Childhood Absence Epilepsy Flashcards Preview

Mo-Neuro 4 > Childhood Absence Epilepsy > Flashcards

Flashcards in Childhood Absence Epilepsy Deck (15):
1

Seizure

an episode of cerebral dysfunction leading to clinical changes in motor, sensory or autonomic function

2

Seizure Epidemiology

Incidence 0.7 – 4.6 per 100,000 children
Prevalence 5-50/100,000
Represent approximately 3-10% of childhood epilepsies
Females > males (60:40)

3

Seizure Genetic factors

Monozygotic twins concordant for absence epilepsy in 75% and 84% for EEG abnormalities
Incidence of seizures or EEG abnormalities in 1st degree relatives ranges from 15-44%

4

Seizure Pathophysiologic mechanism

Thalamocortical oscillatory system
Calcium channels and GABAergic inhibition

5

Simple absence

90% last between 5-15s, 3% of patients may have seizures >30s
Average of 100 seizures per day

6

Complex absence

More common than simple
Automatisms – persistence of an action, mumbling, non-purposeful movements
Autonomic features – pallor, ∆HR, ∆RR, mydriasis, micturition (5-17%)

7

Impairment of consiousness
Prominent motor activity
Myoclonic jerks, automatisms, atonic

Complex absence seizures

8

Impairment of consiousness
Minimal motor activity
Eyelid fluttering, blinking

Simple absence seizures

9

Onset 4-8y (maximum 6-7y)
Frequent absence seizures, often precipitated by HV
GTC seizures in 30% with onset

Childhood Absence Epilepsy

10

Onset 4-30y (mean 13y)
Less frequent absence seizures
Duration may be longer with some preserved awareness
80% with GTC seizures, 15-25% with infrequent myoclonus

Juvenile Absence Epilepsy

11

Infrequent absence seizures
GTC and myoclonic seizures (surrounding sleep) are predominant features
No remission but may be responsive to treatment

Juvenile Myoclonic Epilepsy

12

EEG

Normal background organization and frequencies
Ictal discharges
Abrupt onset and offset
Generalized 3 Hz spike and wave
Frontal maximum
Spikes may become fragmented and irregular during sleep

Typical absence

13

EEG

Often abnormal background with slowing and disorganization
Ictal discharges at 2-2.5 Hz, more irregular

Atypical absence

14

Treatment of Sz

Anticonvulsants
Ethosuximide (Zarontin®) – acts on T type Ca current
Valproic Acid (Depakote®)
Lamotrigine (Lamictal®)
Leviteracetam (Keppra®) – JME

15

Brief arrest in behavior for few seconds
asc. w/ abnormal activity

Absence seizure