asphyxia) or may be idiopathic
- Tx: VIGABATRIN AND STEROIDS

Question 2

Typical (petit mal) absence seizures

Answer 2

Epidemiology: 4-8 years
Duration: few 30 seconds, no warning, quick recovery, often many per day
EEG: 3Hz generalised, symmetrical
Tx: SODIUM VALPORATE, ETHOSUXIMIDE

Question 3

Lennox-Gastaut Sydrome

Answer 3

Extension of infantile spasms
Epidemiology: Onset 1-5 years
Features:
- Atypical absences
- Falls
- Jerks
EEG: Slow spike
Tx: KETOGENIC DIET

Question 4

Benign Rolandic epilepsy

Answer 4

Epidemiology: Childhood (4-12 years), Males (MC)
Features:
- seizures characteristically occur at night
- paraesthesia (e.g. unilateral face),
- secondary generalisation may occur (parents may only report tonic-clonic movements)
- usually on waking up
- child is otherwise normal
EEG: Centrotemporal spikes
Seizures stop by adolescence

Question 5

Juvenile myoclonic epilepsy (Janz syndrome)

Answer 5

Epidemiology: teenage years, girls
Features:
- infrequent generalised seizures,
- often in morning/following sleep deprivation
- day time absences
- sudden, shock-like myoclonic seizures (these may develop before seizures)
- Tx: usually good response to SODIUM VALPORATE