Seizure Disorders

Question 1

Outline West syndrome

infantile seizures

Answer 1

Form of epilepsy starting around 4-8 months

Seizures with myoclonic jerking (jack knife spasms) that occur in clusters

Associated with developmental regression

High morbidity

Diagnosed by history and characteristic EEG findings of hypsarrhythmia

Vigabatrin/steroids

Question 2

Outline Lennox-Gastaut syndrome

Answer 2

May be an extension of infantile spasms (50% have history)

Onset 1-5 years

Few-30 secs

No warning, quick recovery

Often many per day

EEG slow spike

Sodium valproate, ethosuximide

Good prognosis - 90-95% become seizure free in adolescence

Question 3

Outline benign rolandic seizures

Answer 3

Affect children aged 3-10

Occur almost exclusively during sleep

Tonic seizure overnight - child may make noise/fall out of bed

Parents may notice child sleeping on floor/messy bedsheets in morning

Paraesthesia e.g. unilateral face

Diagnosis made from history and EEG findings of centro-temporal spikes

Prognosis is excellent, most completely outgrow by puberty

Question 4

Outline juvenile myoclonic epilepsy (Janz syndrome)

Answer 4

Onset teens

Infrequent generalised seizures

Often in morning/following sleep deprivation

Daytime absences

Sudden, shock like myoclonic seizure (may develop before seizures)

Usually good response to sodium valproate