paeds neuro

Question 1

What is a febrile seizure ?

Answer 1

A seizure that occurs in children with a high fever.

Question 2

What age group suffer from febrile seizures?

Answer 2

6 mnths -> 5 years

Question 3

What are simple febrile convulsions ?

Answer 3

• Generalised, tonic clonic seizures
• Last <15 mins
• Occur once during a single febrile illness

Question 4

What are complex febrile convulsions ?

Answer 4

Any of the following :

• Partial or focal seizures
• Last >15 mins
• Multiple occur during the same febrile illness

Question 5

What needs to be excluded before febrile convulsions are diagnosed ?

Answer 5

• Epilepsy
• Meningitis, encephalitis or other neurological infection
• Intracranial space occupying lesions
• Syncopal episode
• Electrolyte abnormality
• Traume

Question 6

How are febrile convulsions managed ?

Answer 6

• Identify and treat underlying infection
• Fever : paracetamol and ibuprofen
• Period of observation

Question 7

altered consciousness
altered cognition 
unusual behaviour 
acute onset of neurological symptoms 
acute onset of focal seizures
fever

Answer 7

encephalitis

Question 8

how is encephalitis investigated

Answer 8

LP for CSF with viral PCR testing

CT if LP is CI

Question 9

how is encephalitis managed

Answer 9

Aciclovir for HSV and VZV

Ganciclovir for CMV

Question 10

When would a child be admitted with a febrile seizure

Answer 10

-> First seizure or features of complex seizure

Question 11

Benign Rolandic seizures (benign focal epilepsy) : presentation, EEG

Answer 11

• 3 to 10 yrs
• Boys and during sleep
• Tonic seizure : wake up on floor or with messy sheets
• EEG : centro-temporal spikes

Question 12

Infatile spasms (west syndrome) : presentation, diagnosis

Answer 12

• 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

Question 13

Inheritance of juvenile myoclonic epilepsy

Answer 13

AD