Pediatric Epilepsy Flashcards
Origin of psychogenic nonepileptic seizures (PNES)?
Psychological
How do you distinguish between a PNES and epileptic seizures?
Epileptiform activity on an EEG is seen in Epileptic seizures but NOT PNES
Who can have seizure?
Anyone
Types of seizure?
Partial/Focal
Generalized
Partial seizures?
Those in which the first clinical and EEG changes indicate initial activation of a system of neurons limited to part of ONE cerebral hemisphere
Generalized seizures?
Those in which the first clinical changes indicate initial involvement of BOTH hemispheres
Impaired consciousness?
Inability to respond normally to exogenous stimuli
Characteristics of absence seizures?
Sudden onset of interruption of activity
Unresponsive if spoken to
Lasts a few seconds to half a minute
May be induced with HYPERVENTILATION
Most common type of childhood seizures?
Febrile seizures
Febrile seizures?
Seizures that occur in febrile children between the ages of 6 and 60 months who do not have an intracranial infection, metabolic distubance, or hx of afebrile seizures
Simple febrile seizures?
Isolated (once in a 24-hr period)
Generalized
Brief (<15 mins)
Majority
Complex febrile seizures?
Multiple (occur more than once in a 24-hour period)
Focal
Prolonged (>15 mins)
Associated with higher risk of AFEBRILE seizures but NOT febrile seizures
Risk factors for febrile seizure recurrence?
Young age at onset (<1 hr)
Risk factors for epilepsy in children with febrile seizures?
Complex febrile seizures
FHx of epilepsy
Neurologic impairment prior to the febrile seizure
Children with FSE are at risk for?
Acute hippocampal injuries
Abnormalities in hippocampal development
What infections are commonly associated with FSE?
HHV-6B
HHV-7
Epilepsy?
Multiple UNPROVOKED seizures separated by more than 24 hours
When do infantile spasms appear?
3 to 7 months
Characteristics of infantile spasms seizures?
Brief bilateral symmetric contraction of the muscles of the neck, trunk, and extremities
Most commonly Flexor spasms are seen
“Stomach Crunches” reported by patents
What does an EEG show in a pt during an infantile spasms?
Hypsarrhythmia
West syndrome?
Triad of infantile spasms, hypsarrhythmia, and developmental arrest/regression
Onset of Lennox-Gastaut?
1 to 8 years
Lennox-Gastaut triad?
At least 2 seizure types
Slowing of mental development
EEG showing “slow spike and wave”
-slow background, bursts of diffuse slow spike-wave patters of 1.5-2.5 Hz
Onset of Childhood Absence Epilepsy (CAE)?
4-8 yrs
Characteristics of CAE?
Absence seizures occur multiple times per day
May be triggered by hyperventilation
Generalized 3 Hz spike-and-wave discharges
Onset of juvenile myoclonic epilepsy?
Adolescence
Types of seizures seen in juvenile myoclonic epilepsy?
Tonic-clonic (13-20 yrs)
Myoclonic (12-18 yrs)
Absence (7-13 yrs)
Myoclonic seizures?
Brief, bilateral but not always symmetric, flexor jerks of the arms
Highest frequency in the morning
Pt is conscious
What can be juvenile myoclonic epilepsy be precipitated by?
Sleep deprivation Alcohol ingestion Awakening from nocturnal or daytime sleep PHOTIC stimulation Menstration
Genetics behind Juvenile myoclonic epilepsy?
AD –> chromosome 6
Most common form of benign partial epilepsy of childhood?
Benign Rolandic Epilepsy (BRE)
Where do epileptiform discharges arise from in BRE?
Rolandic (Central) area of the brain
Onset of BRE?
4-12 yrs peak 8-9 yrs
Most common presentation of BRE?
Nocturnal generalized tonic-clonic seizures
Most specific type of BRE?
facial motor seizures
