paeds neuro Flashcards
What is a febrile seizure ?
A seizure that occurs in children with a high fever.
What age group suffer from febrile seizures?
6 mnths -> 5 years
What are simple febrile convulsions ?
- Generalised, tonic clonic seizures
- Last <15 mins
- Occur once during a single febrile illness
What are complex febrile convulsions ?
Any of the following :
- Partial or focal seizures
- Last >15 mins
- Multiple occur during the same febrile illness
What needs to be excluded before febrile convulsions are diagnosed ?
- Epilepsy
- Meningitis, encephalitis or other neurological infection
- Intracranial space occupying lesions
- Syncopal episode
- Electrolyte abnormality
- Traume
How are febrile convulsions managed ?
- Identify and treat underlying infection
- Fever : paracetamol and ibuprofen
- Period of observation
altered consciousness altered cognition unusual behaviour acute onset of neurological symptoms acute onset of focal seizures fever
encephalitis
how is encephalitis investigated
LP for CSF with viral PCR testing
CT if LP is CI
how is encephalitis managed
Aciclovir for HSV and VZV
Ganciclovir for CMV
When would a child be admitted with a febrile seizure
-> First seizure or features of complex seizure
Benign Rolandic seizures (benign focal epilepsy) : presentation, EEG
- 3 to 10 yrs
- Boys and during sleep
- Tonic seizure : wake up on floor or with messy sheets
- EEG : centro-temporal spikes
Infatile spasms (west syndrome) : presentation, diagnosis
- Boys : 4-8 mnths
- Presentation : Salam attacks (flexion of head, trunk, arms, follwed by extension of arms).
- Lasts 1-2 seconds, repeated up to 50 times.
- EEG : hypsarrhymthmia
Inheritance of juvenile myoclonic epilepsy
AD