Seizures in Children Quiz
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Questions and Answers

What are the two main types of seizures in children based on their origin in the brain?

Generalized seizures and focal seizures.

What is the term for a seizure lasting more than 30 minutes?

Status epilepticus.

How prevalent are febrile seizures among the population?

They can affect 4-10% of the population.

What is Todd's paralysis?

<p>Transient paralysis that can occur after a seizure.</p> Signup and view all the answers

What are infantile spasms, and at what age do they typically begin?

<p>General myoclonic jerking of neck, trunk, and limbs that begin around 3-7 months.</p> Signup and view all the answers

List one metabolic cause of seizures.

<p>Hypoglycemia.</p> Signup and view all the answers

What is the relationship between seizures and brain infections?

<p>Infections like meningitis and encephalitis can cause seizures.</p> Signup and view all the answers

What seizure type is characterized by 'staring spells' without jerking?

<p>Absence seizures.</p> Signup and view all the answers

Identify one cause of focal seizures.

<p>Brain tumors.</p> Signup and view all the answers

What are the typical EEG findings in infantile spasms?

<p>Hypsarrhythmia.</p> Signup and view all the answers

What distinguishes pseudoseizures from epileptic seizures?

<p>Pseudoseizures are not caused by electrical disruptions in the brain like epileptic seizures and are often associated with psychological conditions.</p> Signup and view all the answers

What is the initial assessment for a patient suspected of having seizures?

<p>A basic workup includes an EEG and electrolyte tests to rule out metabolic anomalies.</p> Signup and view all the answers

What are some protective measures to take during a febrile seizure?

<p>Loosen tight clothing, place something soft under the person's head, and stay with them until they recover.</p> Signup and view all the answers

What should you avoid doing during a seizure?

<p>Do not try to restrain the person, put anything between their teeth, or give them food or drink.</p> Signup and view all the answers

What is the typical duration for a febrile seizure, and when should medical care be sought?

<p>Febrile seizures last less than 15 minutes, and medical care should be sought if they last more than 5 minutes.</p> Signup and view all the answers

What are some potential side effects of Valproic Acid?

<p>Potential side effects include fetal anomalies in pregnant women and the need to check blood levels for adequacy.</p> Signup and view all the answers

What non-pharmacologic treatment options exist for seizures?

<p>Options include a ketogenic diet, vagal nerve stimulation, and surgery.</p> Signup and view all the answers

What percentage of children experience at least one reoccurrence of febrile seizures?

<p>30-40% of children will experience at least one reoccurrence of febrile seizures.</p> Signup and view all the answers

What is the general population risk for developing epilepsy compared to children with febrile seizures?

<p>The general population risk of epilepsy is 0.5-1%, while the risk in patients with febrile seizures is 1-2%.</p> Signup and view all the answers

What long-term effect can Lamotrigine have on cognitive ability?

<p>Lamotrigine may cause decreased cognitive ability among its long-term effects.</p> Signup and view all the answers

What is the first-line treatment for infantile spasms?

<p>Adrenocorticotropic hormone (ACTH) or oral steroids (prednisolone).</p> Signup and view all the answers

What characterizes absence seizures in children?

<p>Sudden episodes of staring with unresponsiveness lasting 5-15 seconds, often accompanied by subtle automatisms.</p> Signup and view all the answers

What are common triggers for myoclonic seizures?

<p>Sleep deprivation, stress, or flashing lights.</p> Signup and view all the answers

Describe a tonic-clonic seizure's presentation.

<p>It consists of a tonic phase with sudden limb stiffening followed by a clonic phase with rhythmic jerking.</p> Signup and view all the answers

What type of seizure is characterized by sudden loss of muscle tone and often leads to falls?

<p>Atonic seizures, also known as drop attacks.</p> Signup and view all the answers

Which medication is considered the first-line treatment for absence seizures?

<p>Ethosuximide.</p> Signup and view all the answers

How are developmental delays managed in children with epilepsy?

<p>Through long-term care focusing on developmental milestones and addressing underlying causes.</p> Signup and view all the answers

What is a characteristic feature of myoclonic seizure episodes?

<p>They involve brief muscle jerks without loss of consciousness.</p> Signup and view all the answers

What is a notable sign that may accompany tonic-clonic seizures?

<p>Tongue biting or urinary incontinence.</p> Signup and view all the answers

Which medication alternatives exist for treating tonic-clonic seizures?

<p>Valproic acid, carbamazepine, or levetiracetam.</p> Signup and view all the answers

What type of seizure is characterized by rhythmic jerking without sustained muscle stiffness?

<p>Clonic seizures</p> Signup and view all the answers

At what age are febrile seizures most commonly observed?

<p>6 months to 5 years</p> Signup and view all the answers

What is the medical emergency that requires immediate intervention if seizures last more than 5 minutes?

