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Flashcards in peds60 Deck (26):
1

neuroimaging studies in kids with seizure?

yes, in all kids with seizures except absence seizures or benign rolandic epilepsy

2

first time seizure in an otherwise healthy child- evaluation?

no, no further investigation

3

febrile seizure

must rule out CNS infection

4

treatment of status epilepticus

IV anticonvulsants such as short-acting benzos (lorazepam or diazepam) followed by loading dose of either phenobarbitol or pheytoin

5

drugs for generalized epilepsy

valproic acid or phenobarbitol

6

drugs for absence epilepsy

ethosuximide

7

drugs or partial epilepsy

carbamazepine or phenytoin

8

surgery for what kind of seizures

temporal lobe seizures that are refractory to meds; 75% have complete seizure control after surgery

9

alternative treatments for seizures

vagal nerve stimulator (side effect is hoarseness) and ketogenic diet

10

prognosis for epilepsy

about 70% of epileptic kids can be weaned off after 2 years of seizure free; NOT a lifelong disorder

11

febrile seizure

fever with seizure, 6 months to 6 years of age by definition

12

simple febrile seizure

lasts less than 15 mins and is generalized

13

complex febrile seizure

last more than 15 mins, has focal features, or recurs within 24 hours

14

treatment for febrile seizure

anticonvulsants not needed for first time or occasional febrile seizure; antipyretic treatment; recurrent, frequent febrile seizures need meds

15

meds for frequent recurrent febrile seizures

daily anticonvulsant prophylaxis wth valproic acid or phenobarbitol; also abortive treatment with rectal diazepam

16

prognosis for febrile seizures

30% of patients with one febrile seizure will have a recurrance; recurrance risk decr with incr age

17

three common epileptic syndromes

infantile spasms, absence epilepsy of childhood, and benign rolandic epilepsy

18

infantile spasms

aka West syndrome; age of onset 3-8 months; tuberous sclerosis is the most commonly identified cause

19

most commonly identified cause of infantile spasms

tuberous sclerosis

20

tuberous sclerosis

non-malig tumors in many different organs

21

clinical features of infantile spasms

brief myoclonic jerks lasting 1-2 sec, occuring in clusters over 3-5 min

22

jackknife seizures or salaam seizures

suggen arm extension or head and trunk flexion; seen in infantile spasms

23

eeg for infantile spasms

characteristic hypsarrhythmia (hghly disorganized, high amplitude occurign in both hemispheres)

24

management of infantile spasms

IM injection of ACTH for 4-6 weeks; valproic acid is second line; vigabatrin is most effective for patients with infantile spasms assoc w tuberous sclerosis

25

prognosis for infantile spasms

poor; usually kids develop moderate to severe mental retardation

26

absence epilepsy of childhood

age of onset 5 to 9 years; females more common; inheritance aut dom with age-dep penetrance