Status.Epilepticus.dr.sarfaraz-1.pediatrics.pptx

Pediatric status epilepticus

1. Genetic Epilepsy Due to genetic defects, no other brain disorders.E.g., Childhood Absence Epilepsy. Structural EpilepsyCaused by brain structural issues (genetic or non-genetic).E.g., Stroke, tuberous sclerosis. Immune-Mediated EpilepsyFrom CNS inflammation; treated with steroids/IVIG.E.g., Anti-NMDA receptor encephalitis, anti-LG1 encephalitis. Infectious EpilepsyLinked to chronic infections (e.g., tuberculosis, HIV).Excludes acute infections. Metabolic EpilepsyDue to metabolic disorders.E.g., MELAS syndrome, GLUT1 deficiency. Unknown EpilepsyPresumed brain disorder, cause unknown.

2. Benign Focal Syndromes: Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS): Ages 3–10, centrotemporal spikes, often outgrown.Benign Occipital Epilepsy (Panayiotopoulos Type): Early childhood, ictal vomiting, impaired awareness.Benign Occipital Epilepsy (Gastaut Type): Later childhood, visual auras, migraines.Benign Infantile Familial Convulsions: Neonatal/infantile onset, KCNQ2, KCNQ3, SCN2A genes.Benign Infantile Nonfamilial Syndromes: Temporal/midline foci, gastroenteritis-associated.Nocturnal Autosomal Dominant Frontal Lobe Epilepsy: Dystonic posturing, KCNT1 variants.Severe Focal Syndromes:Epilepsy of Infancy with Migrating Focal Seizures (EIMFS): Multifocal seizures, KCNT1 variants, mental regression.Temporal Lobe Epilepsy (Mesial Temporal Sclerosis): Febrile seizure history, SUCO variants.Rasmussen Encephalitis: Unilateral intractable seizures, progressive hemiparesis.

3. Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS) Benign Occipital Epilepsy (Panayiotopoulos Type) Benign Occipital Epilepsy (Gastaut Type) Benign Infantile Familial Convulsions Benign Infantile Nonfamilial Syndromes Nocturnal Autosomal Dominant Frontal Lobe Epilepsy Epilepsy of Infancy with Migrating Focal Seizures (EIMFS) Temporal Lobe Epilepsy (Mesial Temporal Sclerosis) Rasmussen encephalitis Childhood Absence Epilepsy Benign Myoclonic Epilepsy of Infancy Juvenile Myoclonic Epilepsy (Janz Syndrome) GEFS+ (Genetic Epilepsy with Febrile Seizures Plus) Early Myoclonic Encephalopathy (EME) Early Infantile Epileptic Encephalopathy (EIEE)/Ohtahara Syndrome West Syndrome Lennox-Gastaut Syndrome Dravet Syndrome Myoclonic Astatic Epilepsy (Doose Syndrome)

4. Understanding Seizure Impact:Recognize motor (e.g., tonic-clonic, myoclonic) and non-motor (e.g., absence) seizures to ensure safe therapy sessions.Identify postictal deficits (e.g., weakness, ataxia, Todd paralysis) to adjust treatment plans and avoid injury.Tailoring Interventions:Adapt exercises for children with epilepsy (e.g., avoid high-risk activities like pole vaulting; see Table 633.12).Support motor development in severe syndromes (e.g., West, Lennox-Gastaut) with developmental delay or hemiparesis (e.g., Rasmussen encephalitis).Promoting Safety and Function:Educate families on safe physical activity to reduce neuropsychologic impairments and improve quality of life.Monitor for seizure triggers (e.g., fatigue, photic stimulation) during therapy to prevent exacerbation.Interdisciplinary Role:Collaborate with neurologists to align physiotherapy with AED therapy, ketogenic diet, or post-surgical rehabilitation (e.g., after focal resection, hemispherectomy).Support neurodevelopmental outcomes in metabolic epilepsies (e.g., GLUT-1 deficiency) through targeted physical therapy.