Fits II

Question 1

When should cardiac arrhythmias be considered?

Answer 1

If there is a clear history of preceding palpitations or if there is a family history of sudden death or cardiac tachyarrhythmias

Question 2

What usually precedes a faint?

Answer 2

Blurring of vision, light-headedness, sweating and nausea

Question 3

What is the characteristic ECG of Wolff-Parkinson-White syndrome?

Answer 3

short PR interval and a delta wave upstroke to the R wave. There is also QRS prolongation.

Question 4

Febrile convulsions occurs in children of which age range?

Answer 4

Ages 6 months to 6 years

Question 5

What is infantile spasms associated with?

Answer 5

Tuberous sclerosis

Question 6

What is the first line treatment of infantile spasms?

Answer 6

Vigabatrin or steroids

Question 7

What are the 3 classifications of febrile convulsions?

Answer 7

1. Simple Febrile Convulsion: Last <15mins and does NOT recur within 24 hours, or within the same febrile illness.
2. Complex Febrile Seizure: Have 1 or more of the following features:
   - Focal features at onset or during the seizure
   - Duration of >15mins
   - Recurrence within the same febrile illness
3. Febrile Status Epilepticus: Last >30mins

Question 8

Give 2 other seizures related to an acute illness that occurs in children.

Answer 8

1. Febrile myoclonic seizures
2. Afebrile convulsions in young children with mild gastroenteritis - clusters of seizures with or without fever over several days, in the setting of gastroenteritis.

Question 9

What should be considered if a child presents with seizures but no acute illness or fever?

Answer 9

• Epilepsy
• Hypoglycaemia or other metabolic conditions
• A permanent neurological condition such as Cerebral Palsy or Tuberous sclerosis
• Brain injury (either from accidental or non-accidental injury)
• Poisoning