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CSI > peds seizure > Flashcards

peds seizure Flashcards

1
Q

generalized seizures

A

Tonic clonic (including febrile sz)
Absence
Atypical Absence
Myoclonic tonic (or atonic)

(epileptic encephalopathy: infantile spasms)

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2
Q

generalized seizures

A

Tonic clonic (including febrile sz)
Absence
Atypical Absence
Myoclonic tonic (or atonic)

(epileptic encephalopathy: infantile spasms)

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3
Q

partial seizures

A

Simple Partial Seizure: initial clinical signs begin focally and no impairment of consciousness

Complex Partial: focal neurologic signs with impairment of consciousness (may have secondary generalization)

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4
Q

paroxysmal events that are not a seizure

A 
Breath holding spells
Tics
Sleep disorders (ie Night terrors)
GE reflux (Sandifer Syndrome)
ADHD
Pseudoseizures
Migraines
Etc.
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5
Q

is a seizure and may be missed

A

Absence Seizure

Infantile spasms

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6
Q

most common peds seizures causes

A 
Fevers
Infections: meningitis
encephalitis
brain abscess
Head injury
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7
Q

Perinatal Conditions:

A

congenital malformations, hypoxic-ischemic injury, hemorrhage, infection, trauma

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8
Q

Metabolic Conditions:

A

hypoglycemia, hypoglycemia, hypomagnesemia, hyponatremia, hypernatremia, storage diseases, Reye syndrome, degenerative disorders, Porphyria,Pyridoxine dependency and deficiency

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9
Q

infant tonic clonic seizures

A

don’t look like typical, less shaking, still eye movement, tongue biting

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10
Q

poisoning

A

lead, cocaine, drug toxicity, drug withdrawal

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11
Q

Neurocutaneous Syndromes:

A

Tuberous sclerosis, Neurofibromatosis, Sturge-Weber syndrome,etc.

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12
Q

systemic diseases

A

Vasculitis, SLE, renal failure, hepatic encephalopathy

other: : trauma, tumor, febrile, idiopathic, familial/genetic

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13
Q

this hx tidbit is v. important

A

immunization hx

pneumococcal, hib

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14
Q

criteria for febrile seizure

A

cannot if have other metabolic/neurog. factor
just lowers threshold
(normal CNS for criteria)

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15
Q

important fam hx

A 
febrile seizures
migraines
tics or Tourettes’
rheumatic fever or metabolic disorders
meds are in the home 
if syncope; add fmhx of SVT, prolonged QTc syndrome
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16
Q

most common peds seizures causes

A 
Fevers
Infections: meningitis
                      encephalitis
                       brain abscess
Head injury
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17
Q

Perinatal Conditions:

A

congenital malformations, hypoxic-ischemic injury, hemorrhage, infection, trauma

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18
Q
A

50% chance of having second

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19
Q

typically walking by

A

15 mos

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20
Q

other seizure causes

A

trauma, tumor, febrile, idiopathic, familial/genetic

21
Q

at risk for ??? if mom is giving lots of water

or diluting formula

A

hyponatremia

22
Q

little child may not have tip. ??? if have meningitis

A

Kurnig, Brudzinski sign

need LP

23
Q

want CSF to be about

A

50% serum glucose

24
Q

seizures in febrile child

A 
•meningitis
 febrile seizure
•encephalitis
•epilepsy
•electrolyte imbalance
•poisoning
•hypoglycemia
•severe myoclonic epilepsy in infancy (Dravet syndrome)(1)
•intracranial lesion, such as(3)◦brain abscess
◦brain tumor
•traumatic brain injury
25
Q

may mimic seizures in febrile child

A

rigors
•febrile delirium
•breath-holding spell
•syncope

26
Q

cafe au lair spots in…

A

neurofibromatosis

27
Q

unilateral port-wine facial nevus
CNS aneurysms
seizures

A

Sturge-Weber syndrome

28
Q

Facial angiofibromas (adenoma sebaceum, hypopigmented ash leaf spots)

A

tuberous sclerosis

29
Q

von Hippel landauRetinocerebellar Angiomatosis

A

Rare, dominant inheritance

Retinal and cerebellar hemangioblastomas
Cysts of kidneys, pancreas, epidydimis
Renal cancers

Can present with retinal detachment,
or cerebellar signs from the hemangioblastoma

30
Q

repetitive movements arms forward legs up

A 
infantile spasms
Hypsarrhthmia on EEG
assoc. with tuberous sclerosis
tx with ACTH (not antiepilptics)
can be very severe
31
Q

Kernig:
Brudzinski:

A

flex hib to 90d, extending the knee
reflex flexion of thighs when pt nk passively flexed
not reliable

32
Q

GI: ??? toxin can cause seizure

A

Shigella

33
Q

midline defect may imply seizures

A

??

34
Q

neuro exam

A

Dysarthria (not able to evaluate in young child)
Visual field deficits (not able to evaluate in young child)
Cranial nerve palsies
Sensory deficits
Focal weakness (Todd’s paralysis
Ignoring ½ body for transient time after)
Babinski (rub on pre-tibial region)
Achilles reflex
Developmental milestones

35
Q

typically walking by

A

15 mos

36
Q

slide 49, 51

A

??

37
Q

at risk for ??? if mom is giving lots of water

or diluting formula

A

hyponatremia

38
Q

lab exam

A 
CBC
Glucose
Electrolytes: Calcium, Magnesium
Ammonia (?)
Urine toxicology
Anticonvulsant levels (if on meds)
Consider: LP
imaging based on hx
 eeg (usually not done emergently)
39
Q

want CSF to be about

A

50% serum glucose

40
Q

classic febrile seizure

A

Brief Generalized seizure
Seizure less than 15 minutes
Fever on presentation
Normal developmental history
often ….Positive family history of febrile Seizure
*No CNS infection
*typical age: 6months to 60 months (5 years)

41
Q

febrile seizures

A 
Occur AFTER 1 month of age
Associated with febrile illness but NOT CNS infection
No hx of neonatal or other seizures
Typical ages 6m to 5years
Incidence 3-8%
42
Q

risk of febrile seizure reoccurrence is

A

60%
2-7% with febrile sz have risk of developing epilepsy
Risk factors for epilepsy: fmhx of epilepsy, complex febrile sz, neurodevelopmental abnormalities

43
Q

febrile seizure risk factors

A

Peak temperature during illness
Hx of febrile sz in first degree relative
Increased exposure to HHV-6
Vaccinations with MMR, DTaP, influenza vaccines
50% have no risk factors
Sodium channel mutations
see slide 68 for tx

44
Q

febrile seizure tx: antipyretics

A

While will not prevent febrile seizure, may make febrile child more comfortable

45
Q

ash leaf spots

A

tuberous sclerosis

46
Q

repetitive movements arms forward legs up

A 
infantile spasms
Hypsarrhthmia on EEG
assoc. with tuberous sclerosis
tx with ACTC (not antiepilptics)
can be very severe
47
Q

febrile seizures in kids ages: ??

50% chance of having second if

A

6 mos - 6 yrs

have seizure when

48
Q

+ babinski up to

A

18 mos

do pre-tibial instead

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