Childhood epilepsy can be classified according to seizure type, cause, and clinical features. Common childhood epilepsy syndromes include childhood absence epilepsy, juvenile myoclonic epilepsy, and Rolandic epilepsy. Evaluation involves a detailed history, physical exam, EEG, and imaging. Treatment options include antiepileptic medications, the ketogenic diet, vagus nerve stimulation, and surgery. Choice of treatment depends on seizure type, epilepsy syndrome, age, and drug tolerability. Discontinuation of medications may be considered after 2-5 seizure-free years.
Seizure disorder is one of the important topic in children and adult also. here i explained the seizure disorder in pediatrics, include all most content for nurses level
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Seizure disorder is one of the important topic in children and adult also. here i explained the seizure disorder in pediatrics, include all most content for nurses level
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
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Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
2. EPILEPSY DEFINITION
Seizure Disturbance in the electrical activity of the brain
Epilepsy Is recurrent (2 or more) unprovoked seizures
Transient provoked seizures caused by
fever
electrolyte imbalance
toxic expos
head injury
Are not classified as epilepsy
3. Status epilepticus
Continuous seizures >5 minutes , generalized or focal ,
during which the patient remains unconscious or has 2
or more sequential seizures without full recovery of
consciousness between seizures .
4. Etiology
70% Unknown cause
30% are due to the following:
Head trauma
Poisoning
Infection
Maternal injury
Brain tumor and CVA
5. Classification of epilepsy
3 classifications
1- accordind to semiology :
generalized
partial :simple ,complex
2-according to cause :
idiopathic
sypmtomatic
cryptogenic
3-according to clinical + EEG + age : syndromic
classification
6. PARTIAL SEIZURES
a. Simple partial (no impairment of consciousness) -
motor/sensory/autonomic/psychic
b. Complex partial (impairment of consciousness)
- simple evolving to complex
- complex from outset
c. Partial seizures evolving to secondary GTCS
7. GENERALIZED SEIZURES
The first clinical and EEG changes indicate involvement of both cerebral
hemispheres.
a. Absence
b. Myoclonic
c. Clonic
d. Tonic
e. Tonic-clonic
f. Atonic
8. Generalized convulsive (grand
mal) or generalized tonic-clonic
sudden, immediate loss of consciousness
without warning
initial generalized tonic contraction and
posture (causing fall and epileptic cry)
then, generalized, bisynchronous rhythmic
forceful jerking movements
slowing of the frequency of the convulsive
movements
Typically last 1-3 minutes
post-ictal exhaustion, sleep, disorientation
9. Childhood Absence Epilepsy
Seizure type: simple
absence seizures. 1/3 or less
will also have at least one
generalized tonic-clonic
seizure. Often frequent
(many per day).
Etiology: unknown
(idiopathic). often familial.
Age: childhood (5-12years)
EEG: generalized 3/sec spike
and wave discharges.
Treatment: ethosuximide or
valproic acid.
Prognosis: excellent. easy
seizure control. remission in
70% or more. few with long
term sequellae
No aura
Abrupt onset
Brief duration
Prompt recovery
11. Juvenile Myoclonic Epilepsy
Seizure type: early morning
myoclonic seizures (single or
multiple myoclonic jerks). absence
seizures. generalized tonic-clonic
seizures.
Etiology: unknown (idiopathic).
often familial. presumed ion
channel?
Age: childhood (10-16years); female
predominance.
EEG: generalized fast spike and
wave discharges (4 to 6 cycles/sec)
often with photosensitivity.
Treatment: valproic acid.
Prognosis: generally excellent
seizure control possible but
remission is rare
12. Rolandic Epilepsy
The most common seizure disorder of
childhood.
Seizure type: partial or secondarily
generalized sensory-motor seizures occurring
at the transitions between wakefulness and
sleep. usually affect oral-motor function
particularly. infrequent (weekly or less)
Etiology: unknown (idiopathic). often
familial. presumed ion channel?.
Age: childhood (5-12years)
EEG: focal, centrotemporal (Rolandic) spikes.
Treatment: no treatment or carbamazepine.
Prognosis: excellent. easy seizure control.
remission in 95%. no long term sequellae.
