Seizures and Epilepsies in Children Flashcards
What is a seizure?
Neurological phenomenon characterised by overactivity in the cerebral cortex, often uniform, synchronous
How common are seizures?
5% of children will have them
Febrile seizures at the majority (3% children)
What are the causes of seizures?
- Febrile seizures
- Acute symptomatic seizure secondary to meningitis, trauma
- Single or recurrent, unprovoked seizures = epilepsy
- Non-epileptic “seizures” - convulsive syncope, breath holding spells
At what age are seizures most common? Why?
Infancy
Undeveloped brain
What is characteristic of generalised seizures?
Loss of consciousness
Some motor activity
Epileptic activity recorded all over the brain
What is the difference between simple and complex partial seizures?
Simple - consciousness is retained
Complex - consciousness is impaired
What are some DDx for seizures?
- Normal phenomenon - sleep jerks, tantrums, day dreaming
- Syncope and related episodes - vasovagal attacks, breath-holding spells, long QT syndrome
- Parasomnias
- Migraine variants and neurovascular disturbances
- Movement disorders
- Behavioural and psychiatric disturbances
What are some clues that a seizure is actually syncope?
Context - look for vasovagal triggers eg standing, needles
Speed of recovery - quicker in syncope
Can you get jerking in syncope?
Yes, due to transient ischaemia
How do you differentiate tonic clonic movements for tremor?
TC has unequal contraction and relaxation phases
What is a clue that a reported generalised seizure was actually a focal transforming into generalised?
Any memory of the start of the seizure or an “aura”
What type of seizures exhibit a lot of fidgeting?
Temporal lobe
What is stretch syncope?
Syncope induced by stretching - combination of valsalva and vascular change
What is paediatric epilepsy?
Recurrent (2 or more), unprovoked, epileptic seizures
How are epilepsies classified?
Genetic epilepsies
Structural/metabolic epilepsies
