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3 NERVOUS SYSTEM > Seizures PEDIATRICS > Flashcards

Seizures PEDIATRICS Flashcards

1
Q

Refractory status epilepticus

A

Used 1 :1st Line Drug
Used 1 :2nd Line Drug
Still seizure not controlled

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2
Q

Epilepsy syndromes by Age
🧠⚡WOD FEB LARJ ⚡
🧠⚡LG - 2 Letters and LG SYNDROME= 2+8=10 Letters ⚡

A

<1 yr:
Ohtahara syndrome
Dravet Syndrome
West Syndrome.

6month-5yrs: FEBRILE SEIZURES

2yrs-10yrs: Lennox Gestaut syndrome

> 5 yrs-8yrs : Absence Seizure

> 5yrs to Adolescent: Rolandic Seizures

> 10yrs Adolescents : Juvenile Myoclonic Epilepsy

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3
Q

Early Infantile Epileptic Encephalopathy

A

Ohtahara Syndrome
Ass. with Brain Malformation

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4
Q

Mutation in DRAVET SYNDROME
🧠⚡DRAVid SCANS the field ⚡

A

SCN1A GENE DEFECT
1ALPHA- SODIUM CHANNEL

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5
Q

KCNJ10 MUTATION IS ASSOCIATED WITH
🧠⚡Kyoto and ChiNa in EAST ⚡

A

East Syndrome

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6
Q

EAST SYNDROME
🧠⚡ SeSAME⚡

A

Seizures
SNHL
Ataxia
Mental Retardation
Electrolyte imbalances

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7
Q

West Syndrome
🧠⚡ West(US) Great beacuse of –HIMS (Mens)⚡

A

Hypsarrythmic pattern on EEG
Infantile Spasm
Mental Retardation
Salaam Spells

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8
Q

LGS
🧠⚡ SIM⚡

A

Slow spike and wave pattern
Intractable Seizures
Multiple seizure types
Mental Retardation

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9
Q

DOC FOR DRAVET SYNDROME/JME/ ABSENCE SEIZURES
🧠⚡DRAVID aka JaMMY aka WALL ⚡

A

VALPROATE

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10
Q

DOC of ABSENCE SEIZURE

A

> 2 yrs : VALPROATE
< 2 yrs : ETJOSUXIMIDE

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11
Q

Landau Kleffner Syndrome
🧠⚡ L⚡
🧠⚡ Age - Rotate L to form 7⚡

A

Abruptly lost ⭐ LANGUAGE comprehension and Verbal Comprehension
Anger
Frustration

⭐ AGE 3-7 yrs

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12
Q

BECTS aka

A

⭐ ROLANDIC EPILEPSY
Benign Epilepsy with Centro-temporal spikes

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13
Q

Epilepsy that occurs in NIGHT
🧠⚡R = Raat ⚡

A

Rolandic Epilepsy
✨ tingling sensation in buccal mucosa or throat
⭐ tonic clonic contraction on one side of face

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14
Q

💊💉 MANAGEMENT West Syndrome

A

DOC: ACTH
In case of Tuberous Sclerosis patient
DOC: VIGABATRIN
High Dose steroids

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15
Q

PUFF of SMOKE APPEARANCE on Cerebral Angiography

A

MOYAMOYA DISEASE

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16
Q

MOYAMOYA Disease

A

Progressive cerebrovascular disorder caused by blockade of arteries at BASE of BRAIN AND BASAL GANGLIA

TANGLES OF BLOOD VESSELS SEEN

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17
Q

🧑🏻‍⚕️ Clinical Features of MOYA MOYA DISEASE

A

Stroke or recurrent TIA
Muscle weakness or Paralysis
Focal neurological deficits

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18
Q

DROP ATTACKS are associated with

A

JANZ SYNDROME

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19
Q

Genetic abnormality in JANZ/ JME

A

GABRA1
CLNC2
Myoclonin 1

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20
Q

Small muscles of Hand and foot involved in

A

Janz syndrome

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21
Q

Triggers for JANZ SYNDROME

A

Sleep deprivation
Alcohol
Photic stimulation
Reflex Seizures

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22
Q

⚡⚡ MOST COMMON Epilepsy in Young adults and adolescents

A

Janz syndrome
JME

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23
Q

Simple Febrile Seizures and Complex Febrile Seizures
🧠⚡SI =15 ⚡
🧠⚡Complex = F³ ⚡

A
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24
Q

⚡⚡ MOST COMMON type of Seizure in NEONATES

A

Subtle /Minimal

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25
Q

⚡⚡ MOST COMMON TYPE OF SEIZURE IN OLDER CHILDREN

A

GTCS

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26
Q

⚡⚡ MOST COMMON Etiology of Seizure in NEONATES

A

HIE
Hypoxia induced Encephalopathy

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27
Q

⚡⚡ MOST COMMON Etiology of Seizure in OLDER CHILDREN

A

Febrile Seizure

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28
Q

⚡⚡ MOST COMMON CAUSE of SEIZURE IN PRETERM

A

Intracranial HEMORRHAGE

🩺 IOC TRANSCRANIAL USG through Ant Fontanelle

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29
Q

Risk factor for RECURRANCE of FEBRILE SEIZURES
🧠⚡Major: ONCE Dhoni Fan ⚡
🧠⚡ Minor: Always MSD Fan⚡