<p>Status Epilepticus</p> Signup and view all the answers

Which epileptic syndrome is associated with multiple seizure types and a high risk of intellectual disability?

<p>Lennox-Gastaut Syndrome</p> Signup and view all the answers

What distinct EEG pattern is associated with West syndrome, commonly seen in infantile spasms?

<p>Hypsarrhythmia</p> Signup and view all the answers

What type of seizures are triggered by specific stimuli, such as flashing lights or reading?

<p>Reflex seizures</p> Signup and view all the answers

What type of seizure involves sudden loss of muscle tone, often causing the individual to collapse?

<p>Atonic seizures</p> Signup and view all the answers

What are the common features of neonatal seizures observed in infants?

<p>Eye deviation, lip-smacking, apnea, or rhythmic limb movements</p> Signup and view all the answers

What age range characterizes Benign Rolandic Epilepsy, and how does it usually manifest?

<p>Ages 3-13 years; it presents with focal seizures during sleep involving the face and mouth.</p> Signup and view all the answers

What are the main features of juvenile myoclonic epilepsy (JME)?

<p>Myoclonic jerks, generalized tonic-clonic seizures, and absence seizures</p> Signup and view all the answers

What is the primary management for febrile seizures in children?

<p>Antipyretics; no anticonvulsants.</p> Signup and view all the answers

Which medication is commonly used to manage myoclonic seizures in adolescents?

<p>Valproic acid.</p> Signup and view all the answers

Which type of seizure is characterized by flexor/extensor spasms and typically occurs between 3 to 12 months of age?

<p>Infantile spasms.</p> Signup and view all the answers

What is the usual management for absence seizures in children?

<p>Ethosuximide.</p> Signup and view all the answers

In which seizure type does a child remain conscious but may experience twitching or sensory changes?

<p>Focal aware seizures.</p> Signup and view all the answers

What is the primary treatment for neonatal seizures that typically occur in the first 28 days of life?

<p>Treat underlying cause; phenobarbital.</p> Signup and view all the answers

What protective measure should be taken during atonic seizures in children?

<p>Wear a protective helmet.</p> Signup and view all the answers

What clinical feature is associated with tonic-clonic seizures?

<p>Stiffening followed by rhythmic jerking and loss of consciousness.</p> Signup and view all the answers

What is the name of the seizure type characterized by brief episodes of staring, often unresponsive to stimuli?

<p>Absence seizures.</p> Signup and view all the answers

Which seizure type can progress from focal to bilateral tonic-clonic seizures?

<p>Focal impaired awareness seizures.</p> Signup and view all the answers

What triggers febrile seizures in children, and what is the peak age range for their occurrence?

<p>Febrile seizures are often triggered by a rapid rise in temperature, occurring in children aged 6 months to 5 years.</p> Signup and view all the answers

Name one common cause of neonatal seizures.

<p>Hypoxic-ischemic encephalopathy (HIE) is a common cause of neonatal seizures.</p> Signup and view all the answers

What is the characteristic clinical presentation of infantile spasms?

<p>Infantile spasms are characterized by sudden, symmetric flexor or extensor jerks of the head, trunk, and limbs.</p> Signup and view all the answers

List two management strategies for acute neonatal seizures.

<p>Correcting metabolic abnormalities and administering phenobarbital as an anticonvulsant are management strategies.</p> Signup and view all the answers

What are two clinical signs that may indicate neonatal seizures?

<p>Subtle signs include eye deviation or blinking and rhythmic limb jerking.</p> Signup and view all the answers

What is the recommended management for a simple febrile seizure in children?

<p>Management includes ensuring airway patency and providing antipyretics for comfort, without using routine anticonvulsants.</p> Signup and view all the answers

Which demographic factor increases the risk of febrile seizures in children?

<p>A family history of febrile seizures or epilepsy increases the risk.</p> Signup and view all the answers

At what age do infantile spasms typically start, and what metabolic disorder is associated with them?

<p>Infantile spasms typically start between 3 to 12 months of age; they can be associated with metabolic disorders.</p> Signup and view all the answers

What role do viral infections play in the occurrence of febrile seizures?

<p>Viral infections, such as influenza or HHV-6, are often the cause of the fever that triggers febrile seizures.</p> Signup and view all the answers

What is the primary goal when managing acute neonatal seizures?

<p>The primary goal is to correct metabolic abnormalities and treat any underlying infections.</p> Signup and view all the answers

Study Notes

Seizures in Children

  • Seizures are uncontrolled nerve firings in the brain
  • Generalized seizures involve both cerebral hemispheres
  • Focal seizures involve one hemisphere
  • Young infants' seizures can be subtle and look different from other seizures

Learning Objectives

  • Identify different types of seizures in children
  • Differentiate the causes of seizures
  • Recognize components of a seizure workup
  • Discuss treatment for seizures in children

Seizure Prevalence

  • Seizures affect 1% of the population
  • Febrile seizures occur in 4-10% of the population
  • 15% of children with an initial seizure will have another within a year.

