Tag Archives: epilepsy

March 2018 PDF in time for Easter

NICE on faltering growth this month, paediatric stroke, a reminder of the new epilepsy classification and a contribution from the safeguarding team on what constitutes a “legal high”?  Do leave comments below:

Epilepsy classification changes again…

Actually the classification of seizures changed in July 2017 but I’ve only just been brought up to date by Emily O’Connor, a medical student who writes blog posts for Paediatric Pearls.  Here is her article:

In 2017 the International League Against Epilepsy revised their classification of seizure types, with the aim of creating greater flexibility, accuracy and transparency in the naming of seizures. Below, is a brief guide to applying this new approach to classification and a summary of the changes in terminology.

The new approach can be applied by asking two or three questions about the seizure:

  1. Where was the onset of the seizure?
    • It could be: focal/generalised/focal to bilateral/unknown
  2. What was the patient’s level of awareness during the seizure?FOR FOCAL SEIZURES ONLY
    • It could be: focal aware/focal impaired awareness
  3. What was the first prominent sign or symptom of the seizure?
    • It could be: motor/non-motor
    • This can then be further classified according to the specific symptom

This new classification system for seizures has led to a change in some of the traditional terminology used to describe seizure types, the below table shows a summary of these changes:

Traditional/‘Obsolete’ Term New/‘Replacement’ Term
Partial seizure Focal seizure
Simple partial seizure Focal aware seizure
Complex partial/Dyscognitive seizure Focal impaired awareness seizure
Psychic seizure Cognitive seizure
Primary generalised seizure Generalised seizure
Secondary generalised seizure Focal to bilateral tonic-clonic seizure

 

For more information on the ILEA 2017 classification system, please see the below references:

1.       Fisher et al. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017. 58. 4. 522-530.

2.       Epilepsy Foundation of America. 2017 Revised Classification of Seizures. [online] Epilepsy Foundation of America. 2017. 18/02/2018. <https://www.epilepsy.com/article/2016/12/2017-revised-classification-seizures>

December 2017 reading list

Retinoblastoma mnemonic this month.  Plus information on lower sugar content recipes for the reintroduction of cows milk into a child’s diet, labial adhesions, 6 in 1 vaccine and don’t miss infantile spasms as early treatment improves overall prognosis.  Do leave comments below.

2 months in one for Nov/Dec 2016

First part of information on gangs this month, plus HbA1c units compared, last bit on orthopaedic feet, a warning about phenytoin overdose and a couple of links to good relevant courses.  Do leave comments below:

March 2015 published

March 2015: the first post of the new ENT feature this month – glue ear, more help with viral exanthems, important safeguarding information on the UK government’s Prevent Strategy, breastfeeding for mums and research in the paediatric ED. 

March 2013 up and running

Delayed sleep phase this month and chronotherapy which sounds like quite an undertaking.  Also a link to a new parent’s guide to picking up and talking about sexual abuse, links to handy recent uploads to the site, the BSACI guideline on allergic rhinitis and more banging on about vitamin D supplementation – please.

February 2013 uploaded!

A timely reminder of an albeit old guideline on otitis media this month, continuation of our minor injuries series and introduction to a new series on sleep disorders.  Also a link to a new Whipps “1st afebrile fit” guideline and a bit of background on hypospadias.

January 2012 PDF ready

Do you know your valgus from your varus?  Or your myclonic epilepsy from your sleep myoclonus?  A link this month to new asthma patient information leaflets and some reminders of NICE’s “Do not do recommendations” in feverish children.  Also the BSACI egg allergy guideline.  Do leave comments on any of these topics below.

December PDF for the ED

This month’s emergency department version of Paediatric Pearls has information on dehydration from the NICE guideline on gastroenteritis in the under 5s, a bit on seizures and the evidence behind our reluctance to let you request chest x-rays for children.  I’ve featured the NICE guideline on antibiotics for respiratory illness in primary care too as they are also relevant for the children we see in EUCC and the Emergency Department.  I hope you find it helpful; I think the average length of time for each infection is useful information to be able to hand on to parents.  Download December’s Paediatric Pearls here.

September GP Paediatric Pearls published!

September brings us tinea capitis, epilepsy and a reminder that antibiotics are not generally indicated for children presenting with wheeze.  Please do send in your comments, requests and questions.  Download the September edition here.