Evaluation of the First Non-Febrile Seizure and Childhood Epilepsy

by Carlo Raj, MD

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    00:01 Evaluation of First Non-Febrile Seizure.

    00:04 We have two age groups.

    00:06 Children and adults.

    00:08 Let’s talk about these seizures.

    00:12 H&P in children is important.

    00:15 In a child, EEG, lab work, neuroimaging, CSF analysis based on the age of your patient and clinical situation.

    00:23 H&P in adult EEG and neuroimaging for the most part is all that you’d require here to find out what’s causing the first non-febrile seizure.

    00:35 Laboratory evaluation and CSF analysis is case dependent, whereas in a child, CSF analysis is based on age of patient and then clinical situation.

    00:48 Childhood Epilepsy.

    00:50 So what are all the different causes of childhood epilepsy? And you keep this separate from febrile at this point.

    00:59 Obviously, I need to put it in as well, but...

    01:02 febrile seizure, remember the fever itself could be the possible trigger for the – The fever could be the trigger for the seizure.

    01:10 Metabolic etiologies includes cerebral folate deficiency, creatine disorders, folinic acis responsive seizures GLUT1 deficiency, mitochondrial disorders, PNPO deficiency and peroxismal disorders.

    01:29 Genetic factors of childhood epilepsy.

    01:31 Genetic means any genetic mutation that can be chromosomal or molecular that results in the syndrome or epilepsy is a core feature and that is not a metabolic disorder.

    01:42 It is important to stick to the accurate ILAE classification in epilepsy.

    01:48 Multiple defects in metabolic pathways and other genetic diseases.

    01:53 Idiopathic may be perhaps, the genetics could play a role, especially as we learn more and more and more about these channels, right? So you know about channelopathies.

    02:05 Meningitis, possibly head injury.

    02:08 Perinatal insults such as corticaldysplasia or palsy, perhaps.

    02:14 Or tumors, much less common.

    02:17 Much less common.

    02:18 Childhood epilepsy.

    02:20 Unprovoked.

    02:21 Could febrile seizure go into epilepsy? Yes, it could.

    02:26 But a very small percentage.

    02:29 Hopefully, as we’re moving through here, you’re gaining a clear understanding of what you need to know for seizures in general.

    About the Lecture

    The lecture Evaluation of the First Non-Febrile Seizure and Childhood Epilepsy by Carlo Raj, MD is from the course Seizures.

    Included Quiz Questions

    1. There are multiple defects in metabolic pathways and genetic diseases that cause childhood epilepsy.
    2. Most children with febrile seizures will progress to epilepsy.
    3. Encephalitis and meningitis have no relation to seizures.
    4. Brain tumors are a common cause of childhood seizures.
    5. A single febrile seizure in a child warrants an immediate lumbar puncture for CSF analysis.
    1. EEG
    2. Blood tests
    3. Lumbar puncture
    4. MRI brain
    5. CT brain

    Author of lecture Evaluation of the First Non-Febrile Seizure and Childhood Epilepsy

     Carlo Raj, MD

    Carlo Raj, MD

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