Dr. Puja Kapoor

Epilepsy: How to differentiate from benign movements?

Dr. Puja Kapoor,  director & co-founder CONTINUA Kids, Consultant pediatric neurologist, was invited as a faculty at Haryana state CME at Asian Hospital, Faridabad.  She delivered a lecture on “Epilepsy: How to differentiate from benign movements?” The CME was well organised and the topics were of use for regular office practice.

She defined, What is Epilepsy and how to differentiate between seizure and seizure mimics,  and other benign movements of infancy.

The presentation was through case based approach where different scenarios were explained through videos. Various modalities used like MRI Brain, EEG etc. to reach to the diagnosis was explained at basic level for the pediatrician .

It was explained in detail that West Syndrome is a medical emergency. West syndrome is a triad of hypsarrythmias noted on EEG, regression of milestones, and infantile spasm. Salient features of Infantile spasm are that they occur in clusters, usually occurs during drowsy state ,that is during going to sleep or getting up from sleep. They are jerk like movement which is commonly missed as startle. It can occur after 4 to 5 months in a case of Hypoxic Ischemic Encephalopathy or in a child with structural malformation of brain,  metabolic causes, tuberous sclerosis etc.

The treatment should be started on an emergency basis. The treatment comprises of steroids, vigabatrin, topiramate, clobazam etc.

Other conditions like Shuddering attacks, tonic upgaze of infancy,  gratification phenomenon , syncopal events, breath holding spells etc were discussed.

Infantile

Infantile Spasm is a jerk like movement which is commonly missed as startle.

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