Lsu Pa Pediatric Epilepsy Syndromes Csm

Front 1

Define Status Epilepticus

Back 1

condition in which epileptic seizure activity continues or is repeated without regaining consciousness for a period of 15 minutes or more
Medical emergency

Front 2

Define simple partial seizure

Back 2

the most localized type of partial seizure, with a discharge that is predominantly one sided or that presents localized features, and without a loss of consciousness

Front 3

Define Complex partial seizure

Back 3

consciousness is impaired

Front 4

Define Secondarily generalized seizure

Back 4

seizures with partial onset which spreads to become a generalized seizure

Front 5

Describe Infantile spasms

Back 5

Rapid flexion or extension movements that involve the neck, trunk, and extremities
Brief head nods
Onset in the first year of life
Hundreds of seizures a day
Occurs in clusters

Front 6

Possible etiology of infantile spasms?

Back 6

Etiology:
Cryptogenic
Tuberous sclerosis
Down’s syndrome
Metabolic disorders
Trauma
Anoxia/Hypoxic Ischemic Encephalopathy

Front 7

Describe Lennox Gastaut Syndrome

Back 7

Multiple seizure types:
-Atonic
-Tonic
-Clonic
-myoclonic
-Generalized tonic-clonic

EEG: slow 2 Hz spike and wave act

Front 8

Describe treatment and prognosis of Lennox Gastaut Syndrome

Back 8

Treatment:
Antiseizure medications
Lamotrigine, Zonisamide, Valproic acid, Topiramate, Felbamate
Vagus nerve stimulator
Ketogenic diet
Clinical study: Clobazam
Prognosis:
Poor with mental retardation and behavioral difficulties

Front 9

Describe Childhood Absence Epilepsy/Pyknolepsy (CAE)

Back 9

Onset 5 to 12 yrs
8% of all epilepsies in school age kids
Remits by puberty in 50-75%
Dysfunction in thalamocortical pathways
May manifest as a drop in school performance, day dreaming, staring
Signs - Short stare, eye blinking or upward rolling of eyes briefly
Abrupt onset & recovery of seizure, lasting 5 seconds – minute with no postictal state,
Development normal
Strong family history
EEG: Burst of 3 Hz spike & wave on normal background

Front 10

Describe treatment for absence epilepsy.

Back 10

Treatment:
Ethosuximide : is the usual choice, if typical absence
Valproic acid : in typical absence with GTC and with atypical absence
Lamotrigine: alone or used in combination with Valproic acid or with Ethosuximide

Front 11

Describe Juvenile Myoclonic Epilepsy

Back 11

-Intelligence & examination is normal, but higher rate of psychiatric problems
Frequently observed problems are:
-Inattention, behavior & poor social judgement
-MRI and CT scans usually normal
-family history may be positive
-happens in the early morning with myoclonic jerks i.e. spills orange juice, toothbrush flies off etc
-may have generalized tonic-clonic seizures
-May have absence seizures

Front 12

Age of onset for Juvenile Myoclonic Epilepsy?

Back 12

onset 8 to 30 years

Front 13

List some factors that will exacerbate Juvenile Myoclonic Epilepsy.

Back 13

Stress, anxiety, fatigue, sleep deprivation and alcohol exacerbate seizures

Front 14

List some medications used in the treatment of Juvenile Myoclonic Epilepsy.

Back 14

Valproic acid
Lamotrigine
Topiramate
Levetiracetam

Front 15

Describe Benign Rolandic Epilepsy

Back 15

BECTS (Benign Epilepsy with Centrotemporal spikes)
Onset 1st and 2nd decade
Nocturnal seizures
Hemifacial grimacing and twitching
Drooling
Inability to speak
EEG: unilateral or bilateral centrotemporal spikes

Front 16

Describe treatment and prognosis of Benign Rolandic Epilepsy.

Back 16

Management:
No meds if isolated, infrequent, nocturnal seizures
If seizures are often and diurnal, use antiseziure meds
Carbamazepine
Oxcarbazepine
Prognosis: good, usually remits by 17 years of age

Front 17

List some precipitating factors of febrile seizures.

Back 17

Common precipitating factors:
Viral infection 80% (URI)
UTI seldom
Gastroenteritis ( Shigella , Campylobacter)
Immunizations

Front 18

Describe febrile seizures.

Back 18

“Benign” Febrile seizures:
Brief
Isolated
No CNS infection
In ages 3 months to 5 years ( most often between 6 to 18 months)
May be recurrent in 30% of cases

Front 19

Define the age group most affected by febrile seizures.

Back 19

In ages 3 months to 5 years ( most often between 6 to 18 months)

Front 20

Define epileptic syndrome.

Back 20

complex of signs and symptoms that occur together more often than by chance & that define a unique epilepsy condition.

Front 21

Tonic seizure

Back 21

seizure characterized by tonic but not clonic contractions usually occuring in Lennox-Gastaut syndrome or multiple sclerosis
Muscle "tone" is the muscle's normal tension at rest. In a "tonic" seizure, the tone is greatly increased and the body, arms, or legs make sudden stiffening movements. Consciousness is usually preserved. Tonic seizures most often occur during sleep and usually involve all or most of the brain, affecting both sides of the body. If the person is standing when the seizure starts, he or she often will fall.

Front 22

Atonic seizure

Back 22

an absence seizure characterized by sudden loss of muscle tone
Muscle "tone" is the muscle's normal tension. "Atonic" (a-TON-ik) means "without tone," so in an atonic seizure, muscles suddenly lose strength. The eyelids may droop, the head may nod, and the person may drop things and often falls to the ground. These seizures are also called "drop attacks" or "drop seizures." The person usually remains conscious.

Front 23

Clonic seizure

Back 23

a rare kind of seizure in which there are generalized clonic contractions without a preceding tonic phase
"Clonus" (KLOH-nus) means rapidly alternating contraction and relaxation of a muscle -- in other words, repeated jerking. The movements cannot be stopped by restraining or repositioning the arms or legs. Clonic (KLON-ik) seizures are rare, however. Much more common are tonic-clonic seizures, in which the jerking is preceded by stiffening (the "tonic" part). Sometimes tonic-clonic seizures start with jerking alone. These are called clonic-tonic-clonic seizures!

Front 24

Myoclonic seizure

Back 24

one characterized by a brief episode of myoclonus with immediate recovery and often without loss of consciouness
Myoclonic (MY-o-KLON-ik) seizures are brief, shock-like jerks of a muscle or a group of muscles. "Myo" means muscle and "clonus" (KLOH-nus) means rapidly alternating contraction and relaxation—jerking or twitching—of a muscle

Front 25

Describe the appropriate treatment protocol for a patient who presents to the emergency room or location of care with an ongoing seizure in which the onset was not witnessed

Back 25

Always treat a seizure that was not witnessed as status epilepticus.