Seizures in Childhood Lecture Powerpoint Flashcards
Recall ictal, post ictal, tonic, clonic, activation procedures
ictal - related to or caused by stroke/seizure
post ictal - altered conscioussness after seizure
tonic - producing tone or contraction of muscles
clonic - alternating pattern of relaxation and contraction
3 activation procedures to induce a seizure for EEG, 4 other labs utilized in seizure workup (4)
- flashing bright lights
- sleep deprivation study
- hyperventiliation
- MRI
- labs to rule out metabolic abnormalities
- LP
- EKG
Seizure causes (3)
- mostly idiopathic
- following hypoxic/ischemic attacks
- head trauma
Epilepsy definition
Recurrent seizures unrelated to fever or acute cerebral insult, no discernable underlying provocation
Seizure is a ___ and epilepsy is a ___
symptom, diagnosis
Infantile spasms
Brief motor spasms affecting trunk and extremities, similar to infantile startle reaction (morrow reflex), although momentary, can occur hundreds of times a day, fairly subtle and called hypsarhythmia
lennox gastaut syndrome
Triad of mental retardation, absence and tonic seizures, and slow spike wave discharges on EEG, onset 2-7 years often have history of infantile spasms and status epilepticus as initial manifestation
Complex partial seizures (psychomotor seizures)
characteristically manifest with variety of motor, sensory, or behavioral alterations, motor activity may remain focal, with transient somnolence or confusion following often
Rolandic (benign/simple) partial seizures
All symptoms of complex partial seizures but no altered consciousness, familial with very specific eeg
Juveniile myoclonic epilepsy (Janz syndrome)
recessively inherited epilepsy, neuroimaging typically reveals no abnormalities, clinical manifesetations include tonic clonic seizures, absence seizures, and myoclonus most frequently affecting the arms, distinct in that it isn’t associated with other neurologic abnormalities whcih carry a much worse prognosis
Febrile seizures
most common seizure of childhood, tonic clonic seizure lasting 1-2 minutes with rapid return of consciousness, seizures tend to occur in conjunction with rapid rise in body temp (if sick with virus for example)
atypical febrile seizures
those that have prolonged activity exceeding 15 min, focal seizure manifestations, or multiple seizures during same febrile illness
Absence (petit mal) seizures
Generalized seizures where absence spells may last up to 10 seconds and occur dozens of times daily, patients have no recollection of events durring seizures and will resume previous activity without postictal symptoms, may be preceded by hyperventilation
Way to differentiate seizure from something like a hypnotic jerk
seizures normally have grimacing or neck stretching but most of all when grabbed don’t cease action - other movements do
Status epilepticus and 3 subtypes
Seizure lasting greater than 30 minutes or serial seizures which there has been no return to same level of consciousness as occurred prior to seizure, 1 of 3 subtypes including prolonged febrile seizure, idiopathic status epilepticus, and symtomatic status epilepticus
