Pediatric Seizures, Head Injuries, and Concussion - Dow

Question 1

generalized tonic-clonic seizures

Answer 1

rare before 2yo

Question 2

young children

Answer 2

less complex behaviors - expecially with complex partial seizures

Question 3

LOC in infants and young children

Answer 3

difficult to determine

Question 4

absence seizures

Answer 4

start around 5-6yo
short - lapse in consciousness, speech, or motor activity

no aura
no postictal drowsiness
may have autisms

EEG - 3 cycles per second spike and wave activity

Question 5

infantile spasm

Answer 5

any disorder than can produce brain damage
-EEG - hypsarrhythmia

long term prognosis - poor - cognitive impairment

2% childhood epilepsy but 25% of epilepsy with onset in first year of life

Question 6

ciTBI

Answer 6

clinically important traumatic brain injury

Question 7

predictors of ciTBI

Answer 7

altered mental status
GCS < 14

history of vomiting

LOC > 5 seconds

severe mechanism
basilar skull fx

severe headache

Question 8

head CT recommended if

Answer 8

GCS < year old

Question 9

management of concussion

Answer 9

no same day return to play
no driving

premature return to play - increased risk
-follow return-to-play criteria

Question 10

return to play

Answer 10

5 steps

1 - light activity - to increase HR
2 - sport specific exercise - add movement
3 - noncontact training - exercise, coordination, cognitive effort
4 - full contact practice - assess skills by coach, instill confidence
5 - return to play

each step 24 hours
-proceed to next level if without symptoms

symptoms - drop to previous level