pediatric epilepsy

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1、PediatricEpilepsyOverviewofseizuresandepilepsyandmedicationsManagementofspecificissuesThefirstunprovokedseizureThepatientwithknownepilepsyFebrileSeizuresNeonatalseizuresDoesthepatienthaveepilepsy?Seizuresvs.EpilepsyEpilepsy:MostrecentILAEdefinition:“adisorder

2、ofthebraincharacterizedbyanenduringpredispostiontogenerateepilepticseizuresandbytheneurobiologicalcognitivepsychologicalandsocialconsequencesofthiscondition”occurrenceoftwoormoreunprovokedseizuresSeizure:atransientoccurrenceofsignsandsymptomsduetoabnormalorex

3、cessiveorsynchronousneuronalactivityinthebrainWasitaseizure?Syncope-vasovagal,cardiogenicSandifersyndromeBreathholdingspellMigraineTicsPsychogenicSleepmyoclonusParoxysmaldystoniaClassificationofseizuresGeneralizedlossofconsciousnesswholebrainatonsetPartialnol

4、ossofconsciousnessfocalonsetConvulsivetonicclonictonicclonicNonconvulsiveabsenceatypicalabsencemyoclonicatonicComplexPartialchangeinlevelofconsciousnessSimplePartialnochangeinconsciousnessPartialSeizureevolvingtosecondarygeneralizationEpilepsySyndromesTriadof

5、seizuretypeortypes,ageandEEGfindingsDifferentmedicationsfordifferentsyndromes!!VerydifferentprognosesfordifferentsyndromesEpilepsySyndromesBenignRolandicEpilepsyofChildhoodAbsenceEpilepsyJuvenileMyoclonicEpilepsyBenignOccipialEpilepsyLennox-GastautSyndromeInf

6、antileSpasmsBenignRolandicEpilepsyofChildhoodAge:5-16yearsoldSeizuretype:nocturnal,partial(anarthria),maygeneralizeEEG:bilateralindependentcentraltemporalspikesPrognosis:ExcellentMeds:Tegretol,anymedicationforpartialseizuresBenignRolandicEpilepsyAbsenceepilep

7、syAge:Childhoodabsenceepilepsybegins5-10yearsoldJuvenileabsencebeginsaroundpubertySeizuretype:absence,mayalsohavegeneralizedconvulsionsEEG:3HZspikewavedischargesPrognosis:excellent(particularlyforchildhoodonset)Medication:Ethosuccimide,valproicacid,lamotrigin

8、eExacerbatedbyTegretolAbsenceepilepsyJuvenileMyoclonicEpilepsyAge:begins10-15yearsoldSeizuretype:myoclonicjerks(usuallyinmorning),staringspells,convulsionsEEG:3-4Hzgeneralizeddischargewit