peds60

Question 1

neuroimaging studies in kids with seizure?

Answer 1

yes, in all kids with seizures except absence seizures or benign rolandic epilepsy

Question 2

first time seizure in an otherwise healthy child- evaluation?

Answer 2

no, no further investigation

Question 3

febrile seizure

Answer 3

must rule out CNS infection

Question 4

treatment of status epilepticus

Answer 4

IV anticonvulsants such as short-acting benzos (lorazepam or diazepam) followed by loading dose of either phenobarbitol or pheytoin

Question 5

drugs for generalized epilepsy

Answer 5

valproic acid or phenobarbitol

Question 6

drugs for absence epilepsy

Answer 6

ethosuximide

Question 7

drugs or partial epilepsy

Answer 7

carbamazepine or phenytoin

Question 8

surgery for what kind of seizures

Answer 8

temporal lobe seizures that are refractory to meds; 75% have complete seizure control after surgery

Question 9

alternative treatments for seizures

Answer 9

vagal nerve stimulator (side effect is hoarseness) and ketogenic diet

Question 10

prognosis for epilepsy

Answer 10

about 70% of epileptic kids can be weaned off after 2 years of seizure free; NOT a lifelong disorder

Question 11

febrile seizure

Answer 11

fever with seizure, 6 months to 6 years of age by definition

Question 12

simple febrile seizure

Answer 12

lasts less than 15 mins and is generalized

Question 13

complex febrile seizure

Answer 13

last more than 15 mins, has focal features, or recurs within 24 hours

Question 14

treatment for febrile seizure

Answer 14

anticonvulsants not needed for first time or occasional febrile seizure; antipyretic treatment; recurrent, frequent febrile seizures need meds

Question 15

meds for frequent recurrent febrile seizures

Answer 15

daily anticonvulsant prophylaxis wth valproic acid or phenobarbitol; also abortive treatment with rectal diazepam

Question 16

prognosis for febrile seizures

Answer 16

30% of patients with one febrile seizure will have a recurrance; recurrance risk decr with incr age

Question 17

three common epileptic syndromes

Answer 17

infantile spasms, absence epilepsy of childhood, and benign rolandic epilepsy

Question 18

infantile spasms

Answer 18

aka West syndrome; age of onset 3-8 months; tuberous sclerosis is the most commonly identified cause

Question 19

most commonly identified cause of infantile spasms

Answer 19

tuberous sclerosis

Question 20

tuberous sclerosis

Answer 20

non-malig tumors in many different organs

Question 21

clinical features of infantile spasms

Answer 21

brief myoclonic jerks lasting 1-2 sec, occuring in clusters over 3-5 min

Question 22

jackknife seizures or salaam seizures

Answer 22

suggen arm extension or head and trunk flexion; seen in infantile spasms

Question 23

eeg for infantile spasms

Answer 23

characteristic hypsarrhythmia (hghly disorganized, high amplitude occurign in both hemispheres)

Question 24

management of infantile spasms

Answer 24

IM injection of ACTH for 4-6 weeks; valproic acid is second line; vigabatrin is most effective for patients with infantile spasms assoc w tuberous sclerosis

Question 25

prognosis for infantile spasms

Answer 25

poor; usually kids develop moderate to severe mental retardation

Question 26

absence epilepsy of childhood

Answer 26

age of onset 5 to 9 years; females more common; inheritance aut dom with age-dep penetrance