Flashcards in Pediatric Seizure Disorders Deck (24)
Psychogenic nonepileptic seizures (PNES)
Paroxysmal (sudden) episodes that resemble epileptic seizures; however, PNES are psychological in origin.
How do you differentiate PNES from an epileptic seizure
Video- EEG monitoring in an epilepsy monitoring unit. PNES will not show epileptiform activity on the EEG.
see chart on pg 4 dfor diff between epileptic seizures and psychogenic
Pt has a seizure in the hospital. What do you do?
- ABC (airway, breathing, circulation)
- Place the patient on their side and administer oxygen
- Ask the nurse to administer a benzodiazepine
- Consider loading with anti-epileptic meds
Seizures divided into what 2 groups
- Partial (focal)
Definition of a partial seizure
- Starts in one hemisphere
- Can secondarily generealize
Definition of a generalized seizure
- Those in which the first clinical changes indicate initial involvement of both hemispheres
Patial seizures may be divided into 2 categories
Simple Partial- consciousness intact
Complex partial- consciousness not intact
Types of generalized seizures
Brief loss of consciousness where they stop doing whatever it is they were doing and stare at you blankly.
- lasts up to 30 seconds
ABsence seizures may be induced with?
Absence characterized by what type of EEG behavior
3 hz spike and wave discharges
most common type of childhood seizure, affect 2-5% of children in the USA.
Peak incidence of febrile seizures
Definition of febrile seizures
Seizures that occur in kids with fevers between the ages of 6 and 60 months who do not have an intracranial infection, metabolic disturbance, or history of afebrile seizures
Simple febrile seizure
Isolated (once in a 24 hour period), generalized, brief
Complex febrile seizure
Multiple (occur more than once in a 24 hour period), focal, prolonged
Recurrence of febrile seizure
90% of kids have recurrence within 1 year of onset
Risk factors for recurrence
young age at onset
febrile seizures in 1st degree relative
low grade fever in ER
brief duration between fever and seizure
Epilepsy can develop from febrile seizures. The risk factors for the development of epilepsy in children with febrile seizures is:
- complex febrile seizures
- A family history of epilepsy
- Neurologic impairment prior to the febrile seizure
Long term management for a kid with simple febrile seizures
Do not give anticovulsants to a kid with one or more simple febrile seizures.
If the parents are very concerned, give oral diazepem at teh onset of febrile illness
Children with febrile status epilepticus are at risk for what
hippocampal injury and a substantial number also have abnormalities in hippocampal development
Focal slowing or attenuation are present in EEGs obtained within 72 hours in a substantial proportion of children with febrile status epilepticus and are highly associated with MRI evidence of Acute hippocampal injury