Epilepsy in children

Question 1

What are infantile spasms also known as

Answer 1

west syndrome

Question 2

define infantile spasms and when they occur

Answer 2

breif spasms beginning in the first few months of life

Question 3

key features of infantile spasms

Answer 3

flexion of head trunk and limbs-> extension of arms (Salaam attack)
-lasts 1-2 secs
-repeat up to 50 times

-progressive mental handicap
-EEG: hypsarrhythmia

Question 4

what are infantile spasms usally secondary to

Answer 4

serious neurological abnormality
-eg tuberous sclerosis
-encephalitis
-birth asphyxia

CAN BE IDIOPATHIC

Question 5

possible treatment / prognois for infnantile spams

Answer 5

vigabatrin and sterorids

poor prognosis

Question 6

onset of typical (petit mal) absence seizures

Answer 6

4-8yrs

Question 7

duration of typical (petit mal) absence seizures

Answer 7

duration 3-30 seconds

Question 8

presentation of typical (petit mal) absence seizures 3

Answer 8

no warning -blank out or stare into space for a few seconds/ lip smacking/ fluttering eyelids

symettircal
quick recovery

pften multiople per day

Question 9

EEG in typical (petit mal) absence seizures

Answer 9

3Hz generalized

symmetrical

Question 10

treatment for typical (petit mal) absence seizures 2

Answer 10

sodium valoprate

ethosuximide

Question 11

prognosis for typical (petit mal) absence seizures

Answer 11

good prognosi - 90-95% seizure free in adolescence

Question 12

what type of seziures can be an extension of infantile spasms

Answer 12

lennox-gastaut syndrome

Question 13

onset of lennox-gastaut syndrome

Answer 13

1-5 yrs

Question 14

features of lennox-gastaut syndrome 3

Answer 14

atypical absences , falls,jerks

90% moderate-sever mental handicap

Question 15

EEG on lennox-gastaut syndrome

Answer 15

slow spike

Question 16

treatment for lennox-gastaut syndrome 1

Answer 16

ketogenic diet may help

Question 17

who gets benign rolandic epilepsy (age, gender)

Answer 17

most common inchildhood and amongst males

Question 18

features of benign rolandic epilepsy 1

-treatment

Answer 18

paraestheia (unilateral face)
-usually on waking up]

-levetriceratam

Question 19

who gets juvenile myoclonic epilepsy (Janz syndrome)

Answer 19

teenage years , more common in girls

Question 20

features of juvenile myoclonic epilepsy (Janz syndrome) 4

Answer 20

infrequent generalised seizures
- often in morning/ following sleep deprivation
-daytime absences
-sudden, shock like myoclonic seziures (these may develop before seizures)

Question 21

treatment for juvenile myoclonic epilepsy (Janz syndrome) 1

Answer 21

good response to sodium valporate

Question 22

features of an epilepsy history 8

Answer 22

WITNESS CRUCIAL

where
when
what was person doing before
first signs
detailed descriptiong of event
aftermath
timing
video/ mimicry

Question 23

define febrile convulsions

Answer 23

seizures provoked by fever in otherwise normal children

Question 24

who gets febrile convulsions

Answer 24

-typically occur between ages of 6 months and 5 years
-seen in 3% of children

Question 25

clinical features of febrile convulsions 3

Answer 25

early viral infection as temperature rises rapidly

usually brief last less than 5 mins

most commonly tonic-clonic

Question 26

types of febrile convulsions 3

Answer 26

simple

complex

status epilepticus

Question 27

length of time in simple febrile convulsions

Answer 27

<15 mins

Question 28

length of time in complex febrile convulsions

Answer 28

15-30mins

Question 29

length of time in febrile status epilepticus

Answer 29

> 30mins

Question 30

type of seizure in simple febrile sezirues

would it recur within 24 hours

Answer 30

generalised seziures

typically would not recur within 24hrs

*-should have complete recovery within an hour

Question 31

type of seziure in complex febrile seizures

would it recur within 24 hours

Answer 31

focal seizure

may repated within 24 hours

Question 32

when should children with febrile seizures be admitted to paediatrics 2

Answer 32

first seizure

or

complex

Question 33

managemtn of febrile seizures

Answer 33

advise paretns to call abulance if >5 minutes seizure

antipyretics do not reduced chance pf febrile zeizure occuring

if recurrnet febrile convulsions occur -> benzo as resuce mdication may be considered
-only started on adivce of specialist
-rectal diazepam or buccal midazolma

Question 34

recurrence rate of febirle convulsison

Answer 34

1 in 3