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Pediatric neurology > Seizure & Epilepsy: sum > Flashcards

Seizure & Epilepsy: sum Flashcards

1
Q

age of onset for febrile seizure

A

6m to 60m (5y)

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2
Q

Describe simple febrile seizure

A

brief <15min - generalized - no recurrence within 24hr - no neurological disease

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3
Q

Describe complex febrile seizure

A

> 15min - focal - recur within 24hr - underlying CNS disease

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4
Q

Mx of febrile seizure

A

supportive

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5
Q

risk of recurrance after first febrile seizure

A

1\3rd of patients

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6
Q

Risk of epilepsy in patients with febrile seizure

A

2-10%

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7
Q

risk of neonatal seizure increase in

A

preterm

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8
Q

causes of neonatal seizure

A

1- HIE
2- ICH (intraventricular, subdural, subarachnoid) and Stroke
3- meningitis
4- electrolyte: Hypoglycemia, Hypo or Hypernatremia
5- IEOM
6- genetics.

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9
Q

clinical presentation of neonatal seizure

A

subtle tonic, or clonic movement of one limb ± automatism

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10
Q

Jitterness is associated with which electrolyte imbalance

A

hypoglycemia

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11
Q

first antiepileptic in neonatal seizure

A

phenobarbital

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12
Q

fifth day fits

A

benign familal neonatal convulsion with seizure occuring in the 5th or 6th day of life, self-limited

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13
Q

infantile spasm age group

A

between 4-7m

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14
Q

semiology of infantile spasm

A

flexion of trunk, neck, extremities followed by tonic phase, occurs in clusters, in between there might be loud cry

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15
Q

west syndrome

A

triad of infantile spasm, hypsarrythmia on EEG, developmental regression

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16
Q

hypsarrythmia on EEG

A

high amp - disorganized background - multifocal discharge

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17
Q

Mx of infantile spasm

A

ACTH - vigabatric if patient w\tuberous sclerosis

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18
Q

childhood absence epilepsy age of onset

A

4-8 years

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19
Q

semiology of childhood absence epilepsy

A

staring with behavioral arrest, may develop eye blink or flutter, last seconds, return to baseline daily

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20
Q

how to provoke childhood absence epilepsy

A

2-3 min of hyperventilation

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21
Q

EEG findings of childhood absence epilepsy

A

3hz gen spike-wave discharge

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22
Q

Mx of childhood absence epilepsy

A

ethusuxamide

23
Q

age of onset in ronaldic seizure

A

3-10y

24
Q

Semiology of rolandic seizure

A

1- simple focal motor (face, spread in arm and leg) may also generalize
2- sensory feature (parasthesia)
3- salivation
4- speech arrest
5- occur at night

25
Q

EEG of rolandic

A

focal discharges in centerotemporal reigon
activated during sleep

26
Q

prognosis of rolandic

A

1\4th of patient will have only one seizure and has low seizure frequency with eventual spont remission

27
Q

mx of rolandic

A

carbamezapine

28
Q

Onset of JME

A

12-18 y

29
Q

semiology of JME

A

generalized tonic clonic,, with jerking movement in upper extermity in the morning

30
Q

risk factors of JME

A

sleep deprivation, stress, alcohol

31
Q

EEG of JME

A

polyspike and wake 4-6hz

32
Q

MX of JME

A

depakene

33
Q

lennox-gastuat syndrome def

A

tonic, tonic clonic, myoclonic, atypical absence, atonic with difficulty treating

34
Q

EEG findings of lennox gustat

A

diffuse - slow - spike wave - 1.5 to 2.5

34
Q

EEG findings of Landau-kleffner age

A

3-7 yr

34
Q

MX of lennox gustat

A

multiple medication, ketogeneic, surgical, corpus callosotomy, vNS

35
Q

clinical presentation of landau-kleffner

A

acquired aphasia after normal lang developmenta

36
Q

EEG findings of landau kleffner

A

sharp spikes, spike and wave, over bilateral temporal
with electrical status epilipticus during slow wave sleep

37
Q

Mx of landau kleffner

A

Benzo + corticosteroid

38
Q

prognosis of landau kleffner

A

good in terms of seizure - variable for language

38
Q

definition of rasmussen’s encephalitis

A

autoimmune progressive encephalopathy causing refractory seizures, cognitive decline, hemiparesis

39
Q

neuropathology of rasmussen’s encephalitis

A

periventricular lymphocytic infiltrate

40
Q

imaging of rasmussen’s encephalitis

A

atrophy in the affected cerebral hemisphere

41
Q

antibodies in rasmussen’s encephalitis

A

anti-glutamate receptors

42
Q

Mx of rasmussen’s encephalitis

A

high dose steroids and IVIG

43
Q

Defnitive management of rasmussen’s

A

functional hemispherectomy

44
Q

mx of SE

A

ABCDE + Send blood for metaboic, toxicology, drug level + Blood sugar, IV lorazepam 0.05 to 0.1 mg per kg - if presist give phenyotin 20mg per keg - intubate and load on phenobarb or midozolam

45
Q

Complication after SE

A

neuronal damage, increased ICP, Cerebral edema, Hypoxia, aspiration, hypercapnia, tachycardia, cardiac arrthmia, ARD, myoglobinuria, hyperthermia, lactic acidosis, rabdo

46
Q

diff breath-holding spells from seizure

A
  • triggered by emotional stimuli.
  • are two types cyanotic and pallid
  • LOC can occur after episode
  • movement that looks like tonic posturing or myoclonia after the attack
  • episodes stop at 4 years usually
47
Q

diff Sandifer’s syndrome from seizure

A
  • tonic neck ectension + dystonic posturing of trunk
  • Associated with GERD
48
Q

diff Syncope from seizure

A
  • brief loss of consioussness as well as postural tone secondary to transient decrease in cerebral profusion
  • MC etiology is vasovagal
49
Q

diff night terror from seizure

A
  • occurs in first third of night
  • agitation and facial flushing
  • ## amnesia for event
50
Q

diff movement disorder from seizure

A

tic disoderd, sleep myoklonia, paroxysmal dyskinesia

Pediatric neurology (2 decks)

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