convulsiones

Question 1

Diagnostic Criteria for self-limited (familial) neonatal epilepsy

Answer 1

• focal tonic features at onset, affecting the head, face, and limbs. Focal clonic or tonic
  seizures may alternate sides from seizure to seizure, and may evolve to bilateral tonic or clonic seizure
  – a non-lesional MRI required for Dx

Question 2

Diagnostic criteria for self-limited familial neonatal- infantile epilepsy

Answer 2

• Focal tonic seizures with head and eye deviation, followed by other tonic and clonic features and may evolve to bilateral tonic clonic seizures
• onset 1 day-23 month
• a non-lesional MRI required for Dx

Question 3

Diagnostic criteria for self-limited (familial) infantile epilepsy

Answer 3

Focal seizures occur with behavioral arrest, impaired awareness, automatisms, head/eye version, and clonic movements (often alternating
from one side to the other and
progressing to a hemiclonic or focal to bilateral tonic-clonic seizure).
Seizures are usually brief (<3 min)
– a non-lesional MRI required for Dx
- PRRT2 mutation may be present

Question 4

myoclonic epilepsy in infancy

Answer 4

• myoclonic seizure
• normal background eeg
  -a non-lesional MRI required for Dx

Question 5

early infantile developmental and epileptic encephalopathy

Answer 5

• Tonic and/or myoclonic seizures
• Interictal: Either burst suppression or multifocal
  discharges w/ diffuse slowing
  Onset: Birth to 3 months (adjusted for prematurity)
• Developmental impairment is present prior to or shortly after seizure onset
• intellectual disability

Question 6

infantile epileptic spasms syndrome

Answer 6

• Flexor, extensor or mixed epileptic spasms which often occur in clusters
  -Interictal:
  Hypsarrhythmia, multi-focal or focal epileptiform discharges
  (that might be seen quickly after the spasms onset)
• Onset at 1– 24 months (while epileptic spasms may begin later, this would not be ISS)
• Developmental slowing after spasm onset

Question 7

Dravet Syndrome

Answer 7

• Recurrent focal clonic (hemiclonic) febrile and afebrile seizures (which often alternate sides from seizure to seizure), focal to bilateral tonic-clonic, and/or generalized clonic seizures
• Onset: 1– 20 months
• Drug- resistant epilepsy
  Intellectual disability

Question 8

GLUT-1 Deficiency Syndrome

Answer 8

• Seizures, which may be focal or
  generalized, including absence
  seizures (often beginning before
  3 years of age)
• Pathogenic SLC2A1 variant
• Low fasting CSF glucose and CSF/ plasma glucose ratio
• Intellectual disability

Question 9

Sturge- Weber syndrome

Answer 9

• ## Focal motor or autonomic seizures with or without impaired awareness, which may evolve to bilateral tonic-clonic seizures

Question 10

Define febrile seizure

Answer 10

• 6 months to 5 y/o
• No epilepsy history
• Temp >38,3C intracranial infection
• No evidence of intracranial infection

Question 10

Todd’s Paralysis

Answer 10

Transient focal weakness during postictal state

Question 11

Define complex febrile seizures

Answer 11

• Focal
  or
  ->10-15 min
• 2 or more in 24hr period

Question 12

Define epilepsy

Answer 12

2 or more unprovoked seizures occurring more than 24 hrs apart
OR
1 unprovoked or reflex seizure with high probability of recurrence
OR
Dx of epilepsy syndrome

Question 13

Sandifer Syndrome

Answer 13

Back arching, dystonic posturing of the limbs, and
turning/tilting of the head
* May be provoked by feeding and lying flat
* May be alleviated with sitting up
* Often seen in neurologically abnormal children
* Due to gastroesophageal reflux

Question 14

Encefalitis - Criterio Dx

Answer 14

Criterio Mayor: Alteración de conciencia por >24 hrs sin otra causa
Criterio Menores (>1):
-Convulsiones
-Focalidad neuro de nueva aparición
-Leucorraquia 5 o más por campo
-EEG consistente

Question 15

Contraindicaciones Clínicas PL

Answer 15

-GCS <13 o caída >2pts
-Focalidad neuro
-Papiledema
-Midriasis, anisocoria, desviación
-Sd. Cushing
-Post convulsion
-Inestabilidad hemodinámica
-Coagulopatía/plaquetopenia
-Inf local sitio PL