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13 Cards in this Set
- Front
- Back
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What is a seizure |
Transient occurrence of signs and symptoms resulting from abnormal excessive or synchronous neuronal activity in the brain |
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What are the classifications for epileptic seizures |
Two main-Focal and generalised seizures Febrile seizures Reflex seizures Acute symptomatic seizures Unprovoked seizures Remote symptomatic seizures |
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Focal seizures |
Seizures with EEG changes suggesting limitation to one cerebral hemisphere 1 with and without loss of consciousness |
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What are generalised seizures |
Seizures with EEG changes suggesting synchronous involvement of all or both hemispheres |
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What is a Febrile seizure |
Seizures occurring in 6months to 6 year olds which are associated with temperatures greater than 38 degrees that are not the results of CNS infection or any metabolic imbalance in the absence of a history of afebrile seizure |
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Classification of Febrile seizures |
Simple febrile- primary generalised tonic clonic seizures associated with fever which do not last greater than 15 minutes not recurring withing 24 hours with a positive family history, no permanent EEG changes seen Complex- focal seizures which are prolonged greater than 15 minutes recurring withing 24 hours and no positive family history, risk of epilepsy. |
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Investigations in a convulsing child |
Random blood sugar Full blood count Septic screen Lumbar puncture EEG Imaging CT |
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Causes of convulsions in the child |
Neonatal period Hypoglycemia Hypocalemia Hypoxic ischemic encephalopathy CNS infection Septicemia Inborn errors of metabolism Developmental malformations Pyridoxine dependency Intracranial bleeding POSTNEONATAL Febrile convulsions Epilepsy syndrome CNS infections Metabolic causes Space occupying lesion Drugs: Phenytoin carbon monoxide salicyclates |
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Manage the convulsion |
Secure an airway Administer O2 via mask or nasal prongs Ensure circulatory access and start IV fluids Check RBS and treat if hypoglycemic Take bloods for culture and sensitivity Abort seizure with Phenobarbital Rule out CNS infections |
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What is status epilepticus |
Prolonged single seizures or multiple seizures occurring for greater than 30 minutes without regaining of consciousness in between |
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What is impending status epilepticus |
Any seizure lasting greater than 5 minutes |
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Complications of status epilepticus |
Mental retardation Focal neurological deficits Behavorial disorders Clonic epilepsy |
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First line antiepileptics and side effects |
Carbamazepine - hepatitis, rash, GI symptoms Phenytoin- Hirsutism, gingival hyperplasia, hypercalcemia, nystagmus Sodium valproate- hepatic necrosis Phenobarbital- hypoventilation Ethosuximide- photophobia, leukopenia, drug dyscrasia Lamotrigine- Stevens-Johnson Syndrome |
