Seizures + Funny Turns Flashcards
What is the differential for a seizure in children?
Epilepsy Febrile convulsions CNS infection Metabolic: - hypoglycaemia, high or low sodium, low calcium, low magnesium Acute trauma Toxins
What is the differential for a ‘funny turn’ in a child?
Syncope Reflex anoxic seizures Sleep myoclonus Migraine Arrhythmia e.g. long QT Tics Breath-holding attacks Non-epileptic attack disorder Panic attacks
What are reflex anoxic seizures?
Stimulus like pain, cold or fright –> asystole –> generalised tonic clonic seizure due to brain hypoxia
What is sleep myoclonus?
Benign, random series of myoclonic movements during or just before/after sleep
What are breath holding attacks?
Crying then breath-holding in a toddler
- may become cyanosed or have a short seizure
What is a febrile convulsion?
Tonic clonic seizure as temperature rises rapidly
- signs of underlying infection
- not CNS infection
Which age group do febrile convulsions occur in?
Age 6 months to 6 years
- often family history
What is the management for febrile convulsions?
Explain + reassure parents, it might happen again
Keep temperature down if unwell
Paracetamol + ibuprofen (although no evidence it reduces risk of convulsions)
Keep hydrated
If convulsion –> recovery position, remove dummy
Call ambulance if seizure lasts > 5 minutes
If repeated seizures > 5 minutes –> PR diazepam
What is the management for a child seizing for > 5 minutes?
If IV access possible –> Lorazepam IV/IO
If not –> Midazolam (buccal) or Diazepam PR
What are the red flags for cardiac syncope in children?
Syncope in child with known congenital heart disease
Syncope during exercise or when supine
Family history of sudden death, prolonged QT syndrome or hypertrophic cardiomyopathy
Syncope preceded by palpitations
Heart murmur or other abnormalities on examination
