Seizures and Epilepsy

Question 1

What is a seizure?
What is an epilepsy?
What is a convulsion?

Answer 1

Seizure:
An abnormal paroxysmal electrical activity in the brain resulting in motor, sensory behavioral or autonomic manifestations

Epilepsy:
Occurrence of 2 unprovoked seizures over a day apart beyond the neonatal period

Convulsion:
Series of involuntary contractions of the voluntary muscles. This may or may not be associated with abnormal electrical discharge in the brain

Question 2

What is febrile seizures?

Answer 2

• Seizure accompanied by fever (38 degrees/ 100.4 F or higher)
• w/o central nervous system infection, metabolic or electrolyte
  disturbances, or a history of afebrile seizure or any acute neurological
  insult/head trauma.
• Happen in children aged 6 months to 6 years.
• Fever can occur anytime during or after a seizure and the majority of febrile
  seizures (FSs) occur within 24 hours of fever onset.

Question 3

Differentiate between simple and complex febrile seizures

Answer 3

Simple febrile seizures:
- Generalised (w/o focal features)
- Usually tonic-clonic attack associated with fever
- Seizures lasting for max of 15 mins
- Occurs only once in 24 hrs

Complex:
- Focal signs/symptoms
- Duration > 15 mins
- Recurrence within 24 hrs

Question 4

What is breath holding spells:

Answer 4

• Usually affects boys between 6 months to 3 yrs

Sequence of events:
- Child first has a long cry, usually after being denied some demand > then child holds his breath and turns blue and limp > may be followed by tonic and a few clonic movements

Question 5

What is Status Epilepticus?

Answer 5

Any seizure persisting for more than 30 mins or multiple seizures, irrespective of duration, with no regaining of consciousness in between

Question 6

What are the various generalised onset epilepsy?

Answer 6

Tonic-clonic:
A tonic phase lasting at least 30 seconds and associated with uprolling of eyeballs, frothing from mouth, tongue bite, perioral cyanosis and/or incontinence of stool and urine, followed by clonic movement of all limbs

Myoclonic:
Sudden, jerky shock-like violent contractions involve axial and appendicular muscles

Atonic:
Sudden loss of tone involving axial and appendicular muscles

Spasm:
Well-sustained , sudden inward and/or outward movements of head, neck, trunk & extremities occur in cluster or in isolation