Seizures/Faints

Question 1

Which of the following matches the definition of a febrile seizure?

1 - seizure accompanied by a fever (> 38C) in the absence of intracranial infection
2 - seizure with absence of a fever (> 38C) in the absence of intracranial infection
3 - seizure accompanied by a fever (> 38C) with an intracranial infection
4 - any of the above

Answer 1

1 - seizure accompanied by a fever (> 38C) in the absence of intracranial infection

Question 2

If a patient has a suspected febrile seizure, a seizure accompanied by a fever (> 38C), but in the absence of intracranial infection, but are later diagnosed with meningitis, would this still be a febrile seizure?

Answer 2

• no

Question 3

Are more febrile seizures focal or generalised?

Answer 3

• focal

Question 4

A febrile seizure is when a child has a seizure accompanied by a fever (> 38C), but in the absence of intracranial infection. What % of 6 months to 6 years old have these forms of seizure?

1 - 0.3%
2 - 3%
3 - 30%
4 - 63%

Answer 4

2 - 3%

There is a 10% genetic risk if a 1st degree relative has history of febrile seizures

Question 5

A febrile seizure is when a child has a seizure accompanied by a fever (> 38C), but in the absence of intracranial infection. What % of children who have had 1 febrile seizure, are likely to gave another one?

1 - 5-10%
2 - 15-30%
3 - 30-40%
4 - 50-70%

Answer 5

3 - 30-40%

Question 6

How do children typically present when they are having a febrile seizure (a seizure accompanied by a fever (> 38C), but in the absence of intracranial infection)?

1 - tonic
2 - atonic
3 - clonic
4 - tonic-clonic
5 - myoclonic
6 - absence

Answer 6

4 - tonic-clonic

Typically a generalised seizure and brief in nature

Question 7

In a child who has had a febrile seizure (a seizure accompanied by a fever (> 38C), but in the absence of intracranial infection), are they more likely to develop epilepsy if this was generalised (simple) or focal (complex affecting only part of the brain)?

Answer 7

• focal (complex seizure
  4-12% chance, but only 1-2% in generalised simple seizures

Question 8

In a febrile seizure, we need to do the following to treat the patient:

• Treatment of cause of fever (Beware of serious causes such as bacterial Meningitis)
• Reassurance and Information
• Advice sheets
• First Aid management of seizures

Question 9

Is an EEG indicated in a febrile seizure?

Answer 9

• no

Question 10

Which 2 of the following are1st line medication for a generalised tonic-clonic seizure?

1 - Sodium Valproate
2 - Levetiracetam
3 - Carbamazepine
4 - Clobazam
5 - Topiramate

Answer 10

1 - Sodium Valproate
3 - Carbamazepine

The rest are second line medications

Question 11

Which 2 of the following are1st line medication for absence seizures?

1 - Sodium Valproate
2 - Levetiracetam
3 - Clobazam
4 - Ethosuximide
5 - Topiramate

Answer 11

1 - Sodium Valproate
4 - Ethosuximide

The rest are second line medications

Question 12

Which of the following should be avoided as it can lead to worsening of seizures?

1 - Carbamazepine
2 - Sodium Valproate
3 - Ethosuximide
4 - Levetiracetam
5 - Lamotrigine

Answer 12

1 - Carbamazepine

Question 13

Which 2 of the following are1st line medication for myoclonic seizures?

1 - Sodium Valproate
2 - Levetiracetam
3 - Clobazam
4 - Ethosuximide
5 - Piracetam

Answer 13

1 - Sodium Valproate
2 - Levetiracetam

The rest are second line medications

Question 14

All of the following can be used as a 1st line medication in focal seizures, EXCEPT which drug?

1 - Carbamazepine
2 - Sodium Valproate
3 - Ethosuximide
4 - Levetiracetam
5 - Lamotrigine

Answer 14

3 - Ethosuximide

Question 15

Which of the following drugs should be avoided in women with child bearing potential?

1 - Carbamazepine
2 - Sodium Valproate
3 - Ethosuximide
4 - Levetiracetam
5 - Lamotrigine

Answer 15

2 - Sodium Valproate

Teratogenic

Question 16

Which of the following is NOT a non-pharmaceutical intervention for patients with epilepsy?

1 - neuro surgery
2 - ketogenic diet
3 - gluten free diet
4 - vagal nerve stimulation
5 - lifestyle advice (diet, sleep, etc..)

Answer 16

3 - gluten free diet

Question 17

Which type of seizure can be induced by hyperventilation?

1 - myoclonic
2 - absence
3 - infantile spasms
4 - generalised tonic-clonic seizures

Answer 17

2 - absence