Seizure Disorders Flashcards
1
Q
Things to note about febrile seizures
A
- If patient appears normal after seizure, does not need extensive workuop
- if patient remains obtunded, shouldbe carefully evaluated and should have lumbar puncture
- points of concern: abnormal neurologic development before seizure, prolonged focal or recurrent seizures, more than 3 febrile seizures
2
Q
Peak age of onset 9-10 years characterized by
- Simple partial seizures involving the face and mouth; may secondarily generalize
- consciousness usually impaired
- seizures typically occur at night and may start with parasthesias of throat, tongue, face
- interictal EEG shows centrotemporal (sylvian) spikes
- seizures will resolve in nearly all children by 14-18 years of age
A
Benign rolandic epilepsy
3
Q
Peak age of onset 4-6months, characterized by:
- infantile spasms, mental retardation
- may have up to 100 seizure per day, can be mistaken for colic pain
- EEG abnormal: hypsarrhymia
- multiple causes including tuberous sclerosis
A
West Syndrome
4
Q
- typical age of onset 2-4 year
- most children are normal intellectually and neurologically
- early age onset seizures are frequent and brief, lasting a few seconds
- in children with an older age onset, the seizures can last several seconds to minutes and may occur only a few times a day (nonpyknoleptic or spanioleptic absence seizures)
- myoclonic and tonic-clonic seizures may be present, especially in syndromes with older age of one
A
Childhood -onset absence epilepsy
5
Q
- seizure arise from temporal lobe structures, especially hippocampus/ amygdala
- seizures manifest as: Aura, hallucinatinos, emotional disturbances and depersonalization, deja vu, olfactory hallucinations, followed by impaired consciousness and automatisms
- mesial temporal sclerosis, most common cause of temporal lobe epilepsy
- temporal lobe epilepsy associated with mesial sclerosis usually manifests between 6 and 10 years of age, but cases presenting in infacncy and up to age 32 years have been reported
A
Temporolimbic epilepsy
6
Q
- multi-system autosomal dominant genetic disease causing non-malignant tumor growth in the brain, retina, face and on other vital organs such as the kidneys, heart, etc. skin lesions such as adenoma sebaceum
- gene mutations: TSC1 and TSC2 codes for the protein hamartin and tuberin respectively
- symptoms include seizures, developmental delay, behavioral problems, lung and kidney disease
A
Tuberous sclerosis
7
Q
Peak age of of onset 4-5 years characterized by:
- multiple resistant seizure types including tonic (most common, especially during sleep) myoclonic, atonic, atypical absence
- mental retardation
- EEG shows slow spike and wave
- bursts of fast rhythms at 10-12
A
Lennox- gestaut syndrome
8
Q
peak age of onset between 12-18 years characterized by:
- myoclonic jerks on awakening (sudden, brief, usually bilaterally symmetrical muscle contraction)
- occur also have absence and generalized tonic-clonic seizures
- life-long conditon
- genetic etiology
A
Juvenile myoclonic epilepsy (Janz syndrome)
9
Q
Seen from 6 months to 6yrs, triggered by high fever without intracranial infection, typical cases characterized by
- brief (< 15min) generalized tonic clonic seizures which don’t recur in the first 24hr; neurologically normal child; no family history
- more common in boys
- one-third
- typical cases have minimal risk of subquent epilepsy
A
Febrile Seizures
10
Q
- Duration < 15min
- generalized
- occur once in 24 hours
- no prior neuro problems
A
Simple
11
Q
Duration > 15 min
focal
recurs within 24 hrs
any prior neuro concerns
A
complex seizures
12
Q
medications for seizures
A
- focal onset: levetiracetam
- generalized onset: levetiracetam
- absence: ethosuximide
13
Q
lifestyle & education for seizures
A
- minimize triggers- sleep deprivation, alcohol, illness
- safety first: driving, swimming, falling
- pregnancy planning (safer options: lamictal, keppra); avoid: valproate, dilantin (phenytoin) tegretol
