42b - Pediatric Seizures Flashcards

1
Q

What is PNES?

A

psychogenic nonepileptic seizures. Pychological in orign.

No epileptiform actiivty on EEG

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2
Q

Should you put something in the child’s mouth to prevent them from swallowing the tongue?

A

NO. it is impossible to swallow the tongue.

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3
Q

What should you do to a patient having a seizure in the hospital?

A

ABCs. Place pateint on side. administer oxygen.

give benzodiazepine and possilby antiepileptic.

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4
Q

What type of seizure is a patient whose EEG shows 3Hz spikes having?

A

absence seizure

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5
Q

What is most common type of childhood seizure?

A

febrile seizure.

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6
Q

What is a febrile seizure?

A

occurs in febrile children between 6 and 60 months of age who have had no history of afebrile seizures or other known cause.

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7
Q

What is a simple febrile seizure?

A

an isolated, generalized seizure. (most common)

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8
Q

What is a complex febrile seizure?

A

multiple occuring in a 24-hour period for more than 15 min.

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9
Q

How often will a child who has had a febrile seizure have a recurrance?

A

90% of the time within 1 year.

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10
Q

Should EEG be performed on a child who was just brought in with a febrile seizure?

A

no. should NOT be performed on healthy child with first simple febrile seizure

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11
Q

Should blood studies be done on a child who has had a first simple febrile seizure?

A

no. instead try to find source of seizure. Do not do neuroimaging either.

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12
Q

Will antipyretics prevent febrile seizures?

A

no.

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13
Q

What will help prevent recurrence of febrile seizures?

A

intermittent oral diazepam.

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14
Q

Should anticonvulsants be given to children with 1 or more simple febrile seizures?

A

no. risk benefit is not good enough.

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15
Q

What did FEBSTAT study find?

A

children with FSE are at risk for acute hippocampal injury and abnormal hippocampal development.

HHV-6B infection common in FSE.
HHV-7 less so.
Both together account for 1/3 of FSE.

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16
Q

Is cerebrospinal fluid pleocytosis a contributing factor of FSE?

A

no. not usually.

17
Q

When should AEDs be given to a child?

A

when they have status epilepticus (SE).

18
Q

What are stomach crunching infants doing?

A

having infantile spasms.

19
Q

What is west syndrome?

A

triad of infantile spasms, hypsarrhythmia and develpmental arrest/regression

20
Q

What are treatments for infantile spasms?

A

correct the cause. Ex: B6 or diet for PKU.

Treat with ACTH, vigabatrin, topiramate, zonisamide, valproic acid, BNZs, ketogenic diet.

21
Q

What is Lennox-Gastuaut?

A

traid of specific seizure types, specific EEG and mental deficiencies.

  • tonic, atypical absence, atonic seizures
  • slowed mental develop
  • slow spike and wave EEG (1.25-2.5 Hz)
22
Q

What is childhood absence epilepsy (CAE)?

A

normal neurologic status but have absence seizures multiple times/day.
3Hz spike-and-wave dishcarges
Can be triggered by hyperventilation
Normal EEG background.

23
Q

What is preffered treatment for CAE?

A

ethosuximide, but also valproic acid or lamotrigine if they have more than just absence seizures.

24
Q

What is JME?

A

onset in adolescence, may b tonic-clonic, or myoclonic or absence.
precipitated by sleep deprivation, alcohol, sterss, menstraution.
Normal neuro exam and neuroimaging.
Requires life-long treatment.
Thought to be linked to chromosome 6 autosomal dominant.

25
Q

What is benign rolandic epilepsy (BRE)?

A

most common form of benign partial epilepsy in childhood. discharges arise from lower Rolandic area of brain. AKA BECT or BFEC.

Facial motor seizure!!. with nocturnal generalized tonic-clonic seizures.

EEG = central-temporal spikes.

26
Q

Do studies support use of a 3rd AED for peds epilepsy?

A

no. only 4% show better results.