Types of seizures

• Tonic clonic
• Tonic
• Clonic
• Myoclonic jerks
• Atonic akinetic
• Absense
• Febrile convulsions
• Status epilepticus

Seizure imitators

• Breath holding spells - a nonintentional episode of apnea following prolonged expiration -and it usually happens after a painful, upsetting or startling experience.
  • The child cries, then after forcible expiration, rapidly loses consciousness and becomes either pale or cyanotic, and may jerk or become rigid and arch his or her back - also known as opisthotonos. Breath-holding spells usually occur in children ages 6 months to 6 years and the vast majority outgrow episodes. If the child becomes pale with the episode, this is known as a pallid spell and is usually caused by vasovagal syncope, however, a cardiac pathology, like a ventricular arrhythmia, must be ruled out.
  • It is important to differentiate a breath-holding spell from a seizure. If a child has experienced a breath- holding spell, there is an antecedent event, heart rate decreases and the child becomes pale, and there is NO post-ictal period. If the child has experienced a seizure, there is NO antecedent event, heart rate increases but the child remains pink and well-perfused, and there can be a post-ictal period.

Aetiology

• Infectious
  • Brain abscess
  • encephalitis
  • febrile seizures
  • meningitis
  • neurocystercercosis (rare cause from eating raw beef)
  • TB
  • Toxoplasma
  • HIV
• Neurologic
  • Birth injury
  • Congenital anomaly
  • Degenrative cerebral disease
  • HIE
  • tuberous sclerosis
  • neurofibromatosis
  • VP shunt malformation
  • Hydrocephalus
• Metabolic
  • Hypercapnia
  • Hypo calcaemia/glycaemia/natraemia/magnesemia
  • Inborn errors of metabolism
  • Vitamin B6 deficiency (pyridoxine)
• Traumatic/vascular
  • Cerebral contusions
  • stroke
  • child abuse
  • trauma
  • intracranial haemorrhae
• Toxins
  • lead poisoning
  • organophosphates
  • salicylates