Seizures Flashcards
What can cause seizures in children?
Febrile convulsions
Epilepsy
Electrolyte abnormalities
Meningitis
What electrolyte abnormalities can cause seizures?
Hypocalcaemia
Hyponatraemia
Hypoglycaemia
What are the defining features of febrile convulsions?
Age 6 months - 5 years Generalised tonic-clonic seizure <15 minute duration Absence of CNS infection No history of previous afebrile seizures
How are febrile convulsions managed?
Anti-pyretics
Safety net
- stay with child if happens aain
- keep child safe
- call ambulance if more than 5 min duration
What is the prognosis of having a further febrile seizure?
1/3
What is epilepsy?
2 or more seizures without a cause
What are the types of seizures?
Focal
Generalised
- tonic-clonic
- tonic
- clonic
- abscnence
- myoclonic
- atonic
What are the features of generalised tonic-clonic seizures?
Loss of consciousness Muscle tensing (tonic) Muscle jerking (clonic)
Post-ictal period
Associated
with
- tongue biting
- incontinence
What are features of focal seizures?
Affect hearing, speech, memory and emotions
What are features of absence seizures?
Patient becomes blank and stares into space
Last 10-20 seconds
What is management for tonic-clonic seizures?
1st line - sodium valproate
2nd line - lamotrigine/carbamazepine
What is the management for focal seizures?
1st line - carbamazepine/lamotrigine
2nd line - sodium valproate
What is the management for absence seizures?
1st line - sodium valproate
What are features of atonic seizures?
‘drop attacks’
Brief lapses in muscle tone
How are atonic seizures managed?
1st line - sodium valproate
2nd line - lamotrigine
What are features of myoclonic seizures?
Brief muscle contractions
Remain conscious
How are myoclonic seizures managed?
1st line - sodium valproate
What is West syndrome?
Infantile spasms
Rare disorder starting in first few months of life
What are the features of West syndrome?
Full body spasms
Flex
- head
- limbs
- trunk
Extend
- arms
How is West syndrome managed?
Prednisolone
Vigabatrin
How are seizures investigated?
Refer to first fit clinic
Ask parent to video
EEG
MRI brain
ECG
Bloods
What is benign sleep myclonus?
Myoclonic jerks during sleep only
When does benign sleep myoclonus first present?
1st month
When does benign sleep myoclonus resolve?
Self limiting
Resolves by 2
What are breath holding spells also known as?
Reflex anoxic seizures
What happens in a breath holding spell?
Occur when crying or startled
Child goes pale and cyanotic
What investigation should be done with a child with breath holding spells?
ECG - rule out cardiac arrhythmias
What is self gratification behaviour?
Repetitive/stereotypic behaviour
Rhythmic contraction of legs and trunk
