Zusammenfassung der Ressource
Epilepsies of childhood-pt2
- epilepsy syndromes
- West syndrome
- age
- 4-6
months
- seizure pattern
- violent flexor
spasms of the
head, trunk &
limbs fb
extension of the
arms
- flexor spasms
last 1-2 secs
- multiple bursts
of 20-30 spasms
- often on waking
- but occur many time a day
- may be
misinterpreted
as colic
- social
interaction often
deteriorates
- - a useful marker
in the hx
- causes
- neurological
- 2/3rds
- EEG shows hypsarrhytmia
(chaotic pattern of high-voltage
slow waves, & multi-focal sharp
wave discharges
- Rx
- vigabatrin
- corticosteroids
- prognosis
- most will subseq lose
skills and develop LD
or epilepsy
- Lennox-Gastaut syndrome
- age
- 1-3
years
- seizure pattern
- multiple seizure types
- mostly drop attacks (atastic seizures)
- tonic seizures
- absences
- poor
prognosis
- neurodevelopmental disorder
- behaviour disorder
- often other
complex neuro
probs or hx of
infantile spasms
- childhood absence epilepsy
- age
- 4-12
years
- seizure pattern
- stop momentarily
& stop moving
- may twitch their
eyelids or hand
minimally
- lasts a
few secs,
no longer
than 30s
- child
has no
recall
- but realises they've missed
something & may look
puzzled or say 'pardon' on
regaining consciousness
- developmentally
normal
- developmentally
normal
- but can
interfere w/
schooling
- accounts for
2% of
childhood
epilepsy
- 2/3rds are female
- episodes can be induced by
hyperventilation
- ask child to blow
on a piece of paper
or windmill for 2-3
min
- a useful test
in the outpt
clinic
- EEG
- show
generalised
3/sec spike and
wave discharge
- which is bilat
synchronous during and
sometimes btw episodes
- good prognosis
- 95%
remission in
teens
- 5-10% may
develop
tonic-clonic
seizures in adult
- Mx
- prognosis
- do less well educationally, w/
social outcomes & w/ future
employment
- schooling
- 2/3rds of kids w/
epilepsy go to
mainstream school
- some
require
educational
help for
assoc LD
- 1/3rd attend
special school
- often have
multiple
disabilities and
their epilepsy is
part of a severe
brain disorder
- epilepsy syndromes
- benign epilepsy with
contemporal spikes
(BECTS)
- age
- 4-10 years
- seizure pattern
- tonic-clonic
seizures in
sleep
- simple focal seizures w/
awareness of abnormal
feelings in the tongue &
distortion of the face
- supplied by
Rolandic area of
brain
- EEG shows focal sharp
waves from the Rolandic or
centrotemporal area
- important to recognise
as it is benign &
doesn't always require
Rx
- Almost all remit in teenage yrs
- comprise 15% of all childhood
epilepsies
- early-onset benign childhood
occipital epilepsy
(Panayiotopoulos type)
- age
- 1-4
years
- seizure pattern
- younger kids
- periods of unresponsiveness,
eye deviation, vomiting &
autonomic features
- older kids
- headache & visual
disturbance incl image
distortion and
hallucinations
- juvenile myoclonic
epilepsy
- age
- adolescence-adulthood
- seizure pattern
- myoclonic
seizures
- generalised
seizures
- absences
- typical
hx
- throwing
drinks/corn
flakes about
in morning
- myoclonus
occurs at this
time
- learning is
impaired
- characteristic
EEG
- response to Rx
usually good but
lifelong
- genetic
linkage has
been IDed
- remission unlikely