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07.06.04 (4 years ago)
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Which of the following has the worst prognosis -
a) Rolandic epilelpsy
b) Versive epilepsy
c) Absence epilelpsy
d) Infantile spasm......--->Answer |
Benign rolandic epilepsy is not rare, is misdiagnosed often, and has a very good prognosis without AED therapy.6 Benign rolandic epilepsy may be the most common childhood epilepsy syndrome. Children present between 3 and 12 years of age. Almost all children ‘grow out’ of their benign rolandic seizures before the age of 16 years
In a simple partial seizure the awareness is preserved. The EEG shows unilateral paroxysmal activity during the attack.
Some examples of patterns of simple partial epileptic seizures:
• motor - causes contralateral movement of the face and limbs. Often movement begins at the angle of the finger and then spreads progressively to the arm, trunk, and then leg and foot - termed Jacksonian epilepsy.
• versive - seizures arising in the contralateral frontal lobe, affecting the frontal eye field, and causing turning of eyes to the contralateral side.
absence epilepsy
Onset is age 4 - 8 years
Presenting complaint - impaired school performance, inattention, day dreaming.
Clinical Features - change in facial appearance, sudden cessation of motor activity, immediate return to normal, automatisms, impaired responsiveness, amnesia for event.
Seizures are brief, e.g. 10 seconds, but occur many times per day.
About 30 - 50% of persons with absence seizures also have generalized tonic-clonic seizures (Niedermeyer, 1990).
Family history of absence seizures is often positive.
Seizures often end by young adulthood.
West Syndrome consists of infantile spasms, hypsarrhythmia EEG pattern and developmental delay.
Onset is between 3 - 12 months of age
Infantile Spasm is the typical seizure and consists of bilateral rapid flexion or extension of head, trunk, and limbs lasting seconds. A period of reduced motor activity (akinesia) might follow the spasm.
Spasms occur as clusters soon after awakening.
Developmental delay is common.
Poor prognosis 67% of children develop severe impairment
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