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Pediatrie

QuestionAnswer
.Epilepsia boala cronică cerebrală de etiologie variată, crize de natură sigur epileptică, caracter evolutiv
Incidența epilepsiei 60% în primii 3 ani, 32% în primul în de viață
Etiologia crizelor crizelor antenatale malformațiile cortexului, tulburări de proliferare și migrare neuronală, de organizare corticală anormală, sdr TORCH, factori metabolici si toxici, hemoragii cerebrale, anomalii cromosomiale, sdr neurocutanate
Etilogia crizelor epileptice perinatale Encefalopatia hipoxic-ischemică (EHI), hemoragii intracraniene, disfunctii metabolice tranzitorii, neuroinfectii
Etiologia crizelor epileptice postnatale Infecții cerebro-meningiene, vasculite cerebrale, boli degenerative, scleroza temporala mezială, malformațiile arterio-venoase, factori toxici
Clasificarea crizelor epileptice Crize generalizate, focale, neclasificabile
Clasificarea crizelor epileptice generalizate Crize mioclonice, tonice, clonice, tonico-clonice, atonice, absentele tipice, atipice, spasme epileptice
Crizele mioclonice Secuse musculare masive, scurte, bilaterale ale mb si trunchiului, +- pierderea cunostinței. Apar în epilepsiile cu debut in periada neonatală sau de sugar, ep mioclonice progresive, SLG, sdr Doose, EMJ, EAJ
Crizele tonice Contracție musculară susținută, difuză, + pierderea conștiențeiși tulb vegetative Cauzate de leziuni cerebrale structurale, obligatorii pentru diagnosticul SLG
Crizele clonice Contracții musc ritmice, bilaterale, asimetrice. Pot fi multifocale (contracții migratorii intr-o manieră dezordonată de la un membru la altul) sau focale (localizate la un membru sau hemicorp)
Crizele tonico-clonice Pierderea conștienței > faza tonica 10-20 secunde, initial in flexie, apoi extenise, insotite de tulb. veg.> faza clonica 1 minut Faza postcritica: coma, hipotomie, babinski +, relaxare sfincteriana. Apar in epilepia generalizata, EAC, EAJ, EMJ, SLG
Crizele atonice Cateva secunde, pierderea brusca a constientei si tonusului muscular. Epilepsia mioclono-astatica, SLG
Absentele tipice Sispendarea brusca a constientei 5-30 secunde, cu pastrarea tonusului muscular Apar in epilepsii generalizate idiopatice (EAC, EAJ, EMJ)
Absentele atpice Debut si sfarsit progresiv al crizei, manifesata prin suspendarea starii de constienta 20-60 sec, insotita de semne asociate importante. Pot fi mioclonice, atonice, insotite de automatisme, hipertonice Apar in ep gen simptomatice (SLG)
Spasme epileptice Contractii masive, globale, axiale, bilaterale si simetrice ale muschilor gatului trunchiului si extremitatilor. Tipic sunt in flexie; au intensitate variata, durata 0.5-10 secunde Apar in sdr West, SLG,encefalopatia mioclonica neonatala
Crizele partiale Semnele clinice si EEG indica activarea unui sector neural limitat (focar epileptic). In functie de alterarea starii de constienta pot fi simple sau cu semiologie complexa
Crize partiale simple 1Semiologie motorie: focale jacksoniene, versive/adversive, posturale, afazice, fonatorii 2 somatosenzoriale: somatosenzoriale jacksoniene, vizuale, olfactive, gustative, vertiginoase 3 Vegetative: paloare, roseata, etc 4 Psihice: cognitive, afective
Crize partiale cu semiologie complexa Alterarea constientei cu o durata de 2-3 minute, amnezie postcritica, insotita de automatisme gestuale, orofaringiene, ambulatorii sau verbale.
Created by: 1138241682899194
 

 



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