14. HISTORY
Carefull detailed history corner stone for accurate
diagnosis
Video tape the event diagnostic
Ask parents to mimic the event
Physician may mimic different seizure type to find a
match with the child event
21. Investigation
Laboratory testing
electrolytes
ca po4 alp
mg
glucose
Febrile child
CBC
blood and urine culture
Lumbar puncture
strongly 12 mo or if
previous antibiotics
considered 12-18 mo
indication more 18
22. electroencephalogaphy
EEG
56% abnormal in newly dx epileptics repeat additional
11%
20% of epileptics repeatedly normal EEG
5% of normal children epileptiformeactivity
24. Differential diagnosis cont
BREATH HOLDING SPELLS
cyanotic spells
Always provocated
Cry-apnea-cyanosis-loc-myoclonic
Onset 6 mo---peak 2yr abate 5 yr
EEG normal
pallid spells
Trauma to the back of head or startle
Apnea—loc—pallor---hypotonia—tonic
EEG normal
25. Differential diagnosis cnt
SYNCOPE
Decrease blood flow----hypotension
Loss of conciousness—deviation of eyes
Provoked by pain fear excitement
Rare before 10-12 years
More in females
26. Differential diagnosis cont
Prolonged Q-T syndrome
sudden LOC during exercise or
emotional orstressfull experience
Onset late childhood or adolescence
during event recover or die
30. Phenobarbitone (Luminal)
• Used for all types and
all ages.
• Nowadays also used
for treatment of neonatal
seizures, and status
epilepticus
• Side effects:
•1)In children
Hyperactivity, cognitive
impairment.
•2)In adults
•Sedation
31. Phenytoin (Epanuten)
• Broad spectrum
•The drug of choice in
Status epilepticus
•Follows Zero-order
pharmacokinetics
•Side effects:
•1)May reach toxic levels
•2)Hirsutism
•3)Coarse features
•4)Hypertrophic gums
32. Ethusoximide (Zarontin)
• Narrow spectrum
•The drug of choice in
Absence epilepsy
•Side effects:
•1) Skin rash
•2)Agranulocytosis
33. Carbamazipine (Tegretol)
• The drug of choice in
Partial seizures, also
used in complex
seizures, and
secondary
generalization.
• Also used in treatment
of trigeminal neuralgia.
• Side effects:
•1) Skin rash
•2) Agranulocytosis
•3) Hyponatremia
34. Valproic acid (Depakine)
• Broad spectrum
• A component in all anti-
epileptic regimens.
• When given with
Lamotrigine, the dose should
be lowered to (1/10 th) of the
usual dose, since Valproic
acid increases the half life of
Lamotrigine.
•Mood stabilizer
• Side effects:
1)Hepatotoxic
2)Transient hair loss
3)Weight gain
35. Vigabatrin (Sabril)
• New generation anti-
eplipletic drugs
• The drug of choice in
West syndrome( which
results from tuberculous
sclerosis)
• Side effects:
1)Visual field defects
36. Gabapentin (Neurontin)
• Broad spectrum
• Has no interactions
with other drugs
• Safe to be used in
organ failure( Liver or
renal failure)
• Used in treatment of
neuropathic pain
38. Topiramate (Topamax)
• Broad spectrum
• Used for intractable partial
complex seizures especially
in combination with tegretol
•Also used in prophylaxis of
migraine
•Side effects:
•1)Renal stones
•2)Decreases attention and
ability to concentrate
41. Treatment
MOST OF AEDs
start small dose then increase
if max dose reached no response serum
level
routine drug level discouraged
MONOTHERAPY
avoide interaction
better compliance
BEFORE switching to another drug reconsider
DX
42. Treatment
SIDE EFFECT
Most are idiosyncratic
Skin rash
Steven johonson syndrome
Hepatotoxicity
pancreatitis
45. Guidelines for discontinuation
AEDs
seizure free 2-5 years on AEDs mean 3.5 years
single type of partial generalized seizures
normal neurological and IQ examination
EEG normalized with treatment
46. Vagus Nerve Stimulator
Limited for localization related epilepsy
Implanted device
Stimulates the left vagus nerve for 30 seconds every
five minutes
30% experiences 50% reduction in seizure activity
47. Surgical
First surgery in 1886
Only utilized when medication cannot achieve
satisfactory control
INDICATIONS:
intractable partial seizures
intractable hemiepilepsy
Mesial temporal sclerosis
