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Flashcards in Epilepsy Deck (13):

What is epilepsy?

Chronic neurological disorder characterised by recurrent unprovoked seizures

Seizure = clinical event where there is a sudden disturbance of neurological function caused by
abnormal or excessive neuronal discharge

Epilepsy = underlying tendency to have seizures


What is the most common cause of childhood epilepsy?


Brain abnormality is the most common cause of seizures in children


What is the seizure pattern in West's Syndrome?

Violent flexor spasms of the head,
trunk and limbs followed by
extension of the arms (so-called
'salaam spasms')
• Flexor spasms last 1-2 s
• Often multiple bursts of 20-30
• Often on waking (may occur many
times a day)
• May be misinterpreted as colic
• Social interaction can deteriorate
(useful marker in the Hx)


What are the features of Wests syndrome?

Many causes, but 2/3 have
underlying neurological cause
• EEG – shows characteristic
hypsarrhythmia (chaotic pattern of
high-voltage slow waves, and
multi-focal sharp wave discharges)
• Rx – vigabatrin or corticosteroids
(unwanted effects are common)
• Prognosis – most will
subsequently lose skills and
develop learning disability and/or


What is the seizure pattern in Benign Rolandic epilepsy? (4-10y)

Tonic-clonic seizures in sleep
(characterised by facial twitching
and aphasia)
• Simple focal seizures with
awareness of abnormal feelings in
the tongue and distortion of the
face (supplied by the Rolandic
area of the brain)


What are the features of BRE?

15% of all childhood epilepsies
• More common in boys
• EEG – shows focal sharp waves
from the Rolandic or
centrotemporal area
• Important to recognise as it is
benign and does not always
require Rx
• Almost all remit in adolescence


What is the seizure pattern in JME?

Myoclonic seizures (generalised
tonic-clonic seizures and
absences may also occur)
• Mostly just after waking
• Typical Hx is throwing drinks or
cereal about in the morning
• Learning is unimpaired


What are the features of JME?

Response to Rx is usually good
but lifelong
• Genetic linkage identified
(autosomal dominant)
• Remission unlikely (develop
generalised tonic-clonic seizures


What is the seizure pattern in lennox gastaut syndrome?

Multiple seizure types, but mostly
drop attacks (astatic seizures),
tonic seizures and atypical


What are the fetures of lennox-G? (1-3yr)

Neurodevelopmental arrest or
regression and behaviour disorder
• Often other complex neurological
problems or Hx infantile spasms.
• Prognosis is poor


What is the seizure pattern in Childhood absence?

Stare momentarily and stop
moving, may twitch their eyelids or
a hand minimally.
• Lasts only a few seconds and
certainly not longer than 30 s.
• Child has no recall except realises
they have missed something and
may look puzzled or say 'pardon'

on regaining consciousness.
• Developmentally normal but can
interfere with schooling


What are the features of childhood absence epilepsy?

• Only 2% of childhood epilepsy
• 2/3 female.
• Episodes can be induced by
hyperventilation (ask child to blow
on a piece of paper or windmill for
2-3 min = useful test in the clinic)
• EEG shows generalised 3/second
spike and wave discharge, which


What are the seizure like in benign childhood occipital epilepsy?

Younger children - periods of
unresponsiveness, eye deviation,
vomiting and autonomic features.
• Older children - headache and
visual disturbance including
distorted images, hallucinations

(is uncommon and remit in childhood)