Paediatric seizures Flashcards

1
Q

Describe the seizures in Dravet syndrome.

A
Children <12 months
First seizure febrile 
Last >10 minutes
Unilateral
Triggered by warm water
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2
Q

How is Dravet syndrome managed?

A

Ketogenic diet

Sodium valproate, clobazam and topiramate

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3
Q

What is the prognosis of Dravet syndrome?

A

Poor prognosis, life-long
20% mortality
Developmental delay after 2 years

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4
Q

Describe the seizures in infantile spasms (West syndrome)

A

Absence seizures, generalised
Recurring tonic seizures

Contractions of the head, neck and trunk, usually in flexion

Salaam / jack-knife spasms - sudden drawing up of legs, hunching forward, flinging arms out

Child may cry before or after

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5
Q

What is the EEG finding in infantile spasms?

A

Hypsarrhythmia when seizure is not occurring and

High-voltage spike and wave pattern

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6
Q

How are infantile spasms managed?

A

Steroids

Tetracosactrin, vigabatrin, clonazepam, nitrazepam

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7
Q

What is the prognosis for infantile spasms?

A

Poor prognosis , developmental delay

Develop Lennox Gastraut syndrome

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8
Q

What is the aetiology of infantile spasms?

A

Brain injury or hypoxia

Genetic and metabolic syndromes

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9
Q

Describe the seizures in childhood absence seizures

A

6 year olds
Short period of blanking out and staring into space, loss of awareness ~10s
Automatisms, like lip smacking

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10
Q

What is the EEG finding in absence seizures?

A

Generalised 3Hz spie wave

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11
Q

Which age group gets absence seizures?

A

6 year olds

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12
Q

What is the management for absence seizures?

A

Ethosuximide

Sodium valproate

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13
Q

Describe the seizures in juvenile myoclonic epilepsy

A

Generalised myoclonic after waking and tonic-clonic
Brief bilateral limb jerking, awareness may be maintained
2-3s duration

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14
Q

Which age group gets juvenile myoclonic epilepsy?

A

Adolescence

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15
Q

What is the prognosis for juvenile myoclonic epilepsy?

A

Life-long

May improve

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16
Q

What is the management for juvenile myoclonic epilepsy?

A

Lifestyle changes, regular sleep, reduced EtOH and stress (common triggers)
Sodium valproate

17
Q

Describe the seizures in juvenile absence epilepsy.

A

Absence seizures last 45 seconds

Less frequent than childhood absence seizures, less than daily

18
Q

What are the EEG changes in juvenile absence epilepsy?

A

Generalized polyspike or spike and wave discharges at 3-4 Hz

19
Q

What is the management for juvenile absence epilepsy?

A

Ethosuximide

Sodium valproate

20
Q

Which age group gets juvenile absence epilepsy?

A

13 years old

21
Q

What is the prognosis for juvenile absence epilepsy?

A

Life-long
Develop tonic-clonic seizures
Attention problems

22
Q

Describe the seizures in Lennox-Gastaut Syndrome

A

5 year olds

Epileptic encepalopahty with multiple types of seizures, particularly tonic and aclonic.

23
Q

What are the EEG changes in Lennox-Gastaut Syndrome ?

A

Awake - diffuse or widespread background slowing and slow spike-wave bursts.
Aleep - generalized paroxysmal fast activity.

24
Q

Which age group gets Lennox-Gastaut Syndrome?

A

5 year old

25
Q

What is the prognosis for Lennox-Gastaut syndrome?

A

Severe, life-long

Developmental delay behavioural problems

26
Q

What is the management for Lennox-Gastaut syndrome?

A

Ketogenic diet

Sodium valproate

27
Q

Describe the seizures in Rolandic epilepsy/benign childhood epilepsy with centrotemporal spikes

A

Seizures occur mostly when asleep but can occur when awake
Facial symptoms - gurgling, tongue/face movements, sensation changes
Tonic-clonic seizures can occur

28
Q

What are the EEG changes in Rolandic epilepsy?

A

Contralateral spikes

29
Q

Which age group gets Rolandic epilepsy?

A

6 year olds

30
Q

What is the management for Rolandinc epilepsy?

A

No management

Carbamazepine, sodium valproate, sulthiame

31
Q

What is the mechanism of action of sodium valproate?

A

Blocks voltage and used dependent sodium channels

Other actions - enhancement of GABA, inhibition of glutamate and blockade of T-type calcium channels.

32
Q

What is the mechanism of action of vigabatrin?

A

Increases brain concentrations of GABA and GABA-mediated inhibitionr by reversibly inhibits GABA aminotransferase

33
Q

What is the mechanism of action of topiramate?

A

Blocks voltage-dependent sodium channels. Enhances activity of GABA on postsynaptic chloride channels.

34
Q

What is the mechanism of action of carbamazepine?

A

Blocks voltage-dependent and use-dependent sodium channels.

35
Q

What is the mechanism of action of ethosuximide?

A

Acts of voltage-dependent calcium channels. Thereby, reduces conductance in thalamic neurones.

36
Q

Which seizures is ethosuximide used for?

A

Childhood absence seizures and juvenile absence epilepsy