paediatric neurology - paroxysmal events Flashcards
define seizure/fit
any sudden attack from whatever cause
- lots of different mechanisms
- many aren’t epileptic in nature
define syncope
faint
neuro-cardiogenic mechanism
define convulsion
seizure where there is prominent motor activity
what is an epileptic seizure
electrical phenomenon
abnormal excessive hyper synchronous discharge from a group of cortical neurons
effects of an epileptic seizure
may have clinical manifestations
paroxysmal change in motor, sensory or cognitive function
what does the effect a seizure have depend on
seizure’s location
degree of anatomical spread over cortex
duration
what is epilepsy
a tendency to recurrent, unprovoked (spontaneous) epileptic seizuires
diagnosis of epilepsy
clinical features
EEG for supportive evidence
single seizure isn’t necessarily epilepsy
consequences of misdiagnosis can be serious
types of non-epileptic seizures and seizure mimics in children
acute symptomatic seizures
reflex anoxic seizure
syncope
parasomnias e.g. night terrors
behavioural stereotypies
psychogenic non-epileptic seizures (PNES)
what are acute symptomatic seizures
due to acute insults
e.g. hypoxia-ischaemia, hypoglycaemia, trauma
what are reflex anoxic seizures
result of vagal overstimulation
common in toddlers
always provoked/triggered by certain stimuli e.g. fear, excitement, upset etc
how does vagal overactivity result in reflex anoxic seizure
vagal activity → slows down heart
bradycardia → decreased cerebral perfusion
→ LOC and abnormal movements
parasomnias as seizure mimics
e.g. night terrors
common in pre-school and early school age
can resemble epileptic sei`ures
behavioural stereotypies as seizure mimic
intellectual disability
often have repetitive movements which are behavioural
at what age do PNES occur
adolescents
what are febrile convulsions
a seizure occuring in infancy/childhood
usually between 3mths and 5yrs of age
associated w/ fever but w/o evidence of intracranial infection or defined cause for the seizure
how common are febrile convulsions
commonest cause of acute symptomatic seizure in childhood