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Year 2 Neurology > Pediatric neurology I > Flashcards

Pediatric neurology I Flashcards

1
Q

epilepsy is the occurrence of at least ____ unprovoked seizures

A

2

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2
Q

what is seizure?

A

clinical manifestation of abnormal hyper synchronous discharge of the cortical neurons

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3
Q

what is the other name for a tonic clonic seizure?

A

grand mal

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4
Q

what is the primary difference between simple partial and complex partial seizures?

A
  • simple partial: no loss of consciousness

- complex partial: loss / alteration of consciousness

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5
Q

what are the features that constitute epilepsy?

A
  • type
  • age of onset
  • course
  • characteristic EEG abnormalities
  • drug of choice
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6
Q

what is the duration / onset / provocation / and age onset for childhood absence epilepsy?

A
  • duration: usually less than 20 seconds with multiple seizures throughout the day
  • onset: sudden onset and resolution (no post ictal confusion or sleepiness)
  • provoked by: hyperventilation
  • age onset: 4-14 years
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7
Q

what is the EEG finding in childhood absence epilepsy?

A

generalized 3 Hz spike and slow wave discharges

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8
Q

what is the treatment for childhood absence epilepsy?

A
  • ethosuxamide (primary)
  • valproic acid
  • lamotrigine
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9
Q

what are the seizure characteristics for benign childhood epilepsy with centrotemporal spikes (Rolandic epilepsy)?

A
  • infrequent partial seizures
  • tingling in mouth, face, drooling, dysphagia, speech arrest
  • unilateral upper extremity movement
  • rare generalized tonic clinic seizures
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10
Q

what are the EEG findings in benign childhood epilepsy with centrotemporal spikes (Rolandic epilepsy)?

A

centrotemporal spikes

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11
Q

what is the treatment for benign childhood epilepsy with centrotemporal spikes (Rolandic epilepsy)?

A

carbamazepine or oxcarbazapine

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12
Q

when do most benign childhood epilepsy with centrotemporal spikes (Rolandic epilepsy) seizures occur?

A

while sleeping or on awakening

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13
Q

what are the EEG findings in juvenile myoclonic epilepsy?

A

3-6 Hz polyspikes and wave

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14
Q

juvenile myoclonic epilepsy can be provoked by _________ and triggered by _________________

A
  • photic stimulation

- AM awakening, lack of sleep, fatigue, ETOH

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15
Q

what is the treatment of choice for juvenile myoclonic epilepsy?

A
  • valproate (avoid in adolescent girls)

- can also use levetiracetam, lamotrigine

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16
Q

is juvenile myoclonic epilepsy a lifelong condition or specific to juvenile aged patients?

A

lifelong

17
Q

febrile seizures occur in what age range?

A

3 months - 6 years

18
Q

what is the most common seizure in children?

A

febrile

19
Q

what is the duration and frequency of simple febrile seizures? what if it is more frequent / longer?

A
  • 15 minute duration, once per day

- if more than that, it is a complex febrile seizure

20
Q

what should be the first concern for febrile seizure (pathogen)?

A

meningitis

21
Q

how do you differentiate between febrile seizure and meningitis?

A

history and possibly LP

22
Q

what is the diagnostic workup for febrile seizure?

A
  • LP for meningitis s/sx
  • LP for children 6-12 months of age if not vaccinated for HIB / s. pneumo
  • LP for patient taking abx
  • CBC / electrolytes / blood sugar / Ca / Mg
  • imaging: heat CT, MRI (**NOT FOR SIMPLE FEBRILE)
23
Q

is CT / MRI indicated for simple febrile seizure? what about EEG?

A

NO (to both)

24
Q

what is the treatment for febrile seizure?

A
  • seizure abortion: benzodiazepine (if longer than 5m)
  • febrile status epilepticus: treat like afebrile
  • prophylactic antiepileptic medications are not indicated given benign nature
25
Q

what are the 3 types of infantile spasm?

A
  • flexion: sudden flexion of legs, arms, neck, head
  • extension: sudden extension of head, neck, arms
  • mixed: flexion of head and arms with extension of legs
26
Q

what are the features of infantile spasm?

A
  • occur in clusters
  • occur on awakening from sleep
  • usually associated with developmental arrest or regression
27
Q

what are the different etiologies of infantile spasm?

A
  • symptomatic IS: identified etiology and / or significant developmental delay
  • cryptogenic IS: no known etiology and normal development
28
Q

what are the causes of infantile spasm?

A
  • CNS malformation (common cause)
  • tuberous sclerosis (common cause)
  • hypoxic ischemic encephalopathy
  • inborn error of metabolism
  • chromosomal abnormalities
  • congenital infection
29
Q

infantile spasm is associated with what characteristic EEG abnormality?

A

hypsarrhythmia

30
Q

hypsarrhythmia on EEG indicates what condition?

A

infantile spasm

31
Q

what is the treatment for infantile spasm? what about infantile spasm due to tuberous sclerosis?

A
  • ACTH

- vigabatrin

32
Q

vigabatrin is reserved for what condition?

A

infantile spasm due to tuberous sclerosis

33
Q

what test should follow vigabatrin administration? why?

A

eye exam - side effect is visual field restriction that could be permanent)

Year 2 Neurology (23 decks)

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