Tag Archives: neurology

August 2018 uploaded

August brings more returning travellers, this time with dengue fever.  Also adolescent sleep problems, adverse childhood experiences (ACEs), an update on rhinitis and the neurological effects of rotavirus.  Do leave comments below.

July 2018 newsletter published

July 2018 brings HEADSSS as a communication tool in adolescent medicine this month, vaccine hesitancy, chikungunya, empyemas, a good headache course coming to London and appropriate use of the EEG.  Please do leave comments below.

June 2018 PDF published

June 2018 features include the rotavirus immunisation, febrile myoclonus, investigating normochromic anaemia, complications of sinusitis and the first in our adolescence series.  Please do leave comments below:

May 2018 newsletter published

Cyclical vomiting this month as the message from the front line, BESS as a learning point for those monitoring the size of an infant’s head, milia also for the babies and the perennial problem of whether or not montelukast works to control episodic wheeze.  Do leave comments below:

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>

Happy New Year 2018! January newsletter uploaded.

Raised intracranial pressure this month, nappy rash, complex febrile seizures, tingling side effects of recreational nitrous oxide use and Vitamin D – again….

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September 2107 PDF ready to go

A bit more on babies’ stooling habits this month, NICE’s update on the epilepsies and glycosuria.  Also the annual round up of useful blogs to get newcomers off to a good start in their paediatric practice.  Please do leave comments below:

June 2017 PDF

Haematuria this month with links to an algorithmic Australian guideline on how to manage it in children, assessing paediatric hypertension, postural orthostatic tachycardia syndrome and the last for the time being in the “decoding the FBC” series – MCHC.

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May newsletter – uploaded a little after the bank holiday…

May 2017 brings Tourette’s syndrome, child sexual exploitation, a paper on predicting serious bacterial infection and links to resources on recognising it.  Do leave comments below: