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Pediatrics > Seizures > Flashcards

Seizures Flashcards

1
Q

Unresponsive kid DDx?

A 
Toxic ingestion
Seizures
Syncope (breath holding vs cardiac)
Closed head injury
Infection
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2
Q

Seizure vs seizure-like activity

A

true seizures –> excessive neuronal brain activity

- LOC, deviation of eyes, incontinence, rhythmic motor movements, post-tictal state

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3
Q

General Tonic-clonic

A

most common in kids

  • abruptly with stiffening of body followed by upward deviation of eyes
  • clonic jerks of all extremities
  • flaccid and urinary incontinence
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4
Q

Simple partial seizure

A

motor signs of single extremity

- may spread to more of the body

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5
Q

Complex partial seizure

A

alteration of consciousness

  • glassy eyes, smacking lips, drooling, N/V
  • repeatedly inappropriate verbal and motor signs
  • 30 sec - 2 min with sleep following
  • 2nd generalized seizures can follow
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6
Q

Childhood absence epilepsy

A

petit-mal seizures –> starts around age 3

  • usually regain consciousness quickly
  • no loss of tone or incontinence
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7
Q

Atonic seizure

A

Loss of motor tone

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8
Q

Determining Etiology of Seizure?

A 
Description of event?
History of fever/illness?
Movement prior/post?
Toxic ingestion?
Family History?
Trauma?
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9
Q

Developmental and seizures

A

Kids who are developmentally delayed that have seizures may have 1 thing related to both conditions
- pre-existing developmental abnormalities increase the risk for epilepsy

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10
Q

Heredity and febrile seizures

A

febrile seizures are hereditary -> don’t know inheritance

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11
Q

DDx of febrile seizure in kids

A
  1. CNS infection –> encephalitis/meningitis
  2. Febrile seizure –> can occur with little to no infection (fam hx)
  3. Head injury –> 1-2 hrs post-incident
  4. Ingestion/poison –> generally not associated with fever
  5. Idiopathic
  6. Hypoglycemia
  7. Brain tumor
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12
Q

Fever without a source

A

term used in the acute setting (within 48 hrs)

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13
Q

Fever of unknown origin

A

term used in the chronic setting (days)

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14
Q

DDx for fever in kids

A 
Meningitis
SBI
Occult Bacteremia
UTI
Kawasaki Disease
Viral syndrome
Septic arthritis
Sepsis
Otitis Media
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15
Q

Decreasing risk of SBI

A

Even though the risk is low in an immunized kid, the possibility of missing it and progressing to sepsis or meningitis is enough for pediatricians to do a blood culture

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16
Q

When to obtain an LP?

A

NEED CLINICAL JUDGEMENT!

  • persistent irritability
  • serious illness
  • signs and symptoms
17
Q

Work-up for first NON-febrile seizure

A

EEG - will show brain activity +/- epilepsy
MRI - structural info
CT - structural info

18
Q

Lumbar Puncture

A

CORRECT POSITION AND ADEQUATE RESTRAINT

  • lateral recumbant position and spine flexed
  • L3-L4 level
  • POP felt when entering dura
  • CSF drips into collection tube
  • may need “opening” pressure
19
Q

Bacterial Meningitis

A

one of the most serious infections

2 mon - 12 years = S. pneumo, N. meningitidis

20
Q

Presentation of bacterial meningitis

A 
Fever
Lethargy
Anorexia
Tachycardia
Myalgias
21
Q

Treatment of bacterial meningitis

A

high dose IV Abx –> 3rd gen cephalosporin or vancomycin

- 7-14 day duration

22
Q

Complications of bacterial meningitis

A

Stroke
Subdural effusions
SIADH

23
Q

CSF results of bacterial meningitis

A

Glucose - decreased
CSF gluc/blood gluc - decreased
Protein - elevated
WBC - elevated

24
Q

Traumatic spinal tap

A

hitting a vessel when doing tap –> it results in bloody fluid
- ways to correct the labs

25
Q

CSF in viral meningitis

A

Glucose - normal
CSF gluc/blood gluc - normal
Protein - normal
WBC - elevated

26
Q

Febrile Seizures

A

Simple

- common, 15 minutes, >1x 24 hrs, focal

27
Q

Risk of recurrence of febrile seizues

A

if occur before 12 months = 50% recurrence

if occur after 12 months = 30% recurrence

28
Q

Risk of epilepsy

A

febrile seizure = 0.5-1% chance of epilepsy

- risk increases in recurrent febrile seizures or fam history

29
Q

Guidance for febrile seizures

A

Fever - tylenol and ibu ok but don’t prevent seizures
Seizure again - place child on side away from hurting themselves
Meds - weigh risks/benefits

30
Q

Blanching definition

A

rash turns white when pressed on and then returns to red color

31
Q

Roseloa infantum

A

caused by HHV-6. High fever followed by rash on trunks

- can be the cause of febrile seizure

Pediatrics (36 decks)

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