seizures Flashcards
key features of absence and triggers and EEG
- flickering of eyelids
- no aura
- no memory of event
- daydreaming
- decline in school
- lasts up to 30 s
triggers: hypersalivation, blowing a candle
EEG- 3 HZ
atypical absence features
<2.5 hz Hz
worse prognosis
generalised tonic clonic fetaures
ictal cry cyanosis- pooling of secretions rigidity up rolled eyes can come with/o aura post ictal effect
examples of auro
when do we very rarely give AED after FISRST SEIZURE
smell, abdominal discomfort, de ja vu jerking of a limb
- very abnromal EEG
- abnormal neuro exma
- seizure is epileptic status
how long does tonic phase and clonic phase last
tonic - 10-30 s
clonic - up to 5 mins
features of clonic phase
increase sympathetic
loss of sphincter control
how long can post ictal phase last and features of it
up to 30 m - 2hours
- loss of corneal reflex
- babinski response
- flaccidity
- sleepy, unresponsive
examples of epileptic encepalopathies
west
lennox g
dravet
otharra
age range for othara syndrome
tx of febrile seizure
usually around neonatal period most common first 10 days
most kids dont need tx
but buccal midazalma, rectal diazapam 0.5mg/kg
prophylaxis with oral diazapam 3 x a day during the fever if that doesnt work you can prophylactic with valproate
PHENOBARBITAL IS CRAP
most common benign focal epilepsy syndrome and second
rolandic and second is panaoutopooylase
rolandic features+ eeg + prognosis
3- 10 years night time or upon awakening mainly affects facial area DROOLING can't speak - but can hear and see etc EEG- temporal spikes excellent prognosis
panoutopolous
benign in nature like rolandic prolonged >30 mins vomiting + pallor 2-7 years characterised by autonomous symptoms
EEG- mainly occipital and can progress to rolandic in some cases
what makes a febrile seizure complicated
how does vitamin b6 link to seziures
> 15 mins
focal signs present
occurs multiple times within 1 febrile event
atructural abnormalities in brain
infnats can have them if they dont get enough through milk
time period for febrile seizure
simple partial seizure
tx of status EPILEPITUCS
6 m - 6 year but most common from 1-3
you are aware, motor symptoms prevalant , W/O auras , no automatisms present
FIRST LINE BEZOS
is there a risk for developing epilepsy in febrile seizures
uncomplicated: no
complicated - small chance around 6% ish
what drug is not effective for FS
drug in general for general seziures
drugs for partial seziures
Phenobarbital
VALPROATE
carbamazopine or lamotrigine
what needs to be excluded for FS
neuroinfection
spasmophilia - rikets type
if you suspect neuroinfection what age is absolutely mandatory for a LP
<12 months
the most common cause of seizures in childhood
FS
eeg for west syndome and age of development and offset
hyspassrthmia and around 4-8 m and offset 1-2 years
treatment of west
vigabatrin, valproate, ACTH
CS
triggers for west
when drowsy or immediately upon awakeing
myoclonic juvanille epiepsy features
adolescents
requires life long medication
happens usually in morning
3 types of seizures 1. myoconic (hallmark) 2.abscence 3. generlaised tonic clonic
GEFS - MCQ
AD
continuoation of FS even after 6 years
and seizures even when no fever
temproal lobe vibes
associated with dravet syndrome
treat with valproate and topimerare NO LAMTORIGINE
cause of west
hie, tuberous slecorios, etc 90% there is as structural causes but some babies have a complete normal birth and it happens
types os seizures in west
MYOCLONIC and a mixture of tonic seizures
seizures of hypoglycaemia
which seizures commobly prestent with status epilepticus
give glucose 25% and calcium glcuonate
draveet and panaotopolous
tx absence seizures
dravet syndome
ethosuximide
bad prognosis, developmental regression , common to have status epilepticus, usually starts in first year of life with febrile seizure but hten later they have seizures regardless of fever, associated with gene mutation in majorty of cases SC1NA