A
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30
Q

Risk factor for subsequent Epilepsy after Febrile Seizures
🧠⚡ if 1ST FAN - He might develop EPILEPSY⚡

A
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31
Q

Indications for Febrile Seizures Prophylaxis
🧠⚡ F18⚡

A

Frequent Seizures
Family History ➕
First seizure at Low Temperature
Age <18months

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32
Q

Drugs used in prophylaxis of Febrile Seizure

A

3days
Oral CLOBAZAM in India
Oral Diazepam in World

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33
Q

💊💉 MANAGEMENT of Febrile Seizures

A

✨ Anti Epileptic diazepam lorazepam oral/ intranasal Midazolam/ per rectal Diazepam
✨ Antipyretics

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34
Q

EEG PATTERN IN ATYPICAL, TYPICAL AND JME
🧠⚡ A COMES 1st⚡

A
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35
Q

FIRES
More common in

A

Febrile Infection Related Refractory Epilepsy Syndrome

⭐ Males;
⭐ >5yrs AGE

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36
Q

Early ONSET ABSENCE SEIZURE IS ASSOCIATED WITH

A

Glucose Transporter Defect

37
Q

Day dreaming seizure

A

Absence seizure

38
Q

Hyperventilation is the trigger for which seizure

A

ABSENCE SEIZURE

39
Q

Cause of SEIZURES
🧠⚡ VITAMIN D⚡

40
Q

DOC for Focal SEIZURE
🧠⚡ fOCA-L⚡

A

OxCarbazepine and Levetiracetam

41
Q

Doll’s Eye Reflex
Oculocephalic Reflex
Mediated by?
Use?

A

MLF
Used to examine 3 6 8 Brain stem nuclei

42
Q

🚦DIFFERENTIAL DIAGNOSIS🚦 HYPOTONIA IN UTERO
🧠⚡HAR ⚡

A

HIP DISLOCATION
ARTHROGRYPOSIS: Multiple contractures ➕

🧑🏻‍⚕️ Clinical Features
Reduced fetal movements
Polyhydramnios

43
Q

ISSAC SYNDROME
🧠⚡ISSAC NEWTON ⚡
🧠⚡NEUromyoTONia ⚡

A

Auto antibodies against VOLTAGE GATED K➕ CHANNELS

44
Q

FEBRILE SEIZURE PLUS SYNDROME

A

1st FEBRILE seizure at later age > 5 yrs
6-8yrs
Treat like SIMPLE FEBRILE SEIZURE

45
Q

GENERALIZED EPILEPSY FEBRILE SEIZURE ➕

A

Febrile seizure in children
➕
Generalized epilepsy in Parent

46
Q

Fever RELATED EPILEPSY SYNDROMES
🧠⚡DG-FT ⚡

A

⭐ DRAVET Syndrome
⭐ FIRES
⭐ GEFS Plus (Generalized Epilepsy with Febrile Seizures ➕)
⭐ Temporal Lobe Epilepsy

47
Q

SEIZURE MIMICS
🚦DIFFERENTIAL DIAGNOSIS🚦
🧠⚡ B²SC M⚡

A

✨ Behavioural outburst
✨ Breath Holding Spells
✨ Migraine
✨ Syncope
✨ Cyclical Vomitting

48
Q

TRUE SEIZURES occurs with EYES ?

49
Q

Frontal Lobe SEIZURE

A

Mimics PSEUDOSEIZURE
BRIEF
IN CLUSTERS

50
Q

Parietal LOBE SEIZURES

A

✨ Somatosensory symptoms
✨ Opposite side HAND AND FACE AFFECTED

51
Q

Occipital Lobe Seizure

A

Visual Hallucination
Eye blinking

52
Q

Temporal Lobe Seizure

A

MOST COMMON
EYE DEVIATION ➡️ STARING LOOK
Upper Limb Tonic movements

53
Q

Indication of EEG in EPILEPSY

54
Q

Best Neuroimaging IN EPILEPSY

55
Q

Indications for NEUROIMAGING in SEIZURES

A

All focal epilepsies except BECT
H/O Developmental delay/ Regression
Child <2yrs
SYNDROME west LGS
REFRACTORY EPILEPSY
RAISED ICT

56
Q

REFRACTORY EPILEPSY Definition

A

Failure of adequate trial of 2 appropriately chosen well tolerated AEDs in Right dosage either as MONOTHERAPY or combination to achieve sustained seizure free period

57
Q

Ketogenic Diet used as TREATMENT FOR?

