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Flashcards in Epilepsy Deck (13):
1

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

2

What is the most common cause of childhood epilepsy?

Idiopathic

Brain abnormality is the most common cause of seizures in children

3

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
spasms
• Often on waking (may occur many
times a day)
• May be misinterpreted as colic
• Social interaction can deteriorate
(useful marker in the Hx)

4

What are the features of Wests syndrome?
(4-6MO)

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
epilepsy

5

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

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

6

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

7

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

8

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
later)

9

What is the seizure pattern in lennox gastaut syndrome?

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

10

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

11

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

12

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
92

13

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)