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CHILDHOOD Epilepsy

Dr. Ibrahim Khasraw Lecturer in pediatrics School of Medicine University of Sulaimani. CHILDHOOD Epilepsy. - Age of onset: 4-10y. ,10% of all epilep . In children. - F.H. + ve in 13% of cases. - Attacks closely related to sleep , when the patient asleep or awake.

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CHILDHOOD Epilepsy

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  1. Dr. Ibrahim Khasraw Lecturer in pediatrics School of Medicine University of Sulaimani CHILDHOOD Epilepsy

  2. - Age of onset: 4-10y. ,10% of all epilep. In children. - F.H. +ve in 13% of cases. - Attacks closely related to sleep , when the patient asleep or awake. - It is focal , involve the face , pharynx and possibly the arm . • - The patient is conscious but unable to speak and may drool saliva . - Excellent prognosis and resolves after puberty , may need no treatment . - E.E.G. during sleep show abnormal 1 or both prerolandicgyrus . • Rx. : carbamazapine or phenytoin . Benign focal ep. Of childhood(Rolandicep.) :-

  3. - There are sensory and motor phenomena . - Consciousness impaired . - The motor manifestations are complex and semipurposful e.g.; picking at clothes or walking in a circle (Automatism) . - There is postical state : a period of confusion or exhaustion after the attack . - E.E.G. Show temporal spikes or waves . - Rx. : carbamazapin , phenytoin ± tiagabine . Complex partial seizure :-

  4. Complex Partial Epilepsy

  5. - Commonly starts between 4-6y of age . - Characterized by staring and loss of awareness of the environment . - Attacks are brief lasts <30 sec. and terminates abruptly without postictal state . - Hyperventilation for 3-4 min. will bring the attack. - E.E.G. : Typical spike and wave discharge 3/sec. . - Rx. : Ethosuximide or valproate are 1st choice , clonazipam 2nd line . Absence seizures (petitmal) :-

  6. - It is generallized very common may follow partial S. or occur denovo . - Presence of aura always indicate a focal onset of S. - The patient suddenly loss consciousness , eye roll back and entire body muscles undergo tonic contractions , apnea and cyanosis .The clonic phase slows toward the end of the S. and the patient sigh as the S. stops abruptly . - Postictal children are initaiallysemicomatous and remain asleep for 30-120 min . Then the patient often get vomiting , severe frontal headache . - E.E.G. show generalized spikes and waves . - Rx. : valproate is the drug of choice , 2ndcarbamazopine and phenytoin . Tonic-clonic (grandmalep.) :-

  7. Grandmal Eilepsy

  8. -Its called (west-syndrom) if associated with M.R - May be idiopathic or symptomatic e.g.: tuberosclerosis. - Onset usually at 4-8 m of age . - Characterized by brief symmetric contraction of the neck , tranck and extremities occuring in clusters of S. persisting for minutes with brief interval between each spasm . • - E.E.G shows chaotic pattern of high voltage bilaterally asynchronus , slow wave activity (hypsarrythmia) . - Rx. : A.C.T.H. , oral prednisolone . are drugs of choice or vigabatrin , clonazipam , valproate alternative . - Prognosis : poor in symptomatic better in idop. Infantile spasm :- (salam attack , , hyps-arrythmia)

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