1 / 15

Seizures in Children

Seizures in Children. Dr Penny Mancais Consultant Paediatrician Dorset County Hospital Foundation trust . To be Covered. Terminology History taking Prognosis of Seizures Fits, faints and funny turns When to refer Pragmatic advice in Epilepsy. Definition of Seizure.

gage
Télécharger la présentation

Seizures in Children

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Seizures in Children Dr Penny Mancais Consultant Paediatrician Dorset County Hospital Foundation trust

  2. To be Covered • Terminology • History taking • Prognosis of Seizures • Fits, faints and funny turns • When to refer • Pragmatic advice in Epilepsy

  3. Definition of Seizure ANY SUDDEN ATTACK FROM WHATEVER CAUSE. • Many manifestations determined by site of origin. • Many causes: • Non Epileptic (reflex anoxic ,fainting, Tics ,migraines, night terrors ) • Epileptic

  4. Definition of Epileptic Seizure • Manifestation of Epileptic (excessive) usually self limited activity of neurons in the brain • ILAE

  5. Prognosis of seizures 1% afebrile seizure • 50% will have a recurrence 3% febrile seizure • Risk of recurrence 35% • Risk of Epilepsy following simple 1% • Risk of Epilepsy following complex 6% • Risk of Epilepsy following complex/FH 30%

  6. Taking the History Diagnosis is in the History • No Ix to confirm epilepsy • RELIANT ON HISTORY

  7. What to ask • Eye witness account • Role play • Avoid interpretations • Time line • Use counting • Home videoing

  8. Racing heart Tingling sensations Headache Generalised stiffening Floppiness Ringing noises Hiccups Sudden loss of vision Features that may occur in Seizures • Sudden fall • Jerking limbs • Blank stare • Urinary incontinence • Funny smell • Feeling of fear • Facial flushing • Seeing coloured spots • vomiting

  9. Fits Faints and funny turns • Collapsing with convulsions • Drop attacks • Stiffening attacks • During sleep

  10. Fits faints and funny turns

  11. When to refer • Any child with ‘unexplained seizure’ (NICE) • <1years discuss ?admit • NO investigations • Advise home videoing, diary monitoring • All children with a diagnosis of epilepsy should have a named paediatrician.

  12. Pragmatic advice in Epilepsy Will my child die? • Risk from fit is negligible • SUDEP 1:200 (poor control,teenagers,male) • Accidents • NO climbing/harness, swimming 1:1, shower • Alcohol (1=3 on anticonvulsants) • Recreational drugs (increase risk of seizure)

  13. Advice continued • Contraception: Higher doses of Oestrogen for enzyme inducing drugs plus barrier protection Starting a family • Driving • Nocturnal seizures ok • Fit free 1yr on/off medication • DVLA latest advice

  14. Medication • Now 17 drugs available • Aim to improve seizure control • Minimises effects on learning and behaviour • Blood tests not needed

  15. Summary • History, History, History • All children with unexplained seizure need referral • <1 pick up phone ? Admit • Web sites: • National Society for Epilepsy • Epilepsy action

More Related