Seizures
Content
SEIZURES
10% prevalence. Febrile seizures- 3% of the population
GeneralizedTonic / clonic / tonic-clonic Absence Infantile spasms o Primary o Secondary • Landau-Kleffner- verbal skills loss, generalized seizures, poor prognosis. Tx- everything (anti-epileptic, BZD, steroids, IVIg..) - Myoclonico Benign of infancy- 2y>. No Tx, good prognosis. o Of early childgood- 2y<, moderate prognosis o Juvenile- 12y<, (the hair combers), Tx with valproic acid for life. o Complex- Lennox-Gastaut- accompanying HIE, combined with tonic-clonic seizures, poor prognosis. o Progressive- associated with mitochondrial / metabolic diseases.
Partial seizures- Simple- no loss of consciousness (motor, sensory, autonomic..) - Complex- with loss of consciousness - Partial seizures with generalization • Rolandic- centro-temporal region, usually falling asleep or waking up. • Rasmussen encephalitis- ~10y, ongoing partial seizure, associated with hemiplegia, poor prognosis
Treatments- Effective for all- carbamazepine, valproic acid, Phenobarbital, phenytoin - Myoclonic- valproic acid - Hypsarrythmia- steroids (ACTH), vigabatrin (sabril) - Adjuvants- clobazam (frisium), gabapentin (neurontin), topiramate (topamax), lamotrigine (lamictal) • Ethosuximide- for absence (worsening generalized seizures)
10% prevalence. Febrile seizures- 3% of the population
GeneralizedTonic / clonic / tonic-clonic Absence Infantile spasms o Primary o Secondary • Landau-Kleffner- verbal skills loss, generalized seizures, poor prognosis. Tx- everything (anti-epileptic, BZD, steroids, IVIg..) - Myoclonico Benign of infancy- 2y>. No Tx, good prognosis. o Of early childgood- 2y<, moderate prognosis o Juvenile- 12y<, (the hair combers), Tx with valproic acid for life. o Complex- Lennox-Gastaut- accompanying HIE, combined with tonic-clonic seizures, poor prognosis. o Progressive- associated with mitochondrial / metabolic diseases.
Partial seizures- Simple- no loss of consciousness (motor, sensory, autonomic..) - Complex- with loss of consciousness - Partial seizures with generalization • Rolandic- centro-temporal region, usually falling asleep or waking up. • Rasmussen encephalitis- ~10y, ongoing partial seizure, associated with hemiplegia, poor prognosis
Treatments- Effective for all- carbamazepine, valproic acid, Phenobarbital, phenytoin - Myoclonic- valproic acid - Hypsarrythmia- steroids (ACTH), vigabatrin (sabril) - Adjuvants- clobazam (frisium), gabapentin (neurontin), topiramate (topamax), lamotrigine (lamictal) • Ethosuximide- for absence (worsening generalized seizures)