A

✨ Refractory Epilepsy
✨ LGS
✨ Infantile spasm refractory to steroids
✨ Dravet Syndrome (Severe Myoclonic Epilepsy of Infancy)

58
Q

🚫 CONTRAINDICATION of KETOGENIC DIET
🧠⚡ P²⚡

A

PEM
PORPHYRIA

59
Q

Vagus Nerve Stimulation
USE

A

⭐ Focal onset Epilepsy ⭐
Implantation of Bipolar pulse generator only chest wall, sends impulse to Lt Vagal Nerve

60
Q

Todd’s Paralysis

A

Weakness of Limbs lasting for 24-48 hr following STATUS EPILEPTICUS

61
Q

Difference between
ENCEPHALITIS
ENCEPHALOPATHY
ACUTE FEBRILE ENCEPHALOPATHY

A

⭐ Encephalitis: Inflammation of brain parenchyma

⭐ Encephalopathy: Noninflammatory diffuse cerebral dysfunction (altered sensorium due to any cause)

⭐ Acute febrile encephalopathy: A febrile illness with altered sensorium of ≤2 weeks duration in a previously well child. May have infectious or noninfectious causes

⭐ Meningitis: Inflammation of leptomeninges.

62
Q

Causes of Acute Febrile Encephalopathy

63
Q

Difference between Meningitis and Encephalitis

A

Meningitis
Meningeal signs present predominantly
Seizure Present/Absent

Encephalitis
Sensorium affection (coma)
Seizures

64
Q

Investigation of Choice in AFE

65
Q

CT Brain before Lumbar Puncture

A

Suspected Space occupying Lesion
Papilledema
Asymmetric pupils
Severe raised ICT

66
Q

Acute Encephalitis
CAUSES

A

A person with acute onset of fever with change in mental status and/or new onset seizures

67
Q

Acute Encephalitis
Clinical Pointers

68
Q

Encephalitis vs Encephalopathy

69
Q

Burst suppression Pattern seen in EEG in
🌟After 1st ATTACK ➡️ SUPPRESS COMPLICATIONS 🌟

A

SSPE
Subacute sclerosing panencephalitis
After measles

70
Q

Periodic Lateralization in EEG IN

71
Q

Generalised Slowing in EEG seen in
✨when infection is generalized/disseminated ➡️ Slowing is generalized ✨

A

ADEM
Acute DISSEMINATED ENCEPHALO-MYELITIS

72
Q

Acute Cerebral Injury

73
Q

Difference between different coma states?
✨Sleep wake cycle is NEVER PRESENT IN COMA, as everytime sleeping✨
✨Awareness + in ML
✨ Noxious stimulus response absent in COMA VEGETATIVE STATE

A

✨Awareness + in Minimal Conscious State, Locked in Syndrome✨

74
Q

Causes of COMA in children

75
Q

Neurological Examination Scales in Children

A
  1. Pediatrics GCS
  2. AVPU
76
Q

Lumbar Puncture: Maximum volume for tests

77
Q

SUPER Refractory Seizure
✨MITH (Mythical) seizure✨

A

If seizures present even after using MIDAZOLAM/ THIOPENTONE

78
Q

Management of SUPER Refractory Seizure

A

Ketamine infusion
IVIG
Plasmapheresis

79
Q

Theta point alternans in EEG is diagnostic of
🧠⚡The-tab FaNS ⚡

A

Benign familial Neonatal Seizures

80
Q

MIZRAHLI AND KELLAWAY CLASSIFICATIO USED FOR

A

Neonatal Seizure

81
Q

STURGE WEBER SYNDROME
🧠⚡STURGE ⚡

A

Seizures ; Sporadic
Tram track Calcification
Total Cerebral Atrophy
U/L PORTWINE STAIN
UMN PARALYSIS
RETARDATION
GLAUCOMA
EPILEPSY
EyE PROBLEMS (BUPHTHALMOS)

82
Q

5th DAY SEIZURES

A

Benign FAMILIAL NEONATAL SEIZURES
Potassium Channel Defect

83
Q

Dyke Davidoff Syndrome
🧠⚡RCH ⚡

A

Seen in CHILDREN
Refractory unremitting focal seizure
Cerebral Hemiatrophy
Hemiparesis C/L

84
Q

Laforas Disease
🧠⚡ PL MDH⚡

A

Seen in Children aged

85
Q

NORSE
New Onset Refractory Status EPILEPTICS
Cause

A

Viral encephalitis

86
Q

Anti-Yo antibodies ➕ epilepsy

A

Para neoplastic encephalitis

87
Q

Anti-NMDA ANTIBODY ➕ Epilepsy

A

Autoimmune encephalitis

88
Q

⚡⚡ MOST COMMON ELECTROLYTE ABNORMALITY IN HOSPITALIZED PATIENT CAUSING EPILEPSY

A

Hyponatremia

89
Q

Definition of SEIZURES

A

Transient occurance of signs and symptoms DUE TO: Abnormal Excessive Hypersynchronous Neuronal activity in Brain

3 NERVOUS SYSTEM (40 decks)

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