Pediatric Seizure Disorders

Question 1

Psychogenic nonepileptic seizures (PNES)

Answer 1

Paroxysmal (sudden) episodes that resemble epileptic seizures; however, PNES are psychological in origin.

Question 2

How do you differentiate PNES from an epileptic seizure

Answer 2

Video- EEG monitoring in an epilepsy monitoring unit. PNES will not show epileptiform activity on the EEG.

Question 3

see chart on pg 4 dfor diff between epileptic seizures and psychogenic

Answer 3

ok

Question 4

Pt has a seizure in the hospital. What do you do?

Answer 4

• ABC (airway, breathing, circulation)
• Place the patient on their side and administer oxygen
• Ask the nurse to administer a benzodiazepine
• Consider loading with anti-epileptic meds

Question 5

Seizures divided into what 2 groups

Answer 5

• Partial (focal)

- Generalized

Question 6

Definition of a partial seizure

Answer 6

• Starts in one hemisphere

- Can secondarily generealize

Question 7

Definition of a generalized seizure

Answer 7

• Those in which the first clinical changes indicate initial involvement of both hemispheres

Question 8

Patial seizures may be divided into 2 categories

Answer 8

Simple Partial- consciousness intact

Complex partial- consciousness not intact

Question 9

Types of generalized seizures

Answer 9

A- Absence
M- Myoclonic
C- Clonic
T- Tonic-clonic
T- Tonic
A- Atonic

Question 10

Absence seizures:

Answer 10

Brief loss of consciousness where they stop doing whatever it is they were doing and stare at you blankly.
- lasts up to 30 seconds

Question 11

ABsence seizures may be induced with?

Answer 11

HYPERVENTILATION…know

Question 12

Absence characterized by what type of EEG behavior

Answer 12

3 hz spike and wave discharges

Question 13

Febrile seizures

Answer 13

most common type of childhood seizure, affect 2-5% of children in the USA.

Question 14

Peak incidence of febrile seizures

Answer 14

18 months

Question 15

Definition of febrile seizures

Answer 15

Seizures that occur in kids with fevers between the ages of 6 and 60 months who do not have an intracranial infection, metabolic disturbance, or history of afebrile seizures

Question 16

Simple febrile seizure

Answer 16

Isolated (once in a 24 hour period), generalized, brief

Question 17

Complex febrile seizure

Answer 17

Multiple (occur more than once in a 24 hour period), focal, prolonged

Question 18

Recurrence of febrile seizure

Answer 18

90% of kids have recurrence within 1 year of onset

Question 19

Risk factors for recurrence

Answer 19

young age at onset
febrile seizures in 1st degree relative
low grade fever in ER
brief duration between fever and seizure

Question 20

Epilepsy can develop from febrile seizures. The risk factors for the development of epilepsy in children with febrile seizures is:

Answer 20

• complex febrile seizures
• A family history of epilepsy
• Neurologic impairment prior to the febrile seizure

Question 21

Long term management for a kid with simple febrile seizures

Answer 21

Do not give anticovulsants to a kid with one or more simple febrile seizures.

If the parents are very concerned, give oral diazepem at teh onset of febrile illness

Question 22

Children with febrile status epilepticus are at risk for what

Answer 22

hippocampal injury and a substantial number also have abnormalities in hippocampal development

Question 23

Focal slowing or attenuation are present in EEGs obtained within 72 hours in a substantial proportion of children with febrile status epilepticus and are highly associated with MRI evidence of Acute hippocampal injury

Answer 23

ok

Question 24

If neuroimaging is to be performed in a child, what is the preferred modality

Answer 24

MRI