PAEDS

Question 1

childhood seizures

Answer 1

due to inappropriate signalling w/i the brain
causes incl: fever, nfx, epilepsy, SOL

mx: ABCDE, 1st line = Benzodiazepines

Question 2

Childhood Epilepsy Syndromes - Juvenille Myoclonic Epilepsy

Answer 2

8-26yo
girl
[early morning myoclonic jerks + absence seizures + generalised tonic-clonic]
triggers incl. flashing lights, sleep deprivation and ETOH

mx: may need life long AEDs eg.Na valproate

Question 3

Childhood Epilepsy Syndromes - Benign ROLandic Epilepsy

Answer 3

peaks 9yo (3-12yo)
NOCTURAL seizures w UNILATERAL FACIAL PARAESTHESIA/TWITCHING, DROOLING and APHASIA
no daytime sx

mx: resolves in puberty

Question 4

Childhood Epilepsy Syndromes - Childhood Absence Epilepsy

Answer 4

3-12yo
5-20s of absences
\+/- lip smacking, eyelid flickering
poor school performance
\+ve FHx

mx: resolves in puberty, Na val if req
NOT CARBAMAZEPINE AS THAT INCR ABSENCE SEIZURES

Question 5

West syndrome

Answer 5

= triad of infantile spasms/seizures + regression + hypsarrthymia on EEG (chaotic waves)

tx = steroids, vigabatrin, ACTH… aiming for quick seizure control
prognosis is cause-dependent and many have developemental delay + persistent seizures

Question 6

Febrile convulsions

Answer 6

6month-6yo
+ve FHx
Commonly ppt by viral infx, otitis media, tonsilitis

simple febrile seizures:
tonic-clonic, <15mins, no recurrence w/i same illness

complex febrile seizures:
starts focally, prolonged or sever episodes w/i one illness

mx: identify and treat cause, if unclear do a full septic screen and start broadspec IV abx

Question 7

Reflexic ANOXIC Attacks

Answer 7

NOXIOUS stimuli (pain/anxiety/fear) –> reflex asystole due to vagal stimuation
6month-2yo
suddenly turn pale, limp, LOC and tonic clonic jerking
30-60s
tired afterwards

dx = non-epileptic and diagnosis is on basis of hx w normal EEG/ECG

mx: resolves later in life