During a Seizure

  • Alteration of vital signs and respiratory suppression are possible
  • A period of sleepiness (post-ictal period) follows a seizure
  • Transient paralysis (Todd's paralysis) can develop after a seizure
  • Seizures vary depending on where they start in the brain

Types of Seizures

  • Tonic-clonic (generalized): May be tonic or clonic
  • Focal (one side of the body)
  • Myoclonic: Few to many short jerks in the body
  • Atonic/Akinetic: "Drop spells"
  • Absence: No jerking; "staring spells"

Status Epilepticus

  • A seizure lasting more than 30 minutes
  • Can result in death

Differential Diagnosis of Seizures

  • Infections (e.g., brain abscess, encephalitis, meningitis, tuberculosis, viral illnesses, HIV, toxoplasmosis)
  • Toxins (e.g., cocaine, methamphetamine, lead poisoning, organophosphates, salicylates, sympathomimetics, tricyclic antidepressants, alcohol withdrawal)
  • Traumatic/Vascular (e.g., cerebral contusion, stroke, child abuse)
  • Idiopathic (Epilepsy)
  • Congenital Anomalies
  • Genetic causes
  • Metabolic causes (e.g., hypercarbia, hypocalcemia, hypoglycemia, hyponatremia, hypomagnesemia, inborn errors of metabolism, pyridoxine deficiency)
  • Neoplastic (e.g., brain tumors, metastatic cancers)

Infantile Spasms

  • General myoclonic jerking of neck, trunks, and limbs
  • Typically begins between 3-7 months old
  • Associated with some genetic syndromes
  • Atypical EEG finding: "hypsarrhythmia"
  • Poor prognosis: Death within 3 years in 1/3 of children
  • Often has profound cognitive effects
  • Difficult to control seizures
  • Survivors may develop other seizure types

Benign Rolandic Epilepsy

  • Simple partial seizures often involving face and hands
  • EEG shows centrotemporal spikes
  • Seizures occur or are aggravated during or around sleep
  • Almost always outgrown by adolescence

Conditions That Mimic Seizures

  • Breath holding spells
  • Syncope
  • Panic attacks
  • Tic disorders
  • Benign myoclonus (infants)
  • Dystonic reaction
  • Pseudoseizures
  • Night terrors

Seizure Workup - Basic

  • EEG
  • Electrolytes (to rule out metabolic anomaly)
  • CBC (to rule out infection)

Additional Workup

  • Depends on assessment and physical exam findings
  • Sometimes requires head CT or MRI

Treatment: Febrile Seizures

  • Loosen tight clothing to prevent injury
  • Protect the person from injury
  • Place something soft under their head if they fell
  • Stay with them until fully recovered
  • Call for medical help if seizure lasts over 5 minutes
  • Do not try to restrain the person
  • Do not put anything between their teeth
  • Do not move them unless they are in danger
  • Do not give them food

Acute Seizure Control

  • Treatment varies depending on the duration and type of seizure, presence of complications and the underlying cause. Multiple medications are used in the acute setting.

Anticonvulsants (Medication)

  • Many different drugs with varying mechanisms of action.
  • Side effects are listed in the accompanying table.

Medication Side Effects

  • Valproic Acid/Phenytoin: May cause fetal anomalies, gum hyperplasia. Blood levels need monitoring.
  • Phenobarbital: Long-term cognitive effects
  • Lamotrigine: Can lead to Stevens-Johnson syndrome

Non-Pharmacological Seizure Treatment

  • Vagal Nerve Stimulator
  • Surgery
  • Ketogenic Diet

Febrile Seizures

  • Occurs in approximately 4% of children (6-60 months) associated with a febrile illness
  • Most common form of seizures and neurological disorders in children
  • 30-40% of children with febrile seizures will have a recurrence.
  • General risk of epilepsy 0.5 - 1%. Risk in febrile seizure patients is 1-2%.

Simple Febrile Seizures

  • Symmetrical
  • Lasts less than 15 minutes (Most <5 minutes)
  • Only one seizure associated with a febrile illness/24 hour timeframe.

Complex Febrile Seizures

  • Focal features during or after event
  • Lasts more than 15 minutes.
  • More than one seizure in a 24-hour period.

Febrile Seizures & Epilepsy

  • Dravet Syndrome: Severe myoclonic epilepsy of infancy (prolonged, asymmetric, progressive, starts without fevers)
  • Generalized Epilepsy with Febrile Seizures Plus (GEFS+): Autosomal dominant, febrile seizures can disappear by age 6, or evolve.

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Pediatric Seizure PDF
Seizures in Children PDF

Description

Test your knowledge on seizures in children, including their types, causes, and treatments. This quiz covers important information about generalized and focal seizures, prevalence rates, and the effects of seizures on vital signs. Enhance your understanding of this critical topic in pediatric health.